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Biomedical subjects

M Mascalchi

Publications and source records attributed to M Mascalchi.

At least 55 records · Page 3Linked to original sources
PubMed1995

The cardiovascular outcome of patients with motor impairment and extensive leukoaraiosis.

BACKGROUND AND METHODS: The long-term outcome of patients with motor impairment and extensive leukoaraiosis on computed tomographic scan is unknown. We studied the incidence of stroke, myocardial infarction, and death in 31 such patients (cases) and in 68 neurologic patients without leukoaraiosis (controls). The patients in both groups had a routine neurologic and cardiovascular assessment and were followed up for 51.9 +/- 20.1 (mean +/- SD) months (cases) and 49.5 +/- 18.6 months (controls). RESULTS: The 6-year risk of cumulative stroke, as determined by life table analysis, was 49% among cases and 16% among controls (hazard ratio, 3.0; 95% confidence interval, 1.2 to 7.5). The risk of stroke or myocardial infarction was 69% vs 36% (hazard ratio, 2.9; 95% confidence interval, 1.4 to 6.2). The stroke risk remained significantly increased among cases after adjustment for age, sex, and any conventional vascular risk factor, while it was reduced (hazard ratio, 2.5; 95% confidence interval, 0.8 to 7.4) after adjustment for history of lacunar stroke was corrected for and was almost halved (hazard ratio, 1.6; 95% confidence interval, 0.5 to 4.6) after adjustment for the presence of lacunar infarction images on computed tomographic scan. CONCLUSIONS: Patients with motor impairment and extensive leukoaraiosis have a very poor cardiovascular outcome. Lacunar infarction might be the major determinant of the outcome in these patients.

Brain Diseases↗
PubMed1995

MRI of spinal epidural lymphoma.

We reviewed the MRI features in eight patients with spinal epidural lymphoma (clinically primary in 4 patients); one patient had multiple lesions. The cervical spine was involved in one patient, the thoracolumbar spine in 5 and the sacrum in two. Mean longitudinal extension of the epidural lesion was 2.6 vertebral segments. The tumours were homogeneously isointense with the spinal cord on T1-weighted images and isointense or hyperintense on proton-density and T2-weighted images. The spinal cord was compressed in four patients but showed signal changes in only one. In five patients the lesions communicated through the intervertebral foramina with paravertebral soft tissue masses. In all but one of the patients diffuse signal changes in the vertebral body marrow consistent with osteolytic or osteoblastic changes were identified adjacent to or at distance from the epidural lesion. Vertebral collapse was observed in two patients.

Adult↗
PubMed1995

MRI of congenital Foix-Chavany-Marie syndrome.

MRI findings of bilateral central macrogyria allowed the diagnosis of a congenital variant of Foix-Chavany-Marie syndrome in four patients aged between 13 and 32 years, with facio-pharyngo-glosso-masticatory central diplegia, mental retardation and seizures.

Adolescent↗
PubMed1995

Corticospinal tract degeneration in motor neuron disease.

Long-repetition-time spin-echo MR images showed symmetric hyperintensity of the intracerebral corticospinal tracts in two patients with clinical and neurophysiologic diagnosis of primary lateral sclerosis and amyotrophic lateral sclerosis. In both, axial low-flip-angle gradient-echo images of the cervical spine showed hyperintensity of the lateral columns of the cord consistent with antegrade degeneration of the crossed corticospinal tracts.

Adult↗
PubMed1995

MR angiography of spinal vascular malformations.

PURPOSE: To determine the potential and limitations of MR angiography in the evaluation of spinal vascular malformations. METHODS: Eleven consecutive patients with spinal vascular malformations proved with spinal selective arteriography underwent two-dimensional phase-contrast MR angiography. RESULTS: Abnormal vessels within the spinal canal were identified with MR angiography in 10 patients. In 1 patient with a dural arteriovenous fistula no definite vascular abnormality was seen with MR angiography. Correlation of MR angiography with spinal selective arteriography showed that the former allowed identification of the arterial feeder in 3 patients with intramedullary arteriovenous malformations and 2 with perimedullary arteriovenous fistula, whereas the source of intradural draining vein was seen in only 2 of 6 patients with dural arteriovenous fistula. CONCLUSION: MR angiography is a promising complementary tool to MR imaging for detection and characterization of spinal vascular malformations.

