L M Fantozzi

Sapienza University of Rome, Roma, Latium, Italy

Are you L M Fantozzi?

Claim your profile

Publications (85)145.13 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To assess what kind of information MR examination in flexed and extended positions provides in Down syndrome subjects with suspected cranio-cervical instability. Methods: Between 2005 and 2008, 35 subjects with DS were recruited in the study. Ethics committee approval was granted and a signed informed consent was obtained from the parents. All the subjects were affected by hypotonic status and ligament laxity established by clinical evaluation, but were asymptomatic about focal neurological symptoms due to medullar damage caused by cranio-cervical instability. Each patient underwent lateral supine radiographs and MR imaging in the neutral, active flexed and extended positions. For evaluating the atlanto-axial and atlanto-occipital joint stability, multiple measurements were calculated. Results: A significant reduction of anterior subarachnoid space in flexed position was evident in DS subjects compared to healthy controls in neutral and flexed positions. Both, space available for cord and ligamentous thickness showed significant differences between DS subjects and healthy controls. In DS subjects with occipito-cervical instability, the anterior subarachnoidal space reduction was significantly reduced in flexed position. Conclusions: In DS subjects with asymptomatic cranio-cervical instability, anterior subarachnoidal evaluation and ligamentous status could add new information about the risk of spinal cord damage.
    The Indian Journal of Pediatrics 09/2014; 82(4). DOI:10.1007/s12098-014-1549-6 · 0.87 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: The aim of this study was to verify the sensitivity and specificity of the hyperdense middle cerebral artery sign (HMCAS) obtained by multidetector computed tomography (CT) in predicting acute stroke, using diffusion-weighted (DW) magnetic resonance imaging (MRI) as a reference. The location of the HMCAS, the extension of the ischaemic lesion and its prognostic value were also assessed. Materials and methods: The CT examinations of 654 patients with symptoms related to acute cerebral stroke were retrospectively reviewed. DW-MRI confirmed recent stroke in 175 patients. Two expert neuroradiologists analysed the CT examinations of these patients in four phases. Sensitivity, specificity and interobserver reliability was evaluated. Patients were divided into three groups according to the HMCAS site (M1-M2-M3) and the Alberta Stroke Program Early CT Score (ASPECTS) on DW-MRI was calculated. The ASPECTS average score was correlated with the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) at 3 months. Results: In 41 patients, the presence of HMCAS was confirmed (71 % sensitivity; 100 % specificity; Interobserver reliability k, 84 %). An inverse correlation was found by comparing the ASPECTS and NIHSS scores (Rsq = -0.206). After logistic regression analysis, HMCAS was found to be independently associated with a poor outcome (mRS >2) at 3 months after adjusting for age, NIHSS on admission, risk factors and aetiology of stroke. Conclusions: Our study demonstrated that HMCAS obtained with multidetector CT can be detected in more than 70 % of patients with large acute ischaemic lesion and it is an unfavourable prognostic sign.
    La radiologia medica 08/2014; 120(2). DOI:10.1007/s11547-014-0424-x · 1.34 Impact Factor
  • Silvia Pugliese · Andrea Romano · Giuseppe Minniti · Luigi Maria Fantozzi · Alessandro Bozzao ·
    [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE The usually scheduled treatment in patient affected by glioblastoma multiforme (GBM) is surgery followed by radiotherapy (RT) associated with temozolamide (TMZ) chemotherapy. Possible findings during early (within 4 months) follow-up MRI are new enhancing lesions either due to recurrence or to early radiation necrosis (the so called pseudo-progression, PP). To distinguish these two entities can impact further treatment. The purpose of our study was to evaluate T2*-weighted dynamic susceptibility-weighted contrast–enhanced (DSC) imaging and the derived rCBV and Ktrans, in the differential diagnosis between recurrent GBM from PP. METHOD AND MATERIALS A retrospective study was performed in 115 patients, affected by GBM, enrolled after surgery and RT associated to TMZ chemotherapy. They all underwent DSC-MRI follow-up. In 24 of them, early follow-up MRI (4 months) revealed a new nodular area of contrast enhancement within the radiation field. The diagnosis of recurrence vs PP was established with clinical-radiological follow-up or surgical resection. ROIs were drawn semiautomatically on the enhancing component of the lesion, avoiding cortical vessels. The same ROIs were copied on the CBV and Ktrans color maps (Perfscape - Olea software, France) and the values obtained were normalized to the contralateral normal appearing white matter. T test was used to compare the groups. RESULTS Mean rCBV (2,7 vs 1,7 P<0,05), maximum rCBV (4 vs 2,6 P<0,05) and minimum rCBV (1,2 vs 0,7 P<0,06) were higher in patients with a GBM recurrence than in patients with PP. Mean Ktrans (68,7 vs 112,7 P<0,05) maximum Ktrans (287 vs 312,8 P<0,5) minimum Ktrans (1 vs 14,5 P<0,05) were lower in patients with a GBM recurrence than in patients with PP. We propose a mean rCBV cut-off ≥ 2,3 (sensibility: 64%; specificity: 75%; positive predictive value: 70%; negative predictive value: 70%). CONCLUSION DSC perfusion MRI can differentiate PP from tumor recurrence in patients with GBM treated with RT associated with TMZ chemotherapy. These results reflect the different vascular density and permeability of the GBM recurrence compared to PP. CLINICAL RELEVANCE/APPLICATION The informations given by DSC perfusion MRI help the radiologist in the differential diagnosis and they are of paramount importance for the subsequent therapy of these patients.
