Article exists only in Russian.

Abstract:

We have performed a comparative analysis of magnetic resonance mammography (MRM) and traditional methods of diagnostics in detection of multifocal and multicentric kinds of breast cancer (BC) growth in 21 patients with difficult anatomy structure of mammary gland (MG) Breast-conserving surgery has been already planned for all these patients

Complex diagnostics included ultrasound(US), X-ray mammography (XRM), MRM with contrast enhancement, diagnostic needle biopsy Minimal size of identified breast tumors on the base of XRM data was 7 mm, ultrasound - 4 mm, at MR mammography - 2 mm XRM and US have detected multifocal tumor growth only in 1 case (5%). MRM revealed multifocal and multicentric tumor growth in 9 (43%) and 4 (19%) patients respectively According to revealed data the volume of surgical treatment has changed: 10 patients (48%) underwent radical resection, 10 (48%) mastectomy and 1 (5%) - partial resection

According to the conducted research it has been revealed that preoperative MR mammography is necessary for treatment planning in patients with breast cancer to avoid cancer recurrence after breast-conserving surgery.  

References 

1.    Аксель Е.М. Злокачественные образования молочной железы. Состояние онкологической помощи, заболеваемость и смертность. Маммология. 2006; 1: 9-15.

2.    Аблицова Н.В., Пак Д.Д., Сарибекян Э.К. Возможность выполнения органосохраняющих и реконструктивно-пластических операций при мультицентрическом раке молочной железы. Материалы II Всероссийской научно-практической конференции с международным участием «Научно-организационные аспекты и современные лечебно-диагностические технологии в маммологии». М., 2003; 176-177.

3.    Пак Д.Д., Аблицова Н.В. Лечебная тактика при первично-множественном раке молочной железы. Материалы Всероссийской научно-практической конференции с международным участием 3-4 июля 2007 г. «Профилактика и лечение злокачественных новообразований в современных условиях». Барнаул. 2007; 155.

4.    Brennan M.E. et al. MRI screening of the contralateral breast in women with newly diagnosed breast cancer. Systematic review and meta-analysis of incremental cancer detection and impact on surgical management. J. Clin. Oncol. 2009.

5.    Kurtz J. et al. Breast conserving therapy for macroscopically multiple cancers. Ann. Surg. 1990;212: 38-44.

6.    Zhang Y. et al. The role of contrast-enhanced MR mammography for determining candidates for breast conservation surgery. Breast. Cancer. 2002; 9: 231-239.

7.    Холин А.В. Диагностика рака молочной железы. Перспективы. Маммология. 1996; 4: 5-33.

8.    Anastassiades O. et al. Multicentricity in breast cancer. A study of 366 cases. Am. J. Clin. Pathol. 1993; 99: 238-243.

9.    Drew P. et al. Dynamic contrast enhanced magnetic resonance imaging of the breast is superior to triple assessment for the preoperative detection of multifocal breast cancer. Ann. Surg. Oncol. 1999; 6: 599-603.

10.  Fischer U., Kopka L., Grabbe E. Breast carcinoma. Еffect of the preoperative contrast-enhanced MR imaging on the therapeutic approach. Radiology.  1999; 231: 881-888.

11.  Fischer U. et al. Preoperative MR-mammography in diagnosed breast carcinoma. Useful information or useless extravagance [in German]? Rofo Fortschr Geb RontgenstrNeuen Bildgeb Verfahr. 1994; 161: 300-306.

12.  Holland R., Veling S., Mravunac M., Hendrics J. Histlogic multifocality of Tis, T1-2 breast carcinomas. Implications for clinical trials of breast-conserving surgery. Cancer. 1985; 56: 979-990.

13.  Houssami N. et al. Accuracy and surgical impact of MRI in breast cancer staging. Systematic review and meta-analysis in detection of multifocal and multicentric cancer. J. Clin. Oncol. 2008; 26: 3248-3258.

14.  Moon W.K., Noh D.Y., Im J.G. Multifocal, multicentric and contralateral breast cancers. Вilateral whole-breast US in the preoperative evaluation of patients. Radiology. 2002; 224: 569-576.

15.  Rieber A. et al. MRI of histologically confirmed mammary carcinoma. Oinical relevance of diagnostic procedures for detection  of multifocal  or  contralateral secondary carcinoma. J. Comput. Assist. Tomogr. 1997; 21: 773-779.

