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Biomedical subjects

E Fanucci

Publications and source records attributed to E Fanucci.

At least 19 recordsLinked to original sources
PubMed2006

Multidetector CT and dentascan software: dosimetric evaluation and technique improvement.

PURPOSE: The development of new operative techniques in oral and maxillofacial surgery within the last few years has led to an increasing demand for Dentascan examination, also in paediatric patients. It is necessary to modify acquisition parameters to reduce the absorbed dose. The aim of this study was to define a Dentascan protocol in which a reduced X-ray dose could be used. MATERIALS AND METHODS: Dosimeters were applied to the eyes, mouth, parotid glands, thyroid and back of the neck of an anthropomorphic Plexiglas phantom that underwent multidetector computed tomography (MDCT) Dentascan examinations. Both 120kV and 80 kV were used to study the mandibular and maxillary arches. RESULTS: Examinations obtained with the 80 kV protocol showed a ten-fold reduction in the absorbed dose, without affecting image quality. CONCLUSIONS: We suggest a Dentascan protocol that reduces the X-ray dose administered to the patient while ensuring the same high diagnostic accuracy.

Head↗
PubMed2001

CT-guided injection of botulinic toxin for percutaneous therapy of piriformis muscle syndrome with preliminary MRI results about denervative process.

Piriformis muscle syndrome (PMS) is a cause of sciatica, leg or buttock pain and disability. The pain is usually increased by muscular contraction, palpation or prolonged sitting. The aim of our paper was to evaluate the feasibility of CT-guided percutaneous botulinic toxin (BTX) injection for the purpose of PMS treatment. Thirty patients suffering from PMS, suspected with clinical and electrophysiological criteria, after imaging examinations excluding other causes of sciatic pain, resulted positive at the lidocaine test and were treated by intramuscular injection of BTX type A under CT guidance. The follow-up (12 months) was performed with clinical examination in all cases and with MR 3 months after the procedure in 9 patients to evaluate the denervative process entity of the treated muscle. In 26 cases relief of symptoms was obtained after 5-7 days. In 4 patients an insufficient relief of pain justified a second percutaneous treatment which was clinically successful. No complications or side effects were recorded after BTX injection. The MR examination showed a signal intensity change of the treated muscle in 7 patients due to the denervative process of PM, whereas in the remaining 2 cases only an atrophy of the treated muscle was detected. Larger series are necessary to confirm these MRI preliminary results. The CT-guided BTX injection in the PMS is an emergent and feasible technique that obtains an excellent local therapeutic effect without risk of imprecise inoculation.

Adult↗
PubMed2001

[Magnetic resonance angiography with three-dimensional dynamic technique after contrast media administration for the study of the portal system ].

PURPOSE: To evaluate the feasibility of a contrast enhanced MR angiography (MRA) technique, using the latest 1.5 T MR tomoscan, to obtain optimal imaging of the portal system and compare the angiographic images with those obtained by color-Doppler and DSA. MATERIAL AND METHODS: Thirty patients (9 women and 21 men: average 53 years old) underwent contrast MRA of the portal vein, after portal hypertension had been diagnosed on the basis of clinical and chemical data and by color-Doppler. We used a dynamic 3D FFE T1-weighted breath - hold sequence during the arterial and venous phase after administering. 0.2 mmol/Kg of gadolinium-DTPA were at the rate of 2 ml/s. The contrast bolus was monitored using a 2D FFE T1-weighted sequence on a coronal plane. A FFE T1-weighted sequence was performed on axial plane before and after the dynamic sequence to obtain evaluate the a hepatic parenchyma. In the post processing phase MIP (maximum intensity projection) were reconstructed. We considered the patency of the portal venous system and the presence of cavernomatous and collateral circles; portal thrombosis was classified as partial or complete and as proximal or distal. RESULTS: Good quality MR angiographic images were obtained in 28 of the 30 cases examined; in 2 patients movement artefacts compromised the image quality. We observed a concordance between MRA and Doppler ultrasound in 79 vessels out of 84 (94%). A 97.5% concordance was found between MRA and DSA (82 vessels out of 84) with a sensitivity of 100% and a specificity of 97.3%. MRA was superior to DSA and Doppler ultrasound for evaluating large collateral shunts, above all gastro-esophageal and paraumbilical shunts, and complex anatomical conditions. CONCLUSIONS: Where available, advanced MRA technology with contrast enhancement should be used as a routine modality to study the anatomy and pathology and the portal system in all patients in whom Doppler ultrasound has yielded doubtful information. MRA is well-suited to obtain good vascular imaging before surgical or interventional procedures.

Adult↗
PubMed1995

[Computerized tomography assessment of bone damage following injury of the anterior cruciate ligament].

