Chiara Andreoli - Academia.edu (original) (raw)
Papers by Chiara Andreoli
Journal of Radiological Review
La Radiologia medica, 2001
La Radiologia medica, 2002
The rupture of an ovarian cyst is among the most frequent causes of hemoperitoneum in women, and ... more The rupture of an ovarian cyst is among the most frequent causes of hemoperitoneum in women, and especially in young women. An ultrasound (US) examination performed in emergency allows the easy detection of fluids leaking into the abdomen. It may however be difficult to establish whether this fluid is blood and identify the cyst or the signs of a cystic rupture. The aim of the present study was the assessment of CT diagnostic capabilities in cases of hemoperitoneum following cyst rupture. CT abdominal studies performed in emergency in 15 patients with surgical findings of ovarian cyst rupture and consequent hemoperitoneum were retro-spectively reviewed. An ultrasound examination carried out in 12 women was positive in all cases for abdominal effusion, without however confirming the presence of an ovarian cyst or without definitely defining the cystic rupture. Spiral CT examinations were performed with a preliminary unenhanced study of the abdomen (10-mm thickness image acquisitions,...
European Radiology, Jul 4, 2020
Objectives To correlate a CT-based semi-quantitative score of pulmonary involvement in COVID-19 p... more Objectives To correlate a CT-based semi-quantitative score of pulmonary involvement in COVID-19 pneumonia with clinical staging of disease and laboratory findings. We also aimed to investigate whether CT findings may be predictive of patients' outcome. Methods From March 6 to March 22, 2020, 130 symptomatic SARS-CoV-2 patients were enrolled for this single-center analysis and chest CT examinations were retrospectively evaluated. A semi-quantitative CT score was calculated based on the extent of lobar involvement (0:0%; 1, < 5%; 2:5-25%; 3:26-50%; 4:51-75%; 5, > 75%; range 0-5; global score 0-25). Data were matched with clinical stages and laboratory findings. Survival curves and univariate and multivariate analyses were performed to evaluate the role of CT score as a predictor of patients' outcome. Results Ground glass opacities were predominant in early-phase (≤ 7 days since symptoms' onset), while crazy-paving pattern, consolidation, and fibrosis characterized late-phase disease (> 7 days). CT score was significantly higher in critical and severe than in mild stage (p < 0.0001), and among late-phase than early-phase patients (p < 0.0001). CT score was significantly correlated with CRP (p < 0.0001, r = 0.6204) and D-dimer (p < 0.0001, r = 0.6625) levels. A CT score of ≥ 18 was associated with an increased mortality risk and was found to be predictive of death both in univariate (HR, 8.33; 95% CI, 3.19-21.73; p < 0.0001) and multivariate analysis (HR, 3.74; 95% CI, 1.10-12.77; p = 0.0348). Conclusions Our preliminary data suggest the potential role of CT score for predicting the outcome of SARS-CoV-2 patients. CT score is highly correlated with laboratory findings and disease severity and might be beneficial to speed-up diagnostic workflow in symptomatic cases. Key Points • CT score is positively correlated with age, inflammatory biomarkers, severity of clinical categories, and disease phases. • A CT score ≥ 18 has shown to be highly predictive of patient's mortality in short-term follow-up. • Our multivariate analysis demonstrated that CT parenchymal assessment may more accurately reflect short-term outcome, providing a direct visualization of anatomic injury compared with non-specific inflammatory biomarkers. Keywords Severe acute respiratory syndrome coronavirus 2. COVID-19. Pneumonia. Tomography, X-ray computed Marco Francone and Franco Iafrate contributed equally to this work.
