Biomedical subjects

Guglielmo Manenti

Publications and source records attributed to Guglielmo Manenti.

7 recordsLinked to original sources

PubMed2004

Increased brain apparent diffusion coefficient in tuberous sclerosis.

PURPOSE: To evaluate the water diffusivity of normal-appearing white matter (NAWM) in patients with tuberous sclerosis complex compared with that in control subjects. MATERIALS AND METHODS: Diffusion and conventional magnetic resonance (MR) imaging examinations were performed in 18 patients with clinically established tuberous sclerosis complex (10 male and eight female patients; mean age, 20.1 years; range, 12-30 years), as well as in 18 age-matched control subjects (nine male and nine female; mean age, 20.2 years; range, 11-28 years). Apparent diffusion coefficients (ADCs) were generated, and small elliptic regions of interest were manually placed both in perilesional NAWM and in six anatomic locations of NAWM remote from hamartomatous lesions. Perilesional ADCs were compared with those at the same anatomic site on the contralateral side of the brain (generalized linear regression analysis). ADCs from the predetermined sites in patients were compared with those in control subjects (generalized linear regression analysis). RESULTS: Supratentorial ADCs were higher in patients with tuberous sclerosis complex than in control subjects, and statistically significant differences were observed in the occipital white matter, frontal white matter, centrum semiovale, parietal white matter, and corona radiata (for each location, P <.001). Significant increases were also seen in the perilesional NAWM compared with NAWM at the same anatomic locations on the contralateral side (P <.001). Infratentorial ADCs were normal. CONCLUSION: Significant ADC increases were measured in the supratentorial NAWM.

Adolescent↗

PubMed2003

Giant high-flow renal arteriovenous fistula treated by percutaneous embolization.

We report the case of a giant renal arteriovenous fistula after renal biopsy in a 30-year-old man with hematuria and hypertension. We performed percutaneous endovascular embolization using macrocoils to exclude the fistula. The patient made an uneventful recovery with no further hematuria and progressive reduction of blood pressure. Follow-up by digital subtraction angiography (DSA) at 6 months showed complete occlusion of the fistula with no evidence of renal parenchymal infarction. Although giant renal arteriovenous fistulas are generally treated by nephrectomy, this case shows that embolization is a reasonable alternative to surgery.

Adult↗

PubMedDate not supplied

MRI lung perfusion 2D dynamic breath-hold technique in patients with severe emphysema.

BACKGROUND: Our aim was to prospectively evaluate a semi-quantitative pulmonary perfusion MR technique using a breath-hold 2D dynamic sequence in patients with severe pulmonary emphysema. MATERIALS AND METHODS: Thirty patients with severe emphysema were studied with pulmonary perfusion MRI. Results were compared with those obtained through lung scintigraphy, considered as the gold standard technique. We used Fast Field Echo (FFE) pulse sequences in the coronal and sagittal planes, with paramagnetic contrast agent administration. Ten healthy volunteers were studied as the control group. Three thoracic radiologists independently reviewed all the subjects, evaluating the site and entity of perfusional defects. Peak intensity and apparent mean transit time were calculated. RESULTS: MRI showed high sensitivity (86.7%) and good specifity (80.0%) in detecting perfusional defects. We observed lower peak signal intensities in emphysematous regions. CONCLUSION: Lung perfusion MR is a potential alternative to Nuclear Medicine in the evaluation of severe pulmonary emphysema.

Adult↗

PubMedDate not supplied

Axial loading MRI of the lumbar spine.

BACKGROUND: The aim of our study was to evaluate the incoming interrelations between chronic low back pain and biomechanical changes of the lumbar spine, using an MRI-compatible axial-loading device mimicking the standing position. MATERIALS AND METHODS: Fifty consecutive patients (28 males and 22 females), with both chronic low pack pain and recurrent painful blockages, were selected and studied using a 1.5 T Gyroscan Intera Philips MRI unit (Philips, Best, Holland) and a dedicated axial loading apparatus (MIKAI manufacturing, Genoa, Italy). RESULTS: After loading, no significant modifications occurred in ten patients (20%), a spinal stenosis was seen in 18 patients (45%), an increase in the discal protrusions or hernias was detected in 8 patients (20%) and a significant accentuation of the spondylolisthesis was observed in 6 patients (15%). CONCLUSION: Axial loading MRI provides valuable information for specific non-invasive or operative management of low back pain.

