Poster: "ECR 2019 / C-1634 / A new application of contrast-enhanced ultrasound in the diagno... more Poster: "ECR 2019 / C-1634 / A new application of contrast-enhanced ultrasound in the diagnosis of venous diseases." by: "G. Dedone1, G. Turtulici2, E. Silvestri1; 1Genoa/IT, 2Genova (GE)/IT"
To evaluate the ultrasound features of the extrinsic wrist ligaments in rheumatoid arthritis (RA)... more To evaluate the ultrasound features of the extrinsic wrist ligaments in rheumatoid arthritis (RA) patients in comparison with healthy volunteers. Twenty-one consecutive patients affected by RA (12 men, 9 women; mean age 57 ± 14.6 years) were compared with 21 controls (12, 9; 54 ± 12.1, respectively). Wrists were evaluated using ultrasound on both palmar and dorsal sides along each ligament, using carpal bones as references. The following ligaments were studied: radioscaphocapitate, radiolunotriquetral, palmar ulnolunate, palmar ulnotriquetral, dorsal radiotriquetral, dorsal ulnotriquetral, and radial collateral ligament. Ligament number and thickness were noted. Echotexture was rated as fibrillar, fragmented, or heterogeneous; the surface was rated as smooth or blurred. The number of palmar ulnolunate and palmar ulnotriquetral ligaments detected by ultrasound in patients was significantly lower than in controls (P = 0.031 and P = 0.037, respectively). All ligaments had significantly more fragmented or heterogeneous echotexture and blurred surface and were significantly thinner in patients than in controls (P < 0.001). No correlation was found between ligament thickness and RA duration or clinical parameters. Extrinsic wrist ligaments were less detectable and thinner in patients affected by RA compared with healthy volunteers matched for age and sex. Ligament thinning did not directly correlate with RA duration and clinical parameters. • Ultrasound is increasingly used to evaluate normal anatomy of extrinsic wrist ligaments. • Extrinsic wrist ligaments are thinner in rheumatoid arthritis patients than in controls. • Extrinsic wrist ligaments are less easy to detect in rheumatoid arthritis patients. • Ligament thinning and detectability are not related to clinical parameters.
ABSTRACT PURPOSE/AIM 1. Illustrate the EVLA procedure. 2. Show how to obtain a good US-visualizat... more ABSTRACT PURPOSE/AIM 1. Illustrate the EVLA procedure. 2. Show how to obtain a good US-visualization of veins in order to monitor the ablation procedure and to avoid possible complications. 3. Describe the post-operative management CONTENT ORGANIZATION EVLA is a minimally invasive procedure for the treatment of great and small saphenous venous insufficiency in which, after local anesthesia, a laser fiber is inserted through the skin into the vein under US guidance. The laser heats the vein walls, causing shrinking and vein collapse. This happens due to the radial energy emission at 1470nm, optimally absorbed by water molecules. US guidance is mandatory in order to introduce needle and laser fibers and to monitor vessel shrinking during the ablation procedure. We will provide a "how to do" guide of the EVLA procedure highlighting the following steps: - Pre-treatment US-evaluation of patient lower limb veins with detailed scan planes - Sterile field setting and patient arrangement - US-guided laser fiber insertion procedure - Endovenous laser ablation - Post-operative management and follow-up SUMMARY US-guided EVLA of lower limb varicose veins is an effective and safe treatment that allows a quick and painless shrink of veins. Such an a therapeutic option appear also to be faster and cheaper compared to the gold standard (surgical stripping).
Poster: "ECR 2016 / C-1761 / MRI-US Fusion Imaging for primary diagnosis of prostatic cancer... more Poster: "ECR 2016 / C-1761 / MRI-US Fusion Imaging for primary diagnosis of prostatic cancer: baseline biopsy on supected areas targeted with Fusion Imaging: Preliminary experience" by: "R. Sartoris1, R. Piccazzo1, F. Paparo1, G. Turtulici1, L. Timossi1, E. Daglio1, E. Silvestri1, G. A. Rollandi2; 1Genova/IT, 2Genoa/IT"
Poster: "ECR 2018 / C-2858 / Adult hip ultrasound: a didactic approach for a correct examina... more Poster: "ECR 2018 / C-2858 / Adult hip ultrasound: a didactic approach for a correct examination" by: "G. Rusconi1, D. Orlandi2, E. Massone3, F. La Mantia4, D. Cassata4, E. Silvestri3; 1Napoli/IT, 2Genova/IT, 3Genoa/IT, 4Palermo/IT"
High-resolution US has been established as an effective diagnostic modality for the assessment of... more High-resolution US has been established as an effective diagnostic modality for the assessment of peripheral nerve pathology, in addition to clinical evaluation and electrophysiological studies.
