CT Arthrography of the Elbow: What Radiologists Should Know.

Computed tomography (CT) arthrography is a quickly available imaging modality to investigate elbow disorders. Its excellent spatial resolution enables the detection of subtle pathologic changes of intra-articular structures, which makes this technique extremely valuable in a joint with very tiny chondral layers and complex anatomy of articular capsule and ligaments. Radiation exposure has been widely decreased with the novel CT scanners, thereby increasing the indications of this examination. The main applications of CT arthrography of the elbow are the evaluation of capsule, ligaments, and osteochondral lesions in both the settings of acute trauma, degenerative changes, and chronic injury due to repeated microtrauma and overuse. In this review, we discuss the normal anatomic findings, technical tips for injection and image acquisition, and pathologic findings that can be encountered in CT arthrography of the elbow, shedding light on its role in the diagnosis and management of different orthopedic conditions. We aspire to offer a roadmap for the integration of elbow CT arthrography into routine clinical practice, fostering improved patient outcomes and a deeper understanding of elbow pathologies.

Examining the association between speed and myoelectric activity: Time-based differences and muscle group balance.

The purpose of this study is to investigate the relationship between speed and myoelectric activity, measured during an incremental 25m shuttle running test, exploring the time-based variations and assessing muscle group balance within the context of this association. Twelve male young soccer players (n = 12) aged 18±1.2 years, with an average body mass of 68.4±5.8kg and average body height of 1.72±0.08m, from a professional Italian youth team (Italian "Primavera"), volunteered as participants for this study. The speed of each player during testing was measured using GPS technology, sampling at 50Hz. Myoelectrical activities of the gluteus, hamstrings, and quadriceps muscles were recorded through wearable sEMG devices, sampled at 100Hz. To ensure alignment of the sampling frequencies, the sEMG data was resampled to 50Hz, matching the GPS data sampling rate. This allowed for direct comparison and analysis of the data obtained from both measurement systems. The collected data were then analyzed to determine the relationship between the investigated variables and any potential differences associated with different sides of the body. The results revealed a robust correlation (r2≈0.97) between the speed of the participants (m·s-1) and their myoelectrical activity (µV) during the test. Factorial ANOVA 2x11 showed no significant differences between the sides of the analyzed muscles (p>0.05). The interpolation lines generated by the association of speed and sEMG exhibit very similar angular coefficients (0.9 to 0.12) in all six measurements obtained from electromyography of the three investigated muscle groups on each side of the body. In conclusion, the concurrent validity between the two instruments in this study indicates that GPS and sEMG are valid and consistent in estimating external load and internal load during incremental shuttle running.

Feasibility of Low-Dose and Low-Contrast Media Volume Approach in Computed Tomography Cardiovascular Imaging Reconstructed with Model-Based Algorithm.

Aim: To evaluate the dose reduction and image quality of low-dose, low-contrast media volume in computed tomography (CT) examinations reconstructed with the model-based iterative reconstruction (MBIR) algorithm in comparison with the hybrid iterative (HIR) one. Methods: We prospectively enrolled a total of 401 patients referred for cardiovascular CT, evaluated with a 256-MDCT scan with a low kVp (80 kVp) reconstructed with an MBIR (study group) or a standard HIR protocol (100 kVp-control group) after injection of a fixed dose of contrast medium volume. Vessel contrast enhancement and image noise were measured by placing the region of interest (ROI) in the left ventricle, ascending aorta; left, right and circumflex coronary arteries; main, right and left pulmonary arteries; aortic arch; and abdominal aorta. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were computed. Subjective image quality obtained by consensus was assessed by using a 4-point Likert scale. Radiation dose exposure was recorded. Results: HU values of the proximal tract of all coronary arteries; main, right and left pulmonary arteries; and of the aorta were significantly higher in the study group than in the control group (p < 0.05), while the noise was significantly lower (p < 0.05). SNR and CNR values in all anatomic districts were significantly higher in the study group (p < 0.05). MBIR subjective image quality was significantly higher than HIR in CCTA and CTPA protocols (p < 0.05). Radiation dose was significantly lower in the study group (p < 0.05). Conclusions: The MBIR algorithm combined with low-kVp can help reduce radiation dose exposure, reduce noise, and increase objective and subjective image quality.

Can We Apply Snyder's Arthroscopic Classification to Ultrasound for Evaluating Rotator Cuff Tears? A Comparative Study with MR Arthrography.