    Radiological Society of North America 2012 Scientific Assembly and Annual Meeting; 11/2012
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE The status of MGMT promoter methylation in glioblastomas (GBM) currently is obtained after surgery since considered a prognostic marker of the disease and more frequently related to pseudo-progression. The purpose of this study was to evaluate whether apparent diffusion coefficient (ADC) values can predict the status of MGMT of GBM and correlate with overall survival (OS) and progression free survival (PFS). METHOD AND MATERIALS This retrospective study included 55 patients with pathologic proven glioblastoma. All of them underwent MR DWI study before surgery and the status of MGMT promoter methylation was searched. Minimum ADC values were evaluated drawing multiple regions of interest within the enhancement component of the tumor thus transferred on ADC maps. Oversll survival and PSF parameters were calculated and Student T-test, Kaplan-Meier curves, linear and cox regression were performed. RESULTS Thirty patients showed positive methylation of the MGMT promoter. Patients showing MGMT promoter methylation had higher minimum ADC values (p<0.05) and they survived more over a long time than those without MGMT promoter methylation (OS, p < 0.05; PFS, p<0.05). Choosen the median values of 80 as ADC cut-off, 29 patients showing minimum ADC values higher than 80 survived more over a long time than 26 patients with minimum ADC lower than 80 (OS, p = 0.02; PFS, p<0.05). A linear correlation between minimum ADC values vs the OS and PFS was observed (R = 0.458 and R = 0.520 respectively). A cox regression showed that ADC and positive methylation of the MGMT promoter were indipendent factors. CONCLUSION Minimun ADC values in GBM could be used as a preoperative parameter to estimate the survival of patients indipendently by the status of MGMT promoter methylation. This observation may have clinical impact in those patients in which surgery or biopsy could not be performed. CLINICAL RELEVANCE/APPLICATION Minimun ADC values in GBM could be used as a preoperative survival parameter in those patients in which surgery or biopsy could not be performed.
    Radiological Society of North America 2012 Scientific Assembly and Annual Meeting; 11/2012
  • [Show abstract] [Hide abstract]
    ABSTRACT: Ventricular dyssynchrony significantly impairs cardiac performance. However, the independent role of interventricular dyssynchrony (interVD) and intraventricular dyssynchrony (intraVD) in the development of abnormalities of systolic and diastolic performance is unclear. Cardiac magnetic resonance imaging was performed in 39 patients with left bundle branch block and 13 healthy patients. Structural and functional parameters of the left ventricle and degrees of interVD and intraVD were measured. We found that interVD was inversely correlated with left ventricular (LV) ejection fraction (r = -0.8, p <0.0001) and positively correlated with LV end-diastolic volume (r = 0.4, p <0.01), LV end-systolic volume (r = 0.6, p <0.0001), and LV mass (r = 0.4, p <0.01), thus indicating that interVD significantly affects systolic function and favors ventricular remodeling. Multivariate analysis further confirmed that interVD was an independent predictor of systolic dysfunction. Interestingly, we found that interVD was not associated with abnormalities of diastolic performance. Conversely, we found that intraVD significantly impaired diastolic function, whereas it had no effect on systolic function. IntraVD was inversely correlated with peak filling rate (r = -0.7, p <0.0001) and 1/2 filling fraction (r = 0.4, p = 0.04) and positively correlated with time to peak filling rate (r = 0.6, p <0.0001), validated parameters of diastolic function. Multivariate analysis confirmed that intraVD was an independent predictor of diastolic dysfunction. In conclusion, our study suggests that the 2 components of ventricular dyssynchrony differently affect cardiac performance. If confirmed in prospective studies, our results may help to predict the prognosis of patients with left bundle branch block and different degrees of interVD and intraVD, particularly those subjects undergoing cardiac resynchronization therapy.
