Brain apparent diffusion coefficient evaluation in pediatric patients with neurofibromatosis type 1.

OBJECTIVE: The most frequent intracranial appearance in children with neurofibromatosis type 1 (NF1) is represented by the presence of hyperintense lesions on T2-weighted images, the so-called "unidentified bright objects" (UBOs). Di Paolo demonstrated that these lesions represent foci of myelin vacuolization with increased water content. The aim of this study was to investigate the isotropic apparent diffusion coefficient (ADC) values within the UBOs and normal-appearing brain and at the regressed UBO sites. METHODS: Fifteen consecutive children with NF1 underwent magnetic resonance diffusion evaluation of the brain. Fifteen healthy age- and sex-matched children constituted the control group. Apparent diffusion coefficient maps were obtained, and regions of interest were placed bilaterally in 8 different areas. Two cortical areas were evaluated using single-pixel analysis. Apparent diffusion coefficient values within the UBOs were calculated by using irregular regions of interest. Regressed UBO sites were investigated by using circular regions of interest. Apparent diffusion coefficient values within the different areas were compared using a t test. RESULTS: Compared with the controls, NF1 patients showed higher ADC values (P < 0.001) in all locations. In the NF1 group, the mean ADC value in the UBOs was higher than in other locations (P < 0.001). The mean ADC value within the regressed UBO sites was higher than in the normal-appearing locations (P < 0.001). CONCLUSIONS: The higher ADC values in children with NF1 suggest an increase in water content of the normal-appearing brain. The UBOs are the areas with the highest water content. The regressed UBOs sites show higher water content than the normal-appearing areas.

[Diffuse, micronodular lung disease. The high-resolution CT approach. A pictorial essay].

Careful HRCT evaluation of the preferential distribution of micronodular lesions within the secondary lobule provides a fundamental contribution in the correct interpretation of the different associated patterns. This paper suggests a modern diagnostic algorithm that, together with clinical-anamnestic data and additional imaging features, is able to provide a definitive diagnosis or to reduce the possible differential diagnoses.

Diagnostic imaging of diffuse infiltrative disease of the lung.

Plain chest radiography remains the first diagnostic approach to diffuse infiltrative lung disease but has limited diagnostic sensitivity and specificity. Many diseases remain occult or are not correctly assessed using chest X-ray, appearing as a nonspecific 'reticulonodular pattern'. High-resolution CT (HRCT) is actually the recommended imaging technique in the diagnosis, assessment, and follow-up of these diseases, allowing also the evaluation of the effectiveness of the medical therapy and the selection of the type and the location of the biopsy when required. Appropriate techniques must be used to acquire high-quality HRCT scans, with the thin collimation and high spatial reconstruction algorithm being the most important factors. A nodular pattern, linear and reticular opacities, cystic lesions, ground-glass opacities and consolidations are the most common HRCT patterns of diffuse infiltrative lung disease. This article reviews the role of chest radiography and HRCT in the diagnosis and assessment of these diseases, the technical aspects of HRCT, its clinical indications and the radiological pattern of the most common types of chronic diffuse infiltrative lung disease.

Diagnostic applications of cardiac multislice CT with sixteen-row scanner: state of the art.

Coronary angiography is nowadays the diagnostic standard in the evaluation of coronary artery anatomy, in the identification of stenoses and in the follow-up of revascularization procedures (PTCA-stenting, bypass). The limitations of such technique in terms of invasivity and high cost has targeted research efforts towards the development of non invasive diagnostic tools. Technological evolution in the field of helical CT has provided 2, 4, 8 and 16 detector-row multislice scanners characterized by progressive improvements in terms of spatial and temporal resolution that have made them increasingly suitable for the analysis of moving structures with high quality anatomic detail. The main cardiologic applications of multislice CT include coronary calcium scoring, the evaluation of coronary vascular anatomy and disease, follow-up of revascularization procedures (stenting, bypass), and the evaluation of cardiac walls and chambers. The aim of this paper is to describe the applications of sixteen detector-row multisclice CT in non invasive evaluation of cardiac and coronary diseases.

Diabetes mellitus: CT findings of unusual complications related to the disease: a pictorial essay.

Diabetes mellitus is a common multisystemic disorder with serious effects on the gastrointestinal tract, genitourinary system and soft tissues. The long-term effects of diabetes are mainly related to macro- and microvascular disease, neuropathy, both autonomic and somatic, and to an increased susceptibility to infections, which generally develop 15-20 years after the appearance of overt hyperglycemia. Herein, we discuss the unusual long-term complications related to the disease that can display a characteristic CT pattern. CT, together with clinical findings, proved useful in the identification and characterization of such unusual pictures. Knowledge of the specific pathology and imaging features of unusual late effects related to the disease is of paramount importance for the correct management of diabetic patients.

Small cell carcinoma of the uterine corpus: CT appearance.

We report a rare case of small-cell carcinoma of the uterine corpus. To our knowledge, this is the first radiological report. Computed tomography (CT) demonstrates a hypodense lesion within the endometrial cavity with nonhomogeneous contrast enhancement.