Adolescent↗
PubMed1994

MRI of pleomorphic xanthoastrocytoma: case report.

MRI showed a cortically-based partially cystic and markedly enhancing mass in the uncus of the right temporal lobe in a patient with long standing refractory partial complex seizures. Histopathological examination revealed a pleomorphic xanthoastrocytoma, a rare, usually benign tumour thought to originate from subpial astrocytes.

Adult↗
PubMed1994

Friedreich's ataxia: MR findings involving the cervical portion of the spinal cord.

OBJECTIVE: Loss of myelinated fibers and gliosis in the posterior and lateral columns of the spinal cord are histopathologic hallmarks of Friedreich's ataxia. These are accompanied by atrophy of the upper portion of the spinal cord. We performed a study to determine if MR imaging can be used to detect signal changes in the white matter tracts of the cervical spinal cord in these patients. SUBJECTS AND METHODS: The cervical spinal cord was imaged with a 0.5-T MR imaging system in 10 patients with Friedreich's ataxia and in 14 patients with cerebellar ataxias, who served as control subjects. In all of them, the examination protocol included sagittal T1-weighted spin-echo images, sagittal short T1 inversion-recovery images, and axial cardiac-gated long TR spin-echo or ungated low-flip-angle (20 degrees) gradient-recalled-echo images from C2 to C6. The anteroposterior diameter of the spinal cord at the level of C3 on axial images was measured on the display console in patients and control subjects. Two observers who did not know the clinical diagnosis were then asked to evaluate hard copies of the entire image set for each subject for possible intramedullary signal abnormalities. RESULTS: The anteroposterior diameter of the spinal cord was decreased in all but one of the patients with Friedreich's ataxia. Abnormal signal in the posterior or lateral columns of the spinal cord was observed on sagittal and axial images in nine patients with Friedreich's ataxia and in none of the control subjects. CONCLUSION: MR images of the cervical spinal cord in patients with Friedreich's ataxia show thinning and intramedullary signal changes in the cervical portion of the spinal cord, consistent with degeneration of posterior and lateral white matter tracts. These MR findings might be helpful for differential diagnosis in patients with progressive ataxia of uncertain clinical type.

Adult↗
PubMed1994

[Gadolinium-DTPA combined with a fat suppression technique in studies with magnetic resonance at 0.5 T in soft-tissue neoplasms].

Combination of fat suppression techniques with intravenous paramagnetic contrast administration is usually performed using high-field MR systems. We combined a modified three-point Dixon technique for fat suppression with gadolinium-DTPA administration in the investigation of soft tissue neoplasms at 0.5 T. Nineteen patients with 21 neoplasms (14 primary malignant, 2 metastatic, 5 benign tumors) were examined. Examination protocol included unenhanced SE T1, PD and T2-weighted images. After the intravenous administration of gadolinium-DTPA (0.1 mmol/kg), a modified three-point Dixon technique provided three image sets, i.e., conventional T1-weighted SE images, fat-suppressed T1-weighted images and water-suppressed T1-weighted images. Two observers evaluated the lesions for conspicuity and size in three image groups: unenhanced T1-, PD and T2-weighted images, enhanced conventional T1-weighted images, enhanced T1-weighted images with fat suppression. Ten lesions showed greater conspicuity on enhanced fat-suppressed images than on unenhanced T1-, PD and T2- and enhanced conventional T1-weighted images. In 16 cases lesions were more conspicuous on enhanced water images than on conventional enhanced T1 images. Ten tumors exhibited a larger size (difference exceeding 20%) on enhanced fat-suppressed images. The combination of gadolinium with the modified Dixon technique improves the demonstration of soft tissue neoplasms at 0.5 T and allows lesion size to be measured more accurately.

Adipose Tissue↗
PubMed1994

[Magnetic resonance angiography at 0.5 Tesla of the renal arteries. Capabilities and limitations of the 2-dimensional phase contrast technique].

