Papers by Ignazio Salamone
La radiologia medica, 2011
This study was undertaken to evaluate the potential of multidetector computed tomography (MDCT) f... more This study was undertaken to evaluate the potential of multidetector computed tomography (MDCT) for multiplanar visualisation of the tympanic canaliculus both in healthy individuals and in patients affected by chronic inflammatory disease of the middle ear. A preliminary study was performed on three dried skulls by placing a metal landmark inside the tympanic canal lumen with a view to optimising depiction by multiplanar CT. Subsequently, 50 patients were enrolled in a prospective study. Three of the 100 petrous pyramids studied were excluded owing to the presence of jugulotympanic glomus tumour with severe bone changes. The entire course of the tympanic canaliculus was identified in 80/97 petrous pyramids (82.4%), 57 of which were normal (75.4% detection rate) and 40 pathological (90% detection rate). To assess the tympanic canaliculus in the pathological petrous pyramids and evaluate its possible role in the disease process, some qualitative criteria were introduced: canal enlargement, loss of margin sharpness, focal erosion of canal margins and presence of pathological tissue. MDCT represents the only technique allowing evaluation of the tympanic canal in vivo and with multiplanar images in a large number of cases (82.4%).
Thyroid, 2003
Fifty-five patients with Graves&a... more Fifty-five patients with Graves' disease (GD) and mild to moderate Graves' ophthalmopathy (GO) underwent near-total thyroidectomy (Tx). In 16 patients this was followed by a standard ablative dose of (131)I because of the hystologic evidence of differentiated thyroid carcinoma. We retrospectively evaluated whether or not GO activity could be affected by thyroid surgery alone or followed by complete ablation of thyroid tissue. Accordingly, on the basis of clinical activity score (CAS) values prior to thyroidectomy, we identified two groups: group A with active GO (CAS > or = 3; n = 31) and group B with inactive GO (CAS < or = 2; n = 24). CAS values were then recorded at 6, 12, and 24 months after surgery/(131)I ablation. Over the course of the follow-up period, GO became inactive in approximately 70% of group A patients (CAS 4.2 +/- 0.8 at baseline, 2.1 +/- 2.0 at 24 months, p < 0.0001) and became active in 37.5% patients from group B. When we examined GO activity according to the type of treatment used (Tx or Tx and (131)I), the prevalence of inactive GO both short- and long-term, was significantly higher in the group of patients who underwent Tx and (131)I ablation. Therefore, this seems to be a more effective means of inducing and maintaining inactive GO.
La radiologia medica, 2013
The aim of this study was to evaluate the advantages and limits of virtual magnetic resonance tec... more The aim of this study was to evaluate the advantages and limits of virtual magnetic resonance techniques in planning surgery for microvascular decompression in patients with neurovascular conflict. Between December 2010 and December 2011, we prospectively observed 32 patients (30 with trigeminal neuralgia and two with hemifacial spasm), with a suspected clinical diagnosis of neurovascular conflict. To assess the contact between nerve and vessel, magnetic resonance imaging (MRI) by three-dimensional (3D) constructive interference in steady state (CISS) and high-resolution MR angiography (MRA) were performed in all cases. Moreover, we performed presurgical simulation of microvascular decompression using MR two-dimensional image fusion and virtual cisternography. The neuroradiological findings were compared with the surgical findings. In all cases, we demonstrated the anatomical relations between cranial nerves and offending vessels with an optimal correlation between radiological and surgical patterns. Advanced virtual MRI techniques, such as image fusion and virtual cisternography, are able to depict the complex anatomical relationships between neural and vascular structures within the cisternal spaces of the skull base. These techniques can be considered an optimal presurgical tool to support traditional MRI evaluation of this region.
La radiologia medica, 2006
The purpose of this study was to demonstrate the usefulness of coronal oblique multiplanar recons... more The purpose of this study was to demonstrate the usefulness of coronal oblique multiplanar reconstruction computed tomography (MPR CT) reformation parallel to the basal turn of the cochlea in the evaluation of the retrotympanum and hypotympanum to complete the standard CT examination of the temporal bone obtained with axial and coronal images. We studied 30 patients aged 18-79 years for a total of 60 normal petrous pyramids. All examinations were performed on a multislice CT (MSCT) scanner (Sensation 16, Siemens, Erlangen, Germany) with axial volumetric acquisition and completed with reformations of coronal and coronal-oblique images. MSCT scan parameters for axial acquisition were set as follows: 0.75-mm scan collimation, FOV 300 mm, 170 mAs. Axial images were reconstructed at 0.7-mm thickness and with a reconstruction increment of 0.5 mm using a high-resolution bone algorithm. Coronal oblique MPR CT reformations provided additional information with respect to standard CT images in all cases. In particular, they enabled measurement of the craniocaudal and laterolateral diameters of the sinus tympani. In all cases, there was optimal visualisation of the ponticulus and subiculum. Analysis of the pyramidal eminence was improved thanks to its visualisation in profile. Moreover, we obtained an optimal representation of the hypotympanum, which was always exhaustively explored with only one reconstruction. Finally, in all cases, it was possible to identify the facial nerve canal and main vascular structures and to measure the distance between these and the sinus tympani, pyramidal eminence and hypotympanum. The coronal oblique CT reformation was of no advantage in the evaluation of the fossa of the oval window and the niche of the round window. Coronal oblique MPR CT reformation should not be considered an alternative to the standard CT examination, but it can represent a valid integration to provide additional information on particularly crucial districts characterised by frequent involvement of inflammatory and/or expansile disease and because of their difficult endoscopic approach. Moreover, it can represent a meaningful aid to optimise surgical planning thanks to its different perspectives of observation.