An ACL tear causes an anterior subluxation of the tibial bone which rotates with its fulcrum on the medial collateral ligament; consequently, the lateral femoral condyle impacts on the external tibial plateau. The presence of a subcortical lesion of the spongiform bone in the posterior external tibial plateau is an indirect sign of an ACL tear. On MR images, traumatic changes are depicted as changes in bone marrow signals. To assess the diagnostic capabilities of CT in demonstrating the bone lesion subsequent to ACL trauma, 23 patients with positive MR exams of the knee were submitted to CT. Fifteen patients had complete ACL tears, 8 had partial tears and 20 exhibited an occult fracture of the posterior portion of the external tibial plateau. This study pointed out a significant correlation between ACL tears and changes in the spongiform structure of the posterolateral tibial plateau. Such changes are depicted not only by MRI but also by CT: the latter method is also a valuable tool to study these conditions long after the traumatic event. No more than 5 slices, 1-1.5 mm thick, acquired at the tibial plateau allowed the trabecular structure and its abnormal changes to be studied without markedly lengthening examination time.

Anterior Cruciate Ligament Injuries↗
PubMed1994

Advances in interventional radiology in oncology.

Interventional radiology (IR) includes all procedures performed percutaneously under US, fluoroscopy, CT or DSA guidance by a radiologist to obtain diagnostic and therapeutic achievements. According to the pathology under examination, these procedures may be applied alone, as a definite therapeutic tool, or together with other traditional techniques permitting an easier and more successful application. In this report the authors discuss briefly the IR possibilities in many oncological branches.

Chemoembolization, Therapeutic↗
PubMed1994

[Magnetic resonance imaging in denervated muscle. A preliminary study].

Ten patients with various forms of peripheral neuropathy and spinal radiculopathy were examined with MRI using a low-field permanent magnet (0.2 T) and spin echo (SE)/inversion recovery (IR) sequences, with an adequate inversion time to suppress healthy muscle signal. In acute denervation MR sensitivity was low on both sequences; in subacute denervation the damaged muscle was more intense than the healthy muscle only on IR sequences. MRI adequately depicted fatty infiltration in chronic denervation. In conclusion, MRI is a promising tool for mapping and noninvasively monitoring denervated motor units in skeletal muscles, whose role is currently complementary to that of electromyography.

Acute Disease↗
PubMed1992

[The use of the single-pulse RARE sequence in the study of the cerebrospinal axis].

The authors describe a fast MR sequence allowing to obtain a myelographic-like, markedly T2-weighted, image quite similar to conventional myelographies. Relative to conventional spin-echo sequences, in which echoes are encoded so as to achieve the same phase, each echo of the sequence here employed is given a different phase encoding. The sequence, called MYUR (myelography-urography) is based on the generation, after a 90 degrees pulse, of a "train" of 256 echoes, each one phase-encoded differently, by multiple 180 degrees pulses, producing a single image. The total duration of such a sequence, with 2 repetitions, is 21 seconds. The MR myelographic sequence allows to univocally study tissues with a very long T2 relaxation time; under normal conditions, only cerebrospinal fluid, urine and bile are demonstrated. A resistive MR unit operating at 0.28 T was employed in the present study. MR myelography is capable of pointing out an eventual dural sac compression or a space-occupying mass, thus allowing an effective scout-view to center the subsequent pulse sequences; all MR-myelographic exams need to be completed with other short and long TR sequences.

Brain↗
PubMed1992

[Vascular radiology and physics of fluids].

In the cardiovascular system, morphology and functionality are closely related. The observation that atherosclerotic lesions appear with different incidence in the various sites and prefer bifurcations, suggested that vascular architecture might be an important pathogenic factor. Vascular geometry deals with the evaluation of the "form" element from a theoretical point of a view, pointing out the angles and diameters which can make the arterial system physiologically more efficient. The key element of the system is the bifurcation: depending on whether bifurcations are considered as a single entity or as a whole, either "local" or "global" geometry is employed. The morphology of the bifurcation directly affects blood flow patterns, influencing both blood flow velocity and wall shear stress. Experimental studies evidenced that high blood flow velocities and low wall shear stress have, respectively, a preventive or favorable role in atheroma development. By observing these altered flow sites, the areas which are most likely to develop atherosclerotic damage have been detected in the various bifurcations; the areas correspond to angiographic and autoptic findings. Based on their experience, the authors discuss the contribution that the different imaging techniques can give to the study of vascular geometry.

Angiography↗
PubMed1992

[Oral contrast media in the study of the esophagus with magnetic resonance. Proposal of a new preparation].

The major problem in MRI of the esophagus is the lack of a reliable oral contrast agent. To determine the value of Gd-DTPA as an oral contrast medium for the esophagus as a part of phase III clinical trial, 17 patients (10 esophageal neoplasms, 4 neoplasms of the pharyngo-laryngeal tract, 3 Zenker's diverticula) underwent MRI. The oral contrast medium is proposed in a new preparation: 5 cc of oral Gd-DTPA were emulsionated with 30 g of a low-density barium paste for esophageal CT (3% p/v). High signal intensity in the esophageal lumen was observed in all patients and in all sequences. In neoplastic lesions, the c.m. improved the definition of both the level of stenosis and the longitudinal extent of the lesion. In diverticula, the real and the false lumen could be demonstrated. In one patient the exam could not be completed. No adverse reactions were observed.

