Cerebellum and neurodegenerative diseases:Beyond conventional magnetic resonance imaging

The cerebellum plays a key role in movement control and in cognition and cerebellar involvement is described in several neurodegenerative diseases.While conventional magnetic resonance imaging(MRI) is widely used for brain and cerebellar morphologic evaluation,advanced MRI techniques allow the investigation of cerebellar microstructural and functional characteristics.Volumetry,voxel-based morphometry,diffusion MRI based fiber tractography,resting state and task related functional MRI,perfusion,and proton MR spectroscopy are among the most common techniques applied to the study of cerebellum.In the present review,after providing a brief description of each technique's advantages and limitations,we focus on their application to the study of cerebellar injury in major neurodegenerative diseases,such as multiple sclerosis,Parkinson's and Alzheimer's disease and hereditary ataxia.A brief introduction to the pathological substrate of cerebellar involvement is provided for each disease,followed by the review of MRI studies exploring structural and functional cerebellar abnormalities and by a discussion of the clinical relevance of MRI measures of cerebellar damage in terms of both clinical status and cognitive performance.

Cardiovascular magnetic resonance of cardiac tumors and masses

Cardiac masses diagnosis and treatment are a true challenge,although they are infrequently encountered in clinical practice.They encompass a broad set of lesions that include neoplastic(primary and secondary),non-neoplastic masses and pseudomasses.The clinical presentation of cardiac tumors is highly variable and depends on several factors such as size,location,relation with other structures and mobility.The presumptive diagnosis is made based on a preliminary non-invasive diagnostic work-up due to technical difficulties and risks associated with biopsy,which is still the diagnostic gold standard.The findings should always be interpreted in the clinical context to avoid misdiagnosis,particularly in specific conditions(e.g.,infective endocarditis or thrombi).The modern multi-modality imaging techniques has a key role not only for the initial assessment and differential diagnosis but also for management and surveillance of the cardiac masses.Cardiovascular magnetic resonance(CMR)allows an optimal non-invasive localization of the lesion,providing multiplanar information on its relation to surrounding structures.Moreover,with the additional feature of tissue characterization,CMR can be highly effective to distinguish pseudomasses from masses,as well as benign from malignant lesions,with further differential diagnosis of the latter.Although histopathological assessment is important to make a definitive diagnosis,CMR plays a key role in the diagnosis of suspected cardiac masses with a great impact on patient management.This literature review aims to provide a comprehensive overview of cardiac masses,from clinical and imaging protocol to pathological findings.

Role of molecular imaging in the management of patients affected by inflammatory bowel disease:State-of-the-art

AIM To present the current state-of-the art of molecular imaging in the management of patients affected by inflammatory bowel disease(IBD).METHODS A systematic review of the literature was performed in order to find important original articles on the role of molecular imaging in the management of patients affected by IBD. The search was updated until February 2016 and limited to articles in English.RESULTS Fifty-five original articles were included in this review, highlighting the role of single photon emission tomography and positron emission tomography. CONCLUSION To date, molecular imaging represents a useful tool to detect active disease in IBD. However, the available data need to be validated in prospective multicenter studies on larger patient samples.

Oral Low-Molecular Weight Hyaluronic Acid in the Treatment of Atrophic Vaginitis

The aim of this study was to evaluate the effectiveness of low molecular weight hyaluronic acid oral tablets for the treatment of atrophic vaginitis. 12 women with atrophic vaginitis were recruited for this double blind, placebo-controlled study. Patients were randomized to receive either low molecular weight hyaluronic acid (HA) oral tablets or placebo for three months. Vaginal biopsies were taken at baseline and after three months of treatment, and vaginal epithelium was analysed using light microscopy. The evaluation of symptoms was self-assessed by the patients. Biopsies from HA group showed an epithelium thicker than in placebo group. The lamina propria from the HA group also showed a denser appearance compared to placebo group. Morphometric analysis showed significant differences between HA and baseline in the number of epithelial layers and in the thickness. The evaluation of symptoms also showed an effective improvement in the patients treated with HA, compared to baseline and to placebo group. In conclusion, oral administration of HA tablets improved the vaginal epithelium, decreasing atrophy. This can be an ideal option for patients with atrophic vaginitis who do not want to or can not take estrogen and show low compliance toward vaginal administration.

Cardiovascular magnetic resonance in myocardial infarction with non-obstructive coronary arteries patients: A review

The diagnosis of myocardial infarction with non-obstructive coronary arteries(MINOCA)necessitates documentation of an acute myocardial infarction(AMI),non-obstructive coronary arteries,using invasive coronary angiography or coronary computed tomography angiography and no clinically overt cause for AMI.Historically patients with MINOCA represent a clinical dilemma with subsequent uncertain clinical management.Differential diagnosis is crucial to choose the best therapeutic option for ischemic and non-ischemic MINOCA patients.Cardiovascular magnetic resonance(CMR)is able to analyze cardiac structure and function simultaneously and provides tissue characterization.Moreover,CMR could identify the cause of MINOCA in nearly two-third of patients providing valuable information for clinical decision making.Finally,it allows stratification of patients with worse outcomes which resulted in therapeutic changes in almost half of the patients.In this review we discuss the features of CMR in MINOCA;from exam protocols to imaging findings.