We aimed to demonstrate the applicability of Snyder's arthroscopic classification of rotator cuff tears (RCT) in shoulder ultrasound (US) and to compare it with MR arthrography (MRA). Forty-six patients (34 males; mean age:34 ± 14 years) underwent shoulder US and MRA. Two radiologists (R1 = 25 years of experience; R2 = 2 years of experience) assigned A1-4, B1-4, or C1-4 values depending on the extent of RCT in both US and MRA. Inter-reader intra-modality and intra-reader inter-modality agreement were calculated using Cohen's kappa coefficient. US sensitivity and specificity of both readers were calculated using MRA as the gold standard. Patients were divided into intact cuff vs. tears, mild (A1/B1) vs. moderate (A2-3/B2-3) tears, mild-moderate (A2/B2) vs. high-moderate (A3/B3) cuff tears, moderate (A2-3/B2-3) vs. advanced (A4/B4) and full-thickness (C) tears. The highest agreement values in inter-reader US evaluation were observed for mild-moderate vs. high-moderate RCT (K = 0.745), in inter-reader MRA evaluation for mild vs. moderate RCT (K = 0.821), in R1 inter-modality (US-MRA) for mild-moderate vs. high-moderate and moderate vs. advanced/full-thickness RCT (K = 1.000), in R2 inter-modality (US-MRA) for moderate vs. advanced/full-thickness RCT (K = 1.000). US sensitivity ranged from 88.89%(R1)-84.62%(R2) to 100% (both readers), while specificity from 77.78%(R1)-90.00%(R2) to 100% (both readers). Snyder's classification can be used in US to ensure the correct detection and characterization of RCT.

A quantitative MRCP-derived score for medium-term outcome prediction in primary sclerosing cholangitis.

BACKGROUND: Magnetic resonance cholangiopancreatography (MRCP) is the gold standard for diagnosis of patients with primary sclerosing cholangitis (PSC). The semi-quantitative MRCP-derived Anali scores proposed for risk stratification, have poor-to-moderate inter-reader agreement. AIMS: To evaluate the prognostic performance of quantitative MRCP metrics in PSC. METHODS: This is a retrospective study of PSC patients undergoing MRCP. Images were processed using MRCP+ software (Perspectum Ltd, Oxford) that provides quantitative biliary features, semi-automatically extracted by artificial intelligence-driven analysis of MRCP-3D images. The prognostic value of biliary features has been assessed for all hepato-biliary complications. RESULTS: 87 PSC patients have been included in the analysis. Median follow-up from MRCP to event/censoring of 30.9 months (Q1-Q3=13.6-46.6). An adverse outcome occurred in 27 (31.0%) patients. The number of biliary strictures (HR=1.05 per unit, 95%CI 1.02-1.08, p < 0.0001), spleen length (HR=1.16 per cm, 95%CI 1.01-1.34, p = 0.039), adjusted for height, age at MRCP, and time from diagnosis to MRCP predicted higher risk of hepatobiliary complications. These were incorporated into a the quantitative MRCP-derived PSC (qMRCP-PSC) score (C-statistic=0.80). After 3-fold cross-validation, qMRCP-PSC outperformed the Anali score in our cohort (C-statistic of 0.78 vs 0.64) and enabled the discrimination of survival of PSC patients (log-rank p < 0.0001). CONCLUSIONS: The qMRCP-PSC score identified patients at higher risk of hepatobiliary complications and outperformed the available radiological scores. It represents a novel quantitative biomarker for disease monitoring and a potential surrogate endpoint for clinical trials.

Temporal patterns of fatigue in repeated sprint ability testing in soccer players and acute effects of different IHRs: a comparison between genders.