Thyroid, 2003
Fifty-five patients with Graves&a... more Fifty-five patients with Graves' disease (GD) and mild to moderate Graves' ophthalmopathy (GO) underwent near-total thyroidectomy (Tx). In 16 patients this was followed by a standard ablative dose of (131)I because of the hystologic evidence of differentiated thyroid carcinoma. We retrospectively evaluated whether or not GO activity could be affected by thyroid surgery alone or followed by complete ablation of thyroid tissue. Accordingly, on the basis of clinical activity score (CAS) values prior to thyroidectomy, we identified two groups: group A with active GO (CAS > or = 3; n = 31) and group B with inactive GO (CAS < or = 2; n = 24). CAS values were then recorded at 6, 12, and 24 months after surgery/(131)I ablation. Over the course of the follow-up period, GO became inactive in approximately 70% of group A patients (CAS 4.2 +/- 0.8 at baseline, 2.1 +/- 2.0 at 24 months, p < 0.0001) and became active in 37.5% patients from group B. When we examined GO activity according to the type of treatment used (Tx or Tx and (131)I), the prevalence of inactive GO both short- and long-term, was significantly higher in the group of patients who underwent Tx and (131)I ablation. Therefore, this seems to be a more effective means of inducing and maintaining inactive GO.
Medical Physics, 2010
The objective of this study is to develop a method to calculate the relative dose increase when a... more The objective of this study is to develop a method to calculate the relative dose increase when a computerized tomography scan (CT) is carried out after administration of iodinated contrast medium, with respect to the same CT scan in absence of contrast medium. A Monte Carlo simulation in GEANT4 of anthropomorphic neck and abdomen phantoms exposed to a simplified model of CT scanner was set up in order to calculate the increase of dose to thyroid, liver, spleen, kidneys, and pancreas as a function of the quantity of iodine accumulated; a series of experimental measurements of Hounsfield unit (HU) increment for known concentrations of iodinated contrast medium was carried out on a Siemens Sensation 16 CT scanner in order to obtain a relationship between the increment in HU and the relative dose increase in the organs studied. The authors applied such a method to calculate the average dose increase in three patients who underwent standard CT protocols consisting of one native scan in absence of contrast, followed by a contrast-enhanced scan in venous phase. The authors validated their GEANT4 Monte Carlo simulation by comparing the resulting dose increases for iodine solutions in water with the ones presented in literature and with their experimental data obtained through a Roentgen therapy unit. The relative dose increases as a function of the iodine mass fraction accumulated and as a function of the Hounsfield unit increment between the contrast-enhanced scan and the native scan are presented. The data shown for the three patients exhibit an average relative dose increase between 22% for liver and 74% for kidneys; also, spleen (34%), pancreas (28%), and thyroid (48%) show a remarkable average increase. The method developed allows a simple evaluation of the dose increase when iodinated contrast medium is used in CT scans, basing on the increment in Hounsfield units observed on the patients' organs. Since many clinical protocols employ multiple scans at different circulatory phases after administration of contrast medium, such a method can be useful to evaluate the total dose to the patient, also in view of potential clinical protocol optimizations.
International Journal of Cardiology, 2007
We occurred in a left main (LM) dissection during primary coronary intervention in a 45-year-old ... more We occurred in a left main (LM) dissection during primary coronary intervention in a 45-year-old man with anterior acute myocardial infarction. Successful, multiple direct stenting was performed from the ostial to the mid left anterior descending coronary artery (LAD). Nonetheless, an LM dissection involving the proximal circumflex artery (Cx) was still evident at the end of the intervention. Multislice Computed Tomography (MSCT) coronary angiography images showed that LM dissection was definitely long and close to the ostium; moreover, the proximal stent had both excluded the false lumen in the LAD and stabilized the dissection towards the Cx. Two months later, at MSCT coronary angiography the LM dissection was still evident and the patient had remained totally asymptomatic. MSCT coronary angiography can be recommended as a complementary diagnostic tool for the assessment of LM anatomy because of the possibility of three-dimensional reconstructions and consequent clear evaluation of its take-off, course and bifurcation.
