Article exists only in Russian.

Abstract:

Technological advance in multislice computed tomography (MSCT) set the radiologists all over the world thinking of its application in patients with ischemic heart disease. Proved diagnostic efficiency of 64-slice MSCT coronary angiography nominates the technique to be a first-line screening method for coronary atherosclerosis: it allows quick, accurate, and non-invasive imaging and quantitative assessment of coronary lesions. Though the indications for MSCT has already defined, there still are contro-versies about its place in diagnostic strategy. The aim of our study was to picture the state-of-the-art MSCT capabilities, focusing on MSCT coronary angiography and its place in contemporary clinical medicine.

Reference

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Abstract:

The aim of the study is to evaluate the potentialities of MRI in prenatal differential diagnosis of congenital abnormalities (CA). Results of 65 MR I-studies were analyzed. Ultrasound findings of CA were the indications for MRI. MR-images were obtained on GESigna Execute II (1,5T). The final diagnoses were made by postnatal autopsy, which served as a «golden standard» of neonatal CA diagnostics. Sensitivity of the MRI for fetal CA detection was 96,7%, specificity - 100%, diagnostic accuracy - 96,9%. Predicting reliability of the method for positive results was 100%, for negative results- 71,4%. In 46,2% of cases MRI and echo results agreed, in 23,1% MRI findings changed the diagnosis, and in 16,2% MRI provided additional information, which in 10,8% changed the pregnancy management strategy. Thus, MRI is shown to be highly informative in diagnosis of the fetal CA, and be able to refine the ultrasound findings. Using the MRI improves substantially the results of prenatal testing for CA, decreases the need for invasive procedures, and allows adequate planning of antenatal and postnatal management. 

Reference

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2.     Панов В.О. Методические особенности ивозможности магнитно-резонансной томографии в антенатальной диагностике нарушений внутриутробного плода. Радиология-практика. 2006; 2: 12-23.

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8.     Breysem L., Bosmans H., Dymarkowski S. et al. The value of fast MR imaging as an adjunct to ultrasound in prenatal diagnosis. Eur. Radiol. 2003; 13: 1538-1548.

9.     Huisman ТА, Martin E., Kubik-Huch R., Marincek B. Fetal magnetic resonance imaging of the brain: technical considerations and normal brain development. Eur. J. Radiol. 2002;12: 1941-1951.

10.   Brugger PC, Prayer D. Fetal abdominal magnetic resonance imaging. Eur. J. Radiol. 2006; 57: 278-293.

11.   Prayer D., Kasprian G., Krampl E. et al. MRI of normal fetal brain development. Eur. J. Radiol. 2006; 57: 199-216.

12.   Wang G.B., Shan R.Q., Ma Y.X. et al. Fetal central nervous system anomalies: comparison of magnetic resonance imaging and ultrasonography for diagnosis. Engl. Chin. Med.J. 2006; 119:1272-1277.

13.   Kasprian G., Balassy C., Brugger P.C., Prayer D. MRI of normal and pathological fetal lung development. Eur. J. Radiol. 2006; 57: 261-270.

14.   Brugger P.C., Stuhr F., Lindner C., Prayer D. Methods of fetal MR: beyond T2-weighted imaging. Eur.J. Radiol. 2006; 57: 172-181.

15.   Hormann M., Brugger PC, Balassy C, Witzani L., Prayer D. Fetal MRI of the urinary system. Eur.J. Radiol. 2006; 57: 303-311.

Abstract:

To evaluate the extent and distribution of focal fibrosis by delayed contrast-enhanced magnetic resonance imaging (DCE MRI) in patients with severe left ventricle hypertrophy caused by genetically determined hypertrophy cardiomyopathy (HCP) and compare it with global and regional myocardial function. 15 patients with HCP were studied using 1,5 T MR-scanner (Avanto, Siemens Medical Solution). 80% patients with HCP had foci of delayed CE, which were predominantly located in the anteroseptal. 33% patients with HCP had foci of perfusion defects. Septal walls with DCE foci were significantly thicker than non-enhanced segments (19,0±6,4 and 10,6±4,7, p < 0,001). Significant correlations were observed between end-diastolic segment's thickness and extent of DCE (r = 0,26, p < 0,05). Significant reverse correlation was found between extent of contrast enhancement and stroke volume in patients with HCP (r = -0,57, r < 0,05). Mean volume DCE regions was 18,4±8,5 cm3 (Mean±SE), maximum volume of hyperenhanced area was 127,9 cm3. Abnormal signal intensity from first-pass myocardial perfusion correlates with the delayed enhancement foci in patients with HCM. The extent of focal scarring in patients with HCP may reflect the severity of myocardial damage associated with the regional hypertrophy and hypokinesia of these segments.

Reference 

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10.   Moon J., Reed E., Sheppard M. et al.The histologic basis of late enhancement cardiovascular magnetic resonance in hypertrophic cardiomyopathy.JACC. 2 004; 43: 2260-2264.

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12.   Simonetti O.P., Kim R.J., Fieno D.S., Hillenbrand H.B.,Wu E., Bundy J.M., Finn J.P., Judd R.M. An improved MR imaging technique for the visualization of myocardial infarction. Radiology. 2001; 218: 215-223.

13.   Cerqueira M.D., Weissman N.J., Dilsizian V. et al. Standardised myocardial segmentation and nomenclature for tomographic imaging of the heart. Circulation. 2002;105: 539-542.

14.   Choudhury L., Mahrholdt H., Wagner A., Choi K.M.,Elliott M.D., Klocke F.J., Bonow R.O., Judd R.M., Kim R J. Myocardial scarring in asymptomatic or mildly symptomatic patients with hypertrophic cardiomyopathy. J.Am. Coll. Cardiol. 2002; 40: 2156-2164.

15.   Moon J.C., McKenna W.J., McCrohon J.A., Elliott P.M.,Smith G.C., Pennell D J.Toward clinical risk assessment in hypertrophic cardiomyopathy with gadolinium cardiovascular magnetic resonance. J. