Significant chronic airway abnormalities in never-smoking HIV-infected patients.

OBJECTIVES: The aim of the study was to describe chronic lung disease in HIV-infected never-smokers by looking at clinical, structural and functional abnormalities. METHODS: This comparative cross-sectional study included 159 HIV-infected never-smoking patients [mean (± standard deviation) age 54.6 ± 9.1 years; 13.2% female; 98.1% with undetectable viral load] and 75 nonmatched never-smoking controls [mean (± standard deviation) age 52.6 ± 6.9 years; 46.7% female]. We examined calcium scoring computer tomography (CT) scans or chest CT scans, all with a lung-dedicated algorithm reconstruction, to assess emphysema and airway disease (respiratory bronchiolitis and/or bronchial wall thickening), tested pulmonary function using spirometry, lung volumes and the diffusion lung capacity of carbon monoxide (DLCO), and assessed respiratory symptoms using the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT). RESULTS: Twenty-five (17.2%) of the HIV-infected patients versus two (2.7%) of the controls had a CAT score > 10. Only 5% of the HIV-infected patients showed FEV1% < 80%, and 25% had DLCO < 75% of the predicted value. Based on the CT scans, they had increased prevalences, compared with the controls, of airway disease (37% versus 7.9%, respectively) and emphysema (18% versus 4%, respectively), with more severe and more frequent centrilobular disease. After correction for age, sex and clinical factors, HIV infection was significantly associated with CAT > 10 [odds ratio (OR) 7.7], emphysema (OR 4), airway disease (OR 4.5) and DLCO < 75% of predicted (OR 4). CONCLUSIONS: Although comparisons were limited by the different enrolment methods used for HIV-infected patients and controls, the results suggest that never-smoking HIV-infected patients may present with chronic lung damage characterized by CT evidence of airway disease. A minority of them showed respiratory symptoms, without significant functional abnormalities.

Independent association of subclinical coronary artery disease and emphysema in HIV-infected patients.

OBJECTIVES: Chronic obstructive pulmonary disease (COPD) and coronary artery disease are inflammatory states with a significant clinical impact. The relationship between them has not been investigated in patients with HIV infection. We assessed the presence of subclinical emphysema and coronary artery disease using chest computed tomography (CT) imaging in a cohort of HIV-infected patients receiving antiretroviral therapy. METHODS: Gated chest CT scans were performed in 1446 consecutive patients to assess the presence and severity of coronary artery calcium (CAC) (classified as a score of 0, 1-100 or > 100) and emphysema (classified using a visual semiquantitative scale: 0, absent; 1-4, mild to moderate; > 4, severe). Univariable and multivariable logistic regression analyses were performed to identify factors independently associated with CAC and emphysema. RESULTS: The emphysema score was significantly higher in patients with CAC scores of 1-100 and > 100 compared with those with a CAC score of 0. After adjustments for age, sex, smoking status, pack-years of smoking, visceral adiposity and duration of HIV infection, the presence of any emphysema was significantly associated with a CAC score > 0 [odds ratio (OR) 1.43; 95% confidence interval (CI) 1.08-1.88; P = 0.012]. The association persisted after adjustment for the Framingham risk score (OR 1.52; 95% CI 1.16-1.99; P = 0.002). There was a dose-dependent effect in the association between emphysema score and CAC score. CONCLUSIONS: In this cross-sectional study of HIV-infected patients, there was an independent association between emphysema and CAC, after adjustment for traditional cardiovascular risk factors, suggesting a common pathogenesis of these chronic inflammatory conditions in a chronic inflammatory disease such as HIV infection.

Subjective symptoms and their evolution in a small group of magnetic resonance imaging (MRI) operators recently engaged.

Using a specific questionnaire, we examined subjective symptoms in a group of 17 physicians (9 males and 8 females, mean age 32.9 ± 3.71), attending a Postgraduate Medical School in Radiology and engaged in MRI for less than 1 year. Sixteen subjects (94%) reported the presence of at least one of the investigated symptoms during the period of MRI activity. The main symptoms were: unusual drowsiness/tiredness (88%), concentration problems (82%), headaches (76%), sleep disorders (47%), nausea (47%), illusion of movement (47%) and dizziness/vertigo (35%); the former two were subjectively related to MRI by the majority of the operators. These symptoms appeared (or worsened) in more than 15 min and, in the vast majority disappeared 30 min, or more, after the end of exposure. In 13 subjects (81%), the symptom (or some symptoms) appeared at least weekly. In this small group of health care workers recently exposed to MRI, the prevalence of subjective symptoms was higher than reported in other similar studies but, notably, the majority of subjects (77%) reported a regression within 4-8 weeks, suggesting some form of adaptation.

[Clinical indications for the use of cardiac MRI. By the SIRM Study Group on Cardiac Imaging]. / Indicazioni cliniche per l'utilizzo della cardio RM. A cura del Gruppo di lavoro della Sezione di Cardio-Radiologia della SIRM.

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.

Role of diffusion-weighted magnetic resonance imaging in prostate cancer evaluation.

PURPOSE: The authors analysed the role of diffusion-weighted imaging (DWI) as an additional tool in magnetic resonance (MR) evaluation of prostate cancer. MATERIALS AND METHODS: Forty-one patients with suspected prostate cancer underwent MR imaging (1.5 Tesla). A DWI sequence was added to the standard morphological protocol, with a maximum b value of 1,000 s/mm(2). Diffusion maps were obtained, and the apparent diffusion coefficient (ADC) was calculated by drawing a region of interest (ROI) over healthy tissue and areas suspicious for malignancy. Histology was considered the gold standard. RESULTS: The areas correctly classified by MR imaging (42/51) had a low signal intensity on T2-weighted imaging and low ADC value (0.99 ± 0.15 mm(2)/s; p<0.01) compared with the healthy peripheral zone (PZ) (1.73 ± 0.27 mm(2)/s; p<0.01). Nine areas classified as suspicious for malignancy on T2-weighted sequences showed high ADC (1.44 ± 0.06 mm(2)/s; p<0.01) and were confirmed to be disease free by subsequent histological examination. The accuracy of morphofunctional MR imaging was 81.6% compared with 73.7% of the morphological analysis alone. CONCLUSIONS: The addition of DWI to the standard protocol increases the overall diagnostic performance of MR imaging in detecting prostatic cancer. Thus, DWI can help the clinician determine the most appropriate management strategy for the patient.

Clinical indications for cardiac computed tomography. From the Working Group of the Cardiac Radiology Section of the Italian Society of Medical Radiology (SIRM).

Cardiac computed tomography (CCT) has grown as a useful means in different clinical contexts. Technological development has progressively extended the indications for CCT while reducing the required radiation dose. Even today there is little documentation from the main international scientific societies describing the proper use and clinical indications of CCT; in particular, there are no complete guidelines. This document reflects the position of the Working Group of the Cardiac Radiology Section of the Italian Society of Radiology concerning the indications for CCT.

Contrast-enhanced MRI and PET-CT in the evaluation of patients with suspected local recurrence of rectal carcinoma.

PURPOSE: This study aimed to evaluate the role of contrast-enhanced magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) in the assessment of local recurrence of rectal cancer. MATERIALS AND METHODS: Among 200 patients scheduled for CT follow-up, 60 (48 low risk; 12 high risk) were selected due to CT findings suspicious for or suggestive of local recurrence. Patients underwent contrast-enhanced MRI and PET-CT within 2 weeks. Biopsy was considered the gold standard in 39 cases and follow-up at 6 and 12 months in the remaining 21. RESULTS: Local recurrence was confirmed by histology in 15 cases (7 low risk; 8 high risk) and was excluded in 21 cases by long-term follow-up and in 24 by histology. Sensitivity, specificity, positive and negative predictive value and accuracy were 86.7%, 68.9%, 48.1%, 93.9% and 73.3% for contrast-enhanced MRI and 93.3%, 68.9%, 50%, 96.9% and 75% for PET-CT. CONCLUSIONS: Contrast-enhanced MRI and PET-CT can help in the detection of local recurrence of rectal cancer, even though their roles in early detection remains debatable, as the value of these techniques in current surveillance protocols is still to be defined.

Rhodococcus equi Pneumonia in Kidney Transplant Recipient Affected by Acute Intermittent Porphyria: A Case Report.

