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  1. Article ; Online: Endovascular Interventional Radiology of the Urogenital Tract.

    Pozzi Mucelli, Fabio / Pozzi Mucelli, Roberta A / Marrocchio, Cristina / Tollot, Saverio / Cova, Maria A

    Medicina (Kaunas, Lithuania)

    2021  Volume 57, Issue 3

    Abstract: Interventional radiology of the male urogenital system includes percutaneous and endovascular procedures, and these last consist mostly of transcatheter arterial embolizations. At the kidney level, arterial embolizations are performed mainly for ... ...

    Abstract Interventional radiology of the male urogenital system includes percutaneous and endovascular procedures, and these last consist mostly of transcatheter arterial embolizations. At the kidney level, arterial embolizations are performed mainly for palliative treatment of parenchymal tumors, for renal traumas and, less frequently, for arteriovenous fistulas and renal aneurysms and pseudoaneurysms. These latter may often require emergency intervention as they can cause renal or peri-renal hematomas or significant hematuria. Transcatheter arterial embolization is also an effective therapy for intractable severe bladder hematuria secondary to a number of neoplastic and inflammatory conditions in the pelvis, including unresectable bladder cancer and radiation-induced or cyclophosphamide-induced hemorrhagic cystitis. Endovascular interventional procedures for the penis are indicated for the treatment of post-traumatic priapism. In this article, we review the main endovascular radiological interventions of the male urogenital system, describing the technical aspects, results, and complications of each procedure at the various anatomical districts.
    MeSH term(s) Aneurysm, False ; Arteriovenous Fistula/diagnostic imaging ; Arteriovenous Fistula/therapy ; Embolization, Therapeutic ; Endovascular Procedures ; Humans ; Male ; Radiology, Interventional ; Treatment Outcome
    Language English
    Publishing date 2021-03-17
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2188113-3
    ISSN 1648-9144 ; 1010-660X
    ISSN (online) 1648-9144
    ISSN 1010-660X
    DOI 10.3390/medicina57030278
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6270: Show issues Location:
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  2. Article: Focusing on Single CT Perfusion Quantitative Maps: Percheron's Artery Stroke Detection.

    Cillotto, Tommaso / Furlanis, Giovanni / Buoite Stella, Alex / Lugnan, Carlo / Caruso, Paola / Pozzi Mucelli, Roberta / Naccarato, Marcello / Manganotti, Paolo

    The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques

    2021  Volume 49, Issue 4, Page(s) 600–602

    MeSH term(s) Arteries ; Brain Ischemia ; Cerebrovascular Circulation ; Humans ; Perfusion ; Stroke/diagnostic imaging ; Tomography, X-Ray Computed
    Language English
    Publishing date 2021-07-14
    Publishing country England
    Document type Letter
    ZDB-ID 197622-9
    ISSN 0317-1671
    ISSN 0317-1671
    DOI 10.1017/cjn.2021.173
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  3. Article: MicroRNAs Related to TACE Treatment Response: A Review of the Literature from a Radiological Point of View.

    Bozzato, Alessandro Marco / Martingano, Paola / Pozzi Mucelli, Roberta Antea / Cavallaro, Marco Francesco Maria / Cesarotto, Matteo / Marcello, Cristina / Tiribelli, Claudio / Pascut, Devis / Pizzolato, Riccardo / Pozzi Mucelli, Fabio / Giuffrè, Mauro / Crocè, Lory Saveria / Cova, Maria Assunta

    Diagnostics (Basel, Switzerland)

    2022  Volume 12, Issue 2

    Abstract: Hepatocellular Carcinoma (HCC) is the sixth most common cancer in the world. Patients with intermediate stage (Barcelona Clinic Liver Cancer, B stage) hepatocellular carcinoma (HCC) have been able to benefit from TACE (transarterial chemoembolization) as ...