BACKGROUND: Repeated sprint ability (RSA) in soccer is deemed fundamental to ensure high level of performance. The aim of this study was to investigate the acute effects of two different Initial Heart Rates (IHR) on fatigue when testing RSA in males and females' soccer players and to compare the respective patterns of fatigue. METHODS: Nineteen female soccer players (age: 22.5±3.3 years, height 163.9±7.3 cm, body weight 54.3±6.4 kg, BMI 20.6±1.5 kg·m-2) and 15 male soccer players (age: 17.9±1.5 years, height 175.9±5.8 cm, body weight 68.5±9.6 kg, BMI 22.3±1.5 kg·m-2) participated in this study. HRs reached at the end of two different warm-up protocols (~90 vs. ~ 60% HRmax), have been selected and the respective RSA performances were compared, within and between the groups of participants. Two sets of ten shuttle-sprints (15+15 m) with a 1:3 exercise to rest ratio with different IHR% were administered, in different days, in randomized order. To compare the different sprint performances, we employed the calculated Fatigue Index (FI%). Blood lactate concentration (BLa-) was also measured before and after testing, to compare metabolic energy. RESULTS: Significant differences among trials within each set (P<0.01) were found in both genders. Differences between sets were found in male players, (Factorial ANOVA 2x5; P<0.001), not in female. BLa- after warm-up was higher in 90% vs. 60% HRmax (P<0.05), in both genders but at the completion of RSA tests (after 3 minutes) the differences were not significant (P>0.05). CONCLUSIONS: difference between genders were found, suggesting specific approach in testing and training RSA in soccer players.

Hypertrophic adaptations to a 6-week in-season barbell vs. flywheel squat added to regular soccer training.

BACKGROUND: The aim of this study was to compare the hypertrophic adaptations to barbell or flywheel squat exercise added to regular in-season soccer training. METHODS: Quadriceps' (rectus femoris [RF], vastus medialis [VM] and vastus lateralis [VL]) cross-sectional area (CSA) in its portions (proximal [PROX], middle [MID], and distal [DIST]) was measured on both legs before and after a 6-week barbell (80 to 90% one-maximum repetition; N.=7) or flywheel (0.0611 to 0.0811 kg·m2; N.=7) in an U19 professional soccer team using a 3T magnetic resonance imaging. Both groups underwent 5 sets × 6 reps per session of squat separated by 3-min rest, while controlling the time under tension (within 0.5 and 0.8 s). RESULTS: The barbell squat group experienced moderate CSA increments in the VMMID and the VLDIST of the right leg (d=0.98-0.99). Additionally, the flywheel group experience large CSA increments in the RFMID, VLPROX and VLMID of the right leg (d=1.00-1.84). On average, flywheel squat training largely produced greater force during exercise compared to the barbell squat training (29.2 vs. 12.2 N·kg-1; d=5.95), whereas the barbell squat training produced moderately greater power output (10.5 vs. 9.7; d=0.52). CONCLUSIONS: Barbell squat training seems to be more effective for VM hypertrophy whereas flywheel squat triggers greater RF and VL hypertrophy as complementary to regular field-based soccer practice and competition within a short range of time (6 weeks) during the in-season. These findings can be considered also from either strength or reconditioning perspective based on the increase in the quadriceps muscles' CSA as mechanism underlying strength/power adaptations.

Relative age effect in Italian soccer: a cultural issue in talent management?

BACKGROUND: Relative age effect (RAE) is a well-known phenomenon among those involved in youth sports, especially when the sport being investigated is widespread and involves early selection for participation in national and international competitions. METHODS: The purpose of this study was to verify whether the Italian youth soccer ecosystem has adapted to this issue over the years, comparing players born in 1995 and in 2005 and been playing in Under 16 teams in the appropriate years. The sample included 13 professional Italian soccer teams. The number of players analysed was 260 (1995) and 344 boys (2005), respectively, making a total of 604 players enrolled in this study. RESULTS: Relative age effects were detected by χ2 goodness of fit tests both in players born in 1995 (P<0.000;V=0.40) and in 2005 (P<0.0001;V=0.39). χ2 test of independence showed no significant difference between the two groups of players (P=0.986;V=0.02), confirming a substantial parity of the phenomenon over the two investigated birth years. CONCLUSIONS: Ten years of research and dissemination of RAE did not change the selection policies adopted by coaches and/or scouts, who favor relatively older players during the selection processes. Therefore, RAE appears as the result of the Talent Identification and Development Structures, characterized by early selection and early specialization, and which consider performance as the pre-requisite for gaining access to the next developmental stages. Sport organizations should be aware of this issue and counteract accordingly, since it is important to mitigate the presence of RAE, as it causes inequality of opportunity.

Shoulder Magnetic Resonance Arthrography with the Internal and External Rotation Positions of the Humeral Head in the Evaluation of SLAP Lesions.