Poster: "ECR 2015 / C-2486 / Musculoskeletal Ultrasound (US)-Guided Interventional Procedure... more Poster: "ECR 2015 / C-2486 / Musculoskeletal Ultrasound (US)-Guided Interventional Procedures of the Lower Limb: A Didactical Approach." by: "G. Ferrero1, E. Fabbro1, A. Corazza1, S. Perugin Bernardi1, A. Arcidiacono1, R. Sartoris1, E. Silvestri1, G. Serafini2; 1Genoa/IT, 2Pietra Ligure/IT"
ABSTRACT PURPOSE To evaluate accuracy, safety, and potential uses of a new needle tracking system... more ABSTRACT PURPOSE To evaluate accuracy, safety, and potential uses of a new needle tracking system when performing US-guided percutaneous procedures. METHOD AND MATERIALS An ultrasound machine (LOGIQ E9, GE Healthcare, Chalfont St Giles, UK) coupled with a low magnetic field generator was used. Three electromagnetic position sensors were set, two on the ultrasound probe and one on the needle bottom (VirtuTRAX, CIVCO). 30 percutaneous US-guided fine-needle-aspirations (on thyroid, breast and liver nodules) were made, using conventional 16G to 22G needles with an out-plane approach. The needle tip position is calculated by the system according to the mutual position of the probe and the needle shaft, and of the length of the needle (set in advance by the operator). The system also shows the expected path of the needle and the point of intersection of the needle with the scanning plane. RESULTS In all 30 cases, the positioning system accurately guided the needle tip inside the target and allowed for a correct sampling of the lesions for cytopathological analysis. Sample adequacy was achieved in 28/30 cases (93.3%). CONCLUSION This new electromagnetic positioning system allows to reach difficult or deep targets with the most practical percutaneous approach, even if the needle is not clearly visible. The possibility to position the sensor on the needle bottom allows for using all commercially available needles, without the need of using expensive dedicate needles. CLINICAL RELEVANCE/APPLICATION This new electromagnetic positioning system allows to reach difficult or deep targets with the most practical percutaneous approach, even if the needle is not clearly visible.
ABSTRACT PURPOSE/AIM The purpose of our educational exhibit is to: 1. illustrate the normal anato... more ABSTRACT PURPOSE/AIM The purpose of our educational exhibit is to: 1. illustrate the normal anatomy and the normal D-HRUS appearance of the rotator cuff tendons and other structures aorund the shoulder; 2. describe a detailed systematic technique for D-HRUS evaluation of the shoulder, integrated with dynamic maneuvers; 3. provide a multimedial correlation with detailed teaching videos including a step by step approach. CONTENT ORGANIZATION The rotator cuff of the shoulder can be easily examined with US. Such a technique allows for a high-resolution evaluation of tendinous and periarticular structures . For each of the following structures we will provide a D-HRUS image, a detailed anatomical scheme and a practical guide paired with a practical videos on “how to do” a D-HRUS examination of the shoulder: 1.supraspinatus tendon; 2.infraspinatus tendon; 3.subscapularis tendon; 4.teres minor tendon; 5.long head of the biceps brachii tendon; 6.subacromial-subdeltoid bursa; 7.posterior joint recess; 8.acromion-clavear joint; 9.coraco-humeral and coraco-acromial ligaments; 10.rotator cable. SUMMARY When associated with a deep anatomical knowledge, a systematic HRUS scanning technique allows a punctual and real-time evaluation of tendinous and ligamentous structures of the shoulder. Dynamic manoeuvres can be helpful in the assessment of biomechanical aspects.