European Radiology, 2002
Bronchial mucus has tomodensitometric features and MR signal intensity similar to that of water. ... more Bronchial mucus has tomodensitometric features and MR signal intensity similar to that of water. However, chronic entrapped mucus collections, due to water reabsorption and higher protein content, can have CT attenuation values higher than 20 and reaching even 130 HU. Higher protein concentration also causes a sensible reduction in T1 relaxation time. The demonstration of mucus within a mediastinal, bronchial or pulmonary lesion is an important diagnostic clue permitting remarkable shortening of the list of differential diagnoses. This article illustrates the CT and MR findings allowing correct characterization of the mucus-containing lesions of mediastinum, bronchi, and lung.
Abdominal Imaging, 2001
Gallbladder duplication is a rare anatomic malformation. We present a case of gallbladder duplica... more Gallbladder duplication is a rare anatomic malformation. We present a case of gallbladder duplication in a patient who underwent laparoscopic cholecystectomy in which breath-hold magnetic resonance cholangiography showed the biliary anomaly, allowing a correct preoperative differentiation of the specific type of duplication.
Abdominal Imaging, 2000
We present an uncommon case of hepatic hydatidosis, complicated by transphrenic migration of the ... more We present an uncommon case of hepatic hydatidosis, complicated by transphrenic migration of the cyst, in which the use of magnetic resonance performed with ultrafast, breath-hold, heavily T2-weighted sequences (HASTE) demonstrated a bronchial fistula.
American Journal of Roentgenology, 2013
The purpose of this article is to quantify the CT radiation dose increment in five organs resulti... more The purpose of this article is to quantify the CT radiation dose increment in five organs resulting from the administration of iodinated contrast medium. Forty consecutive patients who underwent both un-enhanced and contrast-enhanced thoracoabdominal CT were included in our retrospective study. The dose increase between CT before and after contrast agent administration was evaluated in the portal phase for the thyroid, liver, spleen, pancreas, and kidneys by applying a previously validated method. An increase in radiation dose was noted in all organs studied. Average dose increments were 19% for liver, 71% for kidneys, 33% for spleen and pancreas, and 41% for thyroid. Kidneys exhibited the maximum dose increment, whereas the pancreas showed the widest variance because of the differences in fibro-fatty involution. Finally, thyroids with high attenuation values on unenhanced CT showed a lower Hounsfield unit increase and, thus, a smaller increment in the dose. Our study showed an increase in radiation dose in several parenchymatous tissues on contrast-enhanced CT. Our method allowed us to evaluate the dose increase from the change in attenuation measured in Hounsfield units. Because diagnostic protocols require multiple acquisitions after the contrast agent administration, such a dose increase should be considered when optimizing these protocols.
American Journal of Roentgenology, 2002
Modern MR urography can be performed by means of two different imaging strategies: unenhanced MR ... more Modern MR urography can be performed by means of two different imaging strategies: unenhanced MR urography, based on heavily T2-weighted “hydrographic” pulse sequences [1, 2, 3], and gadolinium-enhanced excretory MR urography [4, 5].
American Journal of Roentgenology, 2006
The purpose of this study was twofold: to determine whether asymptomatic distance runners exhibit... more The purpose of this study was twofold: to determine whether asymptomatic distance runners exhibit cortical tibial abnormalities on CT and to determine the diagnostic accuracy of CT in athletes with medial tibial stress syndrome. A cross-sectional study with high-resolution CT of both tibiae was performed on 41 subjects: 20 asymptomatic distance runners, 11 distance runners with unilateral or bilateral pain due to medial tibial stress syndrome (14 painful tibiae), and 10 volunteers not involved in a sport. The group was composed of 13 women and 28 men, ranging in age from 18 to 26 years. A total of 82 tibiae, 14 painful and 68 painless, were evaluated. On the basis of CT findings, tibiae were classified in three groups, and correlation between CT classification and symptoms was made. Among distance runners, the presence of CT abnormalities was found in 14 (100%) of 14 painful tibiae in patients with medial tibial stress syndrome and in 8 (16.6%) of 48 painless tibiae. The difference was statistically significant (p < 0.001, Fisher's exact test). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT in diagnosing medial tibial stress syndrome were 100%, 88.2%, 63.6%, 100%, and 90.2%, respectively. High-resolution CT has high diagnostic accuracy in depicting medial tibial stress syndrome. Cortical abnormalities can also be seen in some asymptomatic distance runners.
International Journal of Cardiology, 2012
The chance finding at multislice computed tomography coronary angiography of an ectopic origin of... more The chance finding at multislice computed tomography coronary angiography of an ectopic origin of the left circumflex coronary artery from the right sinus of Valsalva
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Papers by Ignazio Salamone