Werner H.,Radiologia |
Werner H.,Federal University of Rio de Janeiro |
Dos Santos J.R.L.,Brazilian National Institute of Technology |
Dos Santos J.R.L.,Royal College of Art |
And 7 more authors.
Ultrasound in Obstetrics and Gynecology | Year: 2010
Objective To generate physical fetal models using images obtained by three-dimensional ultrasonography (3DUS), magnetic resonance imaging (MRI) and computed tomography (CT) to guide additive manufacturing technology. Methods Images from 33 fetuses, including three sets of twins, were used. Fifteen fetuses were normal and evaluated only by 3DUS. Eighteen cases had abnormalities such as conjoined twins, tumors, aneuploidy, skeletal abnormalities, central nervous system abnormalities and facial or thoracic defects. Scans were performed using high-resolution 3DUS. In cases of abnormalities, MRI and CT were performed on the same day as 3DUS. The images obtained with 3DUS, CT or MRI were exported to a workstation in DICOM format. A single observer performed slice-by-slice manual segmentation using a digital high-definition screen. Software that converts medical images into numerical models was used to construct virtual 3D models, which were physically realized using additive manufacturing technologies. Results Physical models based on 3DUS, MRI and CT images either separately or combined were successfully generated. They were remarkably similar to the postnatal appearance of the aborted fetus or newborn baby, especially in cases with pathology. Conclusion The use of 3DUS, MRI and CT may improve our understanding of fetal anatomical characteristics, and these technologies can be used for educational purposes and as a method for parents to visualize their unborn baby.The images can be segmented and applied separately or combined to construct 3D virtual and physical models. © 2010 ISUOG. Published by John Wiley & Sons, Ltd.
Gobbi P.G.,University of Pavia |
Bergonzi M.,University of Pavia |
Bassi E.,Radiologia |
Merli F.,Unita Operativa di Ematologia |
And 2 more authors.
Hematological Oncology | Year: 2013
We verified whether early resistance to treatment can be predicted in a subset of patients with very favourable, early stage Hodgkin lymphoma, treated with VBM (vinblastine, bleomycin and methotrexate) chemotherapy and involved-field radiotherapy, an effective combination with very low early and late toxicity. The relative tumour burden (rTB) was volumetrically measured from the staging computed tomography and analysed together with the parameters of pre-therapy evaluation in 61 patients enrolled into the protocol MH-1b of the Gruppo Italiano Studio Linfomi between 1996 and 2003. Early failure, codified by either less than complete remission (i.e. partial/null response or progression) or early relapse (within 12months from the end of therapy), was considered as clinical expression of resistance to treatment. Logistic regression and failure-free survival were the statistical tools for the analysis. The rTB demonstrated to be the best predictor of early failure, outperforming every other pre-treatment parameter, International Prognostic Score included. With a mean rTB value of 44.964±34.788cm3/m2 in the 53 patients successfully treated and of 130.185±63.993cm3/m2 in the eight with early treatment failure, the risk of resistance showed fivefold and 10-fold increases at rTB of 52.002 and 74.497cm3/m2, respectively. Only two patients relapsed more than 12months after the end of therapy; both had a high initial rTB. The rTB is the best predictor of resistance also in the subset of patients with very favourable, early stage disease. Safe rTB limits are proposed for successful administration of VBM chemotherapy plus involved-field radiotherapy. © 2012 John Wiley & Sons, Ltd.
Role of echocardiography and cardiac MRI in depicting morphological and functional imaging findings useful for diagnosing hypertrophic cardiomyopathy [Ruolo dell'eco-cardiografia e della cardio-RM nella definizione dei rilievi morfologici e funzionali utili nella diagnosi di cardiomiopatia ipertrofica]
Guarise A.,Radiologia |
Faccioli N.,University of Verona |
Foti G.,University of Verona |
Da Pozzo S.,Radiologia |
And 2 more authors.
Radiologia Medica | Year: 2011
Purpose. Hypertrophic cardiomyopathy (HCM) is a hereditary disease characterised by primary hypertrophy of the left and/or right ventricle. The reference standard for imaging diagnosis is echocardiography. The aim of our study was to prospectively compare the diagnostic accuracy of echocardiography and cardiac magnetic resonance (MR) imaging in patients with HCM. Materials and methods. Twenty-two consecutive patients with a known diagnosis of HCM were prospectively evaluated, with echocardiography and cardiac MR imaging performed within 2 weeks of each other (mean interval 7 days, range 2-14 days). Two experienced radiologists blinded to the previous clinical and imaging findings separately reviewed the images. The following parameters were calculated for both techniques: myocardial mass, wall thickness, end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), systolic anterior motion (SAM) of the mitral valve and degree of myocardial fibrosis (based on the ultrasonic reflectivity at echocardiography and degree of late enhancement at cardiac MR imaging). The statistical correlation was calculated with Student's t test, Spearman coefficient and Fisher's exact test. A value of p<0.05 was considered significant. Results. The diagnosis of HCM was confirmed in all patients with both techniques, with absolute agreement in terms of the site of disease. The mean value of myocardial mass presented a statistically significant difference between the two techniques (114 g, p<0.001). In contrast, a nonsignificant difference between echocardiography and cardiac MR imaging was found for EDV (102 ml vs 111 ml; p=0.31), ESV (30 ml vs 38 ml; p=0.1), EF (74% vs 68%, p=0.5), SAM (p=0.1) and myocardial fibrosis (p=0.15). Conclusions. Cardiac MR imaging correlates well with echocardiography in defining the morphological and functional parameters useful for the imaging diagnosis of HCM and therefore, in selected cases (poor acoustic window, doubtful echocardiography findings), it may be a valid alternative to echocardiography. © 2010 Springer-Verlag.