16.  Schwartz G. et al. Multicentricity of nonpalpable breast cancer. Cancer. 1980; 45:2913-2916.

17.  Tillman G.F. et al. Effect of breast magnetic resonance imaging on the clinical management of women with early-stage breast carcinoma. J. Clin. Oncol. 2002;20: 3413-3423.

18.  Turnbull L. Magnetic resonance imaging in breast cancer. Results of the COMICE trial. Br. Cancer. Res. 2008; 10: 10.

19.  Lagios M.D., Westdahl P.R., Rose M.R. The concept and implications of multicentricity in breast carcinoma. Pathol. Annu. 1981; 16: 83-102.

20.  Vaidya J. et al. Multicentricity of breast cancer. Whole organ analysis and clinical implications. Br. J.  Cancer.  1996; 74: 820-824.

21.  Bedrosian I. et al. Magnetic resonance imaging-guided biopsy of mammographically and clinically occult breast lesions. Ann. Surg. Oncol. 2002; 9: 457-461.

22.  Kuhl C. et al. Interventional breast MR imaging. Oinical use of a stereotatic localization and biopsy device. Radiology. 1997; 204: 667

Article exists only in Russian.

Abstract:

Purpose. Was to reveal atypical MRI-signs of leiomyomas.

Materials and methods. Kinds of degeneration: hyaline (60%), cystous (4%), hemorrhagic and myxomatous. In rare case of 8% myomas can be localized in uterine cervix and its surrounding structure - ligamentum uteri latus, vagina and retroperitoneal area. Connection between uterine and myomatic node can be lost due to torsion and necrosis. Such situation leads to wrong diadnosis ((retroperitoneal tumor with extraorganic localization*. Such tumors displace bladder, rectum and descending colon to the front. Due to surrounding fabrics pressure these tumors have irregular forms. Atypical myomas with extrauterine localization often have cystoid degeneration, necrosis and hemorrahages - such situation needs differential diagnostics firstly with leiomyosarcomas: these malignant newgrowth more often than simple leiomyomas have such localization and structure.

Discussion. We have described two cases of leiomyomas atypical localizations, which had been estimated as an extraorganic tumors during diagnostics' initial stages. It is very important to differentiate leiomyomas from other tumors of the same localization. In case of cancer-tumors - immediate surgical treatment is necessary

Conclusions. Histological structure and clinical current knowledge can help to differentiate this tumor with atypical signs from malignant gynecological new growth. MRI can be used in diagnostics of atypical leiomyomas.  

References

1.    Jiang G.H. et al. Atypical magnetic resonance imaging vs pathological findings of leio-myoma in the female reproductive system.Nan. Fang. Yi Ke Da Xue Xue Bao. 2009; 29 (2): 301-304.

2.    Wzkavukcu E et al. Pelvic retroperitoneal 6 angioleiomyoma mimicking a uterine mass. Diagn. Interv. Radiol. 2009; 15 (4): 262-265.

3.    Nidhanee S.V. et al. An unusual presentation of vaginal leiomyoma in a postmenopausal hysterectomised woman. А case report. Cases. J. 2009; 2: 6461-6464.

4.    Baert A.L., Knauth M., Sartor K. MRI and CT of the female pelvis. Springer. 2007; 388.

5.    Дуда И.В., Дуда Вл.И., Дуда В.И. Клиническая гинекология. В 2-х томах. Т. 1. Минск: «Вышэйшая школа». 1999; 302-325.

6.    Jashnani K.D., Kini S., Dhamija G. Perino-dular hydropic degeneration in leiomyoma. An alarming histology. Indian. J. Pathol. Microbiol. 2010; 53: 173-175.

7.    Кулаков В.И., Адамян Л.В., Мурватов К.Д. Магнитно-резонансная томография в гинекологии. Атлас. М.: Антидор. 1999; 59-98.

Abstract:

Purpose. Was to investigate the radiodiagnostic features of ASD in different age groups and to evaluate the role of chest X-rays in diagnostics of this disease.

Materials and methods. 48 patients with ASD were studied (aged 15–71 yaers, mean 47,2 ± 15), including 16 men and 32 women. We have diagnosed ostium primum defect (3 pts), ostium secundum defect (42 pts), sinus venosus defect, combined with PAPVD (3 pts). All of them underwent chest x-rays, echocardiography and cardiac MRI (with phase-contrast sequences). Patients were divided into two groups: 1st group – older than 40 years (30 pts) and 2nd group – less than 40 years (18 pts).