Poster: "ECR 2019 / C-1634 / A new application of contrast-enhanced ultrasound in the diagno... more Poster: "ECR 2019 / C-1634 / A new application of contrast-enhanced ultrasound in the diagnosis of venous diseases." by: "G. Dedone1, G. Turtulici2, E. Silvestri1; 1Genoa/IT, 2Genova (GE)/IT"
To evaluate the ultrasound features of the extrinsic wrist ligaments in rheumatoid arthritis (RA)... more To evaluate the ultrasound features of the extrinsic wrist ligaments in rheumatoid arthritis (RA) patients in comparison with healthy volunteers. Twenty-one consecutive patients affected by RA (12 men, 9 women; mean age 57 ± 14.6 years) were compared with 21 controls (12, 9; 54 ± 12.1, respectively). Wrists were evaluated using ultrasound on both palmar and dorsal sides along each ligament, using carpal bones as references. The following ligaments were studied: radioscaphocapitate, radiolunotriquetral, palmar ulnolunate, palmar ulnotriquetral, dorsal radiotriquetral, dorsal ulnotriquetral, and radial collateral ligament. Ligament number and thickness were noted. Echotexture was rated as fibrillar, fragmented, or heterogeneous; the surface was rated as smooth or blurred. The number of palmar ulnolunate and palmar ulnotriquetral ligaments detected by ultrasound in patients was significantly lower than in controls (P = 0.031 and P = 0.037, respectively). All ligaments had significantly more fragmented or heterogeneous echotexture and blurred surface and were significantly thinner in patients than in controls (P < 0.001). No correlation was found between ligament thickness and RA duration or clinical parameters. Extrinsic wrist ligaments were less detectable and thinner in patients affected by RA compared with healthy volunteers matched for age and sex. Ligament thinning did not directly correlate with RA duration and clinical parameters. • Ultrasound is increasingly used to evaluate normal anatomy of extrinsic wrist ligaments. • Extrinsic wrist ligaments are thinner in rheumatoid arthritis patients than in controls. • Extrinsic wrist ligaments are less easy to detect in rheumatoid arthritis patients. • Ligament thinning and detectability are not related to clinical parameters.
ABSTRACT PURPOSE/AIM 1. Illustrate the EVLA procedure. 2. Show how to obtain a good US-visualizat... more ABSTRACT PURPOSE/AIM 1. Illustrate the EVLA procedure. 2. Show how to obtain a good US-visualization of veins in order to monitor the ablation procedure and to avoid possible complications. 3. Describe the post-operative management CONTENT ORGANIZATION EVLA is a minimally invasive procedure for the treatment of great and small saphenous venous insufficiency in which, after local anesthesia, a laser fiber is inserted through the skin into the vein under US guidance. The laser heats the vein walls, causing shrinking and vein collapse. This happens due to the radial energy emission at 1470nm, optimally absorbed by water molecules. US guidance is mandatory in order to introduce needle and laser fibers and to monitor vessel shrinking during the ablation procedure. We will provide a "how to do" guide of the EVLA procedure highlighting the following steps: - Pre-treatment US-evaluation of patient lower limb veins with detailed scan planes - Sterile field setting and patient arrangement - US-guided laser fiber insertion procedure - Endovenous laser ablation - Post-operative management and follow-up SUMMARY US-guided EVLA of lower limb varicose veins is an effective and safe treatment that allows a quick and painless shrink of veins. Such an a therapeutic option appear also to be faster and cheaper compared to the gold standard (surgical stripping).
Poster: "ECR 2016 / C-1761 / MRI-US Fusion Imaging for primary diagnosis of prostatic cancer... more Poster: "ECR 2016 / C-1761 / MRI-US Fusion Imaging for primary diagnosis of prostatic cancer: baseline biopsy on supected areas targeted with Fusion Imaging: Preliminary experience" by: "R. Sartoris1, R. Piccazzo1, F. Paparo1, G. Turtulici1, L. Timossi1, E. Daglio1, E. Silvestri1, G. A. Rollandi2; 1Genova/IT, 2Genoa/IT"
Poster: "ECR 2018 / C-2858 / Adult hip ultrasound: a didactic approach for a correct examina... more Poster: "ECR 2018 / C-2858 / Adult hip ultrasound: a didactic approach for a correct examination" by: "G. Rusconi1, D. Orlandi2, E. Massone3, F. La Mantia4, D. Cassata4, E. Silvestri3; 1Napoli/IT, 2Genova/IT, 3Genoa/IT, 4Palermo/IT"
High-resolution US has been established as an effective diagnostic modality for the assessment of... more High-resolution US has been established as an effective diagnostic modality for the assessment of peripheral nerve pathology, in addition to clinical evaluation and electrophysiological studies.