We aimed to evaluate the diagnostic performance of shoulder MR arthrography (MRA) acquired in the neutral (N), internal rotation (IR), and external rotation (ER) positions of the shoulder to detect SLAP lesions. Three observers evaluated 130 MRAs to detect SLAP lesions and to calculate labral diastasis in this triple-blinded study. Sensitivity was much higher in the ER (92.5-97.5%) than in the N (60-72.5%) and IR (42.5-52.5%) positions, and the specificity of all the reviewers was 100% in all the positions. The diagnostic accuracy was higher in the ER too (97.7-99.2%). The diastasis length was significantly higher in the ER (median = 2.5-2.8 mm) than in the N (1 mm) and IR (0 mm) positions and was also significantly higher in those patients requiring surgery (p = 0.001). The highest inter-rater agreement values were observed in the ER both in SLAP detection (k = 0.982) and the diastasis length evaluation (ICC = 0.962). The diastasis length threshold in the ER that best separated the patients who did and did not require surgery was 3.1 mm (AUC = 0.833). In 14.6% of the cases, ER enabled the detection of SLAP lesions not identified in the N position. MRA with the ER improves the diagnosis of SLAP lesions and, together with the IR position, provides additional dynamic information about the diastasis of the lesions. It is recommended to perform additional ER and IR scans in the shoulder MRA protocol.

Magnetic resonance arthrography in patients with multidirectional instability: could inferior capsulsar width be considered the cornerstone in the diagnosis of non-traumatic shoulder instability?

OBJECTIVES: To provide quantitative anatomical parameters in patients with and without non-traumatic multidirectional instability using MR arthrography (MR-a). MATERIALS AND METHODS: One hundred and seventy-six MR-a performed from January 2020 to March 2021 were retrospectively evaluated. Patients were divided according to the presence of clinically diagnosed multidirectional shoulder instability (MDI). Each MR-a was performed immediately after intra-articular injection of 20 ml of gadolinium using the anterior approach. The width of the axillary recess, the width of the rotator interval, and the circumference of the glenoid were measured by three independent radiologists, choosing the average value of the measurements. The difference between the mean values of each of the three parameters between the two study groups was then assessed. RESULTS: Thirty-seven patients were included in the study (20 in the MDI group, 17 in the control group). The mean axillary recess width in the MDI group was significantly greater than in the control group (t(33) = 3.15, p = .003); rotator interval width and glenoid circumference measurements were not significantly different (t(35) = 1.75, p = .08 and t(30) = 0,51, p = .6, respectively). CONCLUSIONS: Inferior capsular redundancy may be an important predisposing factor in MDI, while glenoid circumference is not related to MDI. The relationship between the width of the rotator interval and shoulder instability remains debated.

Low skeletal muscle index and myosteatosis as predictors of mortality in critically ill surgical patients.

OBJECTIVES: After elective surgeries, low muscle mass and other specific body composition indexes, assessed by computed tomography (CT), are associated with adverse outcomes such as an increased risk for postoperative complications and higher mortality. However, limited information is available about the role of these indexes on short- and long-term outcomes in surgical patients admitted to the intensive care unit (ICU). The aim of this study was to assess the association of body composition indexes with 90-d mortality in this specific patient cohort. METHODS: This was a retrospective study including adult surgical patients admitted to the ICU between 2014 and 2018 who underwent a CT scan at the time of admission. Total muscle area (TMA), total fat area (TFA), visceral fat area (VFA), and intramuscular fat area (IMFA) were measured. We then calculated skeletal muscle index (SMI; TMA/m2), myosteatosis (IMFA/TMA), and visceral fat-to-muscle ratio (VFA/TMA). We analyzed the effects of these indexes on mortality. RESULTS: The study included 204 patients. Overall, 90-d mortality was 28%. Log-rank test and Cox multivariate analysis on 90-d mortality showed a significant association of low SMI and myosteatosis with 90-d mortality. Myosteatosis was also significantly associated with prolonged mechanical ventilation and increased ICU length of stay. CONCLUSIONS: Specific body composition indexes may predict mortality in surgical patients admitted to the ICU. Low SMI and myosteatosis were independently associated with increased 90-d mortality.

Accuracy of Inflow Inversion Recovery (IFIR) for Upper Abdominal Arteries Evaluation: Comparison with Contrast-Enhanced MR and CTA.

