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Giuseppe Runza

Publications and source records attributed to Giuseppe Runza.

At least 19 recordsLinked to original sources
PubMed2006

Multislice spiral computed tomography for the evaluation of stent patency after left main coronary artery stenting: a comparison with conventional coronary angiography and intravascular ultrasound.

BACKGROUND: Surveillance conventional coronary angiography (CCA) is recommended 2 to 6 months after stent-supported left main coronary artery (LMCA) percutaneous coronary intervention due to the unpredictable occurrence of in-stent restenosis (ISR), with its attendant risks. Multislice computed tomography (MSCT) is a promising technique for noninvasive coronary evaluation. We evaluated the diagnostic performance of high-resolution MSCT to detect ISR after stenting of the LMCA. METHODS AND RESULTS: Seventy-four patients were prospectively identified from a consecutive patient population scheduled for follow-up CCA after LMCA stenting and underwent MSCT before CCA. Until August 2004, a 16-slice scanner was used (n = 27), but we switched to the 64-slice scanner after that period (n = 43). Patients with initial heart rates > 65 bpm received beta-blockers, which resulted in a mean periscan heart rate of 57 +/- 7 bpm. Among patients with technically adequate scans (n = 70), MSCT correctly identified all patients with ISR (10 of 70) but misclassified 5 patients without ISR (false-positives). Overall, the accuracy of MSCT for detection of angiographic ISR was 93%. The sensitivity, specificity, and positive and negative predictive values were 100%, 91%, 67%, and 100%, respectively. When analysis was restricted to patients with stenting of the LMCA with or without extension into a single major side branch, accuracy was 98%. When both branches of the LMCA bifurcation were stented, accuracy was 83%. For the assessment of stent diameter and area, MSCT showed good correlation with intravascular ultrasound (r = 0.78 and 0.73, respectively). An intravascular ultrasound threshold value > or = 1 mm was identified to reliably detect in-stent neointima hyperplasia with MSCT. CONCLUSIONS: Current MSCT technology, in combination with optimal heart rate control, allows reliable noninvasive evaluation of selected patients after LMCA stenting. MSCT is safe to exclude left main ISR and may therefore be an acceptable first-line alternative to CCA.

Adrenergic beta-Antagonists↗
PubMed2006

Prevalence of "high-riding" superior pericardial recesses on thin-section 16-MDCT scans.

OBJECTIVE: The aim of this study was to evaluate the prevalence of "high-riding" superior pericardial recess (HRSPR) on thin-section (1 mm) 16-multidetector computed tomography (MDCT) scans. MATERIALS AND METHODS: Three hundred and fourteen consecutive chest CT scans obtained with a thin-section 16 MDCT were retrospectively evaluated. The prevalence and characteristic of HRSPR were analyzed. RESULTS: HRSPR was depicted in 21 patients (11 men and 10 women) (6.6%) who ranged in age from 28 to 72 years (mean age, 57 years). The extended recesses were rounded/oval shaped in five patients and triangular, spindle, half moon or irregular shaped in the other 16 patients. CONCLUSION: Our data suggest as HRSPRs are more frequently and better depicted on thinsection MDCT scans, and this improves the capability to distinguish this superior extension of the superior aortic recess from abnormal findings such as lymphadenopathy, cystic lesions, and aortic dissection.

Adult↗
PubMed2006

Qualitative and quantitative evaluation of solitary thyroid nodules with contrast-enhanced ultrasound: initial results.

To assess the feasibility of contrast-enhanced ultrasound (CEUS) of the thyroid gland and to evaluate the potential of this method for characterising solitary thyroid nodules.18 patients affected by solitary thyroid nodules (size range: 0.6 to 3.6 cm; mean: 1.8 cm) confirmed by surgery (nine papillary carcinomas, four follicular carcinomas, three hyperplasias, one follicular adenoma and one Plummer's adenoma) underwent pulse inversion US at low M.I. (0.06 to 0.08) after i.v. injection of a 2.4-mL bolus of SonoVue. Baseline echogenicity and the dynamic enhancement pattern of each nodule, in comparison with adjacent thyroid parenchyma, were assessed. Signal intensity values on grey-scale images were also calculated at baseline, 30 s, 60 s and 120 s after SonoVue administration. Following administration of SonoVue, malignant nodules showed absent (4 out of 13), faint dotted (4 out of 13) and diffuse (5 out of 13) contrast enhancement, in this last case inhomogeneous (4 out of 5 cases) or homogeneous (1 out of 5). Benign nodules showed diffuse contrast enhancement, both homogeneous (3 out of 5) and heterogeneous (2 out of 5). Quantitative data have confirmed subjective findings, but CEUS never modified precontrast analysis. CEUS of thyroid gland is a feasible technique, but overlapping findings seem to limit the potential of this technique in the characterization of thyroid nodules.

