Cerebrovascular diseases are abnormalities of the intracranial vascular system, affecting its ability to carry blood to the brain. The pathogenesis of many of these begins in the wall of the vessel and actual imaging techniques are not able to visualize the vascular wall. Moreover, perfusion imaging techniques do not provide adequate information on the differentiation, onset or progression of the disease. Recently, imaging of vessel walls with magnetic resonance imaging (VWI) allowed to visualize sub-millimeter structures of the arterial wall, emerging as a valuable technique for understanding and evaluating cerebrovascular diseases. Localization of the lesion and characteristic aspects with contrast medium provide therefore new information on the inflammatory etiology of cerebrovascular diseases, such as intracranial steno-occlusive disease, identification of atherosclerotic plaques, localization of vessel pathology in areas with minimal or zero waist to luminal imaging and stability of the aneurysm allowing early diagnosis and treatment. In recent years, intracranial vessel wall (VW) magnetic resonance (MR) imaging has been an exponential increase in popularity and clinical applicability. However, increasing evidence shows that also the intracranial atherosclerosis might be a potential cause of ischemic stroke, focusing the toward the imaging of the intracranial vasculature. The following descriptive study has been carried out on some patients of the University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, using a 3-T MR. This study describes the effectiveness of the magnetic resonance vessel wall imaging in cerebrovascular diseases.

Cost-benefit analysis (CBA) is one of the most widely used evaluation methods for studying the effects of different programs on the allocation of resources and the well-being of the involved agents. Therefore, it is possible to assess the cost-effectiveness of a PACS by analysing the relationship between costs and savings. A complete digitalization of the radiology acquisition, reporting and archiving process leads to a significant improvement in the quality of reporting, allowing the radiologist to intervene directly on the image display, making it faster and more accurate. The savings resulting from the implementation of the PACS can only be appreciated after some time; they take the form of a reduction in the running costs of the Diagnostic Imaging Service, above all due to the lower consumption of X-ray films. Secondly, there is a reduction in the number of staff employed in activities related to film processing and the redistribution of the space required for archives. A proper financial plan and a dilution of the required investment over several years allow an improvement of the systems to be achieved without increasing the costs for the company.

CTU represents the natural technical and instrumental evolution of urography. The multidetector technology, with the possibility of retro-reconstruction of the images, has allowed the direct representation of the excretory tract with a significant reduction in acquisition times, decreasing motion artifacts and increasing the definition of the processed images. Split-Bolus CT dynamic study allows us to obtain, in a single image acquisition, both the nephrographic and the renal excretory phases; at the same time, we can obtain information of the parenchymal organs in the abdominal cavity as in the portal/nephrographic phase of a standard CT protocol. The main advantage of Split-Bolus CTU is undoubtedly the significant saving of the radiation dose administered to the patient, related to the reduction in the number of phases acquired, with a reported diagnostic efficacy comparable to traditional protocols in terms of imaging quality. The Split Bolus technique has been used in several clinical contexts, such as in the characterization of focal liver lesions, in acute pulmonary embolism and in polytrauma patients.

Tako-Tsubo Cardiomyopathy (TTC) is an acute syndrome, identified in the early 1990s by Japanese researchers, which mimics an acute myocardial infarction. Cardiomyopathy is transient and begins with a clinical picture similar to that of an acute myocardial infarction. This pathology seems to be related to intense psychological and physical stress with a prevalence in the female sex (95%) in post-menopause. The term Tako-Tsubo means 'octopus trap' in Japanese: the left ventricle takes on a peculiar appearance in systole, similar to a narrow-necked amphora, morphologically identical to the vessel (tsubo) that Japanese fishermen use to catch octopuses (tako). The appearance of the left ventricle (tako-tsubo shape) is due to a 'complete' depletion of cardiac muscle activity (myocardial stunning), a kind of 'stunning' or paralysis of the middle and apical portions of the heart. Coronarography and ventriculography are an essential step in the diagnosis of TTC. The mere demonstration of a coronary tree free of angiographically significant stenosis is not sufficient for the diagnosis of TTC. The other key diagnostic element is, in fact, the demonstration of left ventricular hypokinesia or akinesia. Since left ventricular wall motility disorders change rapidly, ventriculography performed immediately after coronary examination is the gold standard examination to allow the characteristic appearance of the syndrome to be verified and, consequently, to distinguish it from an acute coronary syndrome with uninjured coronary arteries, thus avoiding a diagnostic error.

Umbilical vessel catheterization is a technique used for neonatal reanimation, in neonatal intensive care units. Imaging techniques provide a strong support for the performance of this practice. In this case, radiography is the most widely used instrumental investigation for the evaluation of umbilical venous catheter placement. By protocol, the image is acquired with an antero-posterior projection of the thoraco-abdominal district, with perpendicular radius to the median sagittal plane. The following descriptive study has been carried out on 20 newborn patients of the Neonatal Intensive Care Unit of the University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, born between December 4th 2020 and March 31th 2021. This study describes the effectiveness of the “thoraco-abdominal” radiological technique for the assessment of neonatal umbilical catheter placement. The basic premise for patients’ recruitment was the request for evaluation of umbilical venous catheter placement in preterm infants.