La Radiologia medica
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La Radiologia medica · Jun 1997
Case Reports[Server World-Wide Web on the Internet for the provision of clinical cases and digital radiologic images for training and continuing education in radiology].
The Internet, as a global computer network, provides opportunities to make available multimedia educational materials, such as teaching files and image databases, that can be accessed using "World-Wide Web" client browser to provide continuing medical education. Since August, 1995, at the Institute of Radiology-University of Palermo, we developed a World-Wide Web server on the Internet to provide a collection of interactive radiology educational resources such as teaching files and image database for continuing medical education in radiology. Our server is based on a UNIX workstation connected to the Internet via our campus Ethernet network and reachable at the uniform resource locator (URL) address: http:/(/)mbox.unipa.it/approximately radpa/ radpa.html. ⋯ Nine teaching files are presently available on the server, together with 49 images in the database, a list of international radiological servers, a section devoted to the museum of radiology hosted by our Institute, the electronic version of the Journal Eido Electa. In the first 12 months of public access through the Internet, 12,280 users accessed the server worldwide: 45% of them to retrieve teaching files; 35% to retrieve images from the database; the remaining 20% to retrieve other documents. Placing teaching files and image database on a World-Wide Web server makes these cases more available to residents and radiologists to provide continuing medical education in radiology.
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La Radiologia medica · May 1997
Comparative Study Clinical Trial[Comparison of magnetic resonance Spin-echo sequences and fat-suppressed sequences in bone diseases].
Thirty-two patients affected with skeletal conditions were examined with MRI using Short TI Inversion Recovery sequence and Spectral Presaturation with Inversion Recovery (SPIR) sequence as well as Spin-Echo (SE) T1-weighted sequence and Fast Spin-Echo (FSE) T2-weighted sequence to compare their value in the assessment of skeletal lesions. SPIR sequence was performed after intravenous injection of Gd-DTPA. The lesions included primary bone tumors (10 cases: 1 osteosarcoma, 1 periosteal sarcoma, 1 Ewing's sarcoma, 1 chondrosarcoma, 2 non-ossifying fibromas, 1 chondroma, 1 chondromyxoid fibroma, 1 desmoplastic fibroma and 1 bone cyst), metastases (7 cases: 3 prostate, 3 breast, 1 lung-squamous cell carcinoma), infections (12 cases: 9 osteomyelitis, 3 spondylodiscitis), sacroiliitis (1 case) and posttraumatic bone bruise (2 cases of bone marrow edema). ⋯ Quantitative evaluation showed statistically significant higher values of percent contrast (%C) and contrast-to-noise ratio (C/N) for STIR sequence compared with SPIR sequence (%C p < .004; C/N p < .040). This study suggests that STIR sequence and SE T1-weighted sequence provide high sensitivity in lesion detection and good anatomical definition. The use of a fat-suppressed sequence with Gd-DTPA can be useful for lesion characterization.
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La Radiologia medica · May 1997
Comparative Study[Magnetic resonance of the brain: comparative assessment of conventional sequences versus fast sequences].
The conventional Spin-Echo sequences have been the most used acquisition techniques on Magnetic Resonance Imaging (MRI) of the brain, since the beginning of 1990s. Recently, however, technological developments proposed such new fast acquisition techniques, with a dramatic reduction in acquisition time as Gradient Echo, Turbo Spin Echo, Gradient Spin Echo ed Echo Planar sequences. We investigated the comparative adequacy of the new fast sequences, in brain MR studies versus conventional sequences, on medium field strength MR equipment (.5 T). ⋯ In conclusion, the present study suggests that fast acquisition techniques can improve the conventional protocol of sequences, in the anatomical representation of the normal brain even with medium field strength equipment only on T2 and T1-IR weighted images. On T1-weighted imaging conventional SE acquisition technique is still the best choice. The time saving obtained with fast sequences can therefore be used for an overall improvement in the quality of images, and to apply accessory acquisition plans on routine exams.
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La Radiologia medica · Apr 1997
Review[Spontaneous carotid-cavernous fistula: correlations between clinical findings and venous drainage].
We reviewed retrospectively 6 cases of spontaneous carotid cavernous fistulas to discuss the differences in clinical findings depending on venous patterns. Orbit US was performed in all patients but one and all patients were examined with CT and intraarterial digital subtraction angiography (DSA). Orbit US, performed in 5 patients with ocular signs, showed dilation of the ophthalmic veins, in 3 cases bilaterally. ⋯ In the patient presenting III, IV and VI nerve palsy, the venous drainage was direct from the cavernous sinus to pericarotid plexus, pterygoid plexus and inferior petrosal sinus; in this case there were no ocular signs. The clinical findings of spontaneous cavernous fistulas are caused by the arterial supply and, especially, by the venous drainage of the fistula; for the early diagnosis and treatment it is important to know that some patients do not exhibit the classic triad of symptoms, characterized by pulsating exophthalmos, bruit and conjunctival chemosis. Our experience has confirmed that spontaneous carotid cavernous fistulas may be characterized by atypical clinical findings, such as ocular signs contralateral to the fistula side or palsies of cranial nerves only.