Results. In the 1st group, heart failure, valve regurgitations and atypical radiographic findings were more common than in the 2nd group. The size of both atria, pulmonary arteries' diameter and systolic PAP levels were also greater in patients older than 40 yaers. Groups did not differ by the volume of intracardiac shunt and the size of the defect. 6 pts with small defects had no radiographical signs of CHD. 11 patients from the 1st group had signs of hypervolemic CHD, but significant heart chambers’ enlargement impeded more accurate diagnostics. Patients with marked pulmonary arterial hypertension differed significantly from patients with lower PAP levels by radiographical signs.

Conclusions. Specificity of chest x-rays in diagnostics of ASD is lower in patients of 2nd group. Chest x-rays is an effective screening method to reveal abnormalities of pulmonary circulation, such as pulmonary venous hypertension and pulmonary plethora.

References

1.     Russell I. A. et al. Congenital heart disease in the adult. А review with internet-accessible transesophageal echocardiographic images. Anesth Analg. 2006; 102: 694–723.

2.     Brickner E.M., Hillis D.L., Lange R.A. Congenital heart disease in adults. First of two parts. NEJM. 2000; 32 (4): 256–263.

3.     Rodstein M., Zeman F.D. Gerber I. Atrial septal defect in the aged. Circulation. 1961; 23: 665–674.

4.     Сердечно-сосудистая хирургия. Под ред. В.К. Бураковского, Л.А. Бокерия. М.: Медицина. 1989.

5.     Белоконь Н.А., Подзолков В. П. Врожденные пороки сердца. М.: Медицина, 1991.

6.     Laks H. Plunkett M., Myers J. Adult сongenital heart disease. Cardiac surgery in the adult. Ed. dy cohn L. New York: McGraw-Hill. 2008; 431–1464.

7.     Дземешкевич С. Л., Синицын В. Е., Королев С. В. и др. Септальные дефекты у взрослых: современная диагностика и лечебная тактика. Грудная и сердечно сосудистая хирургия. 2001; 2: 40–45.

8.     Houston A. et al. Echocardiography in adult congenital heart disease. Heart. 1998;80: 12–26.

9.     Currie P.J. et al. Continuous wave Doppler determination of right ventricular pressure. A simultaneous Doppler-catheterization study in 127 patients. J. Am. Coll. Cardiol. 1985;6: 750–756.

10.   Шиллер Н., Осипов М.А. Клиническая эхо-кардиография. 2-е изд. М.: Практика. 2005.

11.   Ruiz O. et al. Evaluation of congenital heart disease in adults. Rev. Esp. Cardiol. 2003; 56(6): 607–620.

12.   Беленков Ю.Н., Терновой С.К., Синицын В.Е. Магнитно-резонансная томография сердца и сосудов. М.: Видар. 1997.

13.   Wang Z.J. et al. Cardiovascular shunts: MR imaging evaluation. Radiographics. 2003;23: 181–194.

14. Коробкова И.З. Рентгенологические методы исследования сердечно-сосудистой системы. Функциональная диагностика сердечно-сосудистых заболеваний. Под ред. Ю.Н. Беленкова, С.К. Тернового. М.: ГЕОТАР-Медиа. 2007.

15.   Blount S. G., Davides H., Swan H. Atrial septal defect – results of surgical correction in one hundred patients. JAMA. 1959; 169: 210.

16.   Henry D.A., Jolles H., Berberich J.J. The post-cardiac surgery chest radiograph. А clinically integrated approach. J. Thorac. Imaging. 1989; 4 (3): 20–41.

17.   Sanders C. et al. Atrial septal defect in older adults. Аtypical radiographic appearances. Radiology. 1988; 167: 123.

Abstract:

Purpose. Was to compare beam loading and quality of coronary arteries’ imaging (CA) in case of using the 64-lise computed tomography (MSCT) in retro-and prospective electrocardiographic synchronization mode.

Materials and methods. 57 patients with coronar arteries disease suspicious were examined with the help of computed tomography (CT) coronarography in prospective (n = 27) and retrospective (n = 30) EKG-synchronization modes. All the experiments were held on multislice Discovery CT 750 MD («General Electric»). The quality of obtained CR images was estimated subjectively – from 1 (perfect quality) to 4 (non-

diagnostic).

Results. The analyses of obtained images during retro-and prospective EKG-synchronization did not reveal serious differences (1,4 ± 0,38

and 1,5 ± 0,46 accordingly). The effective dose during prospective EKG-synchronization was 59% less than during retrospective EKG-synchronization (3,8 ± 0,83 mSv and 9,3 ± 2,5 mSv, р < 0,05).

