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Di Cesare E, Cademartiri F, Carbone I, Carriero A, Centonze M, De Cobelli F, De Rosa R, Di Renzi P, Esposito A, Faletti R, Fattori R, Francone M, Giovagnoni A, La Grutta L, Ligabue G, Lovato L, Marano R, Midiri M, Romagnoli A, Russo V, Sardanelli F, Natale L, Bogaert J, De Roos A. [Clinical indications for the use of cardiac MRI. By the SIRM Study Group on Cardiac Imaging]. Radiol Med 2012. [PMID: 23184241 DOI: 10.1007/s11547-012-0899-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Cardiac magnetic resonance (CMR) is considered an useful method in the evaluation of many cardiac disorders. Based on our experience and available literature, we wrote a document as a guiding tool in the clinical use of CMR. Synthetically we describe different cardiac disorders and express for each one a classification, I to IV, depending on the significance of diagnostic information expected.
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Fossaceca R, Guzzardi G, Cerini P, Di Terlizzi M, Malatesta E, Filice L, Brustia P, Carriero A. Endovascular treatment of abdominal aortic aneurysms: 6 years of experience at a single centre. Radiol Med 2012. [DOI: 10.1007/s11547-012-0905-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Guzzardi G, Fossaceca R, Di Gesù I, Cerini P, Di Terlizzi M, Stanca C, Malatesta E, Moniaci D, Brustia P, Stratta P, Carriero A. Endovascular treatment of transplanted renal artery stenosis with PTA/stenting. Radiol Med 2012; 118:826-36. [DOI: 10.1007/s11547-012-0884-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Accepted: 11/15/2011] [Indexed: 10/27/2022]
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Carriero A, Bonomo L, Calliada F, Campioni P, Colosimo C, Cotroneo A, Cova M, Ettorre GC, Fugazzola C, Garlaschi G, Macarini L, Mascalchi M, Meloni GB, Midiri M, Mucelli RP, Rossi C, Sironi S, Torricelli P, Beomonte BZ, Zompatori M, Zuiani C. E-learning in radiology: an Italian multicentre experience. Eur J Radiol 2012; 81:3936-41. [PMID: 22902406 DOI: 10.1016/j.ejrad.2012.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Revised: 04/17/2012] [Accepted: 07/09/2012] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The aim of this study was to design, deliver and evaluate an e-learning teaching programme for post-graduate radiodiagnostics training that would involve various post-graduate schools throughout Italy. MATERIALS AND METHODS All of the Directors of Italian post-graduate schools of radiodiagnostics were sent an e-mail on 27 September 2010 informing them of our willingness to set up an e-learning project for the academic year 2010-2011 in the form of single-subject teaching seminars. The proposed subjects were the semeiotics of the various organs and apparatuses in the context of "Urgent/Emergency Pathology". After having received registrations, a calendar of lessons was planned to be held between 10 November 2010 and 12 October 2011. The validity of the project was tested by means of a multiple-choice questionnaire covering the technical and didactic quality of the entire project, to be completed by the students. RESULTS Fifty-one percent of the universities in Italy participated in the project: Trieste, Udine, Verona, Milan-Bicocca, Novara, Varese, Genoa, Sassari, Rome Campus, the Catholic University of Rome, Chieti, Foggia, Catania, Modena, Florence, Palermo, Bologna, Pavia, Parma and Ferrara. The lessons were attended by a total of 10,261 post-graduate medical students, for an average of 513.1 students per lesson. Seventy percent of the students judged the didactic content "excellent", 25% "good", and 5% "satisfactory"; none said it was unsatisfactory. In terms of visual quality (particularly the details of the radiological images proposed in the form of slides and/or video clips), 73% judged it "excellent", 20% "good", 6% "satisfactory", and 1% "poor". The audio quality was judged "excellent" by 71%, "good" by 22%, "satisfactory" by 6% and "poor" by 1%. In relation to judgement of audio and video quality, it has to be underlined that this was greatly affected by the hardware/software configuration and the band speed and technology of the Internet connection. CONCLUSIONS Technological evolution is overcoming all barriers, and technology is also having a positive impact on the approach to teaching. Our multicentre teaching experience merits the following considerations: the quality of the teaching product was certified by the students' judgements of its didactic content and the quality of reception; the economic cost of the teaching had a minimal impact on the post-graduate schools (€ 18 per lesson). In terms of breaking down national barriers, it is to be hoped that the coordination and integration of diagnostic imaging e-learning projects, with the participation of post-graduate schools in different European countries, can be developed not only in a spirit of "cultural sharing" and the exchange of teaching experiences.
