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Biomedical subjects

A Catalucci

Publications and source records attributed to A Catalucci.

7 recordsLinked to original sources

Soft tissue liposarcoma: histological subtypes, MRI and CT findings.

PURPOSE: Liposarcoma is the second most common malignancy of soft tissues. The commonly accepted classification of liposarcoma includes five basic histological categories: well-differentiated, myxoid, round cell, dedifferentiated and pleomorphic liposarcoma. The clinical behaviour of liposarcoma closely reflects its histological appearance, so that to identify the histological subtypes is very important for both prognosis and therapy. The aim of this study was to ascertain whether the histological features of liposarcoma subtypes can be correlated with MRI (Magnetic Resonance Imaging) and CT (Computed Tomography) findings by retrospectively evaluating nineteen cases of histologically-proved liposarcoma. MATERIALS AND METHODS: The MRI examinations performed over the past eight years on nineteen patients affected by liposarcoma were retrospectively reviewed. All patients underwent ultrasound and MRI examination; T2 and T1-weighted sequences were available in all cases and fat-saturated sequences in 4 cases; all patients were administered paramagnetic contrast material. CT scans were obtained in twelve patients. All patients had a biopsy, surgical resection and histology. RESULTS: The study group had 7 well-differentiated, 8 myxoid, 3 pleomorphic and 1 round cell liposarcoma. Well-differentiated liposarcomas had largely lipomatous appearance on both CT and MRI, typically with septa and areas showing high signal intensity on T2w MR images and low signal intensity on T1w images, and slightly hypodense compared to the muscle in CT, representing the sarcomatous areas. Myxoid liposarcomas were mildly heterogeneous with typical high signal intensity on T2w images and isointense to the muscle in T1w images, with lacy or linear septa of fatty tissue in six cases. The pleomorphic and round-cell subtypes demonstrated marked heterogeneity on MR images, with areas of necrosis and heterogeneous contrast enhancement, indistinguishable from other high-grade sarcomas. DISCUSSION AND CONCLUSIONS: Well-differentiated liposarcoma may be distinguished from other types of liposarcoma by its largely lipomatous appearance. Myxoid liposarcoma may be distinguished on the basis of its homogeneous or mildly heterogeneous structure due to the large amounts of the extracellular myxoid material that give it its typical MR appearance. Both well-differentiated and myxoid liposarcomas, the most common types accounting for about 50% of all liposarcomas, have a more favourable clinical behaviour than the other histological types. Differentiation of these from the other histological types of liposarcoma therefore has a high significance for prognosis and therapeutical approach. On the basis of our experience and of the literature, we believe that diagnostic imaging and in particular the MR examination may lead to a correct diagnosis.

Adult↗

Spontaneous involution of pilocytic astrocytoma in a patient without neurofibromatosis type 1: case report.

Serial magnetic resonance imaging findings are described in a patient with a sporadically occurring pilocytic astrocytoma that underwent spontaneous regression over 6 years. To the authors' knowledge, this is the first report in which spontaneous involution of a pilocytic astrocytoma not associated with neurofibromatosis type 1 has been described. A literature review regarding sporadic and syndrome-associated pilocytic astrocytoma was undertaken, with particular reference to treatment and natural history.

Adult↗

Joint impingement syndrome: clinical features.

Joint impingement is a painful syndrome caused by the friction of joint tissues, which is both the cause and the effect of altered joint biomechanics. From the anatomical and clinical viewpoints, these syndromes are classified as bone impingement, soft tissue impingement and entrapment neuropathy, depending on what joint portion impinges on the others. We considered the most important impingement syndromes of the upper and the lower limbs from the clinical viewpoint. As for the upper limb, supraspinatus impingement is a frequent cause of shoulder pain in both athletes and the normal population; the painful subacromial arch is a typical sign of the rotator cuff impingement syndrome and of outlet and non-outlet impingement as well. As for the elbow, we considered both medial and lateral impingement. The carpal tunnel syndrome is the most common peripheral entrapment neuropathy of the upper limb; it is caused by compression of the median nerve at the wrist. We considered the main causes of carpal tunnel narrowing and the relative clinical findings. As for the lower limb, we considered the iliotibial band friction syndrome, which is the most common overuse syndrome of the knee and the ankle impingement syndrome. The latter includes anterolateral impingement (with chronic anterolateral and lateral pain and ankle instability), sinus tarsi impingement, anterior impingement (with pain during foot dorsiflection and posterior impingement. The tarsal tunnel syndrome is the most important ankle entrapment neuropathy causing burn pain and paresthesias in the toes and sole of the foot.

Cumulative Trauma Disorders↗

Ankle impingement syndromes.

The ankle impingement syndrome is a frequent condition in both athletes and the normal population. We investigated this painful syndrome from both a clinical and a diagnostic viewpoint. Depending on what ankle tissue impinges on the other, it is possible to distinguish bone impingement, soft tissue impingement and peripheral nerve entrapment. For each of these pathologic conditions we investigated the diagnostic role of conventional radiography, Computed Tomography and Magnetic Resonance Imaging. The evidence of osteophytes, exostosis and presence of the os trigonum on plain films make clinical diagnosis easy in both anterior and posterior bone impingement. CT can provide useful information about the component of the posterior ankle. MRI always adds important information about chondral or subchondral bone injuries, synovial reaction and adjacent soft tissue involvement. The anterolateral impingement syndrome is caused by repeated injuries in plantar flexion and ankle intrarotation. MRI well detects the meniscoid injury thanks to high contrast sequences; it can also distinguish this syndrome from painful chondral and/or bony lesions at this level. MRI is also the method of choice to study sinus tarsi impingement, especially thanks to fat suppression sequences which increase MR diagnostic capabilities in this important anatomic area. Deep peroneal nerve entrapment, the medial plantar nerve entrapment syndrome and the tarsal tunnel syndrome are the most important entrapment neuropathies of the ankle. US and MRI are very useful to study the tendon and soft tissue abnormalities causing the anterior tarsal tunnel syndrome. CT and particularly MRI can easily detect many pathologic conditions causing the medial plantar nerve entrapment and the tarsal tunnel syndromes.

Ankle Injuries↗

[Superparamagnetic iron oxide in the differential diagnosis of focal hepatic lesions using a 0.5-tesla magnetic resonance apparatus].

INTRODUCTION: We investigated the efficacy of superparamagnetic iron oxide (SPIO) in the characterization of focal liver lesions on MR images by means of quantitative and qualitative analysis. MATERIAL AND METHODS: We examined 60 patients with at least one focal liver lesion on US images. Conventional T1-weighted spin echo (CSE), proton density and T2-weighted MR images were acquired before and after the injection of a SPIO agent (Endorem, slow infusion, 15 micromoles Fe/kg body weight). A qualitative and a quantitative analysis were performed calculating the contrast enhancement rate in different kinds of lesions; the differences were related to the type of sequence statistically using Student's t-test for coupled samples. RESULTS: Excellent correlation was found with biopsy findings in all but two patients who were false positive for hepatocellular carcinoma (scar on cirrhotic liver). T1-weighted sequences after AMI-25 injection were the most specific ones in hemangioma characterization; PD were the most sensitive sequences in the detection and characterization of liver metastases. T2-weighted sequences were helpful only in the detection of focal liver lesions but they were not specific. CONCLUSIONS: In conclusion, SPIO-enhanced MRI is an excellent imaging tool for the differential diagnosis of focal liver lesions, with a good specificity for the differential diagnosis of hemangioma and metastasis. It is also helpful to distinguish benign from malignant lesions.

Contrast Media↗

[Anterior cruciate ligament tears in athletes: assessment and clinico-diagnostic control with a dedicated system].

INTRODUCTION: We investigated the MR signs of anterior cruciate ligament (ACL) tears and tried to assess the patterns of both the acute and the chronic phases since more MR examinations are currently performed of the knee joint in the hyper and acute post-traumatic stage. MATERIAL AND METHODS: December, 1994, through September, 1997, a hundred and 89 sportsmen with a history of hyper and acute knee trauma were submitted to MRI: one hundred and four of them were followed-up for 3-6 months. The MR examinations were performed with a dedicated unit (Artoscan, Esaote Biomedica, Genoa) using T1-weighted SE, T2-weighted GE and Turbo ME sequences on the sagittal, coronal and axial planes, respectively (3-5 mm slice thickness). RESULTS: Of 189 patients examined in the hyper and acute post-traumatic stage, 101 had a complete ACL tear, 23 had a partial tear and 65 had an enlarged and inhomogeneous ACL: Eighty-five patients underwent surgery, while the other 104 had 3-6 months' follow-up MRI. Twenty-four of the latter had a complete ACL tear, 20 had a partial tear and 60 had no MR finding of ACL interruption, with a more or less inhomogeneous ligament. DISCUSSION: ACL tears are difficult to demonstrate in the acute phase because of perilesional swelling, synovitis and hemorrhage; high-contrast sequences on the axial plane are therefore required. In the chronic stage, an uninterrupted ACL does not necessarily imply that function is preserved, as well as the MR finding of a deflected ligament does not necessarily imply altered biomechanics. CONCLUSIONS: MRI of the knee joint is increasingly used to study hyper and acute ACL tears thanks to the availability of dedicated units. The MR study of ACL tears is not meant to refer the patients to surgery, which pertains to the physical examination, but it allows to assess lesion severity and to show associated injuries in other knee structures.

Acute Disease↗

Left ventricular function: MRI assessment.

Biplane left ventricular (LV) angiography has always been considered the standard of reference to measure LV volumes and ejection fraction (EF): however, angiographic measurements depend on the assumption of geometric models derived from two-dimensional information. MRI is the best technique to evaluate cardiac volumes and mass providing direct non geometric analysis of the ventricles with a high contrast resolution. Standard cine MRI is considered a time-consuming technique for acquisition and measurements; breath hold cine MRI and echoplanar imaging (EPI) non gated sequences are useful to reduce the acquisition time from a few minutes to a few seconds. The evaluation of the heart linear parameters (diameters, thickness), areas, volumes and mass is essential in the diagnosis of many heart diseases and in the assessment of the ventricular function. The modalities to evaluate LV measurements and to obtain functional parameters, the acquisition technique and flow analysis were analyzed in this study.

Angiography↗