Background: Inflow-sensitive inversion recovery (IFIR) is a recently introduced technique to perform unenhanced magnetic resonance angiography (MRA). The purpose of our study is to determine the accuracy of IFIR-MRA in the evaluation of upper abdominal arteries, compared to standard MRA and computed tomography angiography (CTA). Materials and Methods: Seventy patients undergoing upper abdomen Magnetic Resonance Imaging (MRI) in different clinical settings were enrolled. The MRI protocol included an IFIR-MRA sequence that was intra-individually compared by using a qualitative 4-point scale in the same patients who underwent concomitant or close MRA (n = 65) and/or CTA (n = 44). Celiac trunk (CA), common-proper-left-right hepatic artery (C-P-L-R-HA), left gastric artery (LGA), gastroduodenal artery (GDA), splenic artery (SA), renal arteries (RA) and superior mesenteric artery (SMA) were assessed. Results: IFIR-MRA images were better rated in comparison with MRA. Particularly, all arteries obtained a statistically significant higher qualitative rating value (all p < 0.05). IFIR-MRA and MRA exhibited acceptable intraclass correlation coefficients (ICC) values for CA, C-L-R-HA, and SMA (ICC 0.507, 0.591, 0.615, 0.570, 0.525). IFIR-MRA and CTA showed significant correlations in C-P-L-R-HA (τ = 0.362, 0.261, 0.308, 0.307, respectively; p < 0.05), and in RA (τ = 0.279, p < 0.05). Conclusions: Compared to MRA, IFIR-MRA demonstrated a higher image quality in the majority of upper abdomen arterial vessels assessment. LHA and RHA branches could be better visualized with IFIR sequences, when visualizable. Based on these findings, we suggest to routinely integrate IFIR sequences in upper abdomen MRI studies.

Immune response evaluation criteria in solid tumors for assessment of atypical responses after immunotherapy.

In 2017, immune response evaluation criteria in solid tumors (iRECIST) were introduced to validate radiologic and clinical interpretations and to better analyze tumor's response to immunotherapy, considering the different time of following and response, between this new therapy compared to the standard one. However, even if the iRECIST are worldwide accepted, to date, different aspects should be better underlined and well reported, especially in clinical practice. Clinical experience has demonstrated that in a non-negligible percentage of patients, it is challenging to determine the correct category of response (stable disease, progression disease, partial or complete response), and consequently, to define which is the best management for those patients. Approaching radiological response in patients who underwent immunotherapy, a new uncommon kind of target lesions behavior was found. This phenomenon is mainly due to the different mechanisms of action of immunotherapeutic drug. Therefore, new groups of response have been described in clinical practice, defined as "atypical responses," and categorized into three new groups: pseudoprogression, hyperprogression, and dissociated response. This review summarizes and reports these patterns, helping clinicians and radiologists get used to atypical responses, in order to identify patients that respond best to treatment.

Whole-body low-dose computed tomography (WBLDCT) in staging and re-staging of multiple myeloma.

The objective of this study is to evaluate the prognostic features of multiple myeloma (MM) using whole-body low-dose computed tomography (WBLDCT). One hundred three patients with biopsy-proven MM who underwent WBLDCT were retrospectively enrolled. The evolution of osteolytic lesions overtime was performed by measuring the maximum axial diameter at the baseline (T0) and the end of follow-up (Te), by using a cut-off value of 10 mm. The location and dimension of up to three lesions were registered. The time-to-fracture (TTF) was recorded. Sixty-three percent of patients presented a focal pattern, 22% a diffuse pattern, and 15% a combined one. Seventy-two percent of patients with lesions ≤ 10 mm presented stability, 27% a dimensional increase, and 1% a decrease. Patients with lesions >10 mm showed a statistically significant difference regarding the mean difference of axial diameter between T0 and Te (p = 0.015). Patients with lesions >10 mm showed an odds ratio (OR) of 29.8 (95%CIs 3.8-230.5) to develop at least one fracture. Mean TTF was significantly lower in patients with lesions >10 mm in comparison with lesions ≤ 10 mm (9 ± 3 vs 23 ± 7 months, respectively, p = 0.011). WBLDCT represents a reliable imaging-based tool for proper management of MM patients, showing that diffuse form or small lytic lesions may deserve a less frequent follow-up.

Use of carotid artery cannulation during redo sternotomy in congenital cardiac surgery: a single-centre experience.

