Image quality and radiation dose reduction in chest CT in pulmonary infection.

Purpose: To evaluate the effect of dose reduction with iterative reconstruction (IR) on image quality of chest CT scan comparing two protocols.

Materials And Methods: Fifty-nine patients were enrolled. The two CT protocols were applied using Iterative Reconstruction (ASIR™) 40% but different noise indexes, recording dose-length product (DLP) and volume computed tomography dose index (CTDI).

Pulmonary measles disease: old and new imaging tools.

Background: Measles virus can cause lower respiratory tract infection, so that chest radiography is necessary to investigate lung involvement in patients with respiratory distress.

Purpose: To assess measles pneumonia imaging during the measles outbreak occurred in 2016-2017 in Italy.

Material And Methods: We retrospectively observed adult patients with a serological diagnosis of measles, who underwent chest-X rays for suspected pneumonia.

A 15-year experience of two hundred and twenty five consecutive right hepatectomies.

Background: In case of liver tumor, surgical resection is the therapeutic gold standard to increase patient survival. Among liver resections, right hepatectomy (RH) is defined as a major hepatectomy. The first aim of this study was to analyze the overall morbidity and mortality of patients undergoing RH, the second aim was to assess changes in both patients characteristic and surgical parameters and mortality rates in a single center institution.

ALPPS for primary and secondary liver tumors.

Introduction: To report our experience on associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in patients with liver tumors.

Methods: ALPPS is a surgical technique that allows hepatic resection after rapid liver hypertrophy.

Results: Thirteen operations were performed: 8 for hepatocellular carcinoma (HCC) with liver cirrhosis (LC) and 5 for colorectal liver metastases (CRLM, n = 3) and cholangiocarcinoma (CC, n = 2) in normal livers (NL).

Polyfunctional Specific Response to Echinococcus Granulosus Associates to the Biological Activity of the Cysts.

Background: Cystic echinococcosis (CE) is a complex disease caused by Echinococcus granulosus (E.granulosus), and its immunophatogenesis is still not clearly defined. A peculiar feature of chronic CE is the coexistence of Th1 and Th2 responses.

Brain tuberculosis-associated immune reconstitution inflammatory syndrome in an HIV-positive patient: a biopsy-proven case.

The case of an HIV-infected man from Eritrea previously diagnosed with tuberculosis, who presented neurological impairment and cerebral lesion after having voluntarily stopped anti-tubercular and antiretroviral therapies, is here reported. Treatments associated with steroids and mannitol were administered. The patient's condition improved, but neuroimaging showed a continuous worsening of the lesion, while a great immunological reconstitution was observed.

Radiographic imaging in Ebola Virus Disease: protocol to acquire chest radiographs.

Unlabelled: Proper procedures to minimize the risk of contamination in contagious and potentially lethal viral infections are needed; therefore radiology departments should develop appropriate imaging protocols. We describe the imaging protocol used by National Institute for Infectious Diseases Lazzaro Spallanzani to acquire chest radiographs in patients with Ebola virus disease.

Key Points: • Nosocomial transmission to healthcare workers can be prevented using protective equipment.

IL-4 specific-response in whole blood associates with human Cystic Echinococcosis and cyst activity.

Objectives: Human Cystic Echinococcosis (CE) is estimated in 2-3 million global cases. CE diagnosis and clinical management are based on imaging and serology, which lacks sensitivity and does not provide cyst stage information. This study aimed to evaluate tools for improving diagnosis by analysing the Interleukin (IL)-4-response to Antigen B (AgB) of Echinococcus granulosus.

Relationship between body mass index and bone mineral density in HIV-infected patients referred for DXA.

Introduction: Reduced bone mass density (BMD) is a frequent observation in HIV-infected persons. Relationship between body mass index (BMI), weight, height and BMD was reported for many populations. In particular, BMI has been found to be inversely related to the risk of osteoporosis.

Cystic echinococcosis in a single tertiary care center in Rome, Italy.

Background: Cystic echinococcosis (CE) is a chronic, clinically complex, and neglected disease. Its prevalence in Italy, a country of medium to high endemicity, remains poorly defined, as notification has long ceased to be mandatory.

Methods: We set up a retrospective cohort study involving all CE patients followed at our institute between January 2005 and December 2012.

Giant hydatid cyst of the liver with a retroperitoneal growth: a case report.

Introduction: Hydatid disease is a helminthic anthropozoonosis with worldwide distribution due to the close associations among sheep, dogs, and humans. It can occur almost anywhere in the body with a variety of imaging features, which may change according to the growth stage, associated complications, and affected tissues. A definitive diagnosis requires a combination of imaging, serologic and immunologic studies.

IP-10 is an additional marker for tuberculosis (TB) detection in HIV-infected persons in a low-TB endemic country.

Objective: In Indian HIV-infected patients, IP-10 response to QuantiFERON-TB Gold In tube (QFT-IT) antigens has been associated to tuberculosis (TB). However, specificity for active TB was lower than that reported by QFT-IT, making accuracy for TB detection questionable. To investigate this uncertainty, likely due to India being highly endemic for TB, and to better identify TB correlates, we evaluated the IP-10-based assay in HIV-infected subjects in Italy, a low-TB endemic country.

Detection of Pulmonary tuberculosis: comparing MR imaging with HRCT.