Rhodococcus equi is a gram-positive coccobacillus responsible for severe infections in patients with weakened immune systems. R equi generally causes pnumonia that may evolve into fatal systemic infection if left untreated. Here, we present a case of a 67-year-old woman affected by acute intermittent porphyria (AIP) who developed R equi pneumonia 7 months after kidney transplantation. Although clinical features at presentation were nonspecific, lung computed tomography showed right perihilar consolidation with a mass-like appearance causing bronchial obstruction. Appropriate antibiotic including intravenous meropenem and oral azithromycin that was then switched to oral levofloxacin and oral azithromycin along with reduction of immunosuppressive therapy resolved pneumonia without provoking an acute attack of porphyria. AIP limited the choice of antibiotics for the treatment of R equi infection because some potentially porphyrinogenic antibacterial agents were avoided. Based on this experience, azithromycin and meropenem can be safely administered for the treatment of R Equi infection in patients with AIP.

[Dyslipidemia and the risk of kidney disease]. / Dislipidemia e rischio nella patologia renale.

An abnormal lipid profile is very frequent in patients with kidney disease due to the well-known nephrotoxicity of lipids. During progression of chronic kidney disease, the excretion of triglycerides, LDL and proteins increases while the glomerular filtration rate declines. Blood lipoproteins and lipids are modulated depending on the type of treatment: hemodialysis, CAPD or renal transplant. We analyzed many studies on dyslipidemia in patients with kidney disease by comparing different therapies. The use of statins reduces protein excretion and hyperlipidemia as well as progression of chronic renal failure with a direct effect on mesangial cell proliferation. A decrease in total cholesterol and LDL occurs in hemodialysis patients, a decrease in LDL and an increase in HDL occur in CAPD patients, and a decrease in LDL and triglycerides is observed in renal transplant recipients; in the latter, graft survival increases without there being any relevant correlation with immunosuppressive treatment. In conclusion, we found that statins are useful to contrast the progression of chronic kidney disease and atherosclerosis in hemodialysis and CAPD patients and to reduce chronic allograft nephropathy in renal transplant recipients.

Os acromiale: frequency and a review of 726 shoulder MRI.

Os acromiale consist in a lack of fusion between the different ossification spots of the acromial side of scapula from the age of 23-25 years. A relation between os acromiale and some shoulder pathology like impingement syndrome, cuff tear and subacromial bursitis has been described. The etiology is not already known. The aim of this study was to evaluate the frequency of os acromiale in our population, the link between os acromiale and sex, side and shoulder pathology. 1042 shoulder MRI were evaluated to find out os acromiale and the linked cuff pathology. In our population, the frequency of os acromiale was 3.44% without differences between sexes, with prevalence on the right shoulder. No differences in cuff and bursa pathology were present between affected and unaffected subjects. Os acromiale is an anomaly still underdiagnosed. It is important to be recognized because it allows to make an accurate pre-surgical plan. To make a correct diagnosis, axial MRI cut or TC is necessary.

Coronary calcification in cardiovascular risk stratification.

The correlation between coronary calcifications and subclinical atherosclerotic disease has been well known for some years now. Today we are able to quantify coronary calcium deposits, the calcium score, by means of new imaging techniques such as electron beam computed tomography and multislice spiral computed tomography. A large number of studies performed using these methods has confirmed the association between coronary calcifications and atherosclerotic disease and has opened up the possibility of early diagnosis of any subclinical atherosclerotic disease in various subpopulations such as diabetics and nephropatics. The etiopathogenesis of coronary calcium has not yet been made clear; it appears to be an active process similar to bone formation that involves cells similar to those involved in the reabsorption of bone matrix. The calcium score, therefore, provides physicians with a further diagnostic tool able to better determine cardiovascular risk patients and supplements the Framingham risk score. International guidelines have not yet illustrated with any precision in which ambits to apply screening for the quantification of coronary calcium and consequently, for the time being, the use of such methods must be restricted to cases in which the possibility of any benefit can be scientifically shown. This review represents the state of the art on coronary calcification and its role in clinical practice.

A functionally active RARalpha nuclear receptor is expressed in retinoic acid non responsive early myeloblastic cell lines.