    Abstract Hepatocellular Carcinoma (HCC) is the sixth most common cancer in the world. Patients with intermediate stage (Barcelona Clinic Liver Cancer, B stage) hepatocellular carcinoma (HCC) have been able to benefit from TACE (transarterial chemoembolization) as a treatment option. MicroRNAs (miRNAs), i.e., a subclass of non-coding RNAs (ncRNAs), participate in post-transcriptional gene regulation processes and miRNA dysfunction has been associated with apoptosis resistance, cellular proliferation, tumor genesis, and progression. Only a few studies have investigated the role of miRNAs as biomarkers predicting TACE treatment response in HCC. Here, we review the studies' characteristics from a radiological point of view, also correlating data with radiological images chosen from the cases of our institution.
    Language English
    Publishing date 2022-02-01
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics12020374
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  4. Article ; Online: CT perfusion and EEG patterns in patients with acute isolated aphasia in seizure-related stroke mimics.

    Manganotti, Paolo / Furlanis, Giovanni / Ajčević, Miloš / Polverino, Paola / Caruso, Paola / Ridolfi, Mariana / Pozzi-Mucelli, Roberta Antea / Cova, Maria Assunta / Naccarato, Marcello

    Seizure

    2019  Volume 71, Page(s) 110–115

    Abstract: Purpose: Isolated speech impairment is one of the most challenging clinical manifestations of stroke mimic (SM). We aimed to investigate perfusional and EEG pattern of isolated aphasia to better differentiate between vascular and epileptic etiology in ... ...

    Abstract Purpose: Isolated speech impairment is one of the most challenging clinical manifestations of stroke mimic (SM). We aimed to investigate perfusional and EEG pattern of isolated aphasia to better differentiate between vascular and epileptic etiology in emergency settings.
    Method: We retrospectively analyzed 481 cases with acute focal neurological symptoms admitted to our Stroke Unit. The patients showing isolated aphasia and confirmed ischemic infarction or SM with seizure etiology on follow-up were included for subsequent analysis of clinical, neuroimaging, and EEG data. We investigated differences in CT Perfusion maps between ROI in the anatomical area compatible with clinical presentation, contralateral ROI and EEG in order to evaluate perfusion and brain oscillatory activity abnormalities.
    Results: 45 patients presented isolated aphasia as principal neurological symptom: 27 cases due to acute ischemic event, 11 due to seizure SM, while 7 were SM due to other etiologies. Out of 11 SM patients with seizure etiology, significant hyperperfusion on CTP maps (MTT AI%<-10%) and sharp EEG waves were observed in 8 patients, while in 3 patients slight hypoperfusion (MTT AI%<20%) and slow EEG rhythms were detected. 24 out of 27 ischemic stroke patients presented severe hypoperfusion with MTT AI above the stroke threshold (MTT AI > 45%). All ischemic stroke patients presented slower EEG rhythms.
    Conclusions: The main finding of this study is the identification of different clinical and neuroimaging patterns of isolated aphasia with epileptic or ischemic etiology in emergency settings.
    MeSH term(s) Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Aphasia/diagnosis ; Aphasia/etiology ; Brain Ischemia/complications ; Brain Ischemia/diagnosis ; Computed Tomography Angiography ; Electroencephalography ; Epilepsy/complications ; Epilepsy/diagnosis ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stroke/complications ; Stroke/diagnosis
    Language English
    Publishing date 2019-07-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 1137610-7
    ISSN 1532-2688 ; 1059-1311
    ISSN (online) 1532-2688
    ISSN 1059-1311
    DOI 10.1016/j.seizure.2019.07.005
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    Zs.A 3573: Show issues Location:
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  5. Article ; Online: CT perfusion in hyper-acute ischemic stroke: the acid test for COVID-19 fear.

    Furlanis, Giovanni / Ajčević, Miloš / Scali, Ilario / Buoite Stella, Alex / Olivo, Sasha / Lugnan, Carlo / Caruso, Paola / Pozzi Mucelli, Roberta Antea / Accardo, Agostino / Cova, Maria Assunta / Naccarato, Marcello / Manganotti, Paolo

    Neuroradiology

    2021  Volume 63, Issue 9, Page(s) 1419–1427

    Abstract: Purpose: The fear of COVID-19 infection may discourage patients from going to the hospital even in case of sudden onset of disabling symptoms. There is growing evidence of the reduction of stroke admissions and higher prevalence of severe clinical ... ...

