Jacopo Tesei

Sapienza University of Rome, Roma, Latium, Italy

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Publications (5)7.9 Total impact

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    ABSTRACT: This paper describes our experience with magnetic resonance imaging (MRI) in the assessment of fetal anatomical structures and major fetal pathologies. The retrospective study included 128 pregnant women between the 22nd and 38th week of gestation. We used the following imaging protocol: T2-weighted single-shot fast spin-echo sequences for all foetuses and, in selected cases, gradient echo with steady-state free precession (SSFP), T1-weighted spoiled gradient echo [fast low-angle shot (FLASH)] with and without fat saturation, and T2 thick-slab sequences with multiplanar technique. In 32 cases, we performed diffusion-weighted sequences with apparent diffusion coefficient (ACD) maps on the brain, the kidneys and the lungs. We achieved diagnostic-quality images in 125 of 128 patients; MR image quality was unsatisfactory in three cases only. In 16 cases with previous negative ultrasound (US) findings, MRI confirmed the US diagnosis. MRI confirmed the positive US diagnosis in 67 of 109 cases (61.5%); in 11 cases it changed the US diagnosis, and in 31/109 the examination was negative. In addition, MRI identified other anomalies not recognised during US examination. With its ultrafast sequences, fetal MRI provides good detail of normal fetal anatomy and allows characterisation of suspected anomalies.
    La radiologia medica 04/2008; 113(2):225-41. DOI:10.1007/s11547-008-0242-0 · 1.37 Impact Factor
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    ABSTRACT: To report our experience with magnetic resonance imaging (MRI) in fetal heart evaluation. Two radiologists examined 31 MRI of fetuses with no ultrasound (US) evidence of cardio-thoracic anomalies. T2-weighted half-Fourier single-shot turbo spin-echo sequences were acquired for anatomic evaluation; fast imaging with steady-state free precession (TrueFISP) and cine-MR sequences with real-time steady-state free precession oriented like standard fetal echocardiographic projections were acquired for the characterization of cardiovascular morphology and function. In every case, MRI assessed the viscero-atrial situs. The four-chamber view and the short-axis view of the left ventricle were obtained in all fetuses, the long-axis view of the aortic arch in 28, the long-axis view of the ductus arteriosus in 17, the five-chamber view in 12, the long-axis of the left ventricle in 9, the three-vessel view in 7, the tricuspid-aortic view in 3, and the transverse view of the aortic arch and the angulated view of the arch and the ductus arteriosus simultaneously in 2 fetuses. Our preliminary experience demonstrates the feasibility to visualize the fetal heart with routine fetal MRI protocols in particular, by means of acquisition of TrueFISP imaging (morphological study) and real-time cine-MRI (dynamic study), potentially making MRI a second-level tool to add to fetal echocardiography in the prenatal study of congenital cardiac malformations.
    Prenatal Diagnosis 02/2008; 28(2):148-56. DOI:10.1002/pd.1945 · 3.27 Impact Factor
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    ABSTRACT: To investigate apparent diffusion coefficient (ADC) mapping with the measurement of renal tissue ADC value of normal and pathological fetal kidneys at various gestational ages (GAs). Fifty pregnant women underwent magnetic resonance images (MRI) after ultrasound (US) for suspected fetal genitourinary disorders (16) or for suspected disorders in other organs (34). A multiplanar study of urinary system was obtained by using conventional T2-weighted sequences and echo planar imaging (EPI); Diffusion-weighted images and ADC maps were evaluated. The renal tissue ADC value was measured for all normal and abnormal fetuses and related to GA. MRI confirmed urinary anomalies in 15 fetuses [2 renal developmental variants, 2 nephropathies, 4 multicystic dysplastic kidneys (MCDK), 7 renal tract dilatations] and detected normal kidneys in the remaining 35 fetuses. Normal renal parenchyma showed bright signal on diffusion-weighted images with ADC values ranging from 1,065 to 1,327 microm(2)/s with a tendency to decrease over GA. A pathological ADC was detected in cases of bilateral MCDK, huge dilatations and in cases of nephropathies. Diffusion-weighted imaging (DWI) with ADC mapping can be used in the evaluation of fetal renal parenchyma and may become a tool of assessing function of the fetal kidney by means of measurement of renal tissue ADC values.
    Prenatal Diagnosis 12/2007; 27(12):1104-11. DOI:10.1002/pd.1839 · 3.27 Impact Factor
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    ABSTRACT: PURPOSE To assess the ability of ultrafast obstetric magnetic resonance imaging to visualize central nervous system abnormalities. METHOD AND MATERIALS 30 fetuses with central nervous system abnormalities were evaluated with obstetric Magnetic Resonance (MR) imaging. The mean gestational age was 24 weeks (range, 17-36 weeks). Every patients underwent multiplanar study with T2-weighted HASTE 90, true fisp and colangiographic sequences. According to the ultrasonographic question, also T1-weighted flash2D breath hold sequences with fat suppression were used. RESULTS In all cases, MR imaging helped confirm sonographically suspected or detected central nervous system disorders, demonstrating a sensitivity of 100% and a specificity of 100%. In 3 cases MR imaging provided additional information about associated abnormalities that were not evident at fetal ultrasonography: 1 fetus had a 6-mm neural tube defect, 1 a complete agenesis of the corpus callosum and 1 a lissenencephaly. CONCLUSION Obstetric MR imaging is an important tool for the evaluation of complex fetal central nervous system pathologies as its high spatial resolution and multiplanar capabilities provides a precise diagnosis of location and severity of most of the cerebral anomalies, particularly when assessing abnormalities in cerebral myelination, migration and sulcation. PURPOSE To assess the ability of ultrafast obstetric magnetic resonance imaging to visualize central nervous system abnormalities. METHOD AND MATERIALS 30 fetuses with central nervous system abnormalities were evaluated with obstetric Magnetic Resonance (MR) imaging. The mean gestational age was 24 weeks (range, 17-36 weeks). Every patients underwent multiplanar study with T2-weighted HASTE 90, true fisp and colangiographic sequences. According to the ultrasonographic question, also T1-weighted flash2D breath hold sequences with fat suppression were used. RESULTS In all cases, MR imaging helped confirm sonographically suspected or detected central nervous system disorders, demonstrating a sensitivity of 100% and a specificity of 100%. In 3 cases MR imaging provided additional information about associated abnormalities that were not evident at fetal ultrasonography: 1 fetus had a 6-mm neural tube defect, 1 a complete agenesis of the corpus callosum and 1 a lissenencephaly. CONCLUSION Obstetric MR imaging is an important tool for the evaluation of complex fetal central nervous system pathologies as its high spatial resolution and multiplanar capabilities provides a precise diagnosis of location and severity of most of the cerebral anomalies, particularly when assessing abnormalities in cerebral myelination, migration and sulcation.
    Radiological Society of North America 2005 Scientific Assembly and Annual Meeting; 12/2005

Publication Stats

63 Citations
7.90 Total Impact Points

Institutions

  • 2007–2008
    • Sapienza University of Rome
      • • Department of Anatomical, Histological, Forensic Medicine and Orthopedic Science
      • • Department of Radiological, Oncological and Pathological Sciences
      Roma, Latium, Italy