    The American journal of cardiology 08/2012; 110(11). DOI:10.1016/j.amjcard.2012.07.036 · 3.28 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To evaluate whether apparent diffusion coefficient (ADC) values can predict the status of MGMT of glioblastoma multiforme (GBM) and correlate with overall survival (OS) and progression-free survival (PFS). Methods: This retrospective study included 47 patients with pathologically proven glioblastoma. All of them underwent MR DWI study before surgery (mean time 1 week) and the status of methylguanine-DNA-methyltransferase (MGMT) promoter methylation was searched for. Minimum apparent diffusion coefficient (ADC) values were evaluated. OS and PSF parameters were calculated, and Student's t-test, Kaplan-Meier curves, linear and Cox regression were performed. Results: Twenty-five patients showed positive methylation of the MGMT promoter. Patients showing MGMT promoter methylation had higher minimum ADC values, and they survived longer than those without MGMT promoter methylation. The median ADCmin value of 0.80 represents the cutoff value able to distinguish between methylated and un-methylated patients. Patients showing minimum ADC values higher than 0.80 survived longer than patients with minimum ADC values lower than 0.80. A linear correlation between minimum ADC values vs. the OS and PFS was observed. Conclusions: Minimum ADC values in glioblastoma multiforme could be used as a preoperative parameter to estimate the status of MGMT promoter methylation and the survival of patients.
    European Radiology 08/2012; 23(2). DOI:10.1007/s00330-012-2601-4 · 4.01 Impact Factor
  • Danilo Guida · Francesco Biraschi · Giulia Francione · Francesco Orzi · Luigi Maria Fantozzi ·

    Neurological Sciences 04/2012; 34(4). DOI:10.1007/s10072-012-1098-6 · 1.45 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Magnetic resonance imaging (MRI) with a dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) sequence to study brain tumours provides information on the haemodynamic characteristics of the neoplastic tissue. Brain perfusion maps and calculation of perfusion parameters, such as relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV) and mean transit time (MTT) allow assessment of vascularity and angiogenesis within tumours of the central nervous system (CNS), thus providing additional information to conventional MRI sequences. Although DSC-PWI has long been used, its clinical use in the study of brain tumours in daily clinical practice is still to be defined. The aim of this review was to analyse the application of perfusion MRI in the study of brain tumours by summarising our personal experience and the main results reported in the literature.
    La radiologia medica 09/2011; 117(3):445-60. DOI:10.1007/s11547-011-0715-4 · 1.34 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We describe a case of asymmetric PRES due to the presence of hyperplastic anterior choroidal artery (AChA) in a man affected by sever hypertension. Posterior reversible encephalopathy syndrome (PRES) has become synonymous with a unique pattern of brain vasogenic edema and predominates in the parietal and occipital regions, accompanied by clinical neurological alterations. Sever hypertension is a risk factor that exceeds the limits of brain autoregulation, leading to breakthrough brain edema. In our knowledge this is the first case reported in literature, in which a similar vascular abnormality is linked to a PRES syndrome.
    The Journal of Headache and Pain 04/2011; 12(2):259-61. DOI:10.1007/s10194-010-0284-2 · 2.80 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Magnetic resonance with diffusion tensor image (DTI) may be able to estimate trajectories compatible with subcortical tracts close to brain lesions. A limit of DTI is brain shifting (movement of the brain after dural opening and tumor resection). To calculate the brain shift of trajectories compatible with the corticospinal tract (CST) in patients undergoing glioma resection and predict the shift directions of CST. DTI was acquired in 20 patients and carried out through 12 noncollinear directions. Dedicated software "merged" all sequences acquired with tractographic processing and the whole dataset was sent to the neuronavigation system. Preoperative, after dural opening (in 11) and tumor resection (in all) DTI acquisitions were performed to evaluate CST shifting. The extent of shifting was considered as the maximum distance between the preoperative and intraoperative contours of the trajectories. An outward shift of CST was observed in 8 patients and an inward shift in 10 patients during surgery. In the remaining 2 patients, no intraoperative displacement was detected. Only peritumoral edema showed a statistically significant correlation with the amount of shift. In those patients in which DTI was acquired after dural opening as well (11 patients), an outward shifting of CST was evident in that phase. The use of intraoperative DTI demonstrated brain shifting of the CST. DTI evaluation of white matter tracts can be used during surgical procedures only if updated with intraoperative acquisitions.
