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Biomedical subjects

L Manfrè

Publications and source records attributed to L Manfrè.

At least 19 recordsLinked to original sources
PubMed2005

[Cerebral venous sinuses thrombosis in an infant with supramitral obstructive membrane associated with partial anomalous pulmonary venous return].

Cerebral venous thrombosis is quite rare in newborn infants, but probably its incidence is not well evaluated because clinical signs and cerebral echocardiography are not specific. We report the case of an newborn infant with massive cerebral venous thrombosis associated with heart malformation: supramitral ring and partial anomalous pulmonary venous connection in the superior vena cava.

Adolescent↗
PubMed2001

[Brain perfusion ultrasound in atherosclerotic disease. Work in progress].

AIM: The use of low frequency probes allows to overcome the resistance of the skull and evaluate Willis's circle by B-mode and Trans-Cranial Color-Doppler (TCCD) to obtain morphological and functional information related to brain circulation during pathologic conditions. With the new software available today modern technology allow us to measure the transient scattering produced by the rupture of the contrast medium microbubbles and estimate the presence of the contrast medium both in macro- and microcircle. In this way it is possible to appraise parenchymal perfusion. This study aims to assess the intracranial micro- and macrocircle using TCCD with contrast medium (Levovist) and to compare the results with the patients' clinical signs. MATERIAL AND METHODS: We studied 21 subjects aged 45-73 years (mean 68 years) with atheromatous uncomplicated plaques in the internal carotid artery producing varying degrees of stenosis and 10 healthy controls. The examinations were performed using an ATL HDI 3000 ultrasound machine with a Phased Array 3.25 MHz probe. The mechanic index was calibrated to high values to obtain rupture of the microbubbles under insonation. Intensity/time curves of transient scattering were extrapolated for both the cerebral macrocircle and the parenchymal microcircle in the region of interest. RESULTS: The curves were compared with the clinical presentation of the different classes of patients and the results obtained were consistent in showing a clinical pattern of perfusional deficit in subjects with symptoms of chronic brain ischemia. In particular, it was possible to compare the morphologic data relative to the contrast medium decay curves with the patient's clinical condition, confirming the suspicion of cerebral microcircle pathology. CONCLUSION: Thanks to improvements in the software and to the definition of effective algorithms, contrast-enhanced TCCD will be able to provide information on brain perfusion in a simple, inexpensive and relatively non-invasive manner.

Adult↗
PubMed2000

Plain film, CT and MRI sensibility in the evaluation of intraorbital foreign bodies in an in vitro model of the orbit and in pig eyes.

Detection and characterization of intraorbital foreign bodies (IFB) is fundamental in acute trauma setting, preventing inflammatory sequelae or complications related to IFB movements when a MRI study is planned. Papers concerning plain film and CT sensibility in IFB detection show controversial results. For this reason we investigated plain film, CT and MRI sensibility in the evaluation of IFB. For an in vitro model, specimens of dry and fresh wood, glass, iron, plastic and graphite were immersed in animal lard and in a 0.9% sodium chloride plus 3.5 g/dl human serum albumin solution. Specimens of different size and nature where also implanted into enucleated pig eyes. Air bubbles were introduced also. Plain film, CT and MRI investigation were performed. Plain films underestimated intraocular IFB as plastic, fresh or dry wooden IFB were not demonstrated. The CT study was always able to depict and differentiate IFB according to the attenuation values. Severe artefacts prevented demonstration of iron, glass and graphite IFB on MRI, whereas plastic or wooden IFB were always detected. Despite radiographs have been suggested as a prerequisite for MR imaging, because our results showed plain film to underestimate radiolucent IFB, we suggest CT as the modality of choice when IFB has to be ruled out.

Animals↗
PubMed2000

Therapeutic considerations in cerebellopontine angle lipomas inducing hemifacial spasm.

Lipoma is a very rare tumour at the cerebellopontine angle. We report a case of incomplete hemifacial spasm, associated with a lipoma involving and compressing both facial and acoustic nerves at their origin in the brainstem. The patient was treated with medical therapy (botulinum toxin A) and surgery. We present a review of the last ten years of the literature, with particular regard to management.

Botulinum Toxins, Type A↗
PubMed1999

Sequential contrast-enhanced magnetic resonance imaging in the diagnosis of growth hormone deficiencies.