    Abstract Purpose: The fear of COVID-19 infection may discourage patients from going to the hospital even in case of sudden onset of disabling symptoms. There is growing evidence of the reduction of stroke admissions and higher prevalence of severe clinical presentation. Yet, no studies have investigated the perfusion pattern of acute strokes admitted during the lockdown. We aimed to evaluate the effects of the COVID-19 pandemic on hyper-acute stroke CT perfusion (CTP) pattern during the first months of the pandemic in Italy.
    Methods: In this retrospective observational study, we analyzed CTP images and clinical data of ischemic stroke patients admitted between 9 March and 2 June 2020 that underwent CTP (n = 30), to compare ischemic volumes and clinical features with stroke patients admitted during the same period in 2019 (n = 51). In particular, CTP images were processed to calculate total hypoperfused volumes, core volumes, and mismatch. The final infarct volumes were calculated on follow-up CT.
    Results: Significantly higher total CTP hypoperfused volume (83.3 vs 18.5 ml, p = 0.003), core volume (27.8 vs 1.0 ml, p < 0.001), and unfavorable mismatch (0.51 vs 0.91, p < 0.001) were found during the COVID-19 period compared to no-COVID-19 one. The more unfavorable perfusion pattern at admission resulted in higher infarct volume on follow-up CT during COVID-19 (35.5 vs 3.0 ml, p < 0.001). During lockdown, a reduction of stroke admissions (- 37%) and a higher prevalence of severe clinical presentation (NIHSS ≥ 10; 53% vs 36%, p = 0.029) were observed.
    Conclusion: The results of CTP analysis provided a better insight in the higher prevalence of major severity stroke patients during the COVID-19 period.
    MeSH term(s) Brain Ischemia ; COVID-19 ; Communicable Disease Control ; Fear ; Humans ; Ischemic Stroke ; Pandemics ; Perfusion ; Perfusion Imaging ; SARS-CoV-2 ; Stroke/diagnostic imaging ; Tomography, X-Ray Computed
    Language English
    Publishing date 2021-02-02
    Publishing country Germany
    Document type Journal Article ; Observational Study
    ZDB-ID 123305-1
    ISSN 1432-1920 ; 0028-3940
    ISSN (online) 1432-1920
    ISSN 0028-3940
    DOI 10.1007/s00234-021-02639-5
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    Zs.A 658: Show issues Location:
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  6. Article ; Online: A Novel Fast CT Perfusion Core-Penumbra Mismatch Score: Correlation With Stroke Outcome.

    Pozzi-Mucelli, Roberta A / Furlanis, Giovanni / Caruso, Paola / Lugnan, Carlo / Zdjelar, Adrian / Degrassi, Ferruccio / Bottaro, Lorella / Ukmar, Maja / Naccarato, Marcello / Manganotti, Paolo / Cova, Maria A

    The neurologist

    2021  Volume 26, Issue 2, Page(s) 41–46

    Abstract: Background: Advanced neuroimaging can identify patients who can most benefit from reperfusion treatment, discriminating between ischemic core and penumbra area in a quick and accurate manner. Despite core-penumbra mismatch being an independent ... ...

    Abstract Background: Advanced neuroimaging can identify patients who can most benefit from reperfusion treatment, discriminating between ischemic core and penumbra area in a quick and accurate manner. Despite core-penumbra mismatch being an independent prognostic factor, computed tomography perfusion (CTP) assessment is still debated in hyperacute decision-making. The authors aimed to study a novel CTP mismatch score in emergency settings and to investigate its relation with clinical outcome in acute ischemic stroke patients treated with intravenous thrombolysis (IVT).
    Methods: Neuroimaging and clinical data of 226 consecutive acute ischemic stroke patients were analyzed. The study population was divided into 5 different CTP scores: (0) without perfusion deficit, (1) only penumbra, (2) penumbra > core, (3) core ≥ penumbra, (4) only core. For differences in outcome between treated and nontreated patients, and among CTP core-penumbra groups to be assessed, the authors have evaluated the outcome in terms of National Institutes of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) at discharge and symptomatic intracerebral hemorrhage.
    Results: A decrease in NIHSS was statistically greater in IVT-treated patients compared to nontreated patients showing only penumbra (ΔNIHSS%: 80.0% vs. 50.0%; P=0.0023) or no perfusion deficit (ΔNIHSS%: 89.4% vs. 61.5%; P=0.027) on CTP maps. The same trend was found in other groups without significant difference. A significant correlation was found in IVT patients between core/penumbra score and outcome in terms of ΔNIHSS (Kendall τ=-0.19; P=0.004).
    Conclusions: The authors proposed a novel immediate CTP assessment to score perfusion mismatch in emergency settings to guide clinicians' decision-making for aggressive treatment and to prevent stroke-related disability.
    MeSH term(s) Brain Ischemia/diagnostic imaging ; Brain Ischemia/drug therapy ; Humans ; Perfusion ; Perfusion Imaging ; Stroke/diagnostic imaging ; Stroke/drug therapy ; Tomography, X-Ray Computed ; United States
    Language English
    Publishing date 2021-03-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1361380-7
    ISSN 2331-2637 ; 1074-7931
    ISSN (online) 2331-2637
    ISSN 1074-7931
    DOI 10.1097/NRL.0000000000000315
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    Zs.A 4641: Show issues Location:
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  7. Article ; Online: Perfusion CT in acute stroke: effectiveness of automatically-generated colour maps.