    Neurosurgery 04/2011; 69(3):696-704; discussion 704-5. DOI:10.1227/NEU.0b013e31821a8555 · 3.62 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To demonstrate the accuracy of magnetic resonance tractograpghy (MRT) in localizing the cortical spinal tract (CST) close to brain tumours by using intraoperative electric subcortical stimulation. Nine patients with intra-axial brain tumours underwent neurosurgery. Planning was based on analysis of the course of streamlines compatible with the CST. After tumour removal, intraoperative MRT was reacquired. Sites at various distance from the CST were repeatedly stimulated to assess whether registered motor evoked potential (MEP) could be elicited. All patients were assessed clinically both pre- and postoperatively. The motor function was preserved in all patients. In all patients intraoperative MRT demonstrated shift of the bundle position caused by the surgical procedure. The distance between the estimated intraoperative CST and the point of elicited MEP was 1 cm or less in all nine patients. At distances greater than 2 cm, no patient reported positive MEP. Intraoperative MRT is a reliable technique for localization of CST. In all patients MEP were elicited by direct subcortical electrical stimulation at a distance below 1 cm from the CST as represented by MRT. Brain shifting might impact this evaluation since CST position may change during surgery in the range of 8 mm.
    European Radiology 05/2010; 20(10):2475-81. DOI:10.1007/s00330-010-1806-7 · 4.01 Impact Factor
  • Source
    A Romano · G D'Andrea · G Minniti · L Mastronardi · L Ferrante · L M Fantozzi · A Bozzao ·
    [Show abstract] [Hide abstract]
    ABSTRACT: The purposes of this study were (1) to evaluate the possible identification of trajectories of fibre tracts, (2) to examine the useful of a neuronavigation system for presurgical planning, (3) to assess pre- and post-surgery patients' clinical condition and (4) to evaluate the impact of this information on surgical planning and procedure. Twenty-eight right-handed patients were prospectively and consecutively studied. All the patients were clinically assessed by a neurologist in both pre- and postsurgical phases. Separately the pyramidal tract, optic radiation and arcuate fasciculus were reconstructed. The trajectories were considered suitable for surgical planning if there were no interruptions of any of the layers at the level of the lesion. Dedicated software 'merged' the acquired images with the tractographic processing, and the whole dataset was sent to the neuronavigation system. The assessment of the 37 visualised trajectories close to the tumour resulted in a modification of the surgical approach to corticotomy in six patients (21%); the impact on the definition of the resection margins during surgery was 64%(18 cases). The overall impact percentage on the surgical procedure was 82%. In 27 cases, the symptoms had not changed. MR-tractography provides the neurosurgeon with a new anatomical view that has an impact on the surgical resection planning for brain neoplasms.
    European Radiology 07/2009; 19(12):2798-808. DOI:10.1007/s00330-009-1483-6 · 4.01 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The most frequent type of Krabbe disease has an infantile onset. Unusual slowly progressive adult forms have also been described. We described a different involvement of white matter tracts where magnetic resonance signal alterations were evident in a case of a patient affected by late-onset form of disease.
    Journal of neuroimaging: official journal of the American Society of Neuroimaging 04/2009; 19(2):191-3. DOI:10.1111/j.1552-6569.2008.00258.x · 1.73 Impact Factor
  • M Beccia · V Ceschin · A Bozzao · A Romano · F Biraschi · L M Fantozzi · M Rasura ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Posterior cerebral artery (PCA) territory infarcts account for only 5-10% of all infarcts in stroke registries. Moreover, the clinical features and etiology of such infarcts have not been studied as extensively as those in other vascular territories.We describe two patients with recurrent episodes of visual symptoms and headache due to probable transitory PCA vasospasm. MR angiography in the acute phase revealed incomplete visualization of PCA, conventional MRI showed mild T2 signal alterations and MR perfusion showed the presence of marked hypoperfusion in the same regions. Diffusion weighted MR images were normal. All these findings resolved after therapy. These cases suggest that reversible signal alterations associated with reversible vessel and perfusion abnormalities may be observed in patients with visual symptoms and headache. Normal DWI-MR may help distinguish these patients from those affected by non-reversible ischemic attacks.
