Laura Menchini

Ospedale Pediatrico Bambino Gesù, Roma, Latium, Italy

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Publications (24)49.88 Total impact

  • European Respiratory Journal 09/2015; 46(suppl 59):PA1357. DOI:10.1183/13993003.congress-2015.PA1357 · 7.64 Impact Factor
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    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 03/2014; 49(3). DOI:10.1002/ppul.22852 · 2.70 Impact Factor
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    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 03/2014; 49(3). DOI:10.1002/ppul.22788 · 2.70 Impact Factor
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    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; 44(3). DOI:10.1007/s00247-013-2851-6 · 1.57 Impact Factor
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    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; 102(1). DOI:10.1111/apa.12043 · 1.67 Impact Factor
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    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. DOI:10.1007/s11547-012-0795-9 · 1.34 Impact Factor
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    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. DOI:10.1007/s11547-011-0743-0 · 1.34 Impact Factor
  • F P Rossi · T Salerno · D Peca · O Danhaive · R Boldrini · L Menchini · R Cutrera ·

    European Respiratory Journal 10/2011; 38(4):985-7. DOI:10.1183/09031936.00155310 · 7.64 Impact Factor
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    Archives of Disease in Childhood 08/2011; 96(10):959. DOI:10.1136/archdischild-2011-300376 · 2.90 Impact Factor
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    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. DOI:10.1002/ajmg.a.33954 · 2.16 Impact Factor
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    Archives of Disease in Childhood 09/2010; 96(1):43. DOI:10.1136/adc.2010.196857 · 2.90 Impact Factor
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    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. DOI:10.1016/j.ijporl.2009.05.014 · 1.19 Impact Factor
  • L Menchini · M Remy-Jardin · J-B Faivre · M-C Copin · P Ramon · R Matran · V Deken · A Duhamel · J Remy ·
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    ABSTRACT: The aim of the present study was to describe angiographic findings and embolisation results in smokers with haemoptysis. We retrospectively reviewed the clinical data and angiographic findings from 35 patients with smoking-related bronchopulmonary disease and no associated comorbidity, who were referred for embolisation for mild (n = 6), moderate (n = 14) and severe (n = 15) haemoptysis. Spirometric classification subdivided our population into: 16 patients with chronic bronchitis but no airflow limitation; and 19 patients with chronic obstructive pulmonary disease (COPD) (stage I: n = 12; stage II: n = 5; stage III: n = 2). Bronchoscopy depicted focal submucosal vascular abnormalities in three patients and only endobronchial inflammation in 32 (91%) patients. Bronchial artery angiography revealed moderate (n = 18) or severe (n = 10) hypervascularisation in 28 (80%) patients, and normal vascularisation in seven (20%). No statistically significant difference was observed between the angiographic findings and the severity of COPD, tobacco consumption or the amount of bleeding. Cessation of bleeding was obtained by embolisation in 29 out of the 34 technically successful procedures (85%), requiring surgery in three out of five patients with recurrence. Follow-up (mean duration 7 yrs) demonstrated no recurrence of bleeding in 32 (94%) out of 34 patients and excluded late endobronchial malignancy. Smokers with various stages of COPD severity may suffer from haemoptysis that is efficiently treatable by endovascular treatment.
    European Respiratory Journal 05/2009; 34(5):1031-9. DOI:10.1183/09031936.00018709 · 7.64 Impact Factor
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    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.
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    ABSTRACT: The purpose of this study was to determine non-invasively the frequency of ectopic bronchial arteries (BA) (i.e., bronchial arteries originating at a level of the descending aorta other than T5-T6 or from any aortic collateral vessel) on multidetector-row CT angiograms (CTA) obtained in patients with hemoptysis. Over a 5-year period (2000-2005), 251 consecutive patients with hemoptysis underwent multidetector-row CT angiography of the thorax. From this population, 37 patients were excluded because of a suboptimal CTA examination (n = 19), the presence of extensive mediastinal disease (n = 15) or severe chest deformation (n = 3) precluding any precise analysis of the bronchial arteries at CTA. Our final study group included 214 patients who underwent a thin-collimated CT angiogram (contrast agent: 300 to 350 mg/ml) on