Female↗

PubMedDate not supplied

Percutaneous kyphoplasty: new treatment for painful vertebral body fractures.

AIMS AND BACKGROUND: The purpose of this study was to assess the effectiveness and safety of Percutaneous Kyphoplasty as a new method of treatment for pain deriving from vertebral compression fractures (VCF). PATIENTS AND METHODS: We treated sixteen patients with unremitting pain over spine, which increased particularly when pressure was applied over the spinous process, in absence of neurological signs and refractory to conventional medical therapy. RESULTS: The method demonstrated swift pain relief associated with an evident augmentation in the resistance and restoration of the vertebral body's physiological shape. Polymethylmethacrylate (PMMA) leakages were not observed in the epidural space or foraminal area. The presence of complications such as pulmonary embolism involving the venous plexus, toxicity due to PMMA and infection due the procedure did not occur. CONCLUSION: Kyphoplasty is an effective, alternative, simple and safe treatment of vertebral collapse consequent to osteoporosis. aggressive haemangiomas, myelomas and metastases.

Aged↗

PubMedDate not supplied

Non-invasive diagnostic and functional evaluation of cardiac and pulmonary involvement in systemic sclerosis.

BACKGROUND: The aim of the present study was to evaluate the role of non-invasive methods in the early detection of pulmonary and cardiac involvement in Systemic sclerosis (SSc) and to identify clinical and/or instrumental patterns of prognostic value. PATIENTS AND METHODS: Twenty female patients affected by SSc (8 with diffuse cutaneous SSc and 12 with limited cutaneous SSc) were enrolled in our study. Cardiac and pulmonary involvement (respiratory function tests and carbon monoxide lung diffusion [DLCO], chest radiography, high resolution computed tomography [HRCT] and lung perfusion magnetic resonance) were evaluated. RESULTS: All 18 patients studied with respiratory function tests showed a significant reduction of DLCO. HRCT was considerably more sensitive than traditional chest radiography (59% versus 28%; p<0.05). Lung perfusion MRI revealed normal findings in 15 patients. Abnormal lung perfusion MRI results were found only in 3 patients. Angina pectoris with electrocardiographic and scintigraphic ischemic changes, severe regional wall motion abnormalities and complex arrhythmias seemed to be associated with poor prognosis. CONCLUSION: Taken together these results indicate that a pulmonary involvement occurs both in limited and in diffuse cutaneous SSc patients and develops, in 83% of the cases, without any regional lung perfusion abnormality. Furthermore, cardiac involvement is detected in 65% of the cases as a consequence of a range of noxious events including myocardial ischemia, fibrosis and pressure overload which may result in ventricular dysfunction and arrhythmias. Lung perfusion MRI should be considered as a complementary diagnostic method for the functional evaluation of these symptoms in systemic sclerosis.

Adult↗

PubMedDate not supplied

Correlation of diffusion-weighted MR imaging with cellularity of renal tumours.

BACKGROUND: Diffusion is a physical process based on the random movement of water molecules known as Brownian movement. Diffusion-weighted imaging (DWI) is a magnetic resonance (MR) technique that provides information about the biophysical properties of tissues such cell organization and density, microstructure and microcirculation. MATERIALS AND METHODS: Twenty healthy volunteers and 18 patients with renal tumor were enrolled in our study. The DWI was obtained before contrast media injection with a single-shot SE EPI Inversion Recovery (IR) sequence. The tumor cellularity of each resected lesion was evaluated. RESULTS: The mean apparent diffusion coefficient (ADC) value of renal tumors was significantly lower than the mean ADC value of normal renal parenchyma. In our series, the mean ADC value of renal tumors did not significantly correlate with tumor cellularity, but correlated with histological architecture. CONCLUSION: These preliminary results indicate the utility of DWI in the acquisition of tissue characterization data of renal masses using a minimal acquisition time (17 sec).

Adult↗