Although all-trans retinoic acid (ATRA) can restore the differentiation capacity of leukemic promyelocytes, early leukemic myeloblasts are conversely not responsive to ATRA induced granulocytic differentiation. To assess whether this resistance to ATRA is related to an impaired function of the Retinoic Acid Receptor alpha (RARalpha), we performed an analysis of RARalpha expression and transactivation activity, in several myeloid leukemic cell lines, representative of different types of spontaneous acute myeloid leukemias. Our results indicate that a functionally active RARalpha nuclear receptor is expressed in all the analyzed cell lines, regardless of their differentiation capacity following exposure to ATRA. The observation that ATRA treatment is able to induce the expression of retinoic acid target genes, in late- but not in early-myeloblastic leukemic cells, raises the possibility that the differentiation block of these cells is achieved through a chromatin mediated mechanism. Acetylation is apparently not involved in this process, since the histone deacetylase inhibitor trichostatin A, is not able to restore the differentiation capacity of early leukemic myeloblasts. Further investigation is needed to clarify whether myeloid transcription factors, distinct to RARalpha, play a role in the resistance of these cells to ATRA treatment.

p-Cresol and Cardiovascular Risk in Kidney Transplant Recipients.

p-Cresol Sulphate (pCS) is a uremic toxin that originates exclusively from dietary sources and has a high plasma level related to chronic kidney disease (CKD) and cardiovascular disease (CVD). The aim of our study was to evaluate the plasma levels of pCS in kidney transplant recipients (KTRs) related to estimated glomerular filtration rate (eGFR), traditional risk factors, cardiovascular clinical events and endothelial progenitor cells (EPCs), bone marrow-derived cells for the vascular repair system. We considered 51 KTRs and 25 healthy blood donors (HBDs). pCs levels were analyzed using high-performance liquid chromatography (HPLC) coupled with mass spectrometry with an electrospray ionization (ESI) (LC/ESI-MS/MS) on a triple-quadrupole; EPCs were analyzed using flow cytometric analysis. eGFR was 52.61 ± 19.9 mL/min/1.73 m(2) in KTRs versus 94 ± 21 mL/min/1.73 m(2) in HBDs. We did not find differences in pCS levels between KTRs and HBDs. Levels of pCS were inversely related with eGFR in KTRs and pCS levels were significantly lower in KTRs with eGFR <30 mL/min/1.73 m(2) versus eGFR >30 mL/min/1.73 m(2). Furthermore, there was a difference in pCS levels between eGFR <30 mL/min/1.73 m(2) of KTRs compared with HBDs. Levels of pCS were almost significantly influenced by the presence of a previous vascular event and were inversely related with mature EPCs. These findings suggest that KTRs should not have higher CVD risk than HBDs and their physiological vascular repair system appears to be intact. In KTRs the reduction of eGFR also increased pCS levels and reduced EPCs numbers and angiogenesis capacity. In summary, pCS acts as an emerging marker of a uremic state, helping assess the global vascular competence in KTRs.

Did Columbus also open the exploration of the modern diet?

On the 500th anniversary of Columbus's voyage of discovery, one aspect that merits particular attention is its influence on food and nutrition worldwide. Columbus found an unexpected wealth in food resources rather than the gold he sought. The sailors came from a continent where famine was well known and had subsisted for two months on a typical seamen's diet of preserved foods, primarily hardtack and salt pork. They made landfall in green and fertile islands. The foods that constituted the core of the diet of the Americas before 1492--from maize to potatoes, beans to tomatoes, to numerous other fruits and vegetables--became the true patrimony that the inhabitants of the New World bequeathed to humanity. These foods, new to the Old World, provided the basis for the exchange and evolution of networks of food production and consumption which, with many trials and errors and with no preestablished plan, characterize modern nutrition. The diet of Mediterranean countries, now universally recommended for nutritional health, is high in several foods, tomatoes and beans in particular, that originated in the New World.

In vivo 3 T MR diffusion tensor imaging for detection of the fibre architecture of the human uterus: a feasibility and quantitative study.

