Publications by authors named "Gaetano Rea"

Acute aortic intramural hematoma (IMH) is a relatively uncommon but potentially life-threatening aortic disease that can occur primarily in hypertensive and atherosclerotic patients. The course of IMH varies widely, with the condition either regressing, remaining stable, or progressing until it leads to outward rupture or intimal layer disruption, eventually resulting in overt aortic dissection. Therefore, poor prognostic computed tomography (CT) features must be promptly recognized and reported by the radiologist.

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Quantitative assessment of the extent of radiological alterations in interstitial lung diseases is a promising field of application that goes beyond the limitations of qualitative scoring. Analysis of density histograms, i.e.

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  • Pneumothorax (PNX) is frequent in emergency departments and needs quick diagnosis and treatment; this study examined how well transthoracic ultrasounds (TUSs) identify spontaneous PNX.
  • 637 adult patients with chest pain and breathing issues from four Italian hospitals were included, and TUS results were compared to chest CT scans to determine accuracy metrics like sensitivity and specificity.
  • TUS accurately identified 89.2% of spontaneous PNX cases but had low specificity (43.8%), indicating it shouldn't be the sole diagnostic tool; TUS results should be corroborated with a chest X-ray or CT scan for proper patient management.
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  • Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease that leads to worsening lung function, breathing difficulties, and decreased quality of life.
  • Pulmonary rehabilitation (PR) is a multi-disciplinary program that combines strength training and counseling to improve symptoms and physical abilities in patients with chronic lung diseases like IPF.
  • Despite evidence supporting PR’s benefits for IPF, including better exercise capacity and quality of life, it is still not widely implemented or adequately supported.
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Background: The COVID-19 pandemic caused by SARS-CoV-2 continues to pose a significant threat worldwide, with severe cases leading to hospitalization and death. This study aims to evaluate the potential use of serum nucleocapsid antigen (NAg) and Krebs von den Lungen-6 glycoprotein (KL-6) as biomarkers of severe COVID-19 and to investigate their correlation with clinical, radiological, and biochemical parameters.

Methods: This retrospective study included 128 patients with confirmed SARS-CoV-2 infection admitted to a Neapolitan hospital in Italy between October 2020 and July 2021.

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  • - Immune-checkpoint inhibitors have significantly transformed cancer treatment by enhancing patient outcomes, but they can trigger immune-related side effects across various organs.
  • - Pulmonary complications from these treatments are common and can be severe, making accurate diagnosis complex due to diverse symptoms and imaging findings.
  • - Radiologists play a crucial role in identifying and diagnosing pulmonary complications early to evaluate their severity and help manage patient treatment effectively.
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Technology is making giant strides and is increasingly improving the diagnostic imaging of both frequent and rare acute and chronic diseases [...

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  • Recent research indicates that lung ultrasound can detect hidden pulmonary congestion in patients with pulmonary arterial hypertension (PAH), revealing a relationship between right heart failure and increased lung water content.
  • A study involving 102 PAH patients demonstrated that 75% had pulmonary congestion indicated by B-lines on lung ultrasound, with various factors such as sex, age, and NT-proBNP levels correlating with these findings.
  • The results suggest that pulmonary congestion is tied to right ventricular dysfunction and increased central venous pressure, which may hinder lymphatic drainage.
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Hypersensitivity pneumonitis (HP) is a diffuse parenchymal lung disease (DLPD) characterized by complex interstitial lung damage with polymorphic and protean inflammatory aspects affecting lung tissue targets including small airways, the interstitium, alveolar compartments and vascular structures. HP shares clinical and often radiological features with other lung diseases in acute or chronic forms. In its natural temporal evolution, if specific therapy is not initiated promptly, HP leads to progressive fibrotic damage with reduced lung volumes and impaired gas exchange.

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Background: The aim of this study is to define and determine the rate of acute non-A-non-B aortic dissections, and to evaluate CT angiography findings and possible complications, as well as to discuss management strategies and currently available therapy. Non-A non-B type of aortic dissection is still a grey area in the radiologist's mind, such that it is not entirely clear what should be reported and completed in terms of this disease.

Methods: A retrospective single-center study including 36 pre-treatment CT angiograms of consecutive patients (mean age: 61 years) between January 2012 and December 2022 with aortic dissection involving the aortic arch with/without the thoracic descending/abdominal aorta (type non-A non-B).

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Allergic rhinitis, a common allergic disease affecting a significant number of individuals worldwide, is observed in 25% of children and 40% of adults, with its highest occurrence between the ages of 20 and 40. Its pathogenesis, like other allergic diseases, involves innate and adaptive immune responses, characterized by immunologic hypersensitivity to environmental substances. This response is mediated by type 2 immunity.

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Objectives: The differential diagnosis between pulmonary arterial hypertension (PAH) and postcapillary pulmonary hypertension (PH) in heart failure with preserved ejection fraction (HFpEF) is sometimes difficult despite guidelines-derived standardized step-by-step diagnostic algorithms. We therefore explored the added value of lung ultrasound to a previously validated echocardiographic score of right heart catheterization measurements.

Methods: Patients referred for PH underwent a right heart catheterization, echocardiography, and lung ultrasound before and after rapid infusion of 7 mL/kg of saline.

