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Biomedical subjects

M Mascalchi

Publications and source records attributed to M Mascalchi.

98 records · Page 6Linked to original sources

[MRI and HM-PAO SPECT in 20 patients with drug-resistant partial epilepsy].

Twenty consecutive patients with chronic partial seizures with onset before twenty years of age were investigated by means of 0.5 T MRI (20) and HM-PAO (19) in order to identify focal alterations amenable to surgical therapy. MRI evidentiated parenchymal lesions in 7 patients. Findings consistent with unilateral medial temporal sclerosis and cortico-subcortical parietal scars were found in two patients each. Small solid nodular lesions in the temporal lobe were observed in two patients. These and one additional patient with nodular partially cystic lesions in temporal lobe were administered a paramagnetic contrast agent (Gadolinium DPA) intravenously. In one case a contrast enhancement was observed. Histologic examination post surgery revealed a low grade glioma in one patient. HM-PAO SPECT examination showed area of abnormal captation in 9 of 19 patients. Aspects of EEG correlation with the MRI and SPECT findings are discussed. Our data supported the usefulness of magnetic resonance and SPECT imaging in the completion of pre-surgical assessment in this kind of patients.

Adult↗

[Magnetic resonance study of lesions of the cervical spinal cord in multiple sclerosis].

Lesions consistent with demyelinating plaques were retrospectively identified in the cervical spinal cord of 15/49 patients (31%) with multiple sclerosis examined with cranial and cervical MR imaging. The lesions appeared as hyperintense areas on proton-density and T2-weighted images. Clinical signs and symptoms suggestive of spinal cord location of the demyelinating plaques were observed in 14 of the 15 patients presenting with spinal cord lesions at MR, and also in 11 of the 34 patients with negative MR findings. In 2 patients the cervical lesion was not associated with brain lesions at MR, while in 1 patient it was associated with medullary dilatation. Serial MRs revealed disappearance of the cervical hyperintense area in both patients, and reduction in medullary volume in the latter. Therefore, MR imaging of the cervical spinal cord is suggested as an useful examination in patients with suspected multiple sclerosis, particularly in those presenting with clinical signs and symptoms suggestive of spinal cord involvement.

Adult↗

[Comparison of urokinase and tissue-type plasminogen activator in transcatheter arterial fibrinolysis].

The transcatheter injection of fibrinolytic agents is now the treatment of choice of the acute occlusions of the peripheral arteries. We retrospectively compared the efficacy and safety of two fibrinolytic agents (urokinase and recombinant tissue-type plasminogen activator) in 83 consecutive patients: 37 with occlusion of surgical bypass grafts, 36 with occlusion of atheromatous vessels, 5 with post-angioplasty occlusion, 2 with post-traumatic thrombosis, 2 with cardiogenic emboli and 1 with thrombophilia. Recanalization was achieved in 55 of 59 (93%) patients treated with urokinase and in 21 of 24 (88%) patients treated with recombinant tissue-type plasminogen activator (p > 0.05). The latter provided a more rapid recanalization than urokinase but was also responsible for the complications observed in all 10 (12%) patients. These results indicate that urokinase is to be preferred to recombinant tissue type plasminogen activator for routine arterial transcatheter fibrinolysis.

Adult↗

[Dixon's technic for fat suppression. Its potential applications in combination with gadolinium-DTPA].

Modification of the Dixon technique enables the reconstruction of water and fat images operating at midfield strength. The technique was combined with intravenous administration of gadolinium-DTPA in five patients with lumbosacral spine conditions, four patients with soft tissue neoplasms and three with skeletal neoplasms; all patients were examined at 0.5 T. Mean attenuation of fat signal in T1-weighted images was 85% and implied a redistribution of the gray-scale dynamic range. This allowed easier appreciation of normal and abnormal enhancement in both areas containing fat tissue and areas without it. This was useful in the evaluation of fresh scars in two patients recently submitted to lamino-discectomy and of the prevertebral extension of the inflammatory process in one patient with spondylodiscitis. In the patients with soft tissue neoplasms the combination of fat suppression and Gadolinium was helpful to assess lesion size. Finally, in the patients with skeletal neoplasms fat-suppressed images obviated for the lesion disappearance observed on conventional T1-weighted SE images after contrast administration. The combination of intravenous administration of gadolinium-DPTA with Dixon's fat-suppression technique is a new promising capability of midfield MRI.

