Chiara Zini

• MD
• Azienda USL Toscana Centro

Background and purpose Degenerative and/or herniated discs are a global cause of chronic lower back and neck pain. While multiple treatments exist, the research for long-term effective interventions with minimal side effects continues. The radioplaque gelified ethanol (RGE) (DiscoGel®, Hérouville-Saint-Clair, France), is an addition to the armament...

Vertebral augmentation has emerged as a crucial intervention for cancer patients suffering from vertebral compression fractures (VCFs) due to metastatic spinal tumors. These fractures significantly compromise patients' quality of life and exacerbate pain, leading to increased morbidity and decreased functional status. This comprehensive review expl...

Objective: The aim of this study is to explain the technique used for removing and replacing a novel percutaneous interspinous device (PID). Procedure: Three male patients, with a mean age of 66 years (range 62–72), were included in the study due to displacement ( N = 2) or misplacement ( N = 1) of the novel PID. This occurred after a mean of 23.3...

Vertebral augmentation has been used to treat painful vertebral compression fractures and metastatic lesions in millions of patients around the world. An international group of subject matter experts have considered the evidence, including but not limited to mortality. These considerations led them to ask whether it is appropriate to allow the subj...

AIMS: to assess radiological and clinical outcomes, in terms of safety and efficacy, of symptomatic vertebral fractures with and without posterior wall and\or both endplates involvement, treated with vesselplasty technique (Vessel-X, Dragon Crown Medical Co., Ltd Shandong, China). MATERIALS AND METHODS: We retrospectively evaluated 66 Patients who...

This chapter presents a comprehensive review of disk degeneration and lumbar stenosis disease, diagnosis, and percutaneous image-guided decompressive spinal techniques.

Low back pain, radicular leg pain, and lumbar spinal stenosis are the most common of all chronic pain disorders. Discogenic pain is related to distress of annular fibers and tears, whereas spinal stenosis is related to reduction of the spinal canal dimensions and compression of the neural elements; radicular pain is mainly related to disc herniatio...

Purpose To retrospectively assess safety and potential effectiveness of percutaneous intervertebral disc coagulation therapy (PDCT) using plasma thermal reaction for the treatment of lumbar and cervical disc hernias resistant to medical therapy. Materials and Methods Forty-four patients (age range 18–87 years, mean 52.7) with contained and extrude...

A comprehensive description of the literature regarding interspinous process devices (IPD) mainly focused on comparison with conservative treatment and surgical decompression for the treatment of degenerative lumbar spinal stenosis. Recent meta-analysis and articles are listed in the present article in order to establish IPD pros and cons.

Spinal pain is a common condition leading to significant disability and high cost. Spinal injections have been demonstrated to be effective short-term treatments with cost–utility superior to numerous other treatments, including surgical procedures. Appropriate patient selection—based on clinical and imaging finding—and the use of image guidance as...

Interventional radiology (IR) plays an increasingly important role in the multidisciplinary management of post-operative complications following bariatric surgery. Rapid technological advances have resulted in a range of minimally invasive procedures, which are safe and effective for the treatment of both early and late complications. These include...

Background: To evaluate USPIO labeling in different macrophage populations using a clinical 3.0T MR unit with optical and electron microscopy as the gold standard. Methods: Human monocytic cell line were differentiated into macrophages. Afterwards M0 macrophages were incubated with IL-4 and IL-13 in order to obtain M2 polarized macrophages or wi...

Purpose: To evaluate the potential added value of the intravoxel incoherent motion model to conventional multiparametric magnetic resonance protocol in order to differentiate between healthy and neoplastic prostate tissue in the peripheral zone. Material and methods: Mono-exponential and bi-exponential fits were used to calculate ADC and IVIM pa...

Since its introduction, contrast enhanced magnetic resonance angiography (CE-MRA) has rapidly replaced all the various unenhanced angiographic sequences, becoming one of the reference stand for noninvasive vascular imaging, leading to an increased clinical utilization of gadolinium based contrast agents (GBCA). This chapter describes the basic conc...

Objective: Multiple twin studies have demonstrated the heritability of anthropometric and metabolic traits. However, assessment of body composition parameters by bioimpedance analysis (BIA) has not been routinely performed in this setting. Design: A cross-sectional study. Setting: Study subjects were recruited and assessed at twin festivals or...

Objective Multiple twin studies have demonstrated the heritability of anthropometric and metabolic traits. However, assessment of body composition parameters by bioimpedance analysis (BIA) has not been routinely performed in this setting. Design A cross-sectional study. Setting Study subjects were recruited and assessed at twin festivals or at ma...

Carotid intima-media thickness (IMT) and arterial stiffness parameters, including aortic augmentation index (AIx) and pulse wave velocity (PWV), are independent predictors of stroke and cardiovascular disease. Genetic effects on these traits were never explored in a Mediterranean country. The present study aims to quantify the contribution of genes...