PubMed, Jan 27, 2006
Purpose: To evaluate the role of emergency MRI in the diagnosis of acute spinal injuries, and to ... more Purpose: To evaluate the role of emergency MRI in the diagnosis of acute spinal injuries, and to correlate the MRI pattern with the neurological outcome. Materials and methods: Thirty-eight patients with MRI-proven spinal cord injury were classified according to the Frankel classification. MRI was always performed within 8 hours from trauma. Frankel classification divides spinal cord injuries into 5 classes of decreasing severity based on the presence of motor and/or sensory function loss. On the basis of the MRI findings the patients were classified in 3 groups: group 1 (intramedullary haematoma), group 2 (multi-metamer oedema), group 3 (single-metamer oedema). All patients underwent neurosurgery and were clinically evaluated until the stabilization of neurological recovery. Mean follow-up time was 12 months. The MR images were retrospectively evaluated and correlated to the neurological outcome. Results: Twenty-eight patients showed complete motor loss (Frankel classes A and B); of these 28 patients 12 (42.8%) had MRI evidence of intramedullary haematoma, 12 (42.8%) had multi-metamer oedema and 4 (14.4%) had single-metamer oedema. Of the 10 patients with incomplete motor loss, none had MRI evidence of haemorrhage, 4 (40%) showed multi-metamer oedema and 6 (60%) showed single-metamer oedema. Follow-up clinical assessment revealed that 14/38 patients (36,8%) had clinical improvement and 2/38 cases (5%) had a complete motor recovery, as demonstrated by the move to a higher Frankel class. Conclusions: Our results, consistent with previous reports, confirm a strong correlation between the MRI appearance of traumatic spinal cord injuries in acute phase and long-term recovery of motor and sensory function: patients with initial haemorrhage had a poor prognosis, whereas those with spinal cord oedema had a good clinical outcome, as demonstrated by the passage to a higher Frankel class. MRI is particularly important in the initial evaluation of unconscious patients who cannot undergo a motor and sensory neurological evaluation, and to define the prognosis, which will influence the correct therapeutic choice.
Supplementary materials from: Pituitary T1 signal intensity at magnetic resonance imaging is redu... more Supplementary materials from: Pituitary T1 signal intensity at magnetic resonance imaging is reduced in obese subjects: results from the CHIASM study.<br>
La radiologia medica, 2020
Journal of Radiological Review, 2018
Journal of Ultrasound in Medicine, 2002
Objective. We performed a retrospective study to document the sonographic and color Doppler chara... more Objective. We performed a retrospective study to document the sonographic and color Doppler characteristics of lymphomatous superficial lymph nodes. Methods. We selected 130 individuals who underwent sonography, color Doppler imaging, fine-needle aspiration biopsy, and surgical removal of the nodes with the final diagnosis of lymphoma (87) and chronic adenitis (43). During sonography, for each node we considered the longitudinal and axial diameters, long/short axis ratio, visibility of the hilum, and the internal echogenicity of the node. During the color and power Doppler examination, we classified the nodes into 3 patterns: type I, "hilar normal"; type II, "hilar activated"; and type III, "peripheral." Results. Sonographic evidence was not significant. With color Doppler sonography, 97% of nodes affected by non-Hodgkin lymphoma, 94% of nodes affected by Hodgkin lymphoma, and 100% of non-neoplastic nodes showed hilar vascularity. Type I seemed more frequently associated with inflammation, and type II was more frequently associated with lymphoma. Conclusions. The presence of peripheric subcapsular vessels, which is typical of metastasis, is definitely rare in lymphoma (with the possible exception of the uncommon subtypes of high-grade lymphomas). The differential diagnosis between lymphoma and lymphadenitis is frequently impossible on the basis of sonographic and color Doppler patterns alone; therefore, clinical evaluation and biopsy are generally mandatory.
La Radiologia medica
One the main reasons for the limited use of MRI in the evaluation of aortic dissection in emergen... more One the main reasons for the limited use of MRI in the evaluation of aortic dissection in emergency conditions is its long execution time. The authors report their experience regarding a new MRI sequence that reduces execution time and avoids the use of contrast medium. Eighteen haemodynamically stable patients with suspected (16 cases, 3 with confirmed diagnosis of aneurysm) or known aortic dissection (2 cases) underwent in emergency conditions 1.5T MRI with Steady-State sequence (Fast Imaging Employing Steady-State Acquisition: GRE 2D; TR 3.5, TE 1.6; Flip Angle 45, bandwidth 125, matrix 224x224, NEX 1, acquisition time per slice 7 s, thickness 6-8 mm, FOV 38; 2D-GE breath-hold sequence requiring cardiac triggering). The results obtained were compared in terms of diagnostic accuracy and execution time with those of classical MRI examination (black blood T1, FSE T2 and 3D MR-angiography) or multislice CT. The diagnostic accuracy of MRI, both with Steady-State sequence and the '...