Adult↗
PubMed2006

High iodine concentration contrast material for noninvasive multislice computed tomography coronary angiography: iopromide 370 versus iomeprol 400.

OBJECTIVE: The objective of this study was to compare intracoronary attenuation on 16-row multislice computed tomography (16-MSCT) coronary angiography using 2 contrast materials (CM) with high iodine concentration. MATERIAL AND METHODS: Forty consecutive patients (29 male, 11 female; mean age, 61+/-11 years) with suspected coronary artery disease were randomized to 2 groups to receive 100 mL of either iopromide 370 (group 1: Ultravist 370, 370 mg iodine/mL; Schering AG, Berlin, Germany) or iomeprol 400 (group 2: Iomeron 400, 400 mg iodine/mL; Bracco Imaging SpA, Milan, Italy). Both CM were administered at a rate of 4 mL/s. All patients underwent 16-MSCT coronary angiography (Sensation 16; Siemens, Germany) with collimation 16 x 0.75 mm and rotation time 375 ms. The attenuation in Hounsfield units (HU) achieved after each CM was determined at regions of interest (ROIs) placed at the origin of coronary arteries and on the ascending aorta, descending aorta, and pulmonary artery. Differences in mean attenuation in the coronary arteries and on the ascending aorta, descending aorta, and pulmonary artery were evaluated using Student t test. RESULTS: The mean attenuation achieved at each anatomic site was consistently greater after iomeprol 400 than after iopromide 370. At the origin of coronary arteries, the mean attenuation after iomeprol 400 (340+/-53 HU) was greater (P<0.05) than that after iopromide 370 (313+/- 42 HU). Similar findings were noted for the mean attenuation in the ascending aorta, descending aorta, and pulmonary artery. CONCLUSION: The intravenous administration of iomeprol 400 provides higher attenuation of the coronary arteries and of the great arteries of the thorax as compared with iopromide 370 using the same injection parameters.

Adult↗
PubMed2006

Improving diagnostic accuracy of MDCT coronary angiography in patients with mild heart rhythm irregularities using ECG editing.

OBJECTIVE: The objective of our study was to compare diagnostic accuracy of MDCT coronary angiography in a population of patients with mild heart rhythm irregularities before and after editing the ECG. SUBJECTS AND METHODS: Thirty-eight patients who underwent MDCT coronary angiography and conventional coronary angiography were enrolled in the study. The inclusion criterion was the presence of mild heart rhythm irregularities (i.e., premature beats; atrial fibrillation; mistriggering; or low heart rate, defined as 40 beats per minute or less) during the scan. All patients underwent MDCT with the following parameters: 16 detectors; collimation, 0.75 mm; gantry rotation time, 375 msec; 120 kV; and effective milliampere-second setting, 500-600. Images were reconstructed in two settings: before ECG editing and after ECG editing (i.e., arbitrary modification of temporal windows within the cardiac cycle at the site of mild heart rhythm irregularities). Data sets were scored for the presence of significant stenoses (> or = 50% lumen reduction) in coronary segments > or = 2 mm diameter. The results of the two groups were compared with a McNemar test, and a p value of less than 0.05 was considered significant. RESULTS: The sensitivity, specificity, and negative and positive predictive values of MDCT coronary angiography for the detection of significant stenoses before and after ECG editing were 63% (41/65) and 92% (78/85); 97% (251/260) and 96% (305/317); 87% (62/71) and 87% (81/93); 91% (251/275) and 97% (305/313), respectively (p < 0.05). The proportion of nonassessable segments was reduced from 17% (70/416) before ECG editing to 2% (10/416) after. CONCLUSION: ECG editing significantly improves diagnostic accuracy in a selected population of patients with mild heart rate irregularities.

Atrial Fibrillation↗
PubMed2005

Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris.