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Stecco A, Fabbiano F, Amatuzzo P, Cignini E, Brambilla M, Masini L, Krengli M, Carriero A. Perfusion computed tomography assessments of peri-enhancing brain tissue in high-grade gliomas. LA RADIOLOGIA MEDICA 2012; 118:431-43. [PMID: 22872457 DOI: 10.1007/s11547-012-0865-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 01/03/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE This study was undertaken to identify tumoural infiltration of peri-enhancing brain tissue in patients with glioblastoma by means of perfusion computed tomography (PCT) parameters, cerebral blood volume (CBV) and permeability surface (PS). MATERIALS AND METHODS Eight patients with surgically treated glioblastoma who were eligible for radiotherapy and nine patients with brain metastases from lung and breast cancer underwent CT before and after injection of contrast medium. CBV and PS were calculated in the contrast-enhancing lesion area, in the area of perilesional oedema and in the normal-appearing white matter (NAWM), normalised to contralateral symmetrical areas. RESULTS No significant differences were found for normalised CBV (nCBV) and nPS in NAWM regions between metastasis and glioma. Significant differences in nPS (p<0.005) were found between the typically vasogenic oedema surrounding the metastases and signal alteration surrounding the glial neoplasm. On the contrary, no significant differences were detected in the same areas for nCBV. CONCLUSIONS PCT can analyse the histopathological substrate underlying the hypodense peritumoural halo and differentiate between vasogenic oedema and neoplastic infiltration on the basis of the PS parameter. In our study, PS was more informative than CBV. These findings can be used to integrate plans for radiation therapy and/or surgery.
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Guzzardi G, Moniaci D, Fossaceca R, Lazzaro D, Barini M, Brustia P, Carriero A. Hepatic artery aneurysm treatment with heparin-bonded covered stent: a case report. Minerva Cardioangiol 2012; 60:433-437. [PMID: 22858921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The hepatic artery is the second most common site for aneurysms formation within the splanchnic circulation. Most hepatic artery aneurysms (HAA) are diagnosed incidentally by a computed tomography(CT) scan or a Doppler ultrasonography. We present the case of a HAA diagnosed preoperatively in a 82-year old man, who was treated with an endovascular procedure. An abdominal ultrasonography revealed by chance the presence of a HAA. The abdominal CT scan confirmed an aneurysm of the common hepatic artery, specifically at the origin of the gastroduodenal artery. The gastroduodenal artery was embolized using coils then a heparin-bonded covered stent was deployed into the common hepatic artery to exclude the aneurysm. Final arteriogram documented the regular patency of the stent and the complete exclusion of the aneurysm. No complication occurred and the patient was discharged on the second postoperative day. Six months later, a follow-up with a Duplex scan confirmed the regular patency of the stent, and the patient was in good clinical conditions.
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Carriero A, Zimmermann EA, Busse B, Ager J, Ritchie RO, Shefelbine SJ. FRACTURE TOUGHNESS IN MURINE BONE: A NOVEL MULTISCALE INVESTIGATION. J Biomech 2012. [DOI: 10.1016/s0021-9290(12)70256-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Martellucci J, Naldini G, Carriero A. Sacral nerve modulation in the treatment of chronic pelvic pain. Int J Colorectal Dis 2012; 27:921-6. [PMID: 22203519 DOI: 10.1007/s00384-011-1394-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2011] [Indexed: 02/04/2023]
Abstract
BACKGROUND Chronic pelvic pain is a common condition that significantly compromises the quality of life of affected patients. Unfortunately, despite treatment procedures, the results are often ineffective and symptoms persist for years. For these reasons, the search for less aggressive treatment options with fewer negative consequences leading to minimally invasive techniques was conducted. OBJECTIVE The aim of the present study was to evaluate the efficacy of sacral nerve modulation in the treatment of chronic pelvic pain. Moreover, we aimed to identify potential predictors of positive results of sacral neuromodulation through the comparison between failed and successful patients. PATIENTS From January 2004 to December 2009, all consecutive patients suffering from chronic pelvic pain and tested for sacral nerve modulation in three pelvic floor dedicated centers were evaluated. Severity of symptoms were analyzed by a visual analog scale (VAS) RESULTS: Twenty-seven patients (2 males; mean age, 53 years) were tested for sacral nerve modulation in the screening period and were included in the present study. The mean duration of pain was 51 months (range, 10-132 months). The mean preoperative VAS was 7.8 (range, 5-10). Previous pelvic surgery was reported in 18 patients (66.5%). Sixteen patients (59%) fulfil the successful criteria and were definitively implanted. The mean follow-up was 37 months (range, 12-71 months). The mean preoperative VAS was 8.1 (range, 6-8) and decreased to 2.1 ± 1.2 at 6-month follow-up (p < 0.0001), to 2.1 ± 1.1 at 12 months (16 patients), to 2.0 ± 1.2 at 24 months (13 patients), to 2.3 ± 1.4 at 36 months (9 patients), to 2.1 ± 1.5 at 48 months (5 patients), and to 1.9 ± 1.3 at 60 months (3 patients). CONCLUSIONS Sacral neuromodulation proved to be effective in the treatment of some patients affected by chronic pelvic pain, and the effect persists over time. A positive screening phase and a positive response to gabapentin or pregabalin showed to be predictors of a successful response. Multiple localizations of pelvic pain and pain occurred after stapler surgery seem to be negative factors for the success of the treatment.
