E. Neri

High-Resolution Magnetic Resonance and volume rendering of the labyrinth

Abstract. Our aim was to verify the feasibility of volume rendering (VR) of high-resolution magnetic resonance (HR-MR) data sets of the labyrinth. We retrospectively reviewed the HR-MR data sets of 16 consecutive patients with no MR evidence of labyrinthine pathology. High-resolution MR data sets were obtained by means of a 3D T2-weighted FSE sequence with the use of a 3-in. circular surface coil for signal reception, and processed with a high-end workstation. Two reviewers performed separately VR of the labyrinth by selecting the signal intensity interval for attribution of opacity and transparency. Concerning the time taken for definition of the volume of interest, the two observers needed, respectively, 28.9 and 33.1 min (SD ± 8.7–9.5 min), whereas the time taken for VR was respectively, 26 and 33.2 min (SD ± 8.8–8.9 min). Concerning the selection of the signal intensity interval, the two observers had, respectively, 86.4 and 88.7 mean lower threshold (SD ± 34.5–33.5), 488.9 and 495.4 mean upper threshold (SD ± 56.3–53.8). In our experience, we have found VR of HR-MR to offer a reliable and reproducible technique for producing 3D representations of the labyrinth. The VR algorithms use all data within the imaging volume and optimize the dynamic range ascribed to the object being visualized.

Diagnostic accuracy of CT colonography in patients with positive faecal occult blood test: results of the Italian project Legatumori 2003–2006

PurposeIn the framework of the 3-year project of the Italian Legatumori (2003–2006), we evaluated the diagnostic accuracy of computed tomography (CT) colonography in detecting colorectal lesions in a screening population with positive faecal occult blood test (FOBT).Materials and methodsTwo hundred and thirty asymptomatic subjects (age range 45–80 years) were enrolled in the study. CT colonography was performed with standard patient preparation (no faecal tagging) and a 4-detector-row CT scanner. Image analysis was carried out with primary 2D analysis and the use of 3D endoluminal views to solve difficult cases. Patients were referred for conventional colonoscopy in the following situations: detection of three or more suspected lesions with maximum diameter ≤6 mm; evidence of one or more lesions with maximum diameter >6 mm; presence of colonic masses (maximum diameter >3 cm).ResultsCT colonography detected colonic masses in 12 out of 135 subjects (8%). It generated 93 false positives and 19 false negatives in the identification of diminutive lesions (≤6 mm), and 70 false positives and six false negatives in lesions >6 mm. Sensitivity was 83% in smaller lesions and 93% in lesions >6 mm; specificity was 45% and 59%, respectively.ConclusionsIn a screening population with positive FOBT, CT colonography without faecal tagging and no definite size threshold for the reporting of polyps showed very low specificity but high sensitivity in the detection of all colorectal lesions.RiassuntoObiettiviNell’ambito di un progetto triennale finanziato dalla Legatumori (2003–2006) è stata valutata l’accuratezza diagnostica della CV nel rilievo di lesioni colorettali in una popolazione di screening risultata positiva al test per il SOF.Materiali e metodiSono stati inclusi nello studio 230 soggetti asintomatici. La CV era eseguita con preparazione standard (senza fecal tagging) e apparecchiatura TC a 4 strati. L’analisi delle immagini era effettuata con valutazione primaria 2D e uso delle ricostruzioni 3D nei casi dubbi. L’esame di CC veniva indicato in presenza di: almeno 3 lesioni sospette per polipi con diametro inferiore o uguale a 6 mm, almeno 1 lesione con diametro superiore a 6 mm, o masse coliche (diametro massimo >3 cm).RisultatiLa CV ha consentito la diagnosi di masse coliche in 12/135 (8%) pazienti; ha generato 93 falsi positivi e 19 falsi negativi per polipi di dimensioni minori o uguali a 6 mm, e 70 falsi positivi e 6 falsi negativi per polipi di dimensioni maggiori. La sensibilità era quindi 83% per polipi clinicamente non significativi e 93% per quelli con diametro superiore a 6mm; la specificità rispettivamente di 45% e 59%.ConclusioniIn una popolazione di screening con SOF+, la CV senza fecal tagging e senza l’adozione di un cut off dimensionale nella indicazione alla colonscopia tradizionale, ha evidenziato una bassa specificità, a fronte Pickdi una elevata sensibilità nel rilievo di tutte le lesioni.