Multislice computed tomography (CT) is an emerging technique for the non-invasive detection of coronary stenoses. While the diagnostic accuracy of 4-slice scanners was limited, 16-slice CT imagers showed promising results due to increased temporal and spatial resolution. These technical advances prompted us to evaluate the diagnostic performance of 64-slice CT coronary angiography in the detection of significant stenoses (defined as > or = 50% luminal diameter reduction) versus invasive quantitative coronary angiography (QCA). Thirty-five patients with stable angina pectoris underwent CT coronary angiography performed with a 64-slice scanner (gantry rotation time 330 ms, individual detector width 0.6 mm) prior to conventional coronary angiography. Patients with heart rates >70 beats/min received 100 mg metoprolol orally. One hundred millilitres of contrast agent with an iodine concentration of 400 mgl/ml were injected at a rate of 5 ml/s into the antecubital vein. The CT scan was triggered with the bolus tracking technique. The sensitivity, specificity and the positive and negative predictive values of 64-slice CT were 99%, 96%, 78% and 99%, respectively, on a per-segment basis. The values obtained on a per-patient basis were 100%, 90%, 96% and 100%, respectively. When referral to catheterisation is questionable, CT coronary angiography may identify subjects with normal angiograms and consistently decrease the number of unnecessary invasive procedures.

Aged↗
PubMed2005

High-resolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography.

BACKGROUND: The diagnostic performance of the latest 64-slice CT scanner, with increased temporal (165 ms) and spatial (0.4 mm3) resolution, to detect significant stenoses in the clinically relevant coronary tree is unknown. METHODS AND RESULTS: We studied 52 patients (34 men; mean age, 59.6+/-12.1 years) with atypical chest pain, stable or unstable angina pectoris, or non-ST-segment elevation myocardial infarction scheduled for diagnostic conventional coronary angiography. All patients had stable sinus rhythm. Patients with initial heart rates > or =70 bpm received beta-blockers. Mean scan time was 13.3+/-0.9 seconds. The CT scans were analyzed by 2 observers unaware of the results of invasive coronary angiography, which was used as the standard of reference. All available coronary segments, regardless of size, were included in the evaluation. Lesions with > or =50 luminal narrowing were considered significant stenoses. Invasive coronary angiography demonstrated the absence of significant disease in 25% (13 of 52), single-vessel disease in 31% (16 of 52), and multivessel disease in 45% (23 of 52) of patients. One unsuccessful CT scan was classified as inconclusive. Ninety-four significant stenoses were present in the remaining 51 patients. Sensitivity, specificity, and positive and negative predictive values of CT for detecting significant stenoses on a segment-by-segment analysis were 99% (93 of 94; 95% CI, 94 to 99), 95% (601 of 631; 95% CI, 93 to 96), 76% (93 of 123; 95% CI, 67 to 89), and 99% (601 of 602; 95% CI, 99 to 100), respectively. CONCLUSIONS: Noninvasive 64-slice CT coronary angiography accurately detects coronary stenoses in patients in sinus rhythm and presenting with atypical chest pain, stable or unstable angina, or non-ST-segment elevation myocardial infarction.

Aged↗
PubMed2005

Diagnostic accuracy of multislice computed tomography coronary angiography is improved at low heart rates.

PURPOSE: Assess the effect of heart rate on diagnostic accuracy for the detection of significant coronary artery stenosis using 16-row multislice computed tomography (MSCT). MATERIAL AND METHODS: About 120 patients (105 males; 59+/-11 years) with suspected coronary artery disease who underwent conventional coronary angiography (CA) and MSCT-CA were retrospectively enrolled for the study. Patients underwent a MSCT-CA (Sensation 16, Siemens, Germany), with the following protocol: collimation 16 x 0.75 mm, gantry rotation time 420 ms, feed/rotation 3.0 mm, kV 120, mAs 400-500. The protocol for contrast material administration was 100 ml of Iodixanol (Visipaque 320 mg l/ml, Amersham, UK) at 4 ml/s and the delay was defined with a bolus tracking technique. In all patients the mean heart rate (HR) during the scan was used as a criteria to divide the population in two groups of 60 patients each. In one group (Low HR) the 60 patients with lower heart rates, and in the other group (High HR) the patients with higher heart rates. In the two groups diagnostic accuracy (per coronary segment) for the detection of significant stenosis (>or=50% lumen reduction) was evaluated in vessels >or=2 mm of diameter using quantitative CA as reference standard. The difference in diagnostic accuracy were compared with a Chi(2) test and a p<0.05 was considered significant. RESULTS: There was no significant difference between the two groups regarding age, gender, weight, mean intravascular attenuation, and calcium score. Overall 1,310 (652 for Low HR and 658 for High HR) segments with 219 (105 for Low HR and 114 for High HR) significant lesions were available for the analysis. The average heart rate was 52+/-4 HU and 63+/-5 HU for Low HR and High HR, respectively (p<0.001). The sensitivity and specificity were 92 and 96% for Low HR and 90 and 92% for High HR (p<0.05). There were 22 vs. 44 false positives, and 8 vs. 12 false negatives in the Low HR and High HR, respectively. CONCLUSION: Increasing HR significantly deteriorates diagnostic accuracy in MSCT-CA.