Springer ABC, 2012
Le lesioni traumatiche degli organi addominali si verificano solo nel 10% dei casi di “malattia t... more Le lesioni traumatiche degli organi addominali si verificano solo nel 10% dei casi di “malattia trauma” e sono tipiche del meccanismo decelerativo. Ancora una volta, e necessario ricordare che la malattia trauma e sistemica, pertanto un suo corretto inquadramento non deve mai limitarsi al singolo studio dell’addome ma necessita di una valutazione globale mediante la TC che deve sempre essere eseguita con mdc ev, nel paziente stabile o semi-stabile dal punto di vista emodinamico e respiratorio [20, 91]. L’ecografia ha un ruolo ancora molto importante nei pazienti instabili, alla ricerca di falde di versamento libero mediante l’ecografia FAST, e nel follow-up delle lesioni degli organi solidi gia accertate in prima battuta con la TC attraverso l’utilizzo dei moduli CE-US e color/power Doppler; nel contesto del follow-up delle lesioni addominali trova spazio anche la RM che costituisce metodica di I livello nel sospetto danno del dotto di Wirsung (CPRM).
Springer ABC, 2012
Le fratture di bacino si riscontrano nel 5–8% dei traumi maggiori e, data la solidita strutturale... more Le fratture di bacino si riscontrano nel 5–8% dei traumi maggiori e, data la solidita strutturale del cingolo pelvico, sono generalmente sostenute da traumi ad alta energia cinetica (70%: incidenti stradali automobilistici e motociclistici; 10–20%: caduta dall’alto-precipitazione; 10%: incidenti sul lavoro-trauma da schiacciamento). Sono gravate da un’alta morbilita e mortalita dato che l’elevata energia richiesta per esercitare un danno su una struttura cosi solida e in grado di provocare anche lesioni viscerali e, soprattutto, il coinvolgimento di strutture vascolari arteriose evenose, la cui rottura/lacerazione puo mettere a rischio la vita del paziente per shock emorragico e necessita spesso di un trattamento chirurgico/interventistico di urgenza. L’emorragia pelvica rappresenta la principale causa di morte nel trauma pelvico (mortalita del 5–30%) [78,79].
Springer ABC, 2012
Il trauma del torace e responsabile del 25% dei decessi nel paziente politraumatizzato, al second... more Il trauma del torace e responsabile del 25% dei decessi nel paziente politraumatizzato, al secondo posto dopo il trauma cranico. Nel 90% dei casi si tratta di traumi chiusi e gli incidenti motociclistici e le cadute ne rappresentano la causa piu comune [3,6,7].
Journal of Neuroradiology, 2014
The aim of the study was to assess the diagnostic potential of diffusion tensor imaging (DTI) for... more The aim of the study was to assess the diagnostic potential of diffusion tensor imaging (DTI) for pathologies of the peripheral nervous system (PNS) through clinical, electrophysiological and morphological evaluation of the median nerve. Methods: The present work was a multilevel prospective study involving 30 subjects, 15 of whom had carpal tunnel syndrome (CTS) and 15 healthy controls. All subjects underwent clinical evaluation through administration of the Boston Carpal Tunnel Questionnaire (BCTQ), electroneurography (ENG), 3-Tesla magnetic resonance imaging with DTI, and calculation of fractional anisotropy (FA) and the apparent diffusion coefficient (ADC) at the flexor retinaculum. Tractography was also performed for three-dimensional reconstruction of the route of the median nerve through the carpal tunnel. The degree of functional impairment was compared with the anatomical damage to the median nerve according to ENG and DTI. Results: FA and ADC were significantly correlated with ENG parameters of CTS and BCTQ data. Mean FA and ADC values in the CTS patients were 0.359 ± 0.06 and 1.866 ± 0.050 × 10 −3 mm 2 /s, respectively, vs 0.59 ± 0.014 and 1.395 ± 0.035 × 10 −3 mm 2 /s, respectively, in the controls. FA was decreased and ADC increased in patients with CTS compared with healthy controls (P < 0.05). Conclusion: DTI parameters were clearly confirmed by both clinical and ENG data and, therefore, may be used for the diagnosis of CTS.