The purpose of the present study was to assess the presence and the time-course of contrast-enhancement in the pituitary gland and pituitary stalk of 24 patients with isolated growth hormone (GH) deficiency and multiple pituitary hormone deficiency. The patients were evaluated clinically (auxological measurements), endocrinologically (spontaneous GH secretion and GH stimulation tests) and with conventional MRI scans. In addition, fast-framing dynamic magnetic resonance imaging (MRI) with Gd-DTPA enhancement was used to quantitate the time course of contrast enhancement within the neurohypophysis, pituitary stalk, postero-superior adenohypophysis and antero-inferior adenohypophysis. In 3 patients without evidence of abnormalities at normal conventional MRI scans (normal anterior lobe and pituitary stalk, normal posterior lobe) and a high response to the GRF provocation test, sequential time-resolved Gd-enhanced MRI demonstrates reduced contrast enhancement in the pituitary stalk. These findings are consistent with impairment in stalk vasculature, presumably located at the level of the portal venous system, and could play a role in the pathogenesis of pituitary hormonal deficiency.

Child↗
PubMed1999

MR imaging of the brain: findings in asymptomatic patients with thalassemia intermedia and sickle cell-thalassemia disease.

OBJECTIVE: The purpose of this study was to evaluate the spectrum of MR findings of the brain in asymptomatic patients affected with thalassemia intermedia or sickle cell-thalassemia disease to prevent brain damage by identifying patients at risk for stroke so that transfusional or pharmacologic treatment could be implemented. SUBJECTS AND METHODS: Forty-one asymptomatic patients who were younger than 50 years and were affected by minor hemoglobinopathies underwent MR imaging of the brain. Ischemic lesions were classified as small, medium, or large and as single or multifocal. Atrophic changes were graded subjectively as mild, moderate, or severe. A grade of brain damage was assigned to every patient. The frequency and severity of brain damage were correlated with the number of sickle-cell crises per year, hemoglobin level, sickling hemoglobin level, platelet count, sex, and age. RESULTS: Of the patients with thalassemia intermedia, 37.5% showed asymptomatic brain damage, and 52% of those with sickle cell-thalassemia disease showed asymptomatic brain damage. In the thalassemia intermedia group, atrophy was always mild and ischemic lesions were generally small (25%) and single (25%). Among the patients with sickle cell-thalassemia disease, 24% had small, 16% had medium, and 12% had large ischemic lesions. Multifocal lesions were twice as common in the patients with sickle cell-thalassemia disease (20%) as in those with thalassemia intermedia (12.5%). Only in the patients with thalassemia intermedia did the frequency of brain damage increase with age. Moreover, brain damage inversely correlated with hemoglobin level in patients with thalassemia intermedia but not in those with sickle cell-thalassemia disease. Brain damage was more severe in patients with sickle cell-thalassemia disease who had more crises per year. CONCLUSION: This study suggests that patients with thalassemia intermedia and those with sickle cell-thalassemia disease may have asymptomatic brain damage. Our results suggest that MR imaging is useful in identifying patients at risk for stroke so that they can be treated with transfusional or pharmacologic therapy.

Adolescent↗
PubMed1999

[Changes in the blood-labyrinth barrier. Assessments by magnetic resonance].

PURPOSE: Recent progress in magnetic resonance imaging (MRI), with contrast-enhanced and steady-state sequences, allows fine depiction of labyrinth abnormalities related to neoplastic, inflammatory, ischemic, degenerative or traumatic disorders. We examined 488 patients with sensorineural hearing loss, vertigo or dizziness, but normal CT findings, to evaluate MR capabilities in showing labyrinth conditions. MATERIAL AND METHODS: January 1994 to May 1998, four hundred and eighty-eight patients with labyrinthine symptoms were submitted to CT. Sixty-eight of them, with normal CT findings, were also examined with MRI, which was performed using quadrature head or surface coils and a single dose (0.1 mmol/kg) Gd-DTPA administration. Conventional T1 and T2 high resolution SE images were acquired. The labyrinth was studied of 52 patients with normal CT findings and no abnormalities in the cerebello-pontine angle or internal auditory canal. RESULTS: Fourteen of 52 patients (27%) exhibited labyrinth enhancement from tumor (5%), hemorrhage (3%), infection (15%), surgical (2%) or radiosurgical (2%) procedures. GRASS sequences allowed differentiation of mass lesions (e.g., tumors, clots) from other conditions. CONCLUSION: Generally the labyrinth exhibits no contrast enhancement even after a triple Gd-DTPA dose. In inflammatory conditions, enhancement is not always diffuse, as expected, but may be focal. Spontaneous hemorrhages can account for labyrinth enhancement. In neoplastic conditions, enhancement may persist for as many as 6 months, and a mass effect against labyrinthine fluids may appear on GRASS images. Although there are no reports on labyrinthine degeneration after radiation therapy, one of our patients submitted to irradiation 7 years previously, had focal bilateral cochlear enhancement, which suggested a correlation with previous treatment.