Conclusion. CT-coronarography in prospective EKG-synchronization mode leads to essential decrease in beam loading on the patient without deterioration of the received image quality.  

References 

1.    Gaemperli O. et al. Accuracy of 64-slice CT angiography for the detection of functionally relevant coronary stenoses as assessed with myocardial perfusion SPECT. Eur. J Nucl. Med. Mol. Imaging. 2007; 34: 1162–1171.

2.    Mollet N.R. et al. High-resolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography. Circulation. 2005; 112: 2318–2323.

3.    Raff G.L. et al. Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J. Am. Col. Cardiol. 2005; 46: 552–557.

4.    Scheffel H. et al. Accuracy of dual-source CT coronary angiography. First experience in a high pre-test probability population without heart rate control. Eur. Radiol. 2006; 16: 2739–2747.

5.    Husmann L. et al. Comparison of diagnostic accuracy of 64-slice computed tomography coronary angiography in patients with low, intermediate and high cardiovascular risk.

6.    Acad. Radiol. 2008; 15: 452–461. Leschka S. et al. Low kilovoltage cardiac dual-source CT. Аttenuation, noise, and radiation dose. Eur. Radiol. 2008; 18: 1809–1817.

7.    Hausleiter J. et al. Radiation dose estimates from cardiac multislice computed tomography in daily practice. Impact of different scanning protocols on effective dose estimates. Circulation. 2006; 113: 1305–1310.

8.    Husmann L. et al. Feasibility of low-dose coronary CT angiography. First experience with prospective ECGgating. Eur. Heart. J. 2008; 29:191–197.

9.    Herzog B.A. et al. Accuracy of low-dose computed tomography coronary angiography using prospective electrocardiogram triggering. First clinical experience. Eur. Heart. J. 2008; 29: 3037–3042.

10.  Husmann L. et al. Diagnostic accuracy of computed tomography coronary angiography and evaluation of stress-only single-photon emission computed tomography / computed tomography hybrid imaging. Сomparison of prospective electrocardiogram-triggering vs. retrospective gating. Eur. Heart. J. 2009; 30:600–607.

11.  Hsieh J. et al. Step-and-shoot data acquisition and reconstruction for cardiac x-ray computed tomography. Med. Phys. 2006; 33:4236–4248.

12.  Earls J.P. et al. Prospectively gated trans-verse coronary CT angiography versus retrospectively gated helical technique. Improved image quality and reduced radiation dose. Radiology. 2008; 246: 742–753.

13.  Shuman W.P. et al. Prospective versus retrospective ECG gating for 64-detector CT of the coronary arteries.

Abstract:

Purpose. Was to investigate the role of diffusion weighted imaging (DWI) in focal hepatic lesions diagnostic.

Material and methods. Data of 70 patients (20 men) aged 28-78 years with focal hepatic lesions were analyzed. All of them underwent 1,5 T MRI; DWI obtained at b values of 50 s/mm2, 400 s/mm2, and 800 s/mm2. The results of MSCT data, intra-operative visual and ultrasound examination, histology of operation probes, and follow-up data were confermed.

Results. In 70 patients 203 focal lesions sized 3-168 mm: cysts (55), angiomas(36), metastases (89), nodal hyperplasia(5), primary tumors (5), abscesses (5), focal necroses (2) were revealed. DWI is capable of making differential diagnosis of focal hepatic lesions: cysts were not visualized at b = 800 s/mm2, and their ADC was (2,5 ± 0,2) × 10~3 s/mm2. Metastases were visible in all b-values, and had ADC lower than that for cysts (1,2 ± 0,5) × 10~3 s/mm2). Angiomas also were good visualized in all b-values, but ADC of angiomas was higher and varied from 1,5x 10~3 to 2,6 x 10~3 s/mm2. DWI is advantageous in detecting of small (less than 1 cm) foci: even if this kind of lesions was indistinct atT1 and T2 weighed images, DWI showed high intensity and well-defined edges.

Conclusions. Diffusion weighed MRI appeared to play additional role in differential diagnosis of focal hepatic lesions, enhancing detectabi-lity of the small (less than 1 cm) foci. The technique is simple, cost-effective and not time-consuming. 

     References 

1.     Патютко Ю.И. Хирургическое лечение злокачественных опухолей печени. М.: Практическая медицина. 2005; 11-27, 160-167, 216-291.