New Review of Hypermedia and Multimedia, 1998
Journal of Radiological Review
La Radiologia medica, 2001
La Radiologia medica, 2002
The rupture of an ovarian cyst is among the most frequent causes of hemoperitoneum in women, and ... more The rupture of an ovarian cyst is among the most frequent causes of hemoperitoneum in women, and especially in young women. An ultrasound (US) examination performed in emergency allows the easy detection of fluids leaking into the abdomen. It may however be difficult to establish whether this fluid is blood and identify the cyst or the signs of a cystic rupture. The aim of the present study was the assessment of CT diagnostic capabilities in cases of hemoperitoneum following cyst rupture. CT abdominal studies performed in emergency in 15 patients with surgical findings of ovarian cyst rupture and consequent hemoperitoneum were retro-spectively reviewed. An ultrasound examination carried out in 12 women was positive in all cases for abdominal effusion, without however confirming the presence of an ovarian cyst or without definitely defining the cystic rupture. Spiral CT examinations were performed with a preliminary unenhanced study of the abdomen (10-mm thickness image acquisitions,...
European Radiology, Jul 4, 2020
Objectives To correlate a CT-based semi-quantitative score of pulmonary involvement in COVID-19 p... more Objectives To correlate a CT-based semi-quantitative score of pulmonary involvement in COVID-19 pneumonia with clinical staging of disease and laboratory findings. We also aimed to investigate whether CT findings may be predictive of patients' outcome. Methods From March 6 to March 22, 2020, 130 symptomatic SARS-CoV-2 patients were enrolled for this single-center analysis and chest CT examinations were retrospectively evaluated. A semi-quantitative CT score was calculated based on the extent of lobar involvement (0:0%; 1, < 5%; 2:5-25%; 3:26-50%; 4:51-75%; 5, > 75%; range 0-5; global score 0-25). Data were matched with clinical stages and laboratory findings. Survival curves and univariate and multivariate analyses were performed to evaluate the role of CT score as a predictor of patients' outcome. Results Ground glass opacities were predominant in early-phase (≤ 7 days since symptoms' onset), while crazy-paving pattern, consolidation, and fibrosis characterized late-phase disease (> 7 days). CT score was significantly higher in critical and severe than in mild stage (p < 0.0001), and among late-phase than early-phase patients (p < 0.0001). CT score was significantly correlated with CRP (p < 0.0001, r = 0.6204) and D-dimer (p < 0.0001, r = 0.6625) levels. A CT score of ≥ 18 was associated with an increased mortality risk and was found to be predictive of death both in univariate (HR, 8.33; 95% CI, 3.19-21.73; p < 0.0001) and multivariate analysis (HR, 3.74; 95% CI, 1.10-12.77; p = 0.0348). Conclusions Our preliminary data suggest the potential role of CT score for predicting the outcome of SARS-CoV-2 patients. CT score is highly correlated with laboratory findings and disease severity and might be beneficial to speed-up diagnostic workflow in symptomatic cases. Key Points • CT score is positively correlated with age, inflammatory biomarkers, severity of clinical categories, and disease phases. • A CT score ≥ 18 has shown to be highly predictive of patient's mortality in short-term follow-up. • Our multivariate analysis demonstrated that CT parenchymal assessment may more accurately reflect short-term outcome, providing a direct visualization of anatomic injury compared with non-specific inflammatory biomarkers. Keywords Severe acute respiratory syndrome coronavirus 2. COVID-19. Pneumonia. Tomography, X-ray computed Marco Francone and Franco Iafrate contributed equally to this work.