OBJECTIVES: Management of resternotomy is often a difficult challenge in patients with congenital diseases who have undergone multiple sternotomies. Our goal was to report our single-centre experience with carotid cannulation using a graft interposed during redo sternotomy in complex cardiac reintervention procedures. METHODS: We performed a retrospective review of all patients who had undergone complex redo sternotomies between January 2019 and May 2020 utilizing a cervical cannulation technique with a Gore-Tex graft interposed on the carotid artery. We classified our population study on the basis of the primary diagnosis and the type of surgery. The primary outcomes of our analysis were the evaluation of the safety of the procedure in terms of survival and freedom from neurological events. RESULTS: We analysed 22 patients who had undergone previous complex operations. The median age and weight at the time of reintervention were 130.35 (range 0.46-435) months and 31.5 (range 2.2-85) kg, respectively. Composite graft carotid cannulation provided adequate arterial flow in all patients with a median arterial flow of 3.5 l/min/m2 (range 0.6-6). One major cardiac injury occurred during sternotomy when emergency cardiopulmonary bypass (CPB) was initiated. Moreover, during their hospital stays, all patients had an uneventful recovery without neurological or vascular complications and no cervical wound infections. CONCLUSIONS: Carotid cannulation using interposition of a side graft on the common carotid artery for arterial inflow is a reliable and safe method for initiation of CPB in complex redo surgeries in patients with congenital disease. Complications directly associated with this type of cannulation are uncommon and allow surgical re-entry with overall low risks.

Acute pulmonary embolism in hospitalized patients with SARS-CoV-2-related pneumonia: multicentric experience from Italian endemic area.

PURPOSE: To analyze pulmonary embolism (PE) on chest computed tomography pulmonary angiography (CTPA) in hospitalized patients affected by SARS-CoV-2, according to the severity of lung disease based both on temporal CT features changes and on CT-severity lung involvement (CT-severity score), along with the support of clinical and laboratory findings. METHODS: We retrospectively enrolled a total of 170 patients with confirmed SARS-CoV-2 infection who underwent CTPA examination for PE suspicion. Pulmonary arteries diameters, right ventricle/left ventricle (RV/LV) ratio, presence, absence, and distribution of PE, pulmonary artery obstructive index (PAO index), and lobe involvement were recorded. All CT scans were reviewed to assess temporal CT changes and the COVID CT-severity score. RESULTS: A total of 76 out of 170 patients (44.7%) developed PE without having any major risk factors for venous thromboembolism. The most severe pulmonary arteries involvement, expressed in terms of PAO Index, occurred in those patients with markedly elevated D-dimer and C-reactive protein (CRP) values and those patients with an advanced temporal stage of lung disease. The majority PE-positive patients were hospitalized in non-intensive wards. PE-positive patients showed a slightly higher hospitalization time in comparison with PE-negative ones. In the three months of study, overall 85.9% of patients were discharged while 14.1% died, of whom 13 PE-positive (54.2%). CONCLUSIONS: Patients hospitalized for SARS-CoV-2 infection present a higher cumulative incidence of PE compared to the general population of hospitalized patients, regardless of the severity of lung inflammation or the temporal stage of the disease.

Computed tomography semi-automated lung volume quantification in SARS-CoV-2-related pneumonia.

OBJECTIVES: To evaluate a semi-automated segmentation and ventilated lung quantification on chest computed tomography (CT) to assess lung involvement in patients affected by SARS-CoV-2. Results were compared with clinical and functional parameters and outcomes. METHODS: All images underwent quantitative analyses with a dedicated workstation using a semi-automatic lung segmentation software to compute ventilated lung volume (VLV), Ground-glass opacity (GGO) volume (GGO-V), and consolidation volume (CONS-V) as absolute volume and as a percentage of total lung volume (TLV). The ratio between CONS-V, GGO-V, and VLV (CONS-V/VLV and GGO-V/VLV, respectively), TLV (CONS-V/TLV, GGO-V/TLV, and GGO-V + CONS-V/TLV respectively), and the ratio between VLV and TLV (VLV/TLV) were calculated. RESULTS: A total of 108 patients were enrolled. GGO-V/TLV significantly correlated with WBC (r = 0.369), neutrophils (r = 0.446), platelets (r = 0.182), CRP (r = 0.190), PaCO2 (r = 0.176), HCO3- (r = 0.284), and PaO2/FiO2 (P/F) values (r = - 0.344). CONS-V/TLV significantly correlated with WBC (r = 0.294), neutrophils (r = 0.300), lymphocytes (r = -0.225), CRP (r = 0.306), PaCO2 (r = 0.227), pH (r = 0.162), HCO3- (r = 0.394), and P/F (r = - 0.419) values. Statistically significant differences between CONS-V, GGO-V, GGO-V/TLV, CONS-V/TLV, GGO-V/VLV, CONS-V/VLV, GGO-V + CONS-V/TLV, VLV/TLV, CT score, and invasive ventilation by ET were found (all p < 0.05). CONCLUSION: The use of quantitative semi-automated algorithm for lung CT elaboration effectively correlates the severity of SARS-CoV-2-related pneumonia with laboratory parameters and the need for invasive ventilation. KEY POINTS: • Pathological lung volumes, expressed both as GGO-V and as CONS-V, can be considered a useful tool in SARS-CoV-2-related pneumonia. • All lung volumes, expressed themselves and as ratio with TLV and VLV, correlate with laboratory data, in particular C-reactive protein and white blood cell count. • All lung volumes correlate with patient's outcome, in particular concerning invasive ventilation.

