O. Gagliardo

Azienda Ospedaliera Sant'Andrea

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Michele Gallucci

Sapienza University of Rome

G.B. Minio Paluello

IRCCS Ospedale San Raffaele

M Castrucci

Austrian Institute of Technology

Gianpiero Cardone

Vita-Salute San Raffaele University

Andrea Romano

Sapienza University of Rome

Alessandro Bozzao

Sapienza University of Rome

C. Micheli

University of L'Aquila

Alessandra Splendiani

University of L'Aquila

Francesco Dellepiane

Cornell University

M. Bonamini

Sapienza University of Rome

Cooperative Institutions

Sapienza University of Rome

Azienda Ospedaliera Sant'Andrea

Istituti di Ricovero e Cura a Carattere Scientifico

University of L'Aquila

Bambino Gesù Children's Hospital

IRCCS Ospedale San Raffaele

Policlinico Umberto I

Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele

CTO Andrea Alesini

University of Rome Tor Vergata

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Evaluation of Skull Base Tumors with Dynamic TurboFLASH MRI during Gadolinium Injection

Journal of Neurological Surgery Part B Skull Base (2019)

G. Trasimeni Marina Auconi Andrea Grossi O. Gagliardo Andrea Romano

Abstract Background and Purpose This study was aimed to investigate the role of dynamic TurboFLASH gadolinium (Gd) magnetic resonance (MR) imaging in improving the differential diagnosis of skull base tumors. Methods Eleven patients with skull base tumors underwent standard MR and ultrafast TurboFLASH sequence during gadolinium injection. Results The characterization of tumor vascularity was performed. Different patterns of gadolinium uptake for each tumor type were observed. This is particularly important to identify tumors at high risk of intraoperative bleeding. All glomus tumors, typically highly vascularized, showed an enhancement at the arterial phase, reflecting the arterialization of these tumors which is not detectable on conventional MR. No signal increase at the arterial phase was instead observed in other cases in which the ruling out of a glomus tumor was important because of the location of the lesion. Moreover TurboFLASH identified the pathognomonic “filling-in” profile of cavernous sinus cavernous hemangiomas (CSCH), that is, the progressive centripetal enhancement of the lesion at the beginning of the venous phase. Conclusion The dynamic analysis of tumor contrast enhancement with the TurboFLASH sequence provides useful additional information to that obtained with conventional MR, improving the differential diagnosis of skull base tumors, particularly in the distinction between glomus and nonglomus tumors and in diagnosing CSCH.

Glomus tumor

Vascularity

10.1055/s-0039-1681039

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[Magnetic resonance of the brain: comparative assessment of conventional sequences versus fast sequences].

PubMed (1997)

Gianpiero Cardone Michele Gallucci G.B. Minio Paluello O. Gagliardo M Castrucci

Gradient echo

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3D Gadolinium-Enhanced and 3D TOF MRA of the Brain

Rivista di Neuroradiologia (1998)

O. Gagliardo Michele Gallucci Gianpiero Cardone G.B. Minio Paluello Massimo Caulo

We prospectively compared 3D Gadolinium-enhanced and 3D-TOF MR angiographic acquisition techniques on the main cerebral arteries and cortical branches.

10.1177/19714009980110s255

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Idrocefalo normoteso: Valutazione comparativa tra studi di dinamica liquorale mediante TC e RM

Rivista di Neuroradiologia (1997)

M. Bonamini Michele Gallucci L. Simonetti Maria Gabriella Alagia O. Gagliardo

Aim of this study was to evaluate the sensitivity of MR dynamic Bolus Tracking technique versus CT-cysterno graphy in Normal Pressure Hydrocephalus (NPH). Seven patients (age 64–76 yrs), clinically suspected of NPH, were retrospectively evaluated. They had been submitted to CT-cysternography, MR dynamic Bolus Tracking technique in the acqueduct (cardiac-gated flow direction evaluation by means of 12–16 FFE T2*-w acquisitions per cardiac cycle, on sagittal plane along the acqueduct, with presaturation perpendicular to the acqueduct) and finally to surgical evaluation and subsequent ventriculo-peritoneal shunt. MR showed in all cases altered cerebrospinal fluid (CSF) dynamics: 5 patients showed CSF reflux in the third ventricle during all cardiac cycle, in 2 patients an increased ejection rate through the acqueduct and into the cisterna magna was found. CT-cysternography showed CSF dynamics alterations only in 4 cases. MR dynamic Bolus Tracking technique has proven to be more sensitive than CT-cysternography in the evaluation of NPH. Even though this study has to be considered preliminary, we believe that this simple and noninvasive technique should be recommended when NPH is suspected.

Bolus (digestion)

Cardiac cycle

Cisterna magna

Normal pressure hydrocephalus

10.1177/19714009970100s288

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Malattie demielinizzanti infantili

Rivista di Neuroradiologia (1999)

Michele Gallucci O. Gagliardo Alessandra Splendiani C. Micheli

10.1177/197140099901200120

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Citations (5)

[Magnetic resonance study of patellofemoral cartilage with a fat-suppressed T1-3D gradient-echo sequence: a comparison with other acquisition technics at medium field strength].

