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Mitral regurgitation is the most common valve disorder in the Western world, and although surgery is the established therapeutic gold standard, percutaneous transcatheter mitral interventions are gaining acceptance in selected patients who are inoperable or at an exceedingly high surgical risk. For such patients, multidetector computed tomography (MDCT) can provide a wealth of valuable morphological and functional information in the preoperative setting. Our aim is to give an overview of the MDCT image acquisition protocols, post-processing techniques, and imaging findings with which radiologists should be familiar to convey all relevant information to the Heart Team for successful treatment planning.

Since severe obesity is often associated with a pulmonary function defect and abdominal surgery increases the risks of respiratory postoperative complications (RPC), an increased incidence of RPC might occur after bariatric operations. A cohort of 146 severely obese patients undergoing biliopancreatic diversion (BPD) was retrospectively evaluated for the occurrence of RPC. Respiratory function was evaluated prior to BPD from the quotient between measured and predicted values of forced vital capacity (FVC), forced expiratory volume in 1 s (FEV₁) and the Tiffeneau index (TI: FEV₁/FVC). In this cohort of obese individuals the BMI degree prior to the operation was totally unrelated to the standardized values of TI and to the presence of restrictive or obstructive pulmonary disease. Globally, a very low rate of RPC (7.5%) was found; in patients with suspected restrictive pulmonary impairment, a high occurrence of RPC was observed (p < 0.05). When data are controlled for preoperative BMI values, smoking status and presence of sleep apnoea, a logistic regression model indicates that respiratory function data cannot predict the occurrence of RPC after bariatric surgery.

Aims: Whether different diabetic kidney disease (DKD) phenotypes recognise differences in morphological and vascular properties of the kidney is still unexplored.We evaluated the potential role of kidney ultrasonography in differentiating DKD phenotypes in subjects with type 2 diabetes. Materials and Methods:This is a cross-sectional, single-centre study. Total (TRV) and parenchymal renal volumes (PRV) were calculated by applying the ellipsoid formula for conventional (2D) ultrasonography and with manual segmentation for 3D ultrasonography, and then adjusted for body surface area (aTRV, aPRV). Renal resistive index (RI) was contextually determined. DKD phenotypes have been defined based on increased urinary albumin-to-creatinine ratio (ACR >30 mg/g) and/or reduced eGFR (<60 ml/min/1.73 m 2 ). Recruitment was planned to have groups of the same size.Results: Among 256 subjects, 26.2% had No-DKD, 24.6% increased albuminuria only (Alb + ), 24.2% non-albuminuric DKD (Alb − DKD), and 25.0% albuminuric DKD

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BackgroundJoint involvement is one of the main causes of chronic pain and disability in SLE patients (pts); despite arthritis in SLE is usually considered mild, joint erosions and deformities can be observed with significant impact on patient's quality of life. Imaging techniques are more sensitive than joint count in detecting synovitis and early joint damage.ObjectivesThis study was aimed at evaluating the progression of joint damage in SLE and at evaluating predictive factors for damage accrualMethodsConsecutive SLE pts with active hand-wrists synovitis (detected by joint count and/or ultrasounds) were enrolled in this 5-years prospective observational study. Clinical assessments as well as joint ultrasound (US) and MRI were performed at baseline and after 5 years. Each patient underwent a non-dominant hand–wrist US examination using a Logiq 9 with a linear probe operating at 14 MHz. Synovitis was defined as the presence of synovial hypertrophy and/or the presence of power Doppler signal (PD). A non-dominant hand–wrist MRI study with a 0.3 T extremity dedicated machine to evaluate the presence of bone erosions (BE) and bone marrow edema (BME) was also performed. Coronal and axial T1-weighted gradient-echo images and coronal STIR images were acquired. The images acquired were scored according to the RAMRIS scoring system for RA by a trained radiologist unaware of the clinical picture and diagnosis.ResultsFifty-seven pts were enrolled (female 91.2%, mean age 44±12.2 years, mean disease duration 15.9±9 years);43 (75.4%) completed the follow-up, 3 died (5.2%) and 11 (19.4%) were lost to follow-up. At baseline, 7 (12.3%)satisfied criteria for Jaccoud arthropathy (JA) and 7 (12.3%) had a recent onset arthritis (<1 year of duration). 22 pts (28.6%) showed clinical signs of synovitis, 56 (98.2%) presented positive hand-wrists US (synovitis) and in 14 (24.6%) PD signal was also recorded. Six pts (11.76%) already showed erosions at standard X-Ray, while MRI revealed at least one BE in 30 and 54 patients respectively, for a cumulative mean erosive burden of 9.2 erosions (range 1–63). After 5 years of follow-up, 34 pts consented to repeat the assessment; 11 (33%) had JA and 18 (29%) were still presenting clinical signs of synovitis; 28 pts (82.3%) showed synovitis at US with PD in 7 cases (20.5%). The final mean erosive burden resulted 12.3 (range 2–82) with a significant increase from the baseline evaluation (p=0.001). Overall, 16 pts accrued joint damage. Interestingly, erosion progression was observed also in 12 pts with negative joint count but positive US at baseline. The presence of PD at US and BME at baseline was associated with higher erosive burden at follow-up (p=0.03 and p=0.02 respectively)ConclusionsArthritis in SLE can be persistent over time and progress to joint damage even in a short tem period despite treatment; normal joint count at physical examination but US findings of synovitis can be associated with erosion progression over time. The presence of PD at US and bone marrow edema at MRI are associated ...