To investigate the potentials and limitations of Magnetic Resonance Angiography (MRA) of the renal arteries at mid-field strength, 16 patients with arterial hypertension of suspected renovascular origin were submitted to MRA at 0.5 T with the two-dimensional (2D) phase-contrast technique and to arteriography. MRA yielded diagnostic images in 15 (94%) patients in whom MRA and arteriography identified 38 and 39 renal arteries, respectively. MRA sensitivity and specificity to steno-occlusive alterations of the renal arteries demonstrated by arteriography were 83% and 96%, respectively. These results, although obtained in a small group of patients, indicate that MRA of the renal arteries with a mid-field MR system and the 2D phase-contrast technique can allow the diagnosis of steno-occlusive alterations of the renal arteries. Main MRA limitations were its long acquisition time and some variability in the quality of the MRA images. Nevertheless, the ongoing rapid technical developments in the hardware of MR systems leave room for improving the accuracy of mid-field MRA of the renal arteries and justifies optimism as to its role in the screening of renovascular hypertension.

Adult↗
PubMed1993

Effectiveness of the Short TI Inversion Recovery (STIR) sequence in MR imaging of intramedullary spinal lesions.

A Short TI Inversion Recovery (STIR) sequence with spin-echo data collection was compared to a conventional cardiac gated long TR spin-echo (SE) sequence for detecting intramedullary signal abnormalities. The cervical (n = 48), cervico-thoracic (n = 1), and thoraco-lumbar (n = 18) spinal cord was imaged in a sagittal plane with a 0.5 T (n = 61) or 1.5 T (n = 6) MRI unit in 67 patients with clinical evidence of myelopathy of different etiologies (e.g., multiple sclerosis, trauma, herniated intervertebral disk, spondylosis, etc.). In all patients, ungated double or quadruple echo STIR images (TR 1000-1400 msec, TI 100 msec, TE 30-60 or 30-60-90-120 msec) were compared with cardiac gated long TR (1400-2100 msec), double echo (30-100, 50-100, or 50-150 msec) SE images with first order flow compensation for the second echo. Although STIR images appeared "noisier" than long TR SE images, they showed fewer ghost artifacts. In 55 patients, single or multiple, focal or diffuse, hyperintense areas within the spinal cord were observed on both long TR SE and (magnitude reconstructed) STIR images. Lesion conspicuity was better on the STIR images in 25 patients, better on the SE images in 14 patients, and equal in 16. STIR sequence provides a valuable alternative to gated long TR SE sequence for the MRI investigation of intramedullary spinal lesions.

Adolescent↗
PubMed1993

Acute spinal trauma: prognostic value of MRI appearances at 0.5 T.

Thirty-two patients with post-traumatic myelopathy were examined with a 0.5 T MRI system within 4 days of injury and the MRI findings analysed with respect to the immediate and residual functional deficit and (in 20 patients) the MRI appearances of the spinal cord in the chronic phase. In the acute phase a normal spinal cord was associated with only slight clinical deficit in four patients. Signal abnormalities in the spinal cord at the site of trauma were identified on T2-weighted spin-echo or T2*-weighted gradient-recalled echo images in 28 patients. The 12 most functionally impaired patients showed focal low signal suggestive of intramedullary haemorrhage: the other 16 had homogeneous high signal consistent with diffuse oedema. Swelling of the spinal cord and mild persistent cord compression following reduction were noted in 17 and 26 patients respectively. All patients were treated conservatively other than undergoing surgical decompression. Four died of complications. No patient with low signal in the spinal cord on initial MRI showed significant clinical improvement. Five whose spinal cord was hyperintense remained unchanged, whereas nine made a significant recovery, as did all patients with normal-appearing spinal cords. Cord compression on the initial examination was not relevant to clinical outcome. Intramedullary scars were identified at follow-up in 18 patients and were more extensive in those with haemorrhagic acute lesions. Haemorrhagic contusion of the spinal cord can be demonstrated in the acute phase with midfield MRI and is a valuable predictor of the functional outcome in patients with traumatic myelopathy.

Acute Disease↗