PURPOSE To evaluate the gain of radiologist’s performance in assessing suspected areas of prostate cancer (PC) by assessing the increase of sensitivity and specificity employing PI-RADS scoring system in a Multiparametric-MRI (Mp-MRI). METHOD AND MATERIALS 400 patients who underwent from June 2010 to january 2013 a Mp-MRI examination of the prosta...

Introduction Altered carotid blood flow velocities (CFV) have a complex background but the underlying genetic contribution is still unclear. We sought to evaluate the influence of genetics, shared and unshared environmental components on individual differences of CFV. Methods 193 healthy twin pairs, 126 monozygotic (MZ) and 67 dizygotic (DZ) (mean...

IntroductionThe bony skeleton is the third most common metastatic site from cancer after the lungs and liver. Prostate, breast, and lung cancer represent the three most common tumours that tend to metastasize to bones. Recently different percutaneous techniques have been used to offer pain palliation resulting from bone metastases [1–3]. Although c...

Obesity, blood pressure and arterial stiffness are heritable traits interconnected to each other but their possible common genetic and environmental etiologies are unknown. We studied 228 monozygotic and 150 dizygotic twin pairs aged 18-82 years from Italy, Hungary and the United States, of which 45 monozygotic and 38 dizygotic pairs were discordan...

Obesity is a leading problem in Western countries, and laparoscopic sleeve gastrectomy (SG) is the most commonly used procedure for the surgical management of morbid obesity. SG is recognised as one of the safest and most effective bariatric procedures but it is limited by a rate of gastric leaks (GL) ranging from 1.4% to 20%. No international cons...

Objectives: To evaluate if Diffusion Tensor Imaging technique (DTI) can improve the visualization of periprostatic nerve fibers describing the location and distribution of entire neurovascular plexus around the prostate in patients who are candidates for prostatectomy. Materials and methods: Magnetic Resonance Imaging (MRI), including a 2D T2-we...

Nitric oxide has an important role in the development of the structure and function of the airways and vessel walls. Fractional exhaled nitric oxide (FENO) is inversely related to the markers and risk factors of atherosclerosis. We aimed to estimate the relative contribution of genes and shared and non-shared environmental influences to variations...

Background: An association between reduced lung function and increased cardiovascular risk has been reported, but the underlying mechanisms are unknown. The aim of this study was to assess the heritability of lung function and to estimate its genetic association with arterial stiffness. Methods: 150 monozygotic and 42 dizygotic healthy Hungarian...

Vasculitis (vessel inflammation) refers to several diseases with different causes. According to the Chapel Hill International Consensus, it is possible to identify primary vasculitis and vasculitis secondary to infective processes or rheumatoid diseases; based on the caliber of the vessel involved, cases of primary vasculitis are divided into large...

Objectives: The purpose of this study was to determine the importance of nondiagnostic fine-needle aspiration biopsy results for post-thyroidectomy bed lesions in patients with thyroid cancer. Methods: The Institutional Review Board approved this retrospective Health Insurance Portability and Accountability Act-compliant study with a waiver for...

Background and purpose: Few family studies reported moderate genetic impact on the presence and scores of carotid plaques. However, the heritability of carotid plaque characteristics remains still unclear. Twin studies more reliably estimate the relative contribution of genes to these traits in contrast to family study design. Methods: One hundr...

Celiac trunk injures are rare events, with high mortality rates and difficult management. Endovascular treatment may be considered to avoid bleeding. We report a case of severe bleeding in a 37-year-old man resulting from celiac trunk stretching after a motorcycle crash. Because direct celiac trunk catheterization was not possible, a retrograde cat...

Prostate cancer (PC) is one of the most frequently diagnosed cancers in men. There are a number of treatment options for PC with a different therapeutic approach between USA and Europe. Radical prostatectomy is one of the most used therapies but focal gland therapy is an emerging approach, especially for localized tumors. In this scenario, high int...

Central blood pressure and aortic stiffness have been consistently reported as strong cardiovascular risk factors. Twin studies by comparing identical with nonidentical twins produce information on the relative contribution of genes and environment. One hundred and fifty-four monozygotic (MZ) and 42 dizygotic (DZ) twin pairs (age 43 ± 17 years) fro...

Nella definizione di vasculite (infiammazione dei vasi sanguigni) si annovera un gruppo eterogeneo di patologie con eziologie differenti. Secondo il Chapel Hill International Consensus le vasculiti si classificano in primitive e secondarie (ad esempio causate da processi infettivi o associate a malattie reumatiche); le primitive sono suddivise, in...

To evaluate the diagnostic performance and effect on therapeutic management of 64-section computed tomographic (CT) angiography in the assessment of steno-occlusive disease in patients with peripheral arterial disease (PAD), with conventional digital subtraction angiography (DSA) as the reference standard. The study protocol was approved by the ins...

Introduction Atherosclerosis is an inflammatory process in which the artery wall thickens as a result of plaque deposition, but this process may be preceded by increased arterial stiffness. We sought to evaluate the influence of genetics and shared and unshared environmental components on the onset of atherosclerosis. Methods A total of 135 monozy...