OBJECTIVE: The aim of this study was to investigate the feasibility of depicting fibre architecture of human uteri in vivo using 3 T MR diffusion tensor imaging (MR-DTI) with a three-dimensional (3D) tractography approach. Quantitative results were provided. METHODS: In vivo 3 T MR-DTI was performed on 30 volunteers (9 Caesarean delivery). Main diffusion directions reflecting the fibre orientation were determined using sensitivity-encoding single-shot echo planar imaging with diffusion-sensitised gradients (b=600 mm(2) s(-1)) along 32 directions. A deterministic fibre-tracking algorithm was used to show in vivo fibre architecture, compared with ex vivo histological slides of cadaveric uteri. The number of fibres, the fibre density, the fractional anisotropy (FA) and the apparent diffusion coefficient (ADC) were measured in 13 volunteers. RESULTS: Anisotropy was found in most regions of normal uteri and the preferential order of uterine fibres depicted, consisting of two representative fibre directions: circular and longitudinal, as in ex vivo studies. Two-thirds of uteri with a Caesarean scar did not have the same orientation of fibres in the anterior isthmus when compared with non-scarred myometrium. Quantitative data were obtained from 13 volunteers: Caesarean-scarred uteri (n=5) showed lower fibre number and density in the scarred anterior isthmus than the nulliparous uteri (n=8). No significant differences were found in FA (0.42 ± 0.02, 0.41 ± 0.02; p=0.25) and ADC (1.82 ± 0.18 × 10(-3) mm(2) s(-1), 1.93 ± 0.25 × 10(-3) mm(2) s(-1); p=0.20). CONCLUSION: Fibre architecture of the human uterus can be depicted in vivo using 3 T MR-DTI. Advances in knowledge 3 T MR-DTI can help to provide an in vivo insight of uterine anatomy non-invasively, especially in females with previous Caesarean surgery, in order to provide better management of subsequent deliveries.

Chronic total coronary occlusion in patients with intermediate viability: value of low-dose dobutamine and contrast-enhanced 3-T MRI in predicting functional recovery in patients undergoing percutaneous revascularisation with drug-eluting stent.

PURPOSE: Myocardial viability was evaluated by magnetic resonance imaging (MRI) in patients with chronic total coronary occlusion (CTO) treated with a drug-eluting stent. Change in left ventricular ejection fraction (LVEF) was analysed. MATERIALS AND METHODS: Twenty-three patients with CTO underwent delayed-enhancement (DE) and low-dose dobutamine MRI (LD). Diastolic wall thickness (DWT), dobutamine-induced systolic wall thickening (SWT) and DE transmural extension were quantitatively assessed in vessel-related segments, calculating the contribution of viable tissue to SWT, expressed as viability index (VI)=[SWTx(100 - DE)]/100. Patients with transmural enhancement were excluded from revascularisation. At 6 months follow-up, patients underwent coronary angiography (CA) and MRI. Functional recovery was defined as a 2-mm increase in SWT. RESULTS: Transmural enhancement (mean DE 62.88+/-37.18] was present in three patients. Mean DWT, SWT, VI and DE of recanalised patients were 8.03+/-2.35, 2.64+/-1.56, 1.77+/-1.48 mm and 41.97+/-30.32. Revascularisation was successful in 14/16. Follow-up CA showed patency of treated vessels. Functional recovery was achieved in 13 patients. Functional recovery showed significant correlation with SWT (beta 1,779, p=0.015), and even higher correlation with VI (beta 2.032, p=0.011). LVEF improved significantly [Delta 95% confidence interval (CI) -4.47, p=0.0203). CONCLUSIONS: Invasive CTO treatment has beneficial effects on myocardial contractility that can be predicted by VI, and on LVEF.

3-Tesla MRI for the evaluation of myocardial viability: a comparative study with 1.5-Tesla MRI.

PURPOSE: We compared 3-Tesla (3-T) and 1.5-Tesla (1.5-T) cardiac magnetic resonance imaging (MRI) for the assessment of myocardial viability in nearly identical experimental conditions. MATERIALS AND METHODS: Thirty-five patients (mean age 63+/-11; 94.2% men) submitted to primary coronary angioplasty underwent both 3-T and 1.5-T cardiac MRI, which was considered the gold standard. Comparison was performed on the basis of the same viability imaging protocol, which included resting cine-MR [balanced fast-field echo (B-FFE) sequence] followed by contrast-enhanced MR to evaluate perfusion and delayed enhancement (DE). We then performed functional index measurements and visual estimation of kinesis, perfusion and DE referring to a 5-point scale. Image quality was assessed on the basis of signal to noise ratio (SNR) and contrast to noise ratio (CNR). RESULTS: We found nonsignificant differences between the two scanners (P=NS) in measuring the functional and viability parameters. Myocardial SNR was significantly higher with 3-T MRI compared with 1.5-T MRI (61.3% gain). Even though a loss of CNR was recorded in B-FFE and in first-pass perfusion sequences (12.4% and 23.7%, respectively), on DE images, we quantified the increase of SNR and CNR of infarction of 387.8% and 330%, respectively. CONCLUSIONS: We found that 3-T MRI showed high concordance with 1.5-T MRI in the evaluation of functional and viability parameters and provided better evidence of damaged myocardium.