2.     Holzapfel К. et al. Detection and Characterization of Focal Liver Lesions using Respiratory-Triggered Diffusion-Weighted MR Imaging (DWI). MAGNETOM Flash. The Magazine of MR Issue. RSNA Edition. 2008; 2: 6-9.

3.     Ринкк П.А. Магнитный резонанс в медицине. М. «Гэотар-Мед». 2003; 138.

4.     Bruegel M. et al. Diagnosis of Hepatic Metastasis. Comparison of Respiration-Triggered Diffusion-Weghted Echo-Planar MRI and Five T2-Weighted Turbo Spin-Echo Sequences. Am. J. Roentgenol. 2008; 191: 1421-1429.

5.     Coenegrachts K. et al. Improved focal liver les ion detection: comparison of singleshot diffusion-weighted echoplanar and single-shot T2 weighted turbo spin echo techniques. Brit. J. ofRadiol. 2007; 80, 524-531.

6.     Qayyum A. Diffusion-weighted Imaging in the Abdomen and Pelvis. Concepts and Applications. RadioGraphics. 2009; 29: 1797-1810.

7.     Kandpal H. Respiratory-Triggered Versus Breath-Hold Diffusion-Weighted MRI of Liver Lesions. Comparison of Image Quality and Apparent Diffusion Coefficient Values. Am. J. Roentgenol. 2009; 192: 915-922.

8.     Koh D.M., Collins D.J. Diffusion-weighted MRI in the body: applications and challenges in oncology. Am. J. Roentgenol. 2007; 188: 1622-1635.

Abstract:

Article describes possibilities of MDCT for estimation of treatment effectiveness of antineoplastic therapy, for detection of rudementary or relapsing blastoma. High diagnostic potential of vizualization method for detection of rudementary or relapsing blastoma is shown. 

References

1.     Чиссов В.И., Старинский В.В. Злокачественные новообразования в России в 2010 г М., 2012; 260 с. Chissov V.I., Starinskiy V.V. Malignant neoplasms in Russian Federation in 2010. - M., 2012. - S. 260. [In Russ.]

2.     Vasil'ev P.V. Multidetector computed tomography in the diagnosis of cancer of the larynx and hypopharynx: dis. d-ra. med. nauk. P.V. Vasil'ev. M., 2010. 317s. [In Russ.]

3.     Kushkhov O. A-K. Clinical value of multislice computed tomography in the considering treatment approaches and the amount of surgery for laryngeal cancer: dis. kand. med. nauk. Kushkhov O. A-K. M., 2010. 132s [In Russ.]

4.     Geets X., Daisne J.F., Tomsej M. Impact of the type of imaging modality on target volumes delineation and dose distribution in pharyngo-laryngeal squamous cell carcinoma: comparison between pre- and per-treatment studies. Radiother Oncol. 2006 Mar; 78(3): 291-7.

5.     Hadjiiski L., Mukherji S.K., Gujar S.K.Treatment response assessment of head and neck cancers on CT using computerized volume analysis.AJNR Am. J. Neuroradiol. 2010 Oct; 31(9):1744-51.

6.     Hermans R. Posttreatment imaging in head and neck cancer. Eur. J. Radiol. 2008;.66(3): 501-11.

7.     Karakullukcu B., Nyst H.J., van Veen R.L. et al. mTH- PC mediated interstitial photodynamic therapy of recurrent nonmetastatic base of tongue cancers: Development of a new method. Head Neck. 2012 Nov; 34(11):1597-606.

8.     Kevin G., King MD., Arpakorn Kositwattanarerk, MD, Eric Genden, MD. Cancers of the oral cavity and oropharynx: FDG PET with contrast-enhanced CT in the posttreatment setting. Radiographics. 2011 Mar-Apr; 31(2):355-73.

9.     Moureau-Zabotto L., Touboul E., Lerouge D. et al. Impact of CT and 18F-deoxyglucose positron emission tomography image fusion for conformal radiotherapy in esophageal carcinoma. Int. J. Radiat. Oncol. Biol. Phys. 2005 Oct 1; 63(2):340-5.

10.   Paulino A.C., Koshy M., Howell R. et al. Comparison of CT- and FDG-PET-defined gross tumor volume in intensity-modulated radiotherapy for head-and-neck cancer. Int. J. Radiat. Oncol. Bio. Phys. 2005 Apr 1; 61(5):1385-92.