Poster: "ECR 2015 / C-2486 / Musculoskeletal Ultrasound (US)-Guided Interventional Procedure... more Poster: "ECR 2015 / C-2486 / Musculoskeletal Ultrasound (US)-Guided Interventional Procedures of the Lower Limb: A Didactical Approach." by: "G. Ferrero1, E. Fabbro1, A. Corazza1, S. Perugin Bernardi1, A. Arcidiacono1, R. Sartoris1, E. Silvestri1, G. Serafini2; 1Genoa/IT, 2Pietra Ligure/IT"
ABSTRACT PURPOSE To evaluate accuracy, safety, and potential uses of a new needle tracking system... more ABSTRACT PURPOSE To evaluate accuracy, safety, and potential uses of a new needle tracking system when performing US-guided percutaneous procedures. METHOD AND MATERIALS An ultrasound machine (LOGIQ E9, GE Healthcare, Chalfont St Giles, UK) coupled with a low magnetic field generator was used. Three electromagnetic position sensors were set, two on the ultrasound probe and one on the needle bottom (VirtuTRAX, CIVCO). 30 percutaneous US-guided fine-needle-aspirations (on thyroid, breast and liver nodules) were made, using conventional 16G to 22G needles with an out-plane approach. The needle tip position is calculated by the system according to the mutual position of the probe and the needle shaft, and of the length of the needle (set in advance by the operator). The system also shows the expected path of the needle and the point of intersection of the needle with the scanning plane. RESULTS In all 30 cases, the positioning system accurately guided the needle tip inside the target and allowed for a correct sampling of the lesions for cytopathological analysis. Sample adequacy was achieved in 28/30 cases (93.3%). CONCLUSION This new electromagnetic positioning system allows to reach difficult or deep targets with the most practical percutaneous approach, even if the needle is not clearly visible. The possibility to position the sensor on the needle bottom allows for using all commercially available needles, without the need of using expensive dedicate needles. CLINICAL RELEVANCE/APPLICATION This new electromagnetic positioning system allows to reach difficult or deep targets with the most practical percutaneous approach, even if the needle is not clearly visible.
ABSTRACT PURPOSE/AIM The purpose of our educational exhibit is to: 1. illustrate the normal anato... more ABSTRACT PURPOSE/AIM The purpose of our educational exhibit is to: 1. illustrate the normal anatomy and the normal D-HRUS appearance of the rotator cuff tendons and other structures aorund the shoulder; 2. describe a detailed systematic technique for D-HRUS evaluation of the shoulder, integrated with dynamic maneuvers; 3. provide a multimedial correlation with detailed teaching videos including a step by step approach. CONTENT ORGANIZATION The rotator cuff of the shoulder can be easily examined with US. Such a technique allows for a high-resolution evaluation of tendinous and periarticular structures . For each of the following structures we will provide a D-HRUS image, a detailed anatomical scheme and a practical guide paired with a practical videos on “how to do” a D-HRUS examination of the shoulder: 1.supraspinatus tendon; 2.infraspinatus tendon; 3.subscapularis tendon; 4.teres minor tendon; 5.long head of the biceps brachii tendon; 6.subacromial-subdeltoid bursa; 7.posterior joint recess; 8.acromion-clavear joint; 9.coraco-humeral and coraco-acromial ligaments; 10.rotator cable. SUMMARY When associated with a deep anatomical knowledge, a systematic HRUS scanning technique allows a punctual and real-time evaluation of tendinous and ligamentous structures of the shoulder. Dynamic manoeuvres can be helpful in the assessment of biomechanical aspects.
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Papers by Enzo Silvestri