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Biomedical subjects

L Broglia

Publications and source records attributed to L Broglia.

40 records · Page 3Linked to original sources

Evaluation of Crohn disease activity with magnetic resonance imaging.

BACKGROUND: The purpose of this study was to assess the accuracy of magnetic resonance imaging (MRI) in evaluating Crohn disease (CD) activity. The intestinal inflammatory activity is usually present in patients under pharmacologic treatment, despite their clinical remission. METHODS: Twenty patients with CD, all under pharmacologic treatment, were prospectively studied by MRI at 1.5 T as a periodic control. Positivity of three acute-phase reactants was considered an index of biologic activity (BA). T2-weighted, T2-weighted fat-suppressed turbo spin-echo, and breath-hold T1-weighted turbo field-echo sequences, before and after gadolinium intravenous injection, were obtained. A negative superparamagnetic contrast agent was orally administered. The following MRI parameters were qualitatively evaluated by three radiologists at the level of the affected bowel and compared with clinical data: wall thickness (WT), wall T2-weighted signal (T2W), wall contrast enhancement (WE), amount of fibrofatty proliferation (FP), and T2-weighted signal of fibrofatty proliferation on fat-suppressed images (T2FP). The kappa coefficient of agreement was calculated. The Spearman rank correlation was used for the analysis of clinical and radiologic data. RESULTS: Nineteen of 20 patients were in clinical remission (Crohn Disease Activity Index < 150). On the basis of laboratory tests, nine of 20 patients had biologically active disease. An excellent correlation was found between BA and WE, T2W, and T2FP (0.900, 0.927 and 0.961, respectively; p < 0.0001), and a lower correlation was found between BA and WT and between BA and FP (0.78 and 0.62). Excellent statistical correlation was also found between WE and T2W and between WE and T2FP (0.876 and 0.892). CONCLUSIONS: An excellent statistical correlation was found between biologically "active" disease and the following MRI parameters: wall gadolinium enhancement, wall hyperintensity on T2-weighted fat-suppressed images, and hyperintensity of fibrofatty proliferation on T2-weighted fat-suppressed images. Therefore, MRI can be valuable in assessing CD activity.

Administration, Oral↗

[Integrated imaging of the breast. Use of a hypermedia program and multimedia archives for teaching purposes].

This paper deals with the results obtained with a computerized senology system developed at the Institute of Radiology of "La Sapienza" University in Rome. The system combines a hypermedia program with a multimedia didactic archive integrated with the radiologic information system. These programs have been developed on Macintosh computers: the hypermedia one on a Macintosh IIfx with 160-Mb hard disk and 8-Mb RAM and a Supercard software, the multimedia archive on Macintosh IIvx, IIvi and Quadra 650 units, connected with an Ethernet network to a server Quadra 950 (RAM: 20 Megabytes; optical disk: 1 Giga) and using the 4th Dimension as software. The basics of breast anatomy, radiologic semiology and breast diseases are illustrated with the hypermedia program: such a system has many advantages to teach the basics requiring just a process of learning by heart. The multimedia archive allows to classify a large number of difficult and uncommon clinical cases, according to the ACR code. Thus, it is useful also to teachers to study particular subjects, including anatomical variants and uncommon conditions. In conclusion, we believe these systems to be valuable tools in the formation and update of the physicians devoted to the study of breast diseases.

Breast↗

Non-invasive evaluation of the biliary tree with magnetic resonance cholangiopancreatography: initial clinical experience.

Magnetic resonance cholangiopancreatography is a new, non-invasive imaging technique for visualization of the biliary ducts. Magnetic resonance cholangiopancreatography was performed on 136 patients (20-87 years old) with a superconductive magnet at 0.5T (Philips Gyroscan T5). Volumetric images on coronal planes were acquired; a T2 weighted turbo spin echo sequence (TR = 3000; TE = 700; number of excitations = 8; echo train length = 128; Acquisition time = 5'48") with respiratory compensation was performed. Images were reconstructed on coronal planes rotated at different angles using the MIP algorithm. When neoplastic disease was detected additional images on axial planes (SE Tlw: TR/TE 300/10 and turbo spin echo T2w: TR/TE 3000/120) were acquired. Magnetic resonance cholangiopancreatography allowed images of diagnostic value to be obtained in all cases. In choledocholithiasis, the technique had a sensitivity of 91.6%, specificity of 100% and overall diagnostic accuracy of 96.8%. Of the 48 patients with stenotic lesions, 16 cases were correctly characterized as benign and 30 as malignant. Two cases of focal chronic pancreatitis were misdiagnosed as pancreatic head carcinoma. In patients submitted to bilioenteric anastomosis, the technique was able to detect dilation of intrahepatic ducts, stenosis and associated stones in the 8 positive cases. In all 11 patients with chronic pancreatitis, dilated Wirsung duct and the stenotic tracts were revealed. In conclusion, magnetic resonance cholangiopancreatography can be considered as a technique able to completely replace diagnostic endoscopic retrograde cholangiopancreatography. However, further studies are necessary for a better evaluation of potential advantage and disadvantages.

Bile Duct Neoplasms↗