Endoluminal treatment of abdominal aortic aneurysms

AbstractBackground: We report our preliminary results with endovascular treatment of abdominal aortic aneurysms (AAA). Methods: Between October 1998 and June 2000, 64 patients (62 male, two female; mean age = 70 years) underwent endovascular repair of AAA. Different types of prostheses were used, both bifurcated (n= 58) and straight (n= 6). We performed duplex sonography and spiral computed tomographic angiography (CTA) at discharge and at 3, 6, 12, and 18 months. Follow-up ranged from 1 to 20 months. Results: All procedures were successful, except for three immediate and one late surgical conversions (6.2%). One patient died 14 days after immediate surgical conversion. At discharge, CTA showed 13 endoleaks: three resolved spontaneously, six persisted during follow-up, and four (one angioplasty and three embolizations) were treated successfully. Stenosis of an iliac branch occurred in one patient after 3 months and was successfully treated by angioplasty. Late endoleaks were detected by imaging follow-up in four cases, three at 1 year and one at 6 months, requiring deployment of distal extender cuffs (n= 2), a proximal cuff (n= 1), and lumbar embolization (n= 2). Conclusion: Our preliminary experience supports the efficacy of endovascular repair in selected patients, but strict and accurate follow-up is required.

Diagnostic accuracy of CT colonography in patients with positive faecal occult blood test: results of the Italian project

PurposeIn the framework of the 3-year project of the Italian Legatumori (2003–2006), we evaluated the diagnostic accuracy of computed tomography (CT) colonography in detecting colorectal lesions in a screening population with positive faecal occult blood test (FOBT).Materials and methodsTwo hundred and thirty asymptomatic subjects (age range 45–80 years) were enrolled in the study. CT colonography was performed with standard patient preparation (no faecal tagging) and a 4-detector-row CT scanner. Image analysis was carried out with primary 2D analysis and the use of 3D endoluminal views to solve difficult cases. Patients were referred for conventional colonoscopy in the following situations: detection of three or more suspected lesions with maximum diameter ≤6 mm; evidence of one or more lesions with maximum diameter >6 mm; presence of colonic masses (maximum diameter >3 cm).ResultsCT colonography detected colonic masses in 12 out of 135 subjects (8%). It generated 93 false positives and 19 false negatives in the identification of diminutive lesions (≤6 mm), and 70 false positives and six false negatives in lesions >6 mm. Sensitivity was 83% in smaller lesions and 93% in lesions >6 mm; specificity was 45% and 59%, respectively.ConclusionsIn a screening population with positive FOBT, CT colonography without faecal tagging and no definite size threshold for the reporting of polyps showed very low specificity but high sensitivity in the detection of all colorectal lesions.RiassuntoObiettiviNell’ambito di un progetto triennale finanziato dalla Legatumori (2003–2006) è stata valutata l’accuratezza diagnostica della CV nel rilievo di lesioni colorettali in una popolazione di screening risultata positiva al test per il SOF.Materiali e metodiSono stati inclusi nello studio 230 soggetti asintomatici. La CV era eseguita con preparazione standard (senza fecal tagging) e apparecchiatura TC a 4 strati. L’analisi delle immagini era effettuata con valutazione primaria 2D e uso delle ricostruzioni 3D nei casi dubbi. L’esame di CC veniva indicato in presenza di: almeno 3 lesioni sospette per polipi con diametro inferiore o uguale a 6 mm, almeno 1 lesione con diametro superiore a 6 mm, o masse coliche (diametro massimo >3 cm).RisultatiLa CV ha consentito la diagnosi di masse coliche in 12/135 (8%) pazienti; ha generato 93 falsi positivi e 19 falsi negativi per polipi di dimensioni minori o uguali a 6 mm, e 70 falsi positivi e 6 falsi negativi per polipi di dimensioni maggiori. La sensibilità era quindi 83% per polipi clinicamente non significativi e 93% per quelli con diametro superiore a 6mm; la specificità rispettivamente di 45% e 59%.ConclusioniIn una popolazione di screening con SOF+, la CV senza fecal tagging e senza l’adozione di un cut off dimensionale nella indicazione alla colonscopia tradizionale, ha evidenziato una bassa specificità, a fronte Pickdi una elevata sensibilità nel rilievo di tutte le lesioni.