a 4- (n = 56), 16- (n = 119) and 64- (n = 39) detector-row scanner. The site of origin and distribution of bronchial arteries were analyzed on transverse CT scans, maximum intensity projections and volume-rendered images. The site of the ostium of a bronchial artery was coded as orthotopic when the artery originated from the descending aorta between the levels of the fifth and sixth thoracic vertebrae; all other bronchial arteries were considered ectopic. From the studied population, 137 (64%) patients had only orthotopic bronchial arteries, whereas 77 patients (36%) had at least one bronchial artery of ectopic origin. A total of 147 ectopic arteries were depicted, originating as common bronchial trunks (n = 23; 19%) or isolated right or left bronchial arteries (n = 101; 81%). The most frequent sites of origin of the 124 ostiums were the concavity of the aortic arch (92/124; 74%), the subclavian artery (13/124; 10.5%) and the descending aorta (10/124; 8.5%). The isolated ectopic bronchial arteries supplied the ipsilateral lung in all but three cases. Bronchial artery embolization was indicated in 26 patients. On the basis of CTA information, (1) bronchial embolization was attempted in 24 patients; it was technically successful in 21 patients (orthotopic BAs: 6 patients; orthotopic and ectopic BAs: 3 patients; ectopic BAs: 12 patients) and failed in 3 patients due to an instable catheterization of the ectopic BAs; the absence of additional bronchial arterial supply and no abnormalities of nonbronchial systemic arteries at CTA avoided additional arteriograms in these 3 patients; (2) owing to the iatrogenic risk of the embolization procedure of ectopic BAs, the surgical ligation of the abnormal vessels was the favored therapeutic option in 2 patients. This study enabled the depiction of ectopic bronchial arteries in 36% of the studied population, important anatomical information prior to therapeutic decision making.
    European Radiology 09/2007; 17(8):1943-53. DOI:10.1007/s00330-006-0576-8 · 4.01 Impact Factor
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    ABSTRACT: PURPOSE To evaluate the accuracy of functional parameters in the depiction of pulmonary hypertension (PHT). METHOD AND MATERIALS The ECG-gated CT scans of 25 patients who had undergone right heart catheterization within 1 month of CT in the clinical context of chronic bronchopulmonary (n=17) or pulmonary vascular (n=8) diseases were retrospectively reviewed to analyze morphological and dynamic changes at the level of the right ventricular outflow tract (ROVT) and right pulmonary artery (RPA) on systolic and diastolic 2D reformations. The study group included 18 males and 7 females (mean age: 59.72 years) who had undergone an ECG-gated 64-slice multidetector-row CT examination of the entire thorax as part of their clinical work-up owing to the possibility to provide information on the underlying respiratory disease and right cardiac function (CT protocol approved by the local Ethics Committee). Hemodynamic features of PHT were present in 11 patients (mean pulmonary artery pressure: 38.45 mmHg; range: 26-56) and absent in 14 patients (mean pulmonary artery pressure: 17.1 mmHg; range: 11-23). Systolic and diastolic measurements were performed independently by two experienced radiologists. RESULTS Four parameters showed significant differences in the presence of PHT: the diameter of the pulmonary trunk (p=0.005), the diastolic (p=0.03) and systolic (p=0.006) thickness of the myocardium at the level of the RVOT and the distensibility of the RPA (0.008). For each of these variables, it was possible to define a threshold predictive of PHT (pulmonary trunk: 31.65 mm - specificity: 100%; diastolic thickness of the RVOT : 5.67 mm - specifity : 100% ; systolic thickness of the RVOT: 8.02 mm - specificity : 100%; distensibility of the RPA : 16% - specificity : 100%). The parameter showing the highest correlation with values of the pulmonary artery pressure was the distensibility of the RPA (r = - 0.74; p<0.05), also observed with the highest interobserver agreement using the Fleiss’ method (r=0.93). CONCLUSION Functional CTA could allow a noninvasive approach of PHT. CLINICAL RELEVANCE/APPLICATION ECG-gated 64-slice multidetector-row CT can provide functional information in patients with pulmonary hypertension.
    Radiological Society of North America 2006 Scientific Assembly and Annual Meeting; 11/2006

  • Journal de Radiologie 10/2006; 87(10):1325-1325. DOI:10.1016/S0221-0363(06)87127-1 · 0.57 Impact Factor
  • J. Rémy · M. P. Revel-Dubois · L. Menchini · S. Najar ·

    Journal de Radiologie 10/2006; 87(10):1361-1361. DOI:10.1016/S0221-0363(06)87256-2 · 0.57 Impact Factor
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    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. · 1.34 Impact Factor
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    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