Monaco D.,Radiologia |
Franco F.,Radiologia e Diagnostica per Immagini |
Marcato C.,Radiologia e Diagnostica per Immagini |
Larini P.,Radiologia e Diagnostica per Immagini |
And 2 more authors.
Radiologia Medica | Year: 2011
Purpose: The aim of study was to evaluate the results of our experience with transarterial embolization based on a modified algorithm in patients with splenic injury. Materials and methods: We collected data of patients admitted to our hospital from January 2006 to August 2008 for blunt splenic injury. During this period, 46 patients were admitted for splenic trauma, of whom 17 were treated surgically, 15 conservatively and 14 with percutaneous embolisation (13 men, mean age 44.8, mean injury severity score 18.5, six with grade IV and eight with contrast blush). Patients in shock were referred for laparotomy and splenectomy, whereas those who were haemodynamically stable or responsive to fluid resuscitation were further evaluated with computed tomography (CT). In the presence of imaging evidence of splenic injury ranging from grade I to grade III (n=15) a conservative approach was adopted, whereas haemodynamically unstable patients with grade V injury (n=17) were treated with splenectomy. Embolisation was performed in 14 patients with grade IV injury or in the event of contrast extravasation, regardless of injury grade. In patients with diffuse organ damage, we embolised the main splenic artery, whereas in the case of localised injury, embolisation was selective. Results: Proximal embolization was required in eight cases and distal coil embolization in six. In 13 cases, we placed magnetic-resonance-compatible coils 4-6 mm in diameter; only one patient was treated with gel-foam injection. Immediate technical success was achieved in all cases. In 13/14 patients (92.9%), no periprocedural complications were observed, whereas the remaining patient underwent splenectomy within 24 h due to recurrent bleeding. Conclusions: On the basis of our algorithm, it is possible to reach a quick decision on the most appropriate treatment for patients presenting with blunt abdominal trauma, and splenic artery embolization seems to offer a reliable option in those with high-grade splenic injury or active bleeding. © 2011 Springer-Verlag Italia Riassunto: Obiettivo: Scopo del nostro lavoro è stato valutare i risultati della nostra esperienza sull'embolizzazione percutanea in pazienti con trauma splenico, sulla base di un algoritmo modificato. Materiali e metodi: Abbiamo raccolto i dati dei pazienti con trauma della milza ammessi nel nostro centro da gennaio 2006 ad agosto 2008. In questo periodo sono stati ammessi 46 pazienti con lesione splenica posttraumatica, di cui 17 sono stati trattati chirurgicamente, 15 con trattamento conservativo e 14 con embolizzazione percutanea (13 maschi, età media 44,8, injury severity score [ISS] 18,5 circa, 6 con grado IV e 8 con stravaso di mezzo di contrasto). I pazienti in stato di shock sono stati immediatamente sottoposti a laparotomia e splenectomia, mentre quelli emodinamicamente stabili o responsivi alla somministrazione di fluidi sono stati valutati con TC. In base al dato strumentale, in 15 pazienti, con lesioni spleniche di grado I, II e III è stato considerato il trattamento conservativo, mentre 17 pazienti emodinamicamente instabili, con lesioni di V grado, sono stati sottoposti a splenectomia. L'embolizzazione è stata eseguita in 14 pazienti con lesioni spleniche di IV grado o in caso di stravaso di mezzo di contrasto indipendentemente dal grado della lesione. L'embolizzazione dell'arteria splenica principale è stata effettuata nei pazienti con danno d'organo diffuso, mentre in caso di lesioni localizzate, è stata eseguita l'occlusione selettiva del solo segmento splenico interessato. Risultati: L'embolizzazione prossimale si è resa necessaria in 8 pazienti e quella distale in 6. In 13 casi sono state posizionate spirali RM compatibili con diametro variabile tra 4 e 6 mm; in un solo paziente sono state iniettate solo particelle riassorbibili. Il successo tecnico immediato è stato ottenuto in tutti i casi. In 13/14 casi (92,9%) non sono state osservate complicanze post-procedurali, mentre in un solo paziente, trattato con particelle riassorbibili, si è resa necessaria la splenectomia per recidiva di sanguinamento a 24 ore dall'embolizzazione. Conclusioni: Sulla base del nostro algoritmo, è possibile una veloce decisione sul trattamento più opportuno delle lesioni spleniche post-traumatiche e l'embolizzazione percutanea sembra offrire un'affidabile opzione in pazienti con lesioni d'organo di grado elevato o con sanguinamento attivo. © 2011 Springer-Verlag Italia.