CT colonography: Project of High National Interest No. 2005062137 of the Italian Ministry of Education, University and Research (MIUR).

PurposeThe aim of this paper is to describe the Web site of the Italian Project on CT Colonography (Research Project of High National Interest, PRIN No. 2005062137) and present the prototype of the online database.Materials and methodsThe Web site was created with Microsoft Office Publisher 2003 software, which allows the realisation of multiple Web pages linked through a main menu located on the home page. The Web site contains a database of computed tomography (CT) colonography studies in the Digital Imaging and Communications in Medicine (DICOM) standard, all acquired with multidetector-row CT according to the parameters defined by the European Society of Abdominal and Gastrointestinal Radiology (ESGAR). The cases present different bowel-cleansing and tagging methods, and each case has been anonymised and classified according to the Colonography Reporting and Data System (C-RADS).ResultsThe Web site is available at http address www.ctcolonography.org and is composed of eight pages. Download times for a 294-Mbyte file were 33 min from a residential ADSL (6 Mbit/s) network, 200 s from a local university network (100 Mbit/s) and 2 h and 50 min from a remote academic site in the USA. The Web site received 256 accesses in the 22 days since it went online.ConclusionsThe Web site is an immediate and up-to-date tool for publicising the activity of the research project and a valuable learning resource for CT colonography.RiassuntoObiettivoDescrivere il sito web del Progetto Italiano sulla Colonscopia Virtuale (CV), PRIN 2005062137 e, presentare il prototipo del database online.Materiali e metodiIl sito web è stato realizzato con il software Microsoft Office Publisher 2003 che consente la realizzazione di pagine web multiple, tra loro collegate attraverso un menu principale localizzato nella home page. Nel suo interno sono archiviati studi DICOM di CV, acquisiti con apparecchiature multistrato seguendo i parametri di qualità definiti dall’ESGAR; i casi presentano differenti metodi di pulizia intestinale. Tutti sono stati anonimizzati e classificati secondo il sistema C-RADS.RisultatiIl sito è disponibile all’indirizzo www.ctcolonography.org ed è costituito da 8 pagine web. Nelle prove di scaricamento dei dati TC da tecnologia ADSL (6 Mbit/s), un file di 294 Mbytes è stato scaricato in 33 minuti, da rete universitaria (100 Mbit/s) in 200 secondi, da sito remoto accademico negli USA in 2 ore e 50 minuti. Il monitoraggio del numero di accessi in 22 giorni, dal giorno di pubblicazione, ha evidenziato 220 accessi.ConclusioniIl sito web è uno strumento immediato e aggiornato per la divulgazione dell’attività di ricerca progettuale e una risorsa didattica di CV.

Virtual Endoscopy of the Middle and Inner Ear

OBJECTIVE To evaluate the inner anatomy of the auditory apparatus by means of virtual endoscopy of spiral computed tomography (CT) data sets. BACKGROUND Virtual endoscopy permits simulation of the fiberoptic endoscopy perspective by processing CT or magnetic resonance images. METHODS Seven formalin-fixed specimens of human mastoid were scanned with spiral CT with the following protocol: beam collimation 1 mm, pitch ratio 1, reconstruction spacing 0.2 to 0.5 mm, field of view 90 mm. For the generation of endoscopic views of the auditory spaces, the axial images were processed with Navigator software 2.0 running on UltraSparc I workstation. RESULTS Virtual endoscopy allowed the demonstration of the external auditory canal, the head and handle of the malleus, the stapes and incudostapedial articulation, the corpus, the long process of the incus with its lenticular process and the short limb, the malleoincudal articulation, the rounded promontory, the round and oval windows, and Prussaks space. From inside the basal turn of the cochlea, virtual endoscopy showed the orifices of the fenestrae cochlea and vestibuli, the origin of the lateral and the anterior semicircular canals, and the basal turn of cochlea. The optimal perspectives that allowed demonstration of the anatomical details of the middle and inner ear are described. CONCLUSION Virtual endoscopy allows the generation of inner views of the auditory spaces. This new method of image processing can be proposed as an integrative tool of spiral CT imaging.