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Diffuse lung disorders (DLDs) and interstitial lung diseases (ILDs) are pathological conditions affecting the lung parenchyma and interstitial network. There are approximately 200 different entities within this category. Radiologists play an increasingly important role in diagnosing and monitoring ILDs, as they can provide non-invasive, rapid, and repeatable assessments using high-resolution computed tomography (HRCT).

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A severe mismatch between the supply and demand of oxygen is the common sequela of all types of shock, which present a mortality of up to 80%. Various organs play a protective role in shock and contribute to whole-body homeostasis. The ever-increasing number of multidetector CT examinations in severely ill and sometimes unstable patients leads to more frequently encountered findings leading to imminent death, together called "hypovolemic shock complex".

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  • A systematic review and meta-analysis were conducted to assess the prevalence and types of residual lung abnormalities in COVID-19 patients one year after infection, based on chest CT scans.
  • Out of 22,709 records, 21 studies were included, focusing primarily on 1,854 individuals, showing a pooled prevalence of lung abnormalities at 43.5%, with significant variability among the studies.
  • Fibrotic lung changes were less common, ranging from 1.6% to 25.7%, while specific abnormalities such as ground glass opacities and consolidations were more prevalent, indicating that the long-term respiratory effects of COVID-19 can vary widely.
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Background: GAP (gender-age-physiology) and TORVAN are multi-parametric prognostication scores for idiopathic pulmonary fibrosis (IPF). We compared their prognostic value in patients treated with nintedanib or pirfenidone and explored their effect on patient survival in relation to disease staging.

Study Design And Patients: Retrospective evaluation of 235 naïve IPF patients (M = 179; mean age 69.

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Limited studies and observations conducted on a too small number of patients prevent determining the actual clinical utility of pulmonary contrast-enhanced ultrasound (CEUS). The aim of the present study was to examine the efficacy of contrast enhancement (CE) arrival time (AT) and other dynamic CEUS findings for differentiating between malignant and benign peripheral lung lesions. 317 inpatients and outpatients (215 men, 102 women; mean age: 52 years) with peripheral pulmonary lesions were included in the study and underwent pulmonary CEUS.

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Patients affected by idiopathic pulmonary fibrosis (IPF) have a high mortality rate in the first 2-5 years from diagnosis. It is therefore necessary to identify a prognostic indicator that can guide the care process. The Gender-Age-Physiology (GAP) index and staging system is an easy-to-calculate prediction tool, widely validated, and largely used in clinical practice to estimate the risk of mortality of IPF patients at 1-3 years.

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Background: The coupling of the right ventricle (RV) to the pulmonary circulation is an indicator of RV performance that can be non-invasively estimated by echocardiography. There are no data about its use in patients affected by fibrotic interstitial lung diseases (f-ILD). Methods: Fifty f-ILD patients, including 27 cases with idiopathic pulmonary fibrosis (IPF) (M = 37; mean age 67 ± 7 years), were studied with standard and speckle-tracking echocardiography and compared with 30 age-matched healthy volunteers.

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Acinetobacter baumannii (Ab) is an opportunistic Gram-negative pathogen intrinsically resistant to many antimicrobials. The aim of this retrospective study was to describe the imaging features on chest X-ray (CXR) and computed tomography (CT) scans in hospitalized patients with multidrug-resistant (MDR) Ab pneumonia. CXR and CT findings were graded on a three-point scale: 1 represents normal attenuation, 2 represents ground-glass attenuation, and 3 represents consolidation.

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Coronavirus disease-2019 (COVID-19) is a systemic disorder with the lung and the vasculature being the preferred targets. Patients with interstitial lung diseases represent a category at high risk of progression in the case of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection, and as such deserve special attention. We first describe the combination of acute exacerbation and pulmonary embolism in an elderly ILD patient after booster anti-COVID-19 mRNA vaccination.

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Background: COVID-19 pneumonia may lead to pulmonary fibrosis in the long term. Chest CT is useful to evaluate changes in the lung parenchyma over time.

Purpose: To illustrate the temporal change of lung abnormalities on chest CT scans associated with COVID-19 pneumonia over 1 year.

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Pulmonary involvement is the most common cause of death among patients with systemic sclerosis (SSc). The current coronavirus disease 2019 (COVID-19) is particularly problematic to manage in SSc patients since they may experience a more severe evolution of COVID-19 due to the pre-existent interstitial lung disease (ILD) and the administration of immunosuppressive treatments. In addition, the remarkable radiological similarities between SSc-ILD and COVID-19 complicate the differential diagnosis between these two entities.

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Purpose: To compare clinical success and operative time for percutaneous intradiscal ozone therapy in patients with lumbar disc herniation using fluoroscopic guidance versus computed tomography (CT).

Materials And Methods: During the year 2019, 68 percutaneous single-level intradiscal ozone therapies were performed on patients complaining of low back pain and/or sciatica due to lumbar disc herniation, using fluoroscopic or conventional CT guidance, respectively, in 35 and 32 herniated lumbar discs, with at least 1-month follow-up. Oswestry Disability Index (ODI) was used to assess clinical outcome.

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