Chi-Square Distribution↗
PubMed2005

Impact of coronary calcium score on diagnostic accuracy for the detection of significant coronary stenosis with multislice computed tomography angiography.

One hundred twenty patients in sinus rhythm with suspected coronary artery disease who underwent multislice computed tomography of the heart and conventional coronary angiography were retrospectively selected. The population was divided into 2 groups depending on their calcium score (CS) (e.g., low CS and high CS). The diagnostic accuracy of multislice computed tomographic scans for detecting significant lesions (>50% lumen reduction) in both groups was compared with quantitative coronary angiography. The sensitivity and specificity of multislice computed tomography were 90% and 92%, and 97% and 91% for low and high CS groups, respectively.

Calcinosis↗
PubMed2005

3D reconstruction techniques made easy: know-how and pictures.

Three-dimensional reconstructions represent a visual-based tool for illustrating the basis of three-dimensional post-processing such as interpolation, ray-casting, segmentation, percentage classification, gradient calculation, shading and illumination. The knowledge of the optimal scanning and reconstruction parameters facilitates the use of three-dimensional reconstruction techniques in clinical practise. The aim of this article is to explain the principles of multidimensional image processing in a pictorial way and the advantages and limitations of the different possibilities of 3D visualisation.

Audiovisual Aids↗
PubMed2005

Influence of intracoronary attenuation on coronary plaque measurements using multislice computed tomography: observations in an ex vivo model of coronary computed tomography angiography.

Assessment of attenuation (measured in Hounsfield units, HU) of human coronary plaques was performed using multislice computed tomography (MSCT) in an ex vivo model. In three ex vivo specimens of left coronary arteries in oil, MSCT was performed after intracoronary injection of four solutions of contrast material (400 mgI/ml iomeprol). The four solutions were diluted as follows: 1/infinity, 1/200, 1/80, and 1/20. All scans were performed with the following parameters: slices/collimation 16/0.75 mm, rotation time 375 ms. Each specimen was scored for the presence of atherosclerotic plaques. In each plaque the attenuation was measured in four regions of interest for lumen, plaque (non-calcified thickening of the vessel wall), calcium, and surrounding (oil surrounding the vessel). The results were compared with a one-way analysis of variance test and were correlated with Pearson's test. There were no significant differences in the attenuation of calcium and oil in the four solutions. The mean attenuation in the four solutions for lumen (35+/-10, 91+/-7, 246+/-18, 511+/-89 HU) and plaque (22+/-22, 50+/-26, 107+/-36, 152+/-67 HU) was significantly different between each decreasing dilution (p<0.001). The mean attenuation of lumen and plaque of coronary plaques showed high correlation, while the values were significantly different (r=0.73; p<0.001). Intracoronary attenuation modifies significantly the attenuation of plaques assessed with MSCT.

Cadaver↗
PubMed2005

Multislice CT coronary angiography: how to do it and what is the current clinical performance?

The introduction of multislice computed tomography (MSCT) has allowed non-invasive coronary angiography. Although widely applied, extensive information on technical details of the technique is lacking. This survey offers detailed information on patient preparation, data acquisition, reconstruction and interpretation. In addition, a summary of the available studies using MSCT for non-invasive angiography is provided. Based on pooled analysis of direct comparisons between MSCT and invasive angiography, the weighted mean sensitivity and specificity of current 16-slice MSCT for the detection of coronary artery disease are 88% and 96%, respectively. At present, the technique is particularly well suited for reliable exclusion of coronary artery disease. It is important to emphasise that MSCT only provides anatomical images, visualising the presence of atherosclerosis; information on the haemodynamic significance of these lesions (i.e. ischaemia) cannot be derived.