Colonscopia virtuale: progetto PRIN (Progetto di Rilevante Interesse Nazionale) del MIUR (Ministero dell'Università e della Ricerca), numero 2005062137

PurposeThe aim of this paper is to describe the Web site of the Italian Project on CT Colonography (Research Project of High National Interest, PRIN No. 2005062137) and present the prototype of the online database.Materials and methodsThe Web site was created with Microsoft Office Publisher 2003 software, which allows the realisation of multiple Web pages linked through a main menu located on the home page. The Web site contains a database of computed tomography (CT) colonography studies in the Digital Imaging and Communications in Medicine (DICOM) standard, all acquired with multidetector-row CT according to the parameters defined by the European Society of Abdominal and Gastrointestinal Radiology (ESGAR). The cases present different bowel-cleansing and tagging methods, and each case has been anonymised and classified according to the Colonography Reporting and Data System (C-RADS).ResultsThe Web site is available at http address www.ctcolonography.org and is composed of eight pages. Download times for a 294-Mbyte file were 33 min from a residential ADSL (6 Mbit/s) network, 200 s from a local university network (100 Mbit/s) and 2 h and 50 min from a remote academic site in the USA. The Web site received 256 accesses in the 22 days since it went online.ConclusionsThe Web site is an immediate and up-to-date tool for publicising the activity of the research project and a valuable learning resource for CT colonography.RiassuntoObiettivoDescrivere il sito web del Progetto Italiano sulla Colonscopia Virtuale (CV), PRIN 2005062137 e, presentare il prototipo del database online.Materiali e metodiIl sito web è stato realizzato con il software Microsoft Office Publisher 2003 che consente la realizzazione di pagine web multiple, tra loro collegate attraverso un menu principale localizzato nella home page. Nel suo interno sono archiviati studi DICOM di CV, acquisiti con apparecchiature multistrato seguendo i parametri di qualità definiti dall’ESGAR; i casi presentano differenti metodi di pulizia intestinale. Tutti sono stati anonimizzati e classificati secondo il sistema C-RADS.RisultatiIl sito è disponibile all’indirizzo www.ctcolonography.org ed è costituito da 8 pagine web. Nelle prove di scaricamento dei dati TC da tecnologia ADSL (6 Mbit/s), un file di 294 Mbytes è stato scaricato in 33 minuti, da rete universitaria (100 Mbit/s) in 200 secondi, da sito remoto accademico negli USA in 2 ore e 50 minuti. Il monitoraggio del numero di accessi in 22 giorni, dal giorno di pubblicazione, ha evidenziato 220 accessi.ConclusioniIl sito web è uno strumento immediato e aggiornato per la divulgazione dell’attività di ricerca progettuale e una risorsa didattica di CV.

CT colonography: Project of High National Interest No. 2005062137 of the Italian Ministry of Education, University and Research (MIUR) RID A-2343-2011