Werner H.,Radiologia |
Lopes J.,University of Arts |
Tonni G.,Guastalla Civil Hospital |
Araujo Junior E.,Federal University of São Paulo
Child's Nervous System | Year: 2015
ᅟRapid prototyping is becoming a fast-growing and valuable technique for physical models in case of congenital anomalies. Manufacturing models are generally built from three-dimensional (3D) ultrasound, computed tomography, and fetal magnetic resonance imaging (MRI) scan data. Physical prototype has demonstrated to be clinically of value in case of complex fetal malformations and may improve antenatal management especially in cases of craniosynostosis, orofacial clefts, and giant epignathus. In addition, it may enhance parental bonding in visually impaired parents and have didactic value in teaching program. Hereby, the first 3D physical model from 3D ultrasound and MRI scan data reconstruction of lumbosacral myelomeningocele in a third trimester fetus affected by Chiari II malformation is reported. © 2015, Springer-Verlag Berlin Heidelberg.
PubMed | University of Arts, Guastalla Civil Hospital, Radiologia and Federal University of São Paulo
Type: Case Reports | Journal: Medical ultrasonography | Year: 2015
Cervical teratoma is a rare congenital tumor that tends to be large and is usually solid/cystic. Estimation of the degree of tracheal compression or distortion allows multidisciplinary planning for delivery and neonatal resuscitation. We present a case of prenatal diagnosis of cervical teratoma at 29 weeks of gestation. The use of a physical model from 3D ultrasound and magnetic resonance imaging improved the understanding of spatial relationships of fetal anomaly and the adjacent structures, permitting better parent counselling. This technology can be used for educational purposes and as a method for parents to visualize their unborn baby.
PubMed | Allergologia e Fisiopatologia Respiratoria, Fisiopatologia Respiratoria, University of Genoa, Ematologia 2 and Radiologia
Type: | Journal: Respiratory physiology & neurobiology | Year: 2014
Lung diffusing capacity for CO (DLCO) is compromised in haematopoietic stem-cell transplantation (HSCT) recipients. We derived alveolar-capillary membrane conductance (DM,CO) and pulmonary capillary volume (VC) from DLCO and diffusing capacity for NO (DLNO). Forty patients were studied before and 6 weeks after HSCT. Before HSCT, DLNO and DLCO were significantly lower than in 30 healthy controls. DM,CO was 40% lower in patients than in controls (p<0.001), whereas VC did not differ significantly. After HSCT, DLNO and DM,CO further decreased, the latter by 22% from before HSCT (p<0.01) while VC did not change significantly. Lung density, serum CRP and reactive oxygen metabolites were significantly increased, with the latter being correlated (R2=0.71, p<0.001) with the decrement in DLNO. We conclude that DLNO and, to a lesser extent, DLCO are compromised before HSCT mainly due to a DM,CO reduction. A further reduction of DM,CO without VC loss occurs after HSCT, possibly related to development of oedema, or interstitial fibrosis, or both.
PubMed | Radiologia
Type: Case Reports | Journal: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery | Year: 2015
Rapid prototyping is becoming a fast-growing and valuable technique for physical models in case of congenital anomalies. Manufacturing models are generally built from three-dimensional (3D) ultrasound, computed tomography, and fetal magnetic resonance imaging (MRI) scan data. Physical prototype has demonstrated to be clinically of value in case of complex fetal malformations and may improve antenatal management especially in cases of craniosynostosis, orofacial clefts, and giant epignathus. In addition, it may enhance parental bonding in visually impaired parents and have didactic value in teaching program. Hereby, the first 3D physical model from 3D ultrasound and MRI scan data reconstruction of lumbosacral myelomeningocele in a third trimester fetus affected by Chiari II malformation is reported.
News Article | March 1, 2017
GENOVA, Italia, March 1, 2017 /PRNewswire/ -- Lo stesso sistema sara' visibile nello stand a ECR, il Congresso Europeo di Radiologia a Vienna Paramed Medical Systems sta installando la settima unità MROpen in Gran Bretagna, la prima in Galles. Il sistema di risonanza magnetica...
News Article | March 1, 2017
VIENNA--(BUSINESS WIRE)--GE Healthcare arricchisce la linea di mezzi di contrasto per la risonanza magnetica per immagini (RMI) dedicata a pazienti e radiologi con il lancio di Clariscan™ (acido gadoterico), annunciato durante il Congresso Europeo di Radiologia (ECR) 2017. Clariscan è un mezzo di contrasto contenente gadolinio (GBCA) creato per supportare la visualizzazione efficace delle anomalie del cervello, della colonna vertebrale e dei tessuti associati, e sarà disponibile per gli operatori sanitari globali congiuntamente alle soluzioni e ai servizi di supporto tecnico di GE Healthcare.