Clinical Trials as Topic↗
PubMed2005

Image assessment with multislice CT coronary angiography.

AIM: To investigate the diagnostic accuracy of two different protocols for image evaluation used in multislice computed tomography coronary angiography (MSCT-CA). MATERIALS AND METHODS: Sixty patients with suspected coronary artery disease undergoing conventional coronary angiography (CA) were enrolled for MSCT-CA. All patients underwent 16-row MSCT (Sensation 16, Siemens, Germany) with the following parameters: detector rows 16, collimation 0.75 mm, gantry rotation time 375 ms. Two independent observers assessed the images for significant stenosis using a a protocol with standard projections and a three-dimensional protocol. The diagnostic accuracy for both methods was calculated using quantitative CA as a reference standard. RESULTS: The sensitivity, specificity, negative predictive value and positive predictive value obtained with the conventional projection protocol and with three-dimensional protocol were: 54% and 93%, 97% and 97%, 76% and 86%, 92% and 99%, respectively. CONCLUSIONS: Conventional projections in the assessment of MSCT-CA provide insufficient diagnostic accuracy compared with three-dimensional processing.

Contrast Media↗
PubMed2005

Technical analysis of volume-rendering algorithms: application in low-contrast structures using liver vascularisation as a model.

AIM: To assess the influence of pre-set volume-rendering opacity curves (OC) on image quality and to identify which absolute parameters (density of aorta, hepatic parenchyma and portal vein) affect visualization of portal vascular structures (low-contrast structures). MATERIALS AND METHODS: Twenty-two patients underwent a dual-phase spiral CT with the following parameters: collimation 3 mm, pitch 2, increment 1 mm. Three scans were performed: one without contrast medium and the latter two after the injection of contrast material (conventionally identified as ''arterial'' and ''portal''). The images were sent to a workstation running on an NT platform equipped with post-processing software allowing three-dimensional (3D) reconstructions to generate volume-rendered images of the vascular supply to the liver. Correlation between the absolute values of aorta, liver and portal vein density, OC parameters, and image quality were assessed. RESULTS: 3D images generated using pre-set OC obtained a much lower overall quality score than those produced with OC set by the operator. High contrast between the liver and the portal vein, for example during the portal vascular phase, allows wider windows, thus improving image quality. Conversely, the OC in the parenchymal phase scans must have a high gradient in order to better differentiate between the vascular structures and the surrounding hepatic parenchyma. CONCLUSIONS: Image features considered to be of interest by the operator cannot be simplified by the mean of pre-set OC. Due to their strong individual variability automatic 3D algorithms cannot be universally applied: they should be adapted to both image and patient characteristics.

Aged↗
PubMed2005

Influence of increasing convolution kernel filtering on plaque imaging with multislice CT using an ex-vivo model of coronary angiography.

PURPOSE: To assess the variability in attenuation of coronary plaques with multislice CT-angiography (MSCT-CA) in an ex-vivo model with varying convolution kernels. MATERIALS AND METHODS: MSCT-CA (Sensation 16, Siemens) was performed in three ex-vivo left coronary arteries after instillation of contrast material solution (Iomeprol 400 mgI/ml, dilution: 1/80). The specimens were placed in oil to simulate epicardial fat. Scan parameters: slices 16/0.75 mm, rotation time 375 ms, feed/rotation 3.0 mm, mAs 500, slice thickness 1 mm, and FOV 50 mm. Datasets were reconstructed using 4 different kernels (B30f-smooth, B36f-medium smooth, B46f-medium, and B60f-sharp). Each scan was scored for the presence of plaques. Once a plaque was detected, the operator performed attenuation measurements (HU) in coronary lumen, oil, calcified and soft plaque tissue using the same settings in all datasets. The results were compared with T-test and correlated with Pearson's test. RESULTS: Overall, 464 measurements were performed. Significant differences (p<0.05) were found for the mean attenuation of lumen (B30f/B36f, B30f/B60f, B36f/B46f, B36f/B60f, and B46f/B60f), oil (B30f/B36f, B30f/B46f, B30f/B60f, B36f/B46f, and B46f/B60f), calcium (all kernels), and plaque (B30f/B36f, B30f/B46f, B30f/B60f, and B46f/B60f) using 4 different kernels. The attenuation values (mean+/-SD) within the lumen (246+/-6, 215+/-13, 248+/-5, and 270+/-7), oil (-123+/-3, -127+/-1, -121+/-6, and -127+/-4), calcified plaque tissue (703+/-334, 739+/-364, 817+/-381, and 1181+/-503), and soft plaque tissue (134+/-56, 111+/-49, 120+/-56, and 102+/-41) showed high correlation (p<0.001) when attenuation of all structures were compared in different kernels. CONCLUSIONS: Use of sharper convolution kernels significantly increases the attenuation of the calcium within coronary plaques and reduces the attenuation of soft plaque tissue.