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Guzzardi G, Fossaceca R, Cerini P, Di Terlizzi M, Stanca C, Di Gesù I, Martino F, Brustia P, Carriero A. Endovascular treatment of popliteal artery aneurysms: preliminary results. Radiol Med 2012; 118:229-38. [DOI: 10.1007/s11547-012-0839-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Accepted: 09/07/2011] [Indexed: 10/28/2022]
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Carriero A, Zavatsky A, Stebbins J, Theologis T, Lenaerts G, Jonkers I, Shefelbine SJ. Influence of altered gait patterns on the hip joint contact forces. Comput Methods Biomech Biomed Engin 2012; 17:352-9. [PMID: 22587414 DOI: 10.1080/10255842.2012.683575] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Children who exhibit gait deviations often present a range of bone deformities, particularly at the proximal femur. Altered gait may affect bone growth and lead to deformities by exerting abnormal stresses on the developing bones. The objective of this study was to calculate variations in the hip joint contact forces with different gait patterns. Muscle and hip joint contact forces of four children with different walking characteristics were calculated using an inverse dynamic analysis and a static optimisation algorithm. Kinematic and kinetic analyses were based on a generic musculoskeletal model scaled down to accommodate the dimensions of each child. Results showed that for all the children with altered gaits both the orientation and magnitude of the hip joint contact force deviated from normal. The child with the most severe gait deviations had hip joint contact forces 30% greater than normal, most likely due to the increase in muscle forces required to sustain his crouched stance. Determining how altered gait affects joint loading may help in planning treatment strategies to preserve correct loading on the bone from a young age.
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Martellucci J, Naldini G, Del Popolo G, Carriero A. Sacral nerve modulation in the treatment of chronic pain after pelvic surgery. Colorectal Dis 2012; 14:502-7. [PMID: 21689334 DOI: 10.1111/j.1463-1318.2011.02659.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIM The aim of the study was to evaluate the efficacy of sacral nerve modulation for chronic pelvic pain after pelvic or anal surgery for benign disease. METHOD From January 2004 to December 2009, 17 (14 female; age 56 years) consecutive patients suffering from chronic pelvic pain underwent evaluation for sacral nerve modulation in three pelvic floor units. RESULTS The previous surgery included stapled transanal rectal resection (five), hysterectomy (four), haemorrhoidectomy (two), stapled haemorrhoidopexy (one), fistulectomy (one), urethral sphincterotomy (one), appendicectomy (one), discectomy (one) and laparoscopy for endometriosis (one). Eight (47%) patients fulfilled the criteria for definitive implantation and were followed for a mean of 39 months. Using a visual analog pain score, pain levels fell from 8.2 preoperatively to 1.9, 2.1, 2.0 and 1.8 at 6, 12, 24 and 36 months, respectively. Age < 60 years and duration of symptoms of < 24 months were good predictors and stapling was a poor predictor of success. CONCLUSION Sacral nerve modulation seems to be effective over time in some patients with chronic pain related to previous surgery.