How to quantify infarct size on delayed-enhancement MR images: a comparison between visual and quantitative approach.

PURPOSE: Our aim was to evaluate the reliability of visual quantification of infarct extent on delayed enhanced magnetic resonance images. MATERIALS AND METHODS: Eighty patients with previous myocardial infarction underwent cine and contrast-enhanced cardiac magnetic resonance imaging. The gadolinium-enhanced images were evaluated using a segmental model with two different methods: a visual score on a 5-point scale (0 no hyperenhancement, 4 hyperenhancement>76% of myocardial wall) and a quantitative analysis based on the manual tracing of infarct contours with automatic threshold analysis. Each segment was also assigned a wall-motion score ranging from 0 (normokinesia) to 4 (dyskinesia). Statistical evaluation was performed. RESULTS: Out of 1,280 segments, 322 (25.1%) showed wall-motion abnormalities with enhancement in 327 (25.5%) evaluated with visual score and in 414 (32.3%) quantitatively. Among segments with normal or mild hypokinesia, 89.2% had a delayed-enhancement scoreor=3. Mean time required for the visual and quantitative approach was 7+/-3 and 18+/-9 min, respectively. There was strong agreement between the visual and quantitative method (k=0.92; p<0.01). CONCLUSIONS: Visual analysis of delayed enhancement is a timesaving approach that is sufficient to assess the transmural extent of infarction. Moreover, it has high correlation with wall-motion abnormalities.

Reconstructed urinary bladder following radical cystectomy for bladder cancer. Multidetector CT evaluation of normal findings and complications.

PURPOSE: The aim of this paper is to report the normal and pathological multidetector computed tomography (MDCT) findings in the morphofunctional evaluation of the orthotopic ileal reservoir in patients treated with radical cystectomy for transitional cell carcinoma. MATERIALS AND METHODS: During a clinical and imaging follow-up of 43 months, 30 patients (27 men and three women) with prior cystectomy and urinary reconstruction with an orthotopic ileal neobladder [six Studer and 24 Paduan Ileal Bladder (VIP)] underwent multislice CT scan with multiplanar reconstruction (MPR), volume rendering and virtual endoscopic evaluation of the contrast-filled neobladder. The following CT data were considered: neobladder position within the pelvis, neobladder capacity, sphericity index, vesico-urethral angle, vesico-ureteral reflux, pseudo-diverticular herniation, visualisation of ileal folds and parietal thickness. The CT scan results were correlated with those of the urodynamic assessment (uroflowmetry and entero-cystometry). RESULTS: Right-sided dislocation was observed in 12/30 neobladders (six VIP and six Studer); mean capacity was around 254 ml; six VIP were spherical whereas the others were oval. The vesico-urethral angle was less than 90 degrees in five patients (normal range: 90 degrees-170 degrees). One patient had grade-3 unilateral, passive, vesico-ureteral reflux and nine patients had active or passive bilateral reflux. One patient had pseudo-diverticular herniation. The ileal folds in the afferent limb of the neobladder could be visualised in all six patients with Studer neobladders. Mean parietal thickness was 3.59 mm (SD 1.34 mm). Increased endoluminal pressure, evaluated by uroflowmetry, was associated with lateralisation of the new reservoir during straining in nine patients, with decreased neobladder capacity in six patients, vesico-ureteral reflux in five patients and pseudo-diverticular herniation in one case. Decreased urinary flow was correlated with vesico-urethral angle less than 90 degrees in four patients and with low sphericity index in five patients. No significant correlation was found between parietal thickness, presence of ileal folds and urodynamic data. Absorbed dose due to the two additional scans of our CT protocol was 10 mSv for 4-row CT and 15 mSv for 16-row CT. CONCLUSIONS: MDCT of the contrast-filled neobladder is useful for the morphological and, in part, functional evaluation of the neobladder during postoperative follow-up and helps detect surgical complications. Radiation protection concerns do not, however, support the routine use of the method, even if the MDCT data are in part correlated to the urodynamic data and may in many cases provide a morphological explanation to the presence of functional alterations.