Small bowel neoplasms, including adenocarcinoma, carcinoid tumour, lymphoma and gastrointestinal stromal tumours, represent a small percentage of gastrointestinal cancers, yet are among those with the poorest prognosis compared with other gastrointestinal malignancies. Unclear clinical scenarios and difficult radiological diagnosis often delay trea...

To assess the feasibility of combined first-pass (FP) and steady-state (SS) contrast-enhanced magnetic resonance angiography (MRA) of the peripheral arteries with gadobenate dimeglumine (MultiHance) and to evaluate diagnostic performance relative to digital subtraction angiography (DSA). A total of 35 patients with symptomatic peripheral arterial o...

This study was undertaken to prospectively evaluate the diagnostic performance of colour Doppler ultrasonography (CDUS), first-pass (FP) and steady-state (SS) contrast-enhanced magnetic resonance angiography (MRA) and computed tomography angiography (CTA) of the carotid arteries using digital subtraction angiography (DSA) as the reference standard....

The authors performed a preliminary study with blood-pool contrast-enhanced magnetic resonance angiography (MRA) in evaluating the degree of carotid artery stenosis and plaque morphology, comparing the diagnostic performance of first-pass (FP) and steady-state (SS) acquisitions with 64-slice computed tomography angiography (CTA) and using digital s...

PURPOSE to compare provisional therapeutic approach after 64-CTA with that initiated after DSA. METHOD AND MATERIALS 212 consecutive patients with intermittent claudicatio scheduled for DSA, underwent peripheral CTA. CTA was performed, before the DSA, using a 64x0.6mm detector configuration (Siemens) and 110 ml of contrast medium (Iomeron 400;Brac...

This study was undertaken to compare the accuracy of magnetic resonance (MR) imaging and 64-slice multidetector computed tomography (64-MDCT) in the T staging of gastric carcinoma in comparison with histopathology. Forty patients with an endoscopic diagnosis of gastric carcinoma underwent preoperative MR imaging and 64-MDCT, both of which were perf...

Purpose This study was performed to validate a highresolution whole-body magnetic resonance angiography (MRA) protocol with parallel imaging and biphasic administration of a single bolus of contrast agent in the preliminary assessment of systemic atherosclerotic burden in patients referred for endovascular procedures. Materials and methods Forty...

PURPOSE To assess the diagnostic accuracy of different acquisition planes at blood-pool enhanced MR imaging (MRI) performed with steady-state (SS) sequences in the evaluation of surface morphology of atherosclerotic carotid plaques. METHOD AND MATERIALS Blood-pool enhanced MRI was performed in 58 symptomatic patients candidate to therapeutic DSA f...

PURPOSE To investigate the association between metabolic syndrome (MetS) and subclinical atherosclerosis determined by 64-row Whole Body CT Angiography (WB-CTA) in comparison with a matched control group (non-MetS). METHOD AND MATERIALS 64-row WB-CTA was performed in 50 consecutive patients with known MetS and 50 consecutive non-MetS subjects with...

The aim of this study was to validate a 64-row multidetector computed tomography (64-MDCT) acquisition protocol with biphasic administration of contrast medium for comprehensive assessment of the coronary and systemic arterial tree in a single examination. The scanning protocol comprised two acquisitions: an electrocardiograph (ECG)-gated scan at t...

PURPOSE To detect total atherosclerotic vascular burden using a 64-WBCTA protocol based on combined imaging of coronary and systemic arteries. METHOD AND MATERIALS 52 patients with coronary artery disease underwent WBCTA for the evaluation of the entire arterial system. Two image data sets were acquired using a 64x0.6mm detector configuration with...

PURPOSE To evaluate the correlations between location, extent and severity of arterial involvement using 64-detector row CT Angiography (64CTA) and Framingham risk index (FRI) in patients with Metabolic Syndrome. METHOD AND MATERIALS 243 consecutive patients with known metabolic syndrome underwent Whole Body 64CTA (Sensation Cardiac, Siemens). Two...

PURPOSE To compare the diagnostic accuracy of MDCT axial images and multiplanar reconstruction (MPR) obtained from raw data in the T staging of gastric cancer. METHOD AND MATERIALS Twenty-five patients with endoscopic diagnosis of gastric carcinoma underwent preoperative staging with MDCT. All examinations were performed on a 64-MDCT after i.m. in...

PURPOSE To prospectively assess and compare the diagnostic accuracy of first-pass (FP) and steady-state (SS) phases of blood-pool enhanced MRA in the evaluation of steno-occlusive disease of supra-aortic arteries. METHOD AND MATERIALS Blood-pool enahnced MRA and DSA were prospectively performed in 58 symptomatic patients patients (35M; 46-89 yo) w...

Recently whole-body 3D MR angiography (MRA) with blood-pool contrast agent has become available. The purpose of this study was to introduce and evaluate this technique to demonstrate arterial steno-occlusive involvement in systemic atherosclerosis and to compare blood-pool enhanced MRA results with those of CT angiography (CTA) as reference modalit...