Laura Menchini

Ospedale Pediatrico Bambino Gesù, Roma, Latium, Italy

Are you Laura Menchini?

Claim your profile

Publications (18)28.28 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Wandering spleen is a rare condition in children that is often caused by loss or weakening of the splenic ligaments. Its clinical presentation is variable; 64% of children with wandering spleen have splenic torsion as a complication. To provide up-to-date information on the diagnosis, clinical management and diagnostic imaging approaches for wandering spleen in infants and children and to underline the importance of color Doppler US and CT in providing important information for patient management. We report a series of three children with wandering spleen treated at our children's hospital over the last 6 years. All three underwent clinical evaluation, color Doppler US and CT and were surgically treated. We also reviewed 40 articles that included 55 patients younger than 18 years reported in the Medline database from 2002 to 2012. We correlated pathological data with imaging findings. Color Doppler US, the first imaging modality in investigating abdominal symptoms in children with suspected wandering spleen, yielded a diagnostic sensitivity of 54.9%, whereas CT achieved about 71.7%. Radiologic evaluation has a major role in confirming the diagnosis of a suspected wandering spleen and avoiding potentially life-threatening complications requiring immediate surgery.
    Pediatric Radiology 01/2014; · 1.57 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: NK2 homeobox-1 (NKX2.1) gene encoding the thyroid transcription factor-1 (TTF-1) plays a critical role in lung, thyroid, and central nervous system morphogenesis and function; mutations cause a rare form of progressive respiratory failure associated with alterations of surfactant synthesis, composition, and homeostasis. Molecular mechanisms are heterogeneous and poorly explored. A 28 days old male, soon after birth, presented respiratory failure requiring oxygen treatment at FiO2 27%, prolonged for 2 weeks. Routine neonatal screenings detected a high thyroid stimulating hormone concentration. On day 27 congenital hypothyroidism was confirmed and substitutive treatment was begun. Since the persistence of respiratory symptoms sweat test, CFTR mutation, lymphocyte subpopulations, and sputum cultures were tested, resulting negative. Brain and cardiac defects were also ruled out. Bronchoscopy and BAL analysis were normal. Computed tomography showed bilateral multiple ground glass attenuation, consolidative areas and diffuse bronchial wall thickening. Based on the severity of symptoms, the exclusion of other causes of respiratory disease and the CT findings of interstitial lung disease, we investigated genes affecting the surfactant homeostasis. Sequencing analysis of the three exons of the TTF1 revealed a heterozygous mutation c.334G > T that results in the replacement of glycine in position 112 with a stop codon, generating a nonsense protein that lacks the correct transactivation domain in the C-terminal region. Genetic analysis of the family showed that the father, who was asymptomatic, carried the mutation. Screening for TTF-1 deletions or mutations should always be considered in children with congenital hypothyroidism and an unexplained neonatal respiratory distress or neurodevelopmental deficits. Pediatr Pulmonol. © 2013 Wiley Periodicals, Inc.
    Pediatric Pulmonology 09/2013; · 2.38 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Double aortic arch is the most common congenital anomaly of the aortic arch system, in which the trachea and esophagus are completely encircled by vascular segments of the aortic arch and its branches, often resulting in variable airway compression. One case of late diagnosis of this congenital malformation and long-term consequences of late surgical treatment with persistent tracheo-broncomalacia and dynamic airway obstruction is reported. This report emphasizes the importance of an early diagnosis to minimise the progressive airways damage and subsequent respiratory symptoms, that need an accurate medical follow-up. Pediatr Pulmonol. 2013 9999:1-3. © 2013 Wiley Periodicals, Inc.
    Pediatric Pulmonology 07/2013; · 2.38 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Surfactant Protein C (SP-C) mutations determine a wide range of clinical manifestations, from neonatal/infantile diffuse lung disease to adult pulmonary fibrosis. (1). Mutations in SP-C gene cause diffuse lung disease in infants, older children and adults. The most common mutations are located in the BRICHOS domain, resulting in misfolding and cytosolic aggregation of the protein. Bronchiectasis has not been reported as a prominent feature in SP-C deficiency. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.
