Purpose: The workload of the radiology department (RD) of a university hospital in northern Italy dramatically changed during the COVID-19 outbreak. The restrictive measures of the COVID-19 pandemic lockdown influenced the use of radiological services and particularly in the emergency department (ED). Methods: Data on diagnostic services from March 2020 to May 2020 were retrospectively collected and analysed in aggregate form and compared with those of the same timeframe in the previous year. Data were sorted by patient type in the following categories: inpatients, outpatients, and ED patients; the latter divided in “traumatic” and “not traumatic” cases. Results: Compared to 2019, 6449 fewer patients (−32.6%) were assisted in the RD. This decrease was more pronounced for the emergency radiology unit (ERU) (−41%) compared to the general radiology unit (−25.7%). The proportion of investigations performed for trauma appeared to decrease significantly from 14.8% to 12.5% during the COVID-19 emergency (p < 0.001). Similarly, the proportion of assisted traumatic patients decreased from 16.6% to 12.5% (p < 0.001). The number of emergency patients assisted by the RD was significantly reduced from 45% during routine activity to 39.4% in the COVID-19 outbreak (p < 0.001). Conclusion: The COVID-19 outbreak had a tremendous impact on all radiology activities. We documented a drastic reduction in total imaging volume compared to 2019 because of both the pandemic and the lockdown. In this context, investigations performed for trauma showed a substantial decrease.

Atrial fibrillation (AF) is the most frequently observed type of arrhythmia among adults, and its absolute prevalence is steadily rising in close association with the aging of the population, with its prevalence varying from 2% in the general population to 10–12% among the elderly. The relatively new concepts of ‘atrial cardiomyopathy’ and “AF-related atrial cardiomyopathy”, along with the growing body of knowledge regarding remodeling, function, and tissue characterization, highlight the need for novel approaches to the diagnostic process as well as in the therapeutic guidance and monitoring of atrial arrhythmias. Advanced imaging techniques, particularly cardiac magnetic resonance (CMR) imaging, have emerged as pivotal in the detailed assessment of atrial structure and function. CMR facilitates the precise measurement of left atrial volume and morphology, which are critical predictors of AF recurrence post-intervention. Furthermore, it enables the evaluation of atrial fibrosis using late gadolinium enhancement (LGE), offering a non-invasive method to assess the severity and distribution of fibrotic tissue. The possibility of an accurate CMR pulmonary vein anatomy mapping enhances the precision of pulmonary vein isolation procedures, potentially improving outcomes in AF management. This review underlines the integration of novel diagnostic tools in enhancing the understanding and management of AF, advocating for a shift towards more personalized and effective therapeutic programs.

Background/Objectives: We measured hepatic T2*, T1, and T2 values in N = 81 transfusion-dependent thalassemia (TDT) patients to assess and compare their reproducibility, evaluate their correlations with demographics and clinical parameters, and explore their association with disease-related complications. Methods: All TDT patients (52 females, 38.13 ± 10.79 years), were enrolled in the Extension-Myocardial Iron Overload in Thalassaemia Network. The magnetic resonance imaging protocol (1.5 T) included: multi-echo gradient echo sequences for T2* relaxometry, modified look-locker inversion recovery (MOLLI) sequences for T1 mapping, and multi-echo fast-spin-echo (MEFSE) sequences for T2 mapping. Results: All three relaxation times demonstrated good intra- and inter-observer reproducibility and were significantly correlated with each other. Of the 59 patients with reduced T2*, 45 (76.3%) also had reduced T1, and 42 (71.2%) had reduced T2 values. Among 22 patients with normal T2*, 3 (13.6%) exhibited reduced T1. No patients showed increased T1, and only one had elevated T2. Liver relaxation times were not associated with gender or splenectomy status. All relaxation times inversely correlated with serum ferritin levels, while T2 and T2* inversely correlated with mean alanine aminotransferase levels. Cirrhosis and glucose metabolism alterations were associated with lower relaxation times. All three relaxation times effectively discriminated between the absence and presence of cirrhosis [areas under the curve (AUCs) with 95% confidence intervals (CIs): 0.85 (0.75–0.92) for T2*, 0.78 (0.68–0.87) for T1, and 0.92 (0.84–0.97) for T2]. T2* showed comparable accuracy to T1 and T2, while a significant difference was observed between T1 and T2 values. All liver relaxation times demonstrated similar diagnostic performance in identifying glucose metabolism alterations [AUCs with 95% CIs: 0.67 (0.55–0.77) for T2*, 0.69 (0.57–0.79) for T1, and 0.67 (0.56–0.77) for T2]. Conclusions: In TDT, a comprehensive assessment of hepatic relaxation times may enhance clinical monitoring and management of iron overload and its related complications.

In the original publication [...].

Small bowel obstruction due to ingested fruit pits is rare and often underrecognized. In exceptional cases, these foreign bodies may mimic the clinical and imaging features of gallstone ileus, a complication of cholelithiasis involving biliary-enteric fistula formation and gallstone migration into the intestinal lumen. Such presentations may lead to misdiagnosis and inappropriate management. This case highlights an uncommon but clinically relevant diagnostic pitfall: a pseudo-gallstone ileus caused by an impacted apricot pit in a patient with a prior ileocolic anastomosis. An Italian Caucasian 49-year-old woman presented with acute abdominal pain and vomiting. Her medical history included a remote ileocolic resection for intestinal ischemia. Physical examination revealed a diffusely tender abdomen without signs of peritonitis. Biochemical investigations showed mild hepatopancreatic enzyme elevation and a low-grade inflammatory response. Plain abdominal radiography demonstrated radiopaque intraluminal structures in the right iliac fossa and features of small bowel obstruction. Contrast-enhanced computed tomography confirmed mechanical obstruction above a prior ileocolic anastomosis, with three hyperdense intraluminal masses in the distal ileum and calcified gallstones in the gallbladder. Although no aerobilia or biliary-enteric fistula was detected, imaging raised suspicion of gallstone ileus. Colonoscopy revealed a stenotic ileocolic anastomosis and three hard, stone-like masses in the terminal ileum. Two were endoscopically mobilized into the colon; the third resisted lithotripsy. Magnetic resonance cholangiopancreatography showed no evidence of biliary-enteric fistula. On repeat endoscopy, after balloon dilation of the anastomosis, the remaining object was retrieved and identified as an apricot pit. Upon questioning, the patient recalled recent ingestion of stone fruits. The final diagnosis was mechanical small bowel obstruction from an impacted fruit pit mimicking gallstone ileus. The patient recovered fully and was discharged with dietary recommendations. This case underscores the importance of considering alternative diagnoses when imaging suggests gallstone ileus, especially in the absence of a biliary-enteric fistula. Radiologists and clinicians should be aware that ingested fruit pits may resemble calcified biliary calculi on cross-sectional imaging. A high index of suspicion and multidisciplinary collaboration are essential to avoid misdiagnosis and unnecessary surgical intervention.