    La Clinica terapeutica 03/2009; 160(2):125-7. · 0.33 Impact Factor
  • F Fasoli · G Minniti · N Serio · D Di Stefano · A Romano · M Ferrante · L M Fantozzi · A Bozzao ·
    [Show abstract] [Hide abstract]
    ABSTRACT: We describe a 32-year-old woman who presented with progressive dorsal back pain. Neither sensory nor motor deficit was reported. Magnetic resonance imaging (MRI) of the dorsal spine revealed a primary intradural extramedullary lesion with severe spinal cord compression. No other lesion was found in the central nervous system. During surgery an intradural extramedullary tumor was found without medullary infiltration and a total removal was achieved under microscopic guidance. The histological diagnosis revealed a benign extramedullary ependymoma. The patient recovery completely after surgery and at a follow-up of 24 months MRI showed no evidence of tumor recurrence. Ependymoma should be taken in account in the differential diagnosis on intradural extramedullary tumours.
    04/2008; 21(2):239-243. DOI:10.1177/197140090802100214
  • [Show abstract] [Hide abstract]
    ABSTRACT: Whether fractional anisotropy (FA), apparent diffusion coefficient (ADC), and fiber density index (FDi) values differ in the white matter close to glioblastomas of both symptomatic and asymptomatic patients was investigated. Twenty patients with glioblastomas underwent magnetic resonance imaging study. The FDi, FA and ADC values were calculated in areas of white matter in close proximity to the tumor (perWM) and encompassing fibers of cortico-spinal tract and in the contralateral normal-appearing white matter (nWM). The clinical compromise of the cortico-spinal tract was graded using Brunnstrom's criteria. FA and FDi were significantly decreased and ADC increased in perWM compared with the contralateral. Mean FDi, FA, and ADC values comparing perWM and nWM in symptomatic patients showed similar differences. Comparing the perWM of symptomatic and asymptomatic patients, mean FDi and ADC values were lower in symptomatic patients than in asymptomatic ones. A positive correlation was found between the clinical score (CS) and, separately, FDi, FA and ADC per WM values. In a multiple stepwise regression among the same factors, only the ADC of perWM values showed a positive correlation with the CS. An increased ADC plays a major role in reducing the number of fibers (reduced FDi) in symptomatic patients.
    European Radiology 03/2008; 18(2):331-6. DOI:10.1007/s00330-007-0740-9 · 4.01 Impact Factor
  • A Romano · M Ferrante · V Cipriani · F Fasoli · L Ferrante · G D'Andrea · L M Fantozzi · A Bozzao ·
    [Show abstract] [Hide abstract]
    ABSTRACT: This study was conducted to assess the possibility of identifying precise white matter tracts situated in proximity to intracranial tumours, to define the anatomical and topographical relations between the same white matter tracts and the tumour, to verify the possibility of integrating tractographic images in the context of a package of three-dimensional anatomical images to send to the neuronavigation system, to assess the impact of this information on surgical planning, and to analyse, both pre-and postoperatively, the patient's clinical conditions as an index of the functional integrity of the fibres themselves. Twenty-five patients underwent diffusion tensor study prior to neurosurgery. With the use of dedicated software, relative colour maps were obtained and the trajectories of the white matter tracts adjacent to the tumour were reconstructed in three dimensions. These were then processed for preoperative planning. Planning, which was performed with the neuronavigator, was based on analysis of the location of the course of the main white matter tracts adjacent to the lesion (pyramidal tract, optic radiation and arcuate fasciculus). Two neurosurgeons were asked whether the tractography images had modified the access and/or intraoperative approach to the tumour. All patients were clinically assessed both pre-and postoperatively 1 month after the procedure to define the presence of symptoms related to the involvement of the white matter tracts studied and therefore to assess the integrity of the fibres after the operation. In one patient, the tumour was situated away from all the tracts studied and did not compress them in any way. Overall, 40/75 tracts studied had no anatomical relation with the tumour, were not displaced by the tumour or could not be visualised in their entire course. Analysis