Background: Computer Tomography (CT) is considered the gold standard for assessing the morphological changes of lung parenchyma. Although novel CT techniques have substantially decreased the radiation dose, radiation exposure is still high. Magnetic Resonance Imaging (MRI) has been established as a radiation- free alternative to CT for several lung diseases, but its role in infectious diseases still needs to be explored further.

Sonographic assessment of facial HIV-related lypoatrophy.

Objective: To investigate the utility of ultrasonography (US) for assessing and grading facial lypoatrophy (FLA) in patients with HIV.

Design: The social effect of FLA is huge and may reduce antiretroviral therapy adherence. Strategies for the early detection of FLA are crucial, because complete correction of FLA in late stages is unlikely.

HIV-related pneumococcal lung disease: does highly active antiretroviral therapy or bacteremia modify radiologic appearance?

We reviewed chest radiographs of 57 HIV-infected patients with pulmonary diseases in whom Streptococcus pneumoniae was the sole respiratory pathogen isolated to evaluate whether highly active antiretroviral therapy (HAART) or bacteremia modify radiographic appearance. Pneumococcal lung disease presented as lobar pneumonia in 40% of the cases, 54% of whom were on HAART; as bronchopneumonia in 42%, 58% on HAART; as interstitial infiltrates in 17%, 60% on HAART. Bacteremia was observed 38 times in 23 patients with CD4 less than 200/mm(3), and in 15 with CD4 greater than 200/mm(3) (p > 0.

Progressive multifocal leukoencephalopathy in HIV-infected patients in the era of HAART: radiological features at diagnosis and follow-up and correlation with clinical variables.

The magnetic resonance (MR) imaging patterns of HIV-infected patients affected by progressive multifocal leukoencephalopathy (PML) in the HAART era have not been extensively documented. The aim of the present study is to describe the MR features of PML in HIV-infected patients at diagnosis, and the evolution during follow-up, evaluating the impact of HAART on imaging, and to correlate the MR pattern with the virological and immunological levels and with survival. We retrospectively reviewed MR imaging at baseline and at the last available follow-up within 6 months of diagnosis (median 4 months, range 1-6) of 31 HIV-positive patients affected by PML.

Reduced computed tomography radiation dose in HIV-related pneumonia: effect on diagnostic image quality.

Purpose: The objective of this study was to compare the diagnostic quality of low-dose computed tomography (CT) with that of standard-dose chest CT in the diagnosis of infectious lung diseases.

Materials And Methods: Thirty chest CT scans [high-resolution computed tomography (HRCT), 15; spiral CT, 15] were performed in HIV-positive patients with an infectious lung disease. Two additional slices were obtained at two lower exposures (HRCT, 120 kV/70 mAs and 120 kV/50 mAs; spiral CT, 100 kV/56 mAs and 100 kV/40 mAs) after chest routine CT.

Cavitary pulmonary tuberculosis HIV-related.

Introduction: It was usually assumed that pulmonary tuberculosis (TB) in HIV-seropositive patients represents reactivation TB, despite the radiographic appearance frequently consistent rather with a recent disease. Hence, these radiographic features were considered "atypical". We have hypothesised that the so called "atypical" radiographic features could be due to a greater proportion of primary TB among these patients, representing the typical appearance of primary radiological pattern.

Reduced value of thallium-201 single-photon emission computed tomography in the management of HIV-related focal brain lesions in the era of highly active antiretroviral therapy.

To evaluate the diagnostic value of thallium-201 single-photon emission computed tomography (201Tl SPECT) in the management of focal brain disorders in the era of highly active antiretroviral therapy (HAART), a validation study of diagnostic procedure was performed in a tertiary clinical care center in Italy. Thirty-eight consecutive HIV-infected patients with neurological impairment and focal brain lesions (FBL) were enrolled in a prospective evaluation and underwent diagnostic procedures according to a standardized protocol based on modified previously released guidelines. Six out of seven PCNSL presented high uptake at 201Tl SPECT [sensitivity 86% (95% CI 42-99); specificity 77% (95% CI 58-90); positive predictive value (PPV) 46% (95% CI 20-74); negative predictive value (NPV) 96% (95% CI 78-100)].

Gynecomastia in male HIV patients MRI and US findings.

Purpose: To evaluate the role of MRI and sonography in differential diagnosis between gynecomastia and lipomastia in adult male HIV patients treated with high-activity antiretroviral therapy (HAART) for guide management.

Materials And Methods: Nineteen adult male HIV patients with enlargement of the breast, which developed during treatment with HAART, were examined with ultrasound (US) and magnetic resonance imaging (MRI).

Results: MRI was performed with SPIR T2WI, depicted in 95% of the patients, true gynecomastia and in the remaining 5% lipomastia; US demonstrated in all patients, in the subareolar region, a hypoechoic area, but was enable to make a differential diagnosis between glandular tissue and fat accumulation.

STIR sequence in infectious sacroiliitis in three patients.

Magnetic resonance imaging (MRI) provides the most detailed evaluation of the sacroiliac (SI) joint and surrounding soft tissue. Therefore, this technique represents the most sensitive and specific method in early diagnosis of infectious sacroiliitis. Among three patients diagnosed as having infectious sacroiliitis in our hospital, the short tau inversion recovery sequence (STIR) was found to be more effective than the T1 contrast-enhanced sequence, particularly in delineating all findings of the SI joint inflammation and allowing for the early detection of septic sacroiliitis.