PubMed, Jan 27, 2006
Purpose: To evaluate the role of emergency MRI in the diagnosis of acute spinal injuries, and to ... more Purpose: To evaluate the role of emergency MRI in the diagnosis of acute spinal injuries, and to correlate the MRI pattern with the neurological outcome. Materials and methods: Thirty-eight patients with MRI-proven spinal cord injury were classified according to the Frankel classification. MRI was always performed within 8 hours from trauma. Frankel classification divides spinal cord injuries into 5 classes of decreasing severity based on the presence of motor and/or sensory function loss. On the basis of the MRI findings the patients were classified in 3 groups: group 1 (intramedullary haematoma), group 2 (multi-metamer oedema), group 3 (single-metamer oedema). All patients underwent neurosurgery and were clinically evaluated until the stabilization of neurological recovery. Mean follow-up time was 12 months. The MR images were retrospectively evaluated and correlated to the neurological outcome. Results: Twenty-eight patients showed complete motor loss (Frankel classes A and B); of these 28 patients 12 (42.8%) had MRI evidence of intramedullary haematoma, 12 (42.8%) had multi-metamer oedema and 4 (14.4%) had single-metamer oedema. Of the 10 patients with incomplete motor loss, none had MRI evidence of haemorrhage, 4 (40%) showed multi-metamer oedema and 6 (60%) showed single-metamer oedema. Follow-up clinical assessment revealed that 14/38 patients (36,8%) had clinical improvement and 2/38 cases (5%) had a complete motor recovery, as demonstrated by the move to a higher Frankel class. Conclusions: Our results, consistent with previous reports, confirm a strong correlation between the MRI appearance of traumatic spinal cord injuries in acute phase and long-term recovery of motor and sensory function: patients with initial haemorrhage had a poor prognosis, whereas those with spinal cord oedema had a good clinical outcome, as demonstrated by the passage to a higher Frankel class. MRI is particularly important in the initial evaluation of unconscious patients who cannot undergo a motor and sensory neurological evaluation, and to define the prognosis, which will influence the correct therapeutic choice.
Supplementary materials from: Pituitary T1 signal intensity at magnetic resonance imaging is redu... more Supplementary materials from: Pituitary T1 signal intensity at magnetic resonance imaging is reduced in obese subjects: results from the CHIASM study.<br>
La radiologia medica, 2020
Journal of Radiological Review, 2018
Journal of Ultrasound in Medicine, 2002
Objective. We performed a retrospective study to document the sonographic and color Doppler chara... more Objective. We performed a retrospective study to document the sonographic and color Doppler characteristics of lymphomatous superficial lymph nodes. Methods. We selected 130 individuals who underwent sonography, color Doppler imaging, fine-needle aspiration biopsy, and surgical removal of the nodes with the final diagnosis of lymphoma (87) and chronic adenitis (43). During sonography, for each node we considered the longitudinal and axial diameters, long/short axis ratio, visibility of the hilum, and the internal echogenicity of the node. During the color and power Doppler examination, we classified the nodes into 3 patterns: type I, "hilar normal"; type II, "hilar activated"; and type III, "peripheral." Results. Sonographic evidence was not significant. With color Doppler sonography, 97% of nodes affected by non-Hodgkin lymphoma, 94% of nodes affected by Hodgkin lymphoma, and 100% of non-neoplastic nodes showed hilar vascularity. Type I seemed more frequently associated with inflammation, and type II was more frequently associated with lymphoma. Conclusions. The presence of peripheric subcapsular vessels, which is typical of metastasis, is definitely rare in lymphoma (with the possible exception of the uncommon subtypes of high-grade lymphomas). The differential diagnosis between lymphoma and lymphadenitis is frequently impossible on the basis of sonographic and color Doppler patterns alone; therefore, clinical evaluation and biopsy are generally mandatory.
La Radiologia medica
One the main reasons for the limited use of MRI in the evaluation of aortic dissection in emergen... more One the main reasons for the limited use of MRI in the evaluation of aortic dissection in emergency conditions is its long execution time. The authors report their experience regarding a new MRI sequence that reduces execution time and avoids the use of contrast medium. Eighteen haemodynamically stable patients with suspected (16 cases, 3 with confirmed diagnosis of aneurysm) or known aortic dissection (2 cases) underwent in emergency conditions 1.5T MRI with Steady-State sequence (Fast Imaging Employing Steady-State Acquisition: GRE 2D; TR 3.5, TE 1.6; Flip Angle 45, bandwidth 125, matrix 224x224, NEX 1, acquisition time per slice 7 s, thickness 6-8 mm, FOV 38; 2D-GE breath-hold sequence requiring cardiac triggering). The results obtained were compared in terms of diagnostic accuracy and execution time with those of classical MRI examination (black blood T1, FSE T2 and 3D MR-angiography) or multislice CT. The diagnostic accuracy of MRI, both with Steady-State sequence and the '...