of the remaining 35 white matter tracts led to an a priori change in the surgical approach for corticotomy in four patients (16%), with no disagreement between the two neurosurgeons and an impact on the extent of resection during surgery in 17 (68%), thus an overall impact on the surgical procedure in 80% of cases. Eight patients showed no symptoms related to the involvement of the white matter tracts studied. In the remaining 17 patients, the symptoms were related to involvement of the pyramidal tract, arcuate fasciculus or optic radiation. At 1-month follow-up, one previously asymptomatic patient reported a speech disorder (transcortical sensory dysphasia); in the remaining 24, symptoms remained unchanged, with a tendency to improvement in 14/17 with symptoms related to involvement of white matter tracts studied. Magnetic resonance (MR) tractography offers the neurosurgeon an anatomical panoramic view that can improve surgical planning for the resection of intracranial tumours. Despite the high incidence of cases in which the lesion is responsible for changes that hinder the reconstruction of white matter tracts, the technique can change the surgical approach for corticotomy, defines the extent of resection and leads to some change in the procedure in 80% of cases. The improvement of pre-existing symptoms and the absence of new symptoms in the postoperative phase, in our opinion, confirms the value of the technique.
    La radiologia medica 10/2007; 112(6):906-920. DOI:10.1007/s11547-007-0181-1 · 1.34 Impact Factor
  • A Romano · A Bozzao · P Tisei · L M Fantozzi ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Sporadic Creutzfeldt-Jacob disease (CJD) is a transmissible, progressive, fatal spongiform encephalopathy. Routine MR imaging sequences may show abnormalities in the basal ganglia and cerebral cortex. Recently, several reports claimed that diffusion weighted MRI (DWI) could demonstrate early brain lesions in CJD patients when conventional MR images are normal on T2-weighted sequences. We evaluated the usefulness of DWI, perfusion-weighted MRI (PWI) and spectroscopy to confirm the clinical diagnosis and assess lesion progression in two patients with suspected CJD. We noted a diffuse hypoperfusion in the basal ganglia where ADC values were reduced but spectroscopy values were normal. A strong hypoperfusion was observed in the right head of the caudate nucleus in patient n° 2 where spectroscopy values were abnormal. A typical distribution of hypoperfusion followed the posterior progression of disease. We suggest the hypoperfusion in the areas presenting restricted diffusion probably reflects spongiform degeneration and moderate mass effects from cytotoxic edema.
    02/2007; 20(1):56-60. DOI:10.1177/197140090702000109

  • [Show abstract] [Hide abstract]
    ABSTRACT: Assessment was made of the cerebral vascular haemodynamic parameters in patients with a high-flow extra-intracranial (EC-IC) bypass performed for therapeutic occlusion of the internal carotid artery (ICA). Sixteen patients with ICA occlusion and EC-IC bypass (time interval from surgery 1-6 years) underwent MRI. Perfusion-weighted magnetic resonance imaging (PW-MRI) sequences were performed without the use of an arterial input function. The relative cerebral blood volume (rCBV), mean transit time (MTT) and relative cerebral blood flow (rCBF) were evaluated in all patients at the level of the basal ganglia, centrum semiovale and cortex in both hemispheres. Statistically significant differences (P<0.005) were observed in the haemodynamic parameters, indicating increased rCBV in the basal ganglia and decreased rCBF and rCBV in the cortex of the hemisphere supplied by the graft with respect to the contralateral. Patients with occlusion of the ICA and high flow EC-IC bypass do have altered vascular haemodynamic status between the hemispheres. In particular, rCBF is impaired in the surgical hemisphere at the level of the cortex. These patients should be followed-up to rule out chronic ischemia.
    European Radiology 01/2007; 17(1):33-8. DOI:10.1007/s00330-006-0293-3 · 4.01 Impact Factor

Publication Stats

793 Citations
145.13 Total Impact Points


  • 1988-2014
    • Sapienza University of Rome
      • Department of Anatomical, Histological, Forensic Medicine and Orthopedic Science
      Roma, Latium, Italy
  • 2005-2011
    • Sant´Andrea Hospital
      Roma, Latium, Italy
  • 1990
    • Philadelphia University
      Filadelfia, Pennsylvania, United States