    Acta Paediatrica 10/2012; · 1.97 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE: This study compared the sensitivity of two commercial computer-aided detection (CAD) systems in identifying noncalcified pulmonary nodules on low-dose multidetector computed tomography (MDCT) scans by using a double reference standard. MATERIALS AND METHODS: Three chest low-dose MDCT scans of patients who had undergone lung cancer screening were retrospectively analysed using two distinct commercial CAD systems: LungCAD VC10A, Siemens Medical Solutions (CAD1) and LungVCAR, GE Healthcare (CAD2). The exact location of each finding suggested by each system was recorded by an independent reader according to spatial coordinates (x, y, z). Two panels of experienced thoracic radiologists from two different institutions independently established two reference standards (RS1, RS2) by identifying the true positive findings with spatial coordinates without using CAD. Sensitivity of the two CAD systems, defined by lesionlevel analysis, was tested and sensitivities compared. RESULTS: RS1 identified 34 noncalcified pulmonary nodules, whereas RS2 identified 54. The total number of findings detected by the two CAD systems was 684. CAD1 correctly identified 13/34 nodules (sensitivity 38%) for RS1 and 17/54 (sensitivity 30%) for RS2, whereas CAD2 correctly identified 11/34 nodules (sensitivity 35%) for RS1 and 13/54 (sensitivity 23%) for RS2. Comparison between the two CAD systems did not show a statistically significant difference in terms of sensitivity (p<0.05) for both RS1 (p=0.42) and RS2 (p=0.33). CONCLUSIONS: The two commercial CAD systems had similar sensitivity in detecting noncalcified pulmonary nodules on low-dose MDCT of the chest.
    La radiologia medica 02/2012; 117(6):953-967. · 1.46 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this paper is to describe the imaging features of central nervous system (CNS) tuberculosis on computed tomography (CT) and magnetic resonance imaging (MRI) studies in non-HIV-positive children. A retrospective descriptive evaluation was conducted on imaging studies obtained from ten children admitted to our hospital over a 6-year period who fulfilled criteria for a diagnosis of CNS tuberculosis. Data were collected with regard to patients' clinical, laboratory and demographic characteristics, as well as results of radiological investigation. We studied ten children, of whom five were boys and five were girls and whose mean age was 4 (range 7 months to 16) years. Neuroradiological findings on the first imaging study were basal meningeal enhancement (100%), hydrocephalus (70%), infarcts (90%), tuberculomas (40%) and cranial nerve involvement (20%). Follow-up studies revealed basal meningeal enhancement, hydrocephalus, and infarcts in all patients, tuberculomas in 70% and cranial nerve involvement in 50%. Only one patient showed a pattern of miliary tuberculosis. CNS tuberculosis is still an important cause of childhood morbidity and mortality even in nonimmunosuppressed children. Because prompt diagnosis results in earlier treatment, it is crucial to be aware of tuberculous meningitis and its complications at imaging, especially because of the impact on patients' prognosis.
    La radiologia medica 11/2011; 117(4):669-78. · 1.46 Impact Factor
  • European Respiratory Journal 10/2011; 38(4):985-7. · 6.36 Impact Factor
  • Source
    Archives of Disease in Childhood 08/2011; 96(10):959. · 3.05 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Encephalocraniocutaneous lipomatosis (ECCL) is a rare neurocutaneous syndrome characterized by involvement of tissues of ectodermal and mesodermal origin such as skin, eye, adipose tissue, and brain. Since 1970, when Haberland and Perou had described the first patient, 54 cases of ECCL have been reported in literature. We report on three new boys with ECCL. In addition to their typical dermal, ocular and central nervous system anomalies, one of them had a spheno-ethmoidal osseous lesion. Histopathological evaluation confirmed the benign nature of the lesion and was consistent with fibrous dysplasia. The aim of our study is to review clinical records and brain imaging studies of these three new patients with ECCL and compare these findings with those reported in literature to better define the phenotypic spectrum and radiological findings in ECCL.
    American Journal of Medical Genetics Part A 07/2011; 155A(7):1690-6. · 2.30 Impact Factor
  • Source
    Archives of Disease in Childhood 09/2010; 96(1):43. · 3.05 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Heterotopic neuroglial tissue is a rare lesion, occurring more frequently in the nasal cavities. Other rare locations are the orbit, the scalp, the palate, the pharynx, the parapharyngeal space and the lungs. They are usually detected occasionally because they are often asymptomatic, but sometimes they might present with dyspnoea, feeding difficulty, snorting and nasal flaring. Respiratory symptoms occur when heterotopic neuroglial tissue is located in the parapharyngeal space. We report a case of an infant affected by Pierre Robin sequence (PRS) who was admitted to our Institution for a worsening respiratory distress that was not explainable only by PRS.