PubMed (1997)

Gianpiero Cardone G.B. Minio Paluello Giuseppe Lo Presti O. Gagliardo Michele Gallucci

Gradient echo

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Cerebral Venous Thrombosis: A Challenging Diagnosis; A New Nonenhanced Computed Tomography Standardized Semi-Quantitative Method

Tomography (2021)

Andrea Romano Maria Camilla Rossi Espagnet Luca Pasquini A. Di Napoli Francesco Dellepiane

Cerebral venous sinus thrombosis (CVST) on non-contrast CT (NCCT) is often challenging to detect. We retrospectively selected 41 children and 36 adults with confirmed CVST and two age-matched control groups with comparable initial symptoms. We evaluated NCCT placing four small circular ROIs in standardized regions of the cerebral dural venous system. The mean and maximum HU values were considered from each ROI, and the relative percentage variations were calculated (mean % variation and maximum % variation). We compared the highest measured value to the remaining three HU values through an ad-hoc formula based on the assumption that the thrombosed sinus has higher attenuation compared with the healthy sinuses. Percentage variations were employed to reflect how the attenuation of the thrombosed sinus deviates from the unaffected counterparts. The attenuation of the affected sinus was increased in patients with CVST, and consequently both the mean % and maximum % variations were increased. A mean % variation value of 12.97 and a maximum % variation value of 10.14 were found to be useful to distinguish patients with CVST from healthy subjects, with high sensitivity and specificity. Increased densitometric values were present in the site of venous thrombosis. A systematic, blind evaluation of the brain venous system can assist radiologists in identifying patients who need or do not need further imaging.

10.3390/tomography8010001

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Malattia di Alzheimer: Iperintensità dei lobi temporali in RM

Rivista di Neuroradiologia (1997)

Francesco Navarra Michele Gallucci O. Gagliardo Gianpiero Cardone G.B. Minio Paluello

Signal intensity of temporal lobes was studied in eighteen patients with Alzheimer's disease. Fluid attenuated inversion recovery (FLAIR) sequence and fast spin-echo (TSE) sequence were employed. Diagnosis of Alzheimer's disease was achieved with clinical tests. In 11 patients (61%) pathological temporal lobe hyperintensities were detected. FLAIR sequence was more sensitive (61%) than TSE (28%).

Fluid-attenuated inversion recovery

10.1177/19714009970100s222

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Extra-axial cranial nerve enhancement: a pattern-based approach

La radiologia medica (2023)

Giulia Moltoni Andrea Romano Antonella Blandino Serena Palizzi Allegra Romano

Abstract Cranial nerve enhancement is a common and challenging MRI finding that requires a meticulous and systematic evaluation to identify the correct diagnosis. Literature mainly describes the various pathologies with the associated clinic-radiological characteristics, while the radiologist often needs a reverse approach that starts from the radiological findings to reach the diagnosis. Therefore, our aim is to provide a new and practical pattern-based approach to cranial nerve enhancement, which starts from the radiological findings and follows pattern-driven pipelines to navigate through multiple differential diagnoses, guiding the radiologist to reach the proper diagnosis. Firstly, we reviewed the literature and identified four patterns to categorize the main pathologies presenting with cranial nerve enhancement: unilateral linear pattern, bilateral linear pattern, unilateral thickened pattern, and bilateral thickened pattern. For each pattern, we describe the underlying pathogenic origin, and the main radiological features are displayed through high-quality MRI images and illustrative panels. A suggested MRI protocol for studying cranial nerve enhancement is also provided. In conclusion, our approach for cranial nerve enhancement aims to be an easy tool immediately applicable to clinical practice for converting challenging findings into specific pathological patterns.

10.1007/s11547-023-01734-2

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Alterazioni corticali parietali nei disturbi del movimento: Evidenze in RM

Rivista di Neuroradiologia (1997)

Alessia Catalucci Michele Gallucci Eugenio Scarnati M. Bonamini O. Gagliardo

Aim of our study is to present the findings of parietal cortex alterations in patients affected by movement disorders. We observed 4 patients with movement disorders (3 parkinsonian syndromes, I diffuse dystonia) and MR evidence of cortical alterations, without additional cerebral lesions. MR was performed with a 0.5T unit, SE T1-w, TSE T2-w, and Turbo Fluid Attenuated Inversion Recovery (T-FLAIR) sequences on axial and coronal planes, contiguous slices and 5 mm slice thickness. In the parkinsonian patients, parietal atrophy was observed in 2 cases and fronto-parietal atrophy in I case; in all cases T-FLAIR sequences showed bilateral parietal cortex signal alteration. The patient with diffuse dystonia presented severe bilateral parietal atrophy with bilateral fronto-parietal signal alteration. Our findings are strongly suggestive for cortico-basal degeneration. The evidence of signal alteration within the cortex suggests a primary pathogenetic involvement of cortico-basal pathways.

Fluid-attenuated inversion recovery

Parietal lobe

10.1177/19714009970100s223

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