Adipose Tissue↗

Epidermal nevus syndrome: MR of intracranial involvement.

Focal thickening of the calvarium, hypoplasia of the white matter, cortical calcifications, and a leptomeningeal drape that enhanced after contrast injection were demonstrated by MR in the parietooccipital region ipsilateral to a facial sebaceous nevus in a patient with epidermal nevus syndrome.

Adolescent↗

[Reconstruction of the anterior cruciate ligament using the patellar tendon: its magnetic resonance evaluation].

MRI of the knee was performed in 30 patients who had been submitted to arthroscopically-guided reconstruction of the anterior cruciate ligament from patellar tendon. The autograft structure was investigated and MR results were correlated with clinical findings. Partial/total meniscectomy had been carried out in 21/30 cases. The patients were imaged at various postoperative intervals (3-24 months) by means of an 0.5-T magnet (GE MR Max Plus) in full knee extension and internal rotation. Sagittal and axial T1-weighted images (slice thickness: 3 mm) were combined with real-time reconstruction which better demonstrated the whole graft. T2-weighted coronal images (slice thickness: 5 mm) were also acquired. In each patient the following clinical variables were considered: anterior drawer sign, Lachman test, pivot shift, degree of leg extension, and finally functional recovery. The following MR variables were then considered: structure and alignment of bone tunnels, structure and signal intensity of the graft, degree of synovial inflammation, structure and signal intensity of the posterior cruciate ligament and finally structure of the menisci and/or meniscal residues. Symptoms-MR correlation suggests that the different outcome of surgical reconstruction may depend on the correct alignment of the tibial and femoral bone tunnels and on good meniscal condition. Bone tunnels must be located on the same plane, posterior and parallel to the slope of the intercondylar roof, since angulation causes the latter to impact the graft during knee extension, with inflammation and risk for rupture. As for menisci, tiny residues or total ablation overload tha graft, whose signal increases and whose synovia becomes inflamed. The latter pattern is always distinguished from that of the autograft, whose signal intensity seems not to change in time. In conclusion, MR proved an accurate and non-invasive technique to image this kind of postoperative knee, since metallic artifacts do not reach the joint space.

Anterior Cruciate Ligament↗

MRI and SPECT investigations of the CNS in SLE patients.

Twenty-two SLE patients were examined with Magnetic Resonance Imaging (MRI) and Single Photon Emission Computed Tomography (SPECT). Multifocal areas of cerebral blood flow (CBF) defects were found in 81.8% of the patients. These alterations were present in patients with severe neurological disorders, in those with neuropsychiatric symptoms only, and also in asymptomatic cases. Anticardiolipin antibodies (aCL) were detected in all patients, but no correlation was found between serum aCL positivity and neurological involvement. The high incidence of cerebral blood flow disorders found in asymptomatic patients, and their poor correlation with the MRI alterations suggest a primary defect of CBF in these patients.

Adolescent↗

Dural arteriovenous fistula at the craniocervical junction with perimedullary venous drainage.

MR imaging showed swelling and diffuse signal changes in the spinal cord in two patients with progressive myelopathy. MR angiography revealed slow-flow perimedullary vessels extending to the skull base, which are consistent with drainage vessels of a dural arteriovenous fistula at the craniocervical junction. This fistula was subsequently seen in both patients on selective arteriograms of the ascending pharyngeal and vertebral arteries.

Aged↗