Marco Barillari

The male breast is predisposed to be affected by many of the same pathological processes as the female breast is. The diagnosis of male breast pathologies is generally achievable when clinical evaluation is combined with standard breast imaging methods such as mammography and ultrasound. Magnetic resonance imaging is also a valuable tool in diagnosing the main pathologies affecting the male breast, especially for evaluating pre- and post-surgical treatments and follow-up. However, although this technique has been sufficiently regulated and adopted by many breast radiologists for female breast imaging, its application in the diagnosis of male breast pathologies remains limited to a few specialized centers. This article, based on a retrospective analysis of the experience of the University of Verona, explores various aspects of male breast diseases, including benign conditions such as gynecomastia and breast implant ruptures in transgender women as well as malignant entities such as male breast cancer. Emphasis is placed on the distinctive morphological features, enhancement patterns and kinetics observed in male breast lesions on dynamic contrast-enhanced MRI. This article provides a comprehensive overview of the application of MRI in male breast disease assessment, highlighting the potential role of MRI as a complementary tool to traditional breast imaging techniques.

Background: The aim of this study was to retrospectively evaluate the 3-year radiographic outcomes of periodontal intrabony defects treated with non-surgical subgingival therapy (NST), assessing radiographic bone gain (RBG) through experimental digital software, named “Bone Defect Analysis (BDA)”. Methods: The study included 17 intrabony defects in 14 patients. BDA software (version 1) was used on radiographs to calculate RBG (in %) and variations in defect angle (in °) between baseline (T0) and 3-year follow-up (T1). Soft tissue conditions were registered, reporting bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL). Defects were analyzed according to angles less (group A) or greater (group B) than 30°. Results: Nine and eight defects were, respectively, analyzed in groups A and B. Three years after treatment, an average RBG of 12.28% was found overall, with 13.25% and 10.11% for groups A and B, respectively (p = 0.28). Clinically, a mean CAL of 6.05 mm at T1 (from 10.94 mm at T0) was found, with 6.88 mm and 5.12 mm in groups A and B, respectively (p = 0.07). Conclusions: BDA software demonstrated predictability in the evaluation of bone variations after NST, revealing better clinical findings for intrabony defects with an initial smaller angle.

The aim of this study was to compare Orthopantomograms (OPT) and Computed Tomography (CT) with Cone Beam Computed Tomography (CBCT) in patients with Medication-Related OsteoNecrosis of the Jaws (MRONJ). The study included 25 patients (6 males and 19 females) with MRONJ who had a history of long-term bisphosphonate therapy or one of the recently re-entered MRONJ drugs and underwent OPT, CT and/or CBCT for determination of the extent of disease. We excluded patients with maxillary neoplasia. Considering the presence of early and late signs, OPT was diagnostic in 6 out of 17 cases (35%), while CT and CBCT were diagnostic in 25 out of 25 cases (100%). Analysing the different radiant doses delivered by the selected radiological methods on a phantom, it was found that a more significant effective dose was spread by CT (2.6 mSv) than CBCT (0.164 mSv) or OPT (0.02 mSv). CBCT, from our experience, is a candidate to replace OPT in the first diagnostic step in patients with suspected MRONJ, generating less effective doses and artefacts from metal components than CT.

We report a case of Gorham-Stout disease (GSD) complicated by chylothorax and treated with a combination therapy with interferon and bisphosphonates. This treatment may be helpful in improving the usually unfavorable prognosis of GSD beginning with a chylothorax before 1 year of age, and in reducing bone lesions. Moreover, the use of bisphosphonates appears to be useful in treating pain.

Primary lymphoma of the sphenoid is an extremely rare pathology, therefore it is difficult to hypothesize and the imaging characteristics are not well-known. Here we report the imaging features in computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) scan of a 44-year-old patient who presented with severe headache. CT and MRI showed a sphenoid sinus mass that suggested rhinopharyngeal lesion or a chordoma. However, biopsy from the mass histologically proved it to be Diffuse large B-cell lymphoma and PET examinations revealed increased fluorodeoxyglucose uptake around the sphenoid bone and multiple spinal lesions.

Objective: Craniofacial disharmony in skeletal diseases is strongly associated with sleep-disordered breathing. This study was aimed at studying the sleep respiratory patterns in young children with rare skeletal disorders. Design: This retrospective study included children with achondroplasia (ACH), osteogenesis imperfecta (OI) and Ellis van Creveld Syndrome. Our subjects underwent an in-laboratory overnight respiratory polygraph between January 2012 and April 2016. All medical records were reviewed and brain Magnetic Resonance Imaging was conducted on patients with ACH, nasopharynx, oropharynx and laryngopharynx spaces. Patients: Twenty-four children were enrolled, 13 with ACH, 2 with spondyloepiphyseal dysplasia, 1 with odontochondrodysplasia, 6 with OI and 2 with Ellis van Creveld Syndrome. Results: Children with ACH, who had adenotonsillectomy, showed fewer sleep respiratory involvement than untreated children. Among 13 patients with ACH, brain magnetic resonance imaging was available in 10 subjects and significant negative correlation was found between sleep respiratory patterns, nasopharynx and oropharynx space (p < 0.05). In 2 patients with spondyloepiphyseal dysplasia, mild-to-moderate sleep respiratory involvement was found. Both subjects had a history of adenotonsillectomy. Mild sleep respiratory involvement was also observed in 4 out of 6 patients with OI. One patient with Ellis van Creveld syndrome had mild sleep respiratory disturbance. Conclusions: Sleep respiratory disturbances were detected in children with ACH, and with less severity also in OI and Ellis van Creveld syndrome. Adenotonsillectomy was successful in ACH in reducing symptoms. In light of our findings, multicenter studies are needed to obtain further information on these rare skeletal diseases.

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