Aged↗
PubMed2004

Digital cineradiographic study of swallowing in infants with neurologic disease. Our experience.

PURPOSE: The study is aimed at proposing the use of digital cineradiography in the evaluation of swallowing disorders in children affected by severe neurological or developmental disability, in order to correctly identify these conditions and provide therapeutic approaches that could solve their feeding problem, improve their nutritional conditions and decrease the risk of infections. MATERIALS AND METHODS: In the period between March 2001 and July 2003, 12 children (8 males and 4 females), aged between 9 months and 13 years, (average 6.2 years), affected by severe neurological or psychomotor disorders were evaluated with digital cineradiography. This investigation was requested for recurrent pulmonary infections and/or dysphagia with weight loss. All the examinations were performed with radio-controlled equipment provided with a digital C arm. RESULTS: Using the above mentioned technique, in all 12 patients, it was possible to differentiate those with disorders of the oral and/or pharyngeal swallowing phase (9/12) from those without swallowing dysfunction (3/12). In 9/9 patients passage of contrast medium into the upper airways was observed during swallowing: in 2 of them this was limited to the laryngeal vestibule (sub-epiglottic penetration), while in 7/9 cases aspiration of contrast medium into the trachea (5/9) or into the right bronchus (1/9) or into both bronchi (1/9) was recorded. In one patient the aspiration decreased in the sequences acquired with hyperflexion of the head. In 3/9 patients we recorded the transition of contrast medium into the nasopharynx during swallowing caused by incomplete closing of the oropharyngeal isthmus by the soft palate. In 3/9 patients there was incomplete clearing of the pharynx with contrast medium deposition in glosso-epiglottic vallecules and in the pyriform sinuses; only in one case did this stagnation result in post-swallowing aspiration. More than one disorder was found in 5/9 patients, and one only in 4/9. CONCLUSIONS: On the basis of our preliminary data it is possible to conclude that the dynamic swallowing study with digital technique allows a clear-cut evaluation of the swallowing process with minimum discomfort for the patient. On the other hand, the technique exposes to the risk of ionizing radiation; however, in consideration of the important clinical and therapeutic implications and in agreement with the literature, we believe that the importance of the information provided by the technique outweighs the risks linked to radiations.

Adolescent↗
PubMed2003

The role of MRI in traumatic rupture of the diaphragm. Our experience in three cases and review of the literature.

PURPOSE: To evaluate the role and effectiveness of Magnetic Resonance Imaging (MRI) in blunt diaphragmatic injuries by reviewing the literature and our experience in three cases. MATERIALS AND METHODS: We reviewed the medical records and MRI findings of three patients with diaphragmatic injury due to blunt abdominal trauma. All patients were previously examined with chest X-ray and CT and later with MRI at our institution. Coronal and sagittal SE TI-w and fast SE T2-w sequence images were acquired. All patients underwent surgery. RESULTS: MRI showed a 5.5 cm tear in the left hemidiaphragmatic dome with herniation of the stomach and colon into the thoracic cavity in the first case; a 1 cm tear in the diaphragmatic dome with herniation of the stomach and posterior abscess in the second case; and an 8 cm breach in the left diaphragm with visceral herniation in the third case. CONCLUSIONS: The major advantage of MRI lies in its capability of directly acquiring coronal and sagittal images allowing evaluation of the entire diaphragm, both in normal and in pathological conditions. In our experience, MRI showed the exact site and size of the diaphragmatic rupture in all cases. However, this technique cannot be performed in emergency situations or in multitrauma patients. Therefore, in agreement with the literature, helical CT remains the modality of choice in traumatic patients. MR imaging is useful only in doubtful cases and in haemodynamically stable patients.

Adolescent↗