Capillary Permeability↗
PubMed1998

[MRI in progressive sensorineural hearing loss].

Magnetic resonance contrast imaging using gadolinium-DTPA and performing new high resolution sequences (Fast Spin-Echo, Spoiled Gradient-Echo) or angiographic sequences (Magnetic Resonance Angiography) allows an excellent visualization of the inner ear and the cerebellopontine angle to be obtained. Furthermore, using sequences obtained with the "steady-state" technique (Gradient Recalled At Steady-State-GRASS, Constructive Interference at Steady-State-CISS), a good analysis of the structures of the membranous labyrinth can be achieved. Based on these diagnostic techniques, we have studied the morphological features of the membranous labyrinth in patients with progressive sensorineural hearing loss due to inner ear malformations, labyrinthitis, neuritis of VII and VIII cranial nerves, degenerative entities such as otosclerosis and Ménière's disease, neoplasms of the cerebellopontine angle, of the inner ear and of the middle ear (glomus tumours, acoustic neuromas, meningiomas, epidermoid tumours, arachnoid cysts and malignant neoplasms).

Disease Progression↗
PubMed1997

Evoked potential study in facio-scapulo-humeral muscular dystrophy.

Nerve conduction velocities (NCVs), somatosensory (SEPs) and auditory evoked potentials (BAEPs) were recorded in 9 patients with facio-scapulo-humeral dystrophy (FSHD) and in 20 age-matched controls. In FSHD patients a significant increase of the nerve distal sensory latencies and of the absolute SEP latencies revealed a subclinical involvement of the afferent sensory pathways, as well as the abnormal slowing of the later components of the BAEPs, pointed to a central auditory dysfunction. Moreover all patients underwent brain MRI that showed the presence of white matter hyperintense lesions in 4 of them (44%). No correlations were found between individual or total number of SEP and BAEP abnormal electrophysiological parameters and severity of WMHL, age, age at onset, duration of the disease or muscular impairment. These findings make the interpretation and pathophysiology of the nervous damage in FSHD rather uncertain. More studies are required to better define the aspects of neurogenic involvement in this type of muscular dystrophy.

Adult↗
PubMed1997

[Discitis in childhood: integrated neuroradiological imaging in diagnosis and follow-up study of one case].

Discitis is an inflammatory disease of the intervertebral disc which has usually a benign evolution in childhood. It often recognizes an infectious etiology. Still discussed however is the possibility of a primitive discal involvement (not secondary to a vertebral inflammation) or of a non infectious etiology and the subsequent more correct diagnostic-therapeutic procedures. We report a case of a girl with discitis diagnosed early and treated with antibiotics and orthopedic corset, whose follow-up shows a benign evolution. We underline the importance of modern neuroradiological imaging: in particular, MR plays a major role in the inflammatory diseases of the column, both in diagnosis and in follow-up. MR scans of the involved disc allow frequent controls without radiogenic risks and with a good resolution because of the multiplanarity typical of the method.

Anti-Infective Agents↗
PubMed1996

MRI of the inner ear: use of modified GRASS and fast spin-echo sequences. A preliminary study.

We report our experience with MRI of the normal and pathological inner ear with fast spin-echo and modified gradient recalled at steady state sequences. Although earlier studies on temporal bone MRI were discouraging, improvements in MR technology combined with the use of paramagnetic contrast media can make MRI a useful diagnostic tool for the assessment of inner ear pathology. Conventional spin-echo imaging seems not to be the modality of choice because of the relatively thick slices and the long acquisition times.

Chronic Disease↗