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Fossaceca R, Guzzardi G, Di Terlizzi M, Divenuto I, Cerini P, Malatesta E, Di Gesù I, Stanca C, Brustia P, Carriero A. Long-term efficacy of endovascular treatment of isolated iliac artery aneurysms. Radiol Med 2012; 118:62-73. [PMID: 22430685 DOI: 10.1007/s11547-012-0813-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Accepted: 07/06/2011] [Indexed: 10/28/2022]
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Fossaceca R, Guzzardi G, Di Terlizzi M, Divenuto I, Malatesta E, Cerini P, Cusaro C, Carriero A. Comparison of cryoplasty and conventional angioplasty for treating stenotic-occlusive lesions of the femoropopliteal arteries in diabetic patients: immediate, mid-term and long-term results. Radiol Med 2012; 117:1176-89. [DOI: 10.1007/s11547-012-0793-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Accepted: 05/25/2011] [Indexed: 11/25/2022]
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Martellucci J, Talento P, Carriero A. Early complications after stapled transanal rectal resection performed using the Contour® Transtar™ device. Colorectal Dis 2011; 13:1428-31. [PMID: 20969712 DOI: 10.1111/j.1463-1318.2010.02466.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
AIM This study evaluated the early results (with particular reference to complications) of stapled transanal rectal resection (STARR) carried out using the CCS-30 Contour® Transtar™ device. The procedure was performed in a single centre on patients with obstucted defecation caused by rectocele or rectal intussusception. METHOD From July 2007 to February 2009, 133 patients were treated. Preoperatively, all underwent clinical examination, transanal ultrasonography, anorectal manometry and cinedefaecography. Obstructed defaecation syndrome was assessed using the Cleveland Clinic Constipation Score (CCC-S). Early postoperative complications and those occurring within 6 months were recorded. RESULTS The median follow-up period was 19 (range 12-30) months. The mean ± standard deviation preoperative CCC-S of 19.4 ± 7.1 decreased to 10.1 ± 9.0 postoperatively. The early complication rate was 15.7% and included rectovaginal fistula (n = 1), rectal perforation (n = 1), posterior dehiscence (n = 4), further surgery for retained staples (n = 2), postoperative bleeding (n = 2) and postoperative impaired continence (n = 11). CONCLUSIONS STARR using the Contour Transtar device seems to be effective for treating obstructed defaecation. However, serious complications may occur.
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Carriero A, Jonkers I, Shefelbine SJ. Mechanobiological prediction of proximal femoral deformities in children with cerebral palsy. Comput Methods Biomech Biomed Engin 2011; 14:253-62. [PMID: 20229379 DOI: 10.1080/10255841003682505] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Tondo F, Saponaro A, Stecco A, Lombardi M, Casadio C, Carriero A. Role of diffusion-weighted imaging in the differential diagnosis of benign and malignant lesions of the chest-mediastinum. Radiol Med 2011; 116:720-33. [PMID: 21293944 DOI: 10.1007/s11547-011-0629-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2010] [Accepted: 07/12/2010] [Indexed: 11/24/2022]
Abstract
PURPOSE We retrospectively evaluated the role of diffusion-weighted imaging (DWI) with fat and background signal suppression in the differential diagnosis of benign and malignant lesions of the chest-mediastinum by calculating the mean apparent diffusion coefficient (ADC) values. MATERIALS AND METHODS Thirty-four patients with lung nodules/mediastinal masses underwent magnetic resonance (MR) imaging of the chest with conventional and DWI sequences. All patients had been previously studied with computed tomography (CT). After magnetic resonance (MR) imaging the patients underwent transthoracic CT-guided biopsy or mediastinoscopy. After the histopathological diagnosis had been obtained, the lesions were retrospectively divided into five groups: adenocarcinomas (n=16), squamous cell carcinomas (n=12), chronic pneumonias (n=2), malignant mediastinal tumours (n=2) and typical carcinoids (n=2). We compared ADC values in the different lesion groups using the Mann-Whitney U test. RESULTS There were statistically significant differences (p<0.05) between ADC values of benign and malignant lesions. Using an ADC value of 1.25×10⁻³ mm²/s as a threshold, we were able to differentiate malignant from benign lesions with 91% diagnostic accuracy, 90% sensitivity, 100% specificity, 100% positive predictive value and 57% negative predictive value. CONCLUSIONS Short-tau inversion-recovery echo-planar imaging (STIR-EPI) sequences applied to the chest-mediastinum provided potentially useful images for the differential diagnosis of benign and malignant lesions.