    International journal of pediatric otorhinolaryngology 07/2009; 73(9):1308-10. · 0.85 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of our prospective study was to evaluate the diagnostic accuracy of MR Enteroclysis (MRE) to assess the extension and complications of Crohn's Disease (CD) in comparison with conventional enteroclysis (CE). The study comprised 30 consecutive patients affected by Crohn's disease (18 women and 12 men; age range 16-76, mean age 40.6 years), who underwent conventional and MR enteroclysis. The MR enteroclysis protocol includes three sequences: coronal and axial FIESTA and ssFSE sequences and T1-3D-FSPGR sequences before and after intravenous injection of gadolinium, acquired after administration of 1.6-2 l of iso-osmolar polyethylene glycol solution via a nasojejunal catheter. Two radiologists blindly scored each sequence for opacification of the lumen, small bowel distension and image quality and evaluated the following parameters: presence of wall ulcers, pseudopolyps, stenoses and fistulae. The accuracy of the FIESTA sequence was significantly higher (p<0.01) than the ssFSE and 3D FSPGR sequences in the evaluation of lumen opacification and bowel distension, and for the overall quality of the images (p<0.01). The sensitivity and specificity of MRE were 82% and 100% for the visualisation of parietal ulcers, 87% and 100% for pseudopolyps, 100% and 88% for stenoses, 75% and 100% for parietal fistulae. High-grade stenoses with prestenotic dilation (n=6) and low-grade stenoses (n=9) were visualised both by MRE and CE. MRE also showed abscesses in two patients, not seen at CE. The FIESTA and ssFSE sequences had higher accuracy in the detection of wall ulcers and fistulae, whereas the 3D FSPGR sequences showed higher accuracy in the evaluation of wall thickening. MRE is able to demonstrate the spectrum of superficial, intramural and exoenteric alterations in Crohn's disease and closely correlates with CE in demonstrating alterations of the bowel lumen and wall.
    La radiologia medica 09/2005; 110(3):221-33. · 1.46 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE To assess the capability of dynamic MR cholangiopancreatography (MRCP) after secretin stimulation in identifying disruptions of the pancreatic duct, compared with endoscopic retrograde cholangiopancreatography (ERCP)considered as the gold standard of the study. METHOD AND MATERIALS We prospectively studied 17 consecutive patients (8M; 9F; median age 41,7 range 23-72), haemodynamically stable with clinically suspected pancreatic injury related to blunt abdominal trauma (n = 12; 70.6%), penetrating trauma (n = 2; 11.8%), or iatrogenic trauma (n = 3; 17.6%) with dynamic MRCP after secretin stimulation. The MR examination technique included coronal, sagittal and axial breath-hold Half Fourier RARE 2D imaging using a phased array coil.Two radiologists separately assessed MRCP images to determine: presence/absence and site (head, body, tail) of pancreatic duct disruption; upstream duct visualization. Discrepancies were resolved by consensus. All patients underwent endoscopic retrograde cholangiopancreatography that represented our gold standard, within 7 days (range 4-10 days) from the MRCP examination. Sensitivity and specificity of MRCP was assessed. MRCP/ERCP concordance was assessed using K statistics. RESULTS MRCP detected pancreatic duct disruption in 16/17 (94,4%) patients; 2/15 (13,3%) patients had a rupture in the head, 10/15 (66,8%) patients in the body of the pancreas, 1 case (6,6%) of rupture in the hystmus and 2/15 (13,3%) patients in the tail. Upstream duct was visualized at dynamic MRCP in all patients. The mean interval between MRCP and ERCP was 7 days (range 2-10 days). ERCP detected pancreatic duct disruption in 17/17 (100%) patients. The sensitivity and specificity of MRCP was 94,4% and 100% respectively. K value of MRCP/ERCP concordance was 0.82. CONCLUSION MR pancreatography after secretin stimulation is an adequate noninvasive method for the detection of disruptions of the main pancreatic duct. MR pancreatography can also provide useful additional information for the mapping of the segments of the duct involved in order to establish the most correct therapeutic approach to the disease.