Springer ABC, 2012
Le lesioni traumatiche degli organi addominali si verificano solo nel 10% dei casi di “malattia t... more Le lesioni traumatiche degli organi addominali si verificano solo nel 10% dei casi di “malattia trauma” e sono tipiche del meccanismo decelerativo. Ancora una volta, e necessario ricordare che la malattia trauma e sistemica, pertanto un suo corretto inquadramento non deve mai limitarsi al singolo studio dell’addome ma necessita di una valutazione globale mediante la TC che deve sempre essere eseguita con mdc ev, nel paziente stabile o semi-stabile dal punto di vista emodinamico e respiratorio [20, 91]. L’ecografia ha un ruolo ancora molto importante nei pazienti instabili, alla ricerca di falde di versamento libero mediante l’ecografia FAST, e nel follow-up delle lesioni degli organi solidi gia accertate in prima battuta con la TC attraverso l’utilizzo dei moduli CE-US e color/power Doppler; nel contesto del follow-up delle lesioni addominali trova spazio anche la RM che costituisce metodica di I livello nel sospetto danno del dotto di Wirsung (CPRM).
Springer ABC, 2012
Le fratture di bacino si riscontrano nel 5–8% dei traumi maggiori e, data la solidita strutturale... more Le fratture di bacino si riscontrano nel 5–8% dei traumi maggiori e, data la solidita strutturale del cingolo pelvico, sono generalmente sostenute da traumi ad alta energia cinetica (70%: incidenti stradali automobilistici e motociclistici; 10–20%: caduta dall’alto-precipitazione; 10%: incidenti sul lavoro-trauma da schiacciamento). Sono gravate da un’alta morbilita e mortalita dato che l’elevata energia richiesta per esercitare un danno su una struttura cosi solida e in grado di provocare anche lesioni viscerali e, soprattutto, il coinvolgimento di strutture vascolari arteriose evenose, la cui rottura/lacerazione puo mettere a rischio la vita del paziente per shock emorragico e necessita spesso di un trattamento chirurgico/interventistico di urgenza. L’emorragia pelvica rappresenta la principale causa di morte nel trauma pelvico (mortalita del 5–30%) [78,79].
Springer ABC, 2012
Il trauma del torace e responsabile del 25% dei decessi nel paziente politraumatizzato, al second... more Il trauma del torace e responsabile del 25% dei decessi nel paziente politraumatizzato, al secondo posto dopo il trauma cranico. Nel 90% dei casi si tratta di traumi chiusi e gli incidenti motociclistici e le cadute ne rappresentano la causa piu comune [3,6,7].
Journal of Neuroradiology, 2014
The aim of the study was to assess the diagnostic potential of diffusion tensor imaging (DTI) for... more The aim of the study was to assess the diagnostic potential of diffusion tensor imaging (DTI) for pathologies of the peripheral nervous system (PNS) through clinical, electrophysiological and morphological evaluation of the median nerve. Methods: The present work was a multilevel prospective study involving 30 subjects, 15 of whom had carpal tunnel syndrome (CTS) and 15 healthy controls. All subjects underwent clinical evaluation through administration of the Boston Carpal Tunnel Questionnaire (BCTQ), electroneurography (ENG), 3-Tesla magnetic resonance imaging with DTI, and calculation of fractional anisotropy (FA) and the apparent diffusion coefficient (ADC) at the flexor retinaculum. Tractography was also performed for three-dimensional reconstruction of the route of the median nerve through the carpal tunnel. The degree of functional impairment was compared with the anatomical damage to the median nerve according to ENG and DTI. Results: FA and ADC were significantly correlated with ENG parameters of CTS and BCTQ data. Mean FA and ADC values in the CTS patients were 0.359 ± 0.06 and 1.866 ± 0.050 × 10 −3 mm 2 /s, respectively, vs 0.59 ± 0.014 and 1.395 ± 0.035 × 10 −3 mm 2 /s, respectively, in the controls. FA was decreased and ADC increased in patients with CTS compared with healthy controls (P < 0.05). Conclusion: DTI parameters were clearly confirmed by both clinical and ENG data and, therefore, may be used for the diagnosis of CTS.
New Review of Hypermedia and Multimedia, 1998