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Brambilla M, Occhetta E, Ronconi M, Plebani L, Carriero A, Marino P. Reducing operator radiation exposure during cardiac resynchronization therapy. Europace 2010; 12:1769-73. [DOI: 10.1093/europace/euq356] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Morandi C, Martellucci J, Talento P, Carriero A. Role of enterocele in the obstructed defecation syndrome (ODS): a new radiological point of view. Colorectal Dis 2010; 12:810-6. [PMID: 19788492 DOI: 10.1111/j.1463-1318.2009.02050.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIM The aim of this study was to understand the role of enterocele in the pathogenesis of the obstructed defecation syndrome (ODS) a new defecographic classification based on function. METHOD A total of 597 patients (551 women, 46 men) who underwent cinedefecography between November 2001 and November 2005 were studied. A total of 567 (95%) underwent cinedefecography as they had symptoms of ODS. Enterocele was classified into three types. RESULTS Enterocele was found in 127 (23%) female and one (2.2%) male patients. Thirty-eight (6.9%) patients had type A, 38(6.9%) type B, and 27(4.9%) type C enterocele. A total of 24 patients (4.35%) had sigmoidocele. In patients with type C enterocele, the finding of a radiological pattern of ODS was higher (26/27) than that in the other groups (A + B + Sigmoidocele) (23/100) (P < 0.001). An obstructed evacuation pattern was found in 49 (38.5%) patients with enterocele and in 148 (34.9%) patients in the control group. CONCLUSION Type C enterocele is often associated with a radiological pattern of ODS and usually presents as an isolated condition. Type B is less frequently associated with ODS and is more frequently accompanied by other pathological conditions.
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Mazzini L, Ferrero I, Luparello V, Rustichelli D, Gunetti M, Mareschi K, Testa L, Stecco A, Tarletti R, Miglioretti M, Fava E, Nasuelli N, Cisari C, Massara M, Vercelli R, Oggioni GD, Carriero A, Cantello R, Monaco F, Fagioli F. Mesenchymal stem cell transplantation in amyotrophic lateral sclerosis: A Phase I clinical trial. Exp Neurol 2009; 223:229-37. [PMID: 19682989 DOI: 10.1016/j.expneurol.2009.08.007] [Citation(s) in RCA: 294] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2009] [Revised: 07/31/2009] [Accepted: 08/02/2009] [Indexed: 01/01/2023]
Abstract
Amyotrophic Lateral Sclerosis (ALS) is a devastating incurable disease. Stem-cell-based therapies represent a new possible strategy for ALS clinical research. The objectives of this Phase 1 clinical study were to assess the feasibility and toxicity of mesenchymal stem cell transplantation and to test the impact of a cell therapy in ALS patients. The trial was approved and monitored by the National Institute of Health and by the Ethics Committees of all participating Institutions. Autologous MSCs were isolated from bone marrow, expanded in vitro and analyzed according to GMP conditions. Expanded MSCs were suspended in the autologous cerebrospinal fluid (CSF) and directly transplanted into the spinal cord at a high thoracic level with a surgical procedure. Ten ALS patients were enrolled and regularly monitored before and after transplantation by clinical, psychological, neuroradiological and neurophysiological assessments. There was no immediate or delayed transplant-related toxicity. Clinical, laboratory, and radiographic evaluations of the patients showed no serious transplant-related adverse events. Magnetic resonance images (MRI) showed no structural changes (including tumor formation) in either the brain or the spinal cord. However the lack of post mortem material prevents any definitive conclusion about the vitality of the MSCs after transplantation. In conclusion, this study confirms that MSC transplantation into the spinal cord of ALS patients is safe and that MSCs might have a clinical use for future ALS cell based clinical trials.
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Stecco A, Volpe D, Volpe N, Fornara P, Castagna A, Carriero A. Virtual MR arthroscopy of the shoulder: image gallery with arthroscopic correlation of major pathologies in shoulder instability. J Orthop Traumatol 2009; 9:187-93. [PMID: 19384484 PMCID: PMC2657334 DOI: 10.1007/s10195-008-0027-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2007] [Accepted: 08/19/2008] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The purpose of this study was to compare virtual MR arthroscopic reconstructions with arthroscopic images in patients affected by shoulder joint instability. MR arthrography (MR-AR) of the shoulder is now a well-assessed technique, based on the injection of a contrast medium solution, which fills the articular space and finds its way between the rotator cuff (RC) and the glenohumeral ligaments. In patients with glenolabral pathology, we used an additional sequence that provided virtual arthroscopy (VA) post-processed views, which completed the MR evaluation of shoulder pathology. MATERIALS AND METHODS We enrolled 36 patients, from whom MR arthrographic sequence data (SE T1w and GRE T1 FAT SAT) were obtained using a GE 0.5 T Signa--before any surgical or arthroscopic planned treatment; the protocol included a supplemental 3D, spoiled GE T1w positioned in the coronal plane. Dedicated software loaded on a work-station was used to elaborate VAs. Two radiologists evaluated, on a semiquantitative scale, the visibility of the principal anatomic structures, and then, in consensus, the pathology emerging from the VA images. RESULTS These images were reconstructed in all patients, except one. The visualization of all anatomical structures was acceptable. VA and MR arthrographic images were fairly concordant with intraoperative findings. CONCLUSIONS Although in our pilot study the VA findings did not change the surgical planning, the results showed concordance with the surgical or arthroscopic images.
