An asymptomatic patient with multiple solid renal masses: errors in diagnosis.
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Adenoma, Oxyphilic↗
Biomedical subjects
Federico Cesarani
Publications and source records attributed to Federico Cesarani.
Facial reconstruction of a wrapped Egyptian mummy using MDCT.
OBJECTIVE: Facial reconstruction of mummies and corpses in general is important in anthropological, medical, and forensic studies. The purpose of our study was to evaluate the role of MDCT examination for 3D facial reconstruction and report the results of multidisciplinary work performed by radiologists, anthropologists, and forensic police in reconstructing the possible physiognomy of an ancient Egyptian mummy. MATERIALS AND METHODS: Three-dimensional MDCT data were obtained from a well-preserved, completely wrapped Egyptian mummy from the collection of the Egyptian Museum in Torino, Italy, which dated from the XXII or XXIII dynasty (945-715 BC). Data were used as a model for the rapid prototyping stereolithographic technique, a method that allows the creation of a 3D model with digital data using synthetic materials such as a resin or nylon. RESULTS: The physical creation of the face was accomplished with boosting techniques performed by the progressive layering of plasticine on the nylon model according to the anthropometric data, the conditions of the soft residual dehydrated tissues, and the most accepted scientific and anthropological criteria. CT is the only noninvasive method for obtaining fundamental data for 3D reconstructions of the skull and the body, especially with wrapped mummies. CONCLUSION: Our multidisciplinary cooperative study produced a model of the face of an individual who lived nearly 3,000 years ago, which would not previously have been possible unless we unwrapped, destroyed, and altered the conservation of the bandages and the mummy.
Egypt↗
[Patient dose evaluation and optimization of uropoietic multiphasic multislice CT examination].
PURPOSE: The aim of this study was to optimize acquisition data during multislice multiphasic CT examination of the renal excretory system in order to reduce patient effective dose without deterioration of the imaging quality. MATERIALS AND METHODS: With the aid of two dedicated software programmes we evaluated the patient effective dose during both multislice multiphasic CT examination of the renal excretory system and excretory urography. With the CT acquisition protocol, images of a test object (Helical CT phantom, CIRS) were examined by two expert radiologists to assess the number of visible inserted test images. Other scans of the test object were then obtained utilizing decreased tube current intensity; among these that with minor information loss was identified. Patient effective dose was measured utilizing correspondent acquisition data. RESULTS: Patient effective dose during multiphasic multislice CT examination before optimization (280 mA tube current intensity) was 22.9 mSv for males and 31.1 mSv for females; after optimization it was 19.6 mSv and 26.7 mSv, respectively, with a 14% decrease. Patient effective dose during CT direct phase before optimization was 8.9 mSv for males and 12.8 mSv for females, after optimization 7.6 mSv and 11 mSv with a 15% decrease. The absorbed dose for males is lower because the females gonads are completely included in the primary CT beam, whereas the testicles are hit by diffuse radiation only. DISCUSSION AND CONCLUSIONS: During CT direct phase the patient absorbed dose is 1.45 for males and 1.9 for females (1.2 and 1.6 respectively after optimization) higher than that absorbed during intravenous pyelography; the absorbed dose of a complete multiphasic CT examination is 3.7 for males and 4.6 for females (3.2 and 3.9 respectively after optimization) higher than that absorbed during intravenous pyelography. Such dosimetric data may be justified by diagnostic advantages in stone assessment, especially in males, and by the fact that multislice CT may unify different diagnostic tools such as intravenous pyelography, axial CT and angiography, thereby simplifying the entire diagnostic protocol. As far as exposure is concerned radiologists should follow the optimizing principle referred to each clinical query, bearing in mind that diagnostic accuracy is more important than the simple iconographic aspect.
Female↗
Whole-body three-dimensional multidetector CT of 13 Egyptian human mummies.
OBJECTIVE: The purpose of this article is to assess the role of multidetector CT and three-dimensional (3D) reconstructions in noninvasive studies of Egyptian mummies. MATERIALS AND METHODS: We studied 13 mummies from the Egyptian Museum in Torino, Italy, dating from Dynasty III to Dynasty IV (2650-2450 B.C.) and from the Ptolemaic period (332-30 B.C.) to the Roman period (30 B.C.-A.D. 395), using a multidetector CT unit with a single volumetric acquisition of the whole body, including lower extremities, followed by 3D reconstruction. All mummies were completely wrapped; preservation conditions of external wrappings were good in all. RESULTS: The general setting, embalming techniques, sex and age assessment (from body and skeletal features), anthropometric measurements (cranial measurements and evaluation of stature), conditions of the skeleton and soft tissue, any abnormalities, and the presence of foreign objects were evaluated in each mummy, and a detailed report was drawn up. Virtual unwrapping permitted the identification of physiognomy of the whole dehydrated body placed beneath the wrappings; 3D reconstruction and virtual fly-through navigation allowed further evaluations of the internal parts of the body. CONCLUSION: The results obtained with this protocol provided important anthropologic and paleopathologic information that would have been impossible to obtain by other noninvasive techniques. Moreover, this method has great potential for studies of conservation, anthropology, and paleopathology of other Egyptian and ancient human remains. Multidisciplinary cooperation among anthropologists, paleopathologists, Egyptologists, and radiologists is essential.
Adult↗
Importance of being sure of diagnosis!
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Aortic Diseases↗
Role of interventional radiology in the treatment of biliary strictures following orthotopic liver transplantation.
PURPOSE: To evaluate the efficacy and safety of percutaneous treatment of biliary strictures complicating orthotopic liver transplantation (OLT). METHODS: Between October 1990 and May 2000, 619 patients underwent 678 liver transplants. Seventy of the 619 (11%) patients were found to be affected by biliary strictures by July 2000. Bilioplasty was performed in 51 of these 70 (73%) patients. A cohort of 33 of 51 (65%) patients were clinically followed for more than 12 months after the last percutaneous treatment and included in the survey results. RESULTS: After one to three treatments 24 of 33 (73%) patients were stricture-free on ultrasound and MR cholangiography follow-up. A delayed stricture recurrence required a fourth percutaneous bilioplasty in two of 33 (6%) patients. A surgical bilioenteric anastomosis was performed in six of 33 (18%) patients. Retransplantation was performed due to ischemic damage in one of 33 (3%) patients. CONCLUSION: Interventional radiology is an effective therapeutic alternative for the treatment of most biliary strictures complicating OLT. It has a high success rate and should be considered before surgical interventions. Elective surgery may be necessary in a few failed cases or those with more severe and extensive biliary strictures.
Cholestasis↗