    Radiological Society of North America 2004 Scientific Assembly and Annual Meeting; 12/2004
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE To compare MR enteroclysis (MRE) with conventional enteroclysis (CE) in patients with Crohn’s disease. METHOD AND MATERIALS 52 consecutive patients (27 M; 25F; mean age 40,6; range 16-76) with known or suspected Crohn�s disease underwent MRE and conventional enteroclysis. MRE was performed on 1.5 T magnet by injection of 1,5-2 l of Polyethylene Glycol (PEG) solution via a nasojejunal catheter with the patient in prone position using a phase array body coil. To monitor the filling process of the the small bowel, a ssFSE sequence was applied every 7 seconds. As soon as the entire small bowel was adequately distended, a bowel relaxant was administered i.v. MRE examination protocol included: FIESTA, ssFSE, obtained on coronal and axial plane and gadolinium enhanced fat suppressed 3D-GR sequences.Each sequence was assessed by two radiologists who reached a consensus about the following imaging findings: the site and number of affected segments, of strictures, presence of adhesions, wall ulcers, fistulas, wall thickess, mesenteric nodes enlargement and perienteric changes. MRE findings were subsequently compared to CE findings, that represented the standard of reference in our study. RESULTS The mean interval between MRE and CE was 5 days (range 2-9 days).MRE detected 50/52 (96%) of affected segments, 19/19 (100%) of strictures, 24/30 (80%)of adhesions,14/16 (87,5%) wall ulcers, 8/12 (66%) fistulas. Wall thickening was depicted in 23 patients. Fibrofatty proliferation was disclosed in association with 18 segments on MRE and it might be suggested in 9 cases on CE.Mesenteric lymph nodes were found at MRE in 10 cases, abscesses in 3 and mesenteric phlegmon in 1. The accuracy of FIESTA sequence was statistically higher in depicting wall ulcers and fistulas compared to 3D-GR (p0.05) for the other imaging findings. CONCLUSION MRE accurately correlates with CE in the detection of superficial and transmural abnormalities in Crohn’s disease, with the advantage of assessment the mesenteric manifestations and complications of the disease.
    Radiological Society of North America 2004 Scientific Assembly and Annual Meeting; 11/2004
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE The purpose of this study was to evaluate the accuracy of magnetic resonance cholangiopancreatography (MRCP) for the detection of sclerosing cholangitis (SC) and to compare MRCP findings to endoscopic retrograde cholangiography (ERCP) used as the gold standard. METHOD AND MATERIALS MRCP findings were evaluated in 27 patients with clinical symptoms (progressive fatigue, pruritus followed by jaundice) and/or elevated values for alkaline phosphatase and serum aspartate transaminase, and occasionally an elevated serum concentration of bilirubin as a sign of cholestasis, who were consecutively referred for magnetic resonance imaging. Two observers independently classified bile duct abnormalities and established the MRCP diagnosis in a consensus reading. The results of MRCP were compared with the definitive diagnosis, which was based on the clinical history and laboratory and histological data, as well as on endoscopic retrograde cholangio-pancreatography (ERCP) findings. In a second step, the observers compared the delineation of the biliary system and morphological findings using MRCP and ERCP in patients with confirmed SC to determine the main biliary obstruction. RESULTS Diagnostic examinations were obtained in all patients (27/27). The diagnosis of SC was confirmed by clinical data and ERCP in 20 of these 27 patients (74 %). The sensitivity and specificity of MRCP for diagnosing SC were 95 % (19 of 20) and 100% (7 of 7), respectively. Different bile duct abnormalities leading to the diagnosis of SC were depicted by MRCP and ERCP; more bile duct stenoses and pruning were seen with ERCP and more skip dilatation with MRCP and MRCP has been more useful in the in the localization of the main stenoses in the biliary tree. CONCLUSIONS In patients with SC, MRCP is a highly sensitive method and its diagnostic accuracy is comparable to that of ERCP. MRCP can be used as the preliminary non-invasive imaging modality for the diagnosis of SC.
    Radiological Society of North America 2004 Scientific Assembly and Annual Meeting; 11/2004
  • [Show abstract] [Hide abstract]
    ABSTRACT: The case of a patient admitted to hospital for symptoms characterized by upper abdominal pain of pancreatic type associated with vomiting, is discussed. MRI was performed. It documented a focal fluid lesion apparently in communication with the dilated main pancreatic duct showing filling defects. Based on previous radiologic examinations performed elsewhere and MRI findings the diagnostic suspicion was of a cystic lesion. MRI was performed again for re-evaluation and lithotripsy was done; the patient was discharged with the diagnosis of chronic pancreatitis from alcohol abuse.
    Rays 29(2):185-93.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The evolution of logic thought in relation to the predominant recent advances in technology is analyzed. In fact, the computer was the prime mover of this major change. At present the use of sophisticated software has allowed to attain increasingly accurate levels of simulation of human reasoning. The computer has determined profound transformations in many sectors of work, study and research. Among these, it is extremely relevant how the computer has completely transformed medicine and the medical role, especially in the field of radiology. Expert systems are the most interesting and futuristic applications of artificial intelligence. These systems are able to reproduce on a computer the behavior of an expert human being. Some of the recent innovations introduced in the field of breast, thoracic and mainly neural pathology are illustrated.
    Rays 28(1):103-8.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Pulmonary embolism (PE) is a pathologic condition in which a blood clot as well as some neoplastic or infectious material migrates from any part of the body through the right heart and stops in the pulmonary arterial circulation. It is a life-threatening condition either when presenting as an acute or massive disease or when presenting as a chronic condition followed by repeated episodes.