PurposeThe aim of this paper is to describe the Web site of the Italian Project on CT Colonography (Research Project of High National Interest, PRIN No. 2005062137) and present the prototype of the online database.Materials and methodsThe Web site was created with Microsoft Office Publisher 2003 software, which allows the realisation of multiple Web pages linked through a main menu located on the home page. The Web site contains a database of computed tomography (CT) colonography studies in the Digital Imaging and Communications in Medicine (DICOM) standard, all acquired with multidetector-row CT according to the parameters defined by the European Society of Abdominal and Gastrointestinal Radiology (ESGAR). The cases present different bowel-cleansing and tagging methods, and each case has been anonymised and classified according to the Colonography Reporting and Data System (C-RADS).ResultsThe Web site is available at http address www.ctcolonography.org and is composed of eight pages. Download times for a 294-Mbyte file were 33 min from a residential ADSL (6 Mbit/s) network, 200 s from a local university network (100 Mbit/s) and 2 h and 50 min from a remote academic site in the USA. The Web site received 256 accesses in the 22 days since it went online.ConclusionsThe Web site is an immediate and up-to-date tool for publicising the activity of the research project and a valuable learning resource for CT colonography.RiassuntoObiettivoDescrivere il sito web del Progetto Italiano sulla Colonscopia Virtuale (CV), PRIN 2005062137 e, presentare il prototipo del database online.Materiali e metodiIl sito web è stato realizzato con il software Microsoft Office Publisher 2003 che consente la realizzazione di pagine web multiple, tra loro collegate attraverso un menu principale localizzato nella home page. Nel suo interno sono archiviati studi DICOM di CV, acquisiti con apparecchiature multistrato seguendo i parametri di qualità definiti dall’ESGAR; i casi presentano differenti metodi di pulizia intestinale. Tutti sono stati anonimizzati e classificati secondo il sistema C-RADS.RisultatiIl sito è disponibile all’indirizzo www.ctcolonography.org ed è costituito da 8 pagine web. Nelle prove di scaricamento dei dati TC da tecnologia ADSL (6 Mbit/s), un file di 294 Mbytes è stato scaricato in 33 minuti, da rete universitaria (100 Mbit/s) in 200 secondi, da sito remoto accademico negli USA in 2 ore e 50 minuti. Il monitoraggio del numero di accessi in 22 giorni, dal giorno di pubblicazione, ha evidenziato 220 accessi.ConclusioniIl sito web è uno strumento immediato e aggiornato per la divulgazione dell’attività di ricerca progettuale e una risorsa didattica di CV.

CT colonography: Project of High National Interest No. 2005062137 of the Italian Ministry of Education, University and Research (MIUR)@@@Colonscopia virtuale: progetto PRIN (Progetto di Rilevante Interesse Nazionale) del MIUR (Ministero dell’Università e della Ricerca), numero 2005062137

PurposeThe aim of this paper is to describe the Web site of the Italian Project on CT Colonography (Research Project of High National Interest, PRIN No. 2005062137) and present the prototype of the online database.Materials and methodsThe Web site was created with Microsoft Office Publisher 2003 software, which allows the realisation of multiple Web pages linked through a main menu located on the home page. The Web site contains a database of computed tomography (CT) colonography studies in the Digital Imaging and Communications in Medicine (DICOM) standard, all acquired with multidetector-row CT according to the parameters defined by the European Society of Abdominal and Gastrointestinal Radiology (ESGAR). The cases present different bowel-cleansing and tagging methods, and each case has been anonymised and classified according to the Colonography Reporting and Data System (C-RADS).ResultsThe Web site is available at http address www.ctcolonography.org and is composed of eight pages. Download times for a 294-Mbyte file were 33 min from a residential ADSL (6 Mbit/s) network, 200 s from a local university network (100 Mbit/s) and 2 h and 50 min from a remote academic site in the USA. The Web site received 256 accesses in the 22 days since it went online.ConclusionsThe Web site is an immediate and up-to-date tool for publicising the activity of the research project and a valuable learning resource for CT colonography.RiassuntoObiettivoDescrivere il sito web del Progetto Italiano sulla Colonscopia Virtuale (CV), PRIN 2005062137 e, presentare il prototipo del database online.Materiali e metodiIl sito web è stato realizzato con il software Microsoft Office Publisher 2003 che consente la realizzazione di pagine web multiple, tra loro collegate attraverso un menu principale localizzato nella home page. Nel suo interno sono archiviati studi DICOM di CV, acquisiti con apparecchiature multistrato seguendo i parametri di qualità definiti dall’ESGAR; i casi presentano differenti metodi di pulizia intestinale. Tutti sono stati anonimizzati e classificati secondo il sistema C-RADS.RisultatiIl sito è disponibile all’indirizzo www.ctcolonography.org ed è costituito da 8 pagine web. Nelle prove di scaricamento dei dati TC da tecnologia ADSL (6 Mbit/s), un file di 294 Mbytes è stato scaricato in 33 minuti, da rete universitaria (100 Mbit/s) in 200 secondi, da sito remoto accademico negli USA in 2 ore e 50 minuti. Il monitoraggio del numero di accessi in 22 giorni, dal giorno di pubblicazione, ha evidenziato 220 accessi.ConclusioniIl sito web è uno strumento immediato e aggiornato per la divulgazione dell’attività di ricerca progettuale e una risorsa didattica di CV.