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Scarabino T, Popolizio T, Tosetti M, Montanaro D, Giannatempo GM, Terlizzi R, Pollice S, Maiorana A, Maggialetti N, Carriero A, Leuzzi V, Salvolini U. Phenylketonuria: white-matter changes assessed by 3.0-T magnetic resonance (MR) imaging, MR spectroscopy and MR diffusion. Radiol Med 2009; 114:461-74. [PMID: 19277839 DOI: 10.1007/s11547-009-0365-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2008] [Accepted: 10/06/2008] [Indexed: 12/13/2022]
Abstract
PURPOSE This study evaluated the sensitivity of a 3.0-Tesla (T) magnetic resonance imaging (MRI) in measuring cerebral phenylalanine using proton magnetic resonance spectroscopy and in assessing MR-documented white-matter changes by means of diffusion studies (diffusion-weighted imaging, apparent diffusion coefficient map; diffusion tensor imaging) in patients with phenylketonuria. MATERIALS AND METHODS Thirty-two patients with the classical clinical and biochemical deficits of phenylketonuria underwent biochemical (blood phenylalanine), genotypic (phenylalanine hydroxylase gene) and radiological investigation by means of MRI, proton magnetic resonance spectroscopy and diffusion magnetic resonance imaging with a 3.0-T scanner. RESULTS Periventricular and subcortical white-matter changes were detected on all MR scans. In 29/32 patients, proton magnetic resonance spectroscopy easily documented abnormal signal elevation at 7.36 ppm, corresponding to phenylalanine, despite its low concentration. Phenylalanine signal amplitude relative to the creatine/phosphocreatine signal increased linearly with blood phenylalanine values (r 0.7067; p<0.001). Diffusion MRI demonstrated hyperintensity in the areas exhibiting MRI changes as well as decreased apparent diffusion coefficient values, but fractional anisotropy indices were normal. CONCLUSIONS The high signal, together with better spectral, spatial, contrast and temporal resolution, makes the 3.0-T MR the most suitable technique in the study of the phenylketonuria. In particular, the multimodal approach with MRI, proton magnetic resonance spectroscopy and diffusion magnetic resonance imaging can provide more information than previous studies performed with low-field systems.
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Carriero A, Zavatsky A, Stebbins J, Theologis T, Shefelbine SJ. Determination of gait patterns in children with spastic diplegic cerebral palsy using principal components. Gait Posture 2009; 29:71-5. [PMID: 18676146 DOI: 10.1016/j.gaitpost.2008.06.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2007] [Revised: 05/21/2008] [Accepted: 06/24/2008] [Indexed: 02/02/2023]
Abstract
This study developed an objective graphical classification method of spastic diplegic cerebral palsy (CP) gait patterns based on principal component analysis (PCA). Gait analyses of 20 healthy and 20 spastic diplegic CP children were examined to define gait characteristics. PCA was used to reduce the dimensionality of 27 parameters (26 selected kinematics variables and age of the children) for the 40 subjects in order to identify the dominant variability in the data. Fuzzy C-mean cluster analysis was performed plotting the first three principal components, which accounted for 61% of the total variability. Results indicated that only the healthy children formed a distinct cluster; however it was possible to recognise gait patterns in overlapping clusters in children with spastic diplegia. This study demonstrates that it is possible to quantitatively classify gait types in CP using PCA. Graphical classification of gait types could assist in clinical evaluation of the children and serve as a validation of clinical reports as well as aid treatment planning.
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Di Costanzo A, Pollice S, Trojsi F, Giannatempo GM, Popolizio T, Canalis L, Armillotta M, Maggialetti A, Carriero A, Tedeschi G, Scarabino T. Role of perfusion-weighted imaging at 3 Tesla in the assessment of malignancy of cerebral gliomas. LA RADIOLOGIA MEDICA 2008; 113:134-43. [DOI: 10.1007/s11547-008-0232-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2006] [Accepted: 04/04/2007] [Indexed: 11/29/2022]
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