    Ukmar, Maja / Degrassi, Ferruccio / Pozzi Mucelli, Roberta Antea / Neri, Francesca / Mucelli, Fabio Pozzi / Cova, Maria Assunta

    The British journal of radiology

    2017  Volume 90, Issue 1072, Page(s) 20150472

    Abstract: Objective: To evaluate the accuracy of perfusion CT (pCT) in the definition of the infarcted core and the penumbra, comparing the data obtained from the evaluation of parametric maps [cerebral blood volume (CBV), cerebral blood flow (CBF) and mean ... ...

    Abstract Objective: To evaluate the accuracy of perfusion CT (pCT) in the definition of the infarcted core and the penumbra, comparing the data obtained from the evaluation of parametric maps [cerebral blood volume (CBV), cerebral blood flow (CBF) and mean transit time (MTT)] with software-generated colour maps.
    Methods: A retrospective analysis was performed to identify patients with suspected acute ischaemic strokes and who had undergone unenhanced CT and pCT carried out within 4.5 h from the onset of the symptoms. A qualitative evaluation of the CBV, CBF and MTT maps was performed, followed by an analysis of the colour maps automatically generated by the software.
    Results: 26 patients were identified, but a direct CT follow-up was performed only on 19 patients after 24-48 h. In the qualitative analysis, 14 patients showed perfusion abnormalities. Specifically, 29 perfusion deficit areas were detected, of which 15 areas suggested the penumbra and the remaining 14 areas suggested the infarct. As for automatically software-generated maps, 12 patients showed perfusion abnormalities. 25 perfusion deficit areas were identified, 15 areas of which suggested the penumbra and the other 10 areas the infarct. The McNemar's test showed no statistically significant difference between the two methods of evaluation in highlighting infarcted areas proved later at CT follow-up.
    Conclusion: We demonstrated how pCT provides good diagnostic accuracy in the identification of acute ischaemic lesions. The limits of identification of the lesions mainly lie at the pons level and in the basal ganglia area. Qualitative analysis has proven to be more efficient in identification of perfusion lesions in comparison with software-generated maps. However, software-generated maps have proven to be very useful in the emergency setting. Advances in knowledge: The use of CT perfusion is requested in increasingly more patients in order to optimize the treatment, thanks also to the technological evolution of CT, which now allows a whole-brain study. The need for performing CT perfusion study also in the emergency setting could represent a problem for physicians who are not used to interpreting the parametric maps (CBV, MTT etc.). The software-generated maps could be of value in these settings, helping the less expert physician in the differentiation between different areas.
    MeSH term(s) Brain/blood supply ; Brain/diagnostic imaging ; Brain Mapping/methods ; Cerebrovascular Circulation ; Humans ; Image Processing, Computer-Assisted/methods ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Stroke/diagnostic imaging ; Tomography, X-Ray Computed/methods
    Language English
    Publishing date 2017-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 2982-8
    ISSN 1748-880X ; 0007-1285
    ISSN (online) 1748-880X
    ISSN 0007-1285
    DOI 10.1259/bjr.20150472
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