Diagnostic approach in hepatic lymphoma: radiological imaging findings and literature review.

PURPOSE: Imaging manifestations of hepatic lymphoma, both primary (PHL) and secondary (SHL), are extremely variable and non-specific, but some features are useful diagnostic clues in an appropriate clinical setting. Through a PubMed search, we found several published reviews focused on PHL and SHL diagnosis. However, to the best of our knowledge, few of them encompass a comprehensive analysis of all the diagnostic tools and relative radiological findings. The aim of this review is to provide a description of the radiological features of both PHL and SHL, by critically analyzing the available literature. MATERIALS AND METHODS: An extensive review of published literature along with a description of personal case series of both PHL and SHL has been conducted. RESULTS: SHL can be easily diagnosed with imaging techniques, as it is usually associated with node disease. On the contrary the diagnosis can be a challenge in PHL, often mimicking HCC or liver metastasis of adenocarcinoma. In this context, multiparametric MRI plays a fundamental role in the differential diagnosis. Both for PHL and SHL, liver involvement presents as solitary or multiple lesions or as diffuse infiltrative disease. CONCLUSION: PHL and SHL may be correctly characterized using different radiological techniques. Both CT and MRI have showed a good correlation with histology, as they permit to distinguish between lymphomatous tissue, and necrotic and fibrotic areas.

Data on coastal dunes vulnerability of eleven microtidal wave-dominated beaches of Sardinia (Italy, western Mediterranean).

This article contains data about the values of the Dune Vulnerability Index (DVI) and the Partial Index Vulnerability (IVp) of eleven coastal dune systems located in Sardinia (Italy, western Mediterranean). Specifically, we present the values of 59 variables that summarize the condition of the studied dune systems, clustered in five groups: Geomorphological Condition (GCD), Marine Influence (MI), Aeolian Influence (AI), Vegetation Condition (VC), and Human Effects (HE). Data were collected during numerous field surveys and using aerial-photos. This dataset can be useful to evaluate the coastal dune vulnerability of several Sardinian beaches in order to drive local coastal managers towards an efficient management.

Familiarity is not notoriety: phenomenological accounts of face recognition.

From a phenomenological perspective, faces are perceived differently from objects as their perception always involves the possibility of a relational engagement (Bredlau, 2011). This is especially true for familiar faces, i.e., faces of people with a history of real relational engagements. Similarly, valence of emotional expressions assumes a key role, as they define the sense and direction of this engagement. Following these premises, the aim of the present study is to demonstrate that face recognition is facilitated by at least two variables, familiarity and emotional expression, and that perception of familiar faces is not influenced by orientation. In order to verify this hypothesis, we implemented a 3 × 3 × 2 factorial design, showing 17 healthy subjects three type of faces (unfamiliar, personally familiar, famous) characterized by three different emotional expressions (happy, hungry/sad, neutral) and in two different orientation (upright vs. inverted). We showed every subject a total of 180 faces with the instructions to give a familiarity judgment. Reaction times (RTs) were recorded and we found that the recognition of a face is facilitated by personal familiarity and emotional expression, and that this process is otherwise independent from a cognitive elaboration of stimuli and remains stable despite orientation. These results highlight the need to make a distinction between famous and personally familiar faces when studying face perception and to consider its historical aspects from a phenomenological point of view.