Administration, Oral↗
PubMed1992

[Preoperative staging and recurrence of rectal tumors. Comparison of transrectal ultrasonography and magnetic resonance].

The accuracy of transrectal US (TRUS) and of MRI was evaluated in the preoperative staging and in local recurrences of rectal cancers. Fifty-four patients were examined: 45, with known rectal cancer, for preoperative staging, and 9 for the evaluation of local recurrences. Nineteen patients were examined with MRI in basal conditions, 21 after rectal air enema and 5 after paramagnetic contrast enema (Gd-DTPA). The following parameters were evaluated for preoperative staging: wall infiltration, invasion of perirectal fat and adjacent structures, lymph node involvement. Morphologic and signal intensity (on MRI) changes were evaluated for the diagnosis of local recurrences. TRUS provided 2 false positives. In the same patients, basal MRI results were poor, owing to difficult demonstration of the different wall layers, while in the patients studied after air enema, the lesion was hyperintense. In 20 patients with a fat-infiltrating tumor, TRUS provided 3 false negatives and 2 false positives; basal MRI yielded poor results, while air enema and paramagnetic contrast enema clearly demonstrated all fat-infiltrating lesions, with only one false positive.

Air↗
PubMed1991

[Role of computerized tomography in endosseous implantology].

The Authors are proposing the use of computerized tomography for the evaluation of osseous structures of the maxilla and mandible before installation of titanium fixtures. The results indicate that the CT scan can give information about the structure and bone density. The height and the width of the alveolar osseous crests and the relationship with the incisive canal and the mandibular canal are clearly demonstrated. The CT scan can facilitate the measurement of the space available in order to install the titanium fixtures.

Alveolar Process↗
PubMed1991

[Dynamic study of oro-pharyngeal deglutition].

Oropharyngeal swallowing is too fast and complex a motion for the human eye to seize its various phases and subsequently evaluate morphology and function of the anatomical structures involved. A chronological subdivision of the swallowing act is needed for a step-by-step analysis. Dynamic evaluation of oropharyngeal swallowing by means of fluoroscopic and US videorecording proved to be a reliable method. Echovideorecording allowed tongue movements to be depicted, together with bolus formation and propulsion. Fluorovideorecording (U-matic Sony unit, 25-30 images/sec) demonstrated pharyngeal and esophageal phases. A series of chronological and morphological reference points, which characterize oropharyngeal swallowing, were employed to analyze videorecorded images. Slow-motion mode, "freezed" images, and rewinding allowed an easy and accurate evaluation of swallowing details. Combined chronological and morphological pieces of information allow a comprehensive evaluation of the swallowing act.

Deglutition↗
PubMed1990

Optimal branching of human arterial bifurcations.

The area ratio, defined as the combined cross-sectional areas of the daughter branches divided by that of the parent artery, is an important indicator of "expansion" or "narrowing" in an arterial tree. In 120 morphologically normal human arterial bifurcations, angiographically studied, we measured branch artery diameters at and away from the bifurcation point to obtain "beta" and "D" ratios, respectively. These results were compared with optimal curves. Area ratio D values showed better agreement than area ratio beta with theoretical curves; for area ratio D, the positive regression line showed the same trend as expected from theory (y = 1.26 + 0.153x); for area ratio beta, the regression line was negative, showing a trend opposite to theory (y = 0.962 - 0.191x). Area ratio beta showed a significant correlation coefficient (r = 0.194; P less than 0.05) associated with aging, while for area ratio D it was not the same (r = 0.023; P less than 0.05). A significant correlation coefficient was also found between both of the area ratios and total branching angle. The new area ratio D, reflecting the branching geometry nearer to the bifurcation, is more promising than area ratio beta in the evaluation of optimal arterial bifurcation.

Adolescent↗
PubMed1989

[Diverticula of the pharyngoesophageal area].

Hypopharyngeal diverticula are relatively unknown, with the exception of Zenker's diverticulum. Spot-camera and videorecording techniques were employed for the examination of 95 dysphagic and 250 asymptomatic patients. On the whole, 345 cases. 40% of diverticula were found in dysphagic patients, and 14% in asymptomatic ones. Fifty diverticula were detected through the thyrohyoid membrane, and 14 pseudodiverticula, 4 Zenker's diverticula, 4 lateral diverticula at the pharyngoesophageal junction, and 2 outpouchings through the tonsillar fossa. A statistically significant correlation (p less than 0.001) with dysphagia was demonstrated only for diverticula through the thyrohyoid membrane. Most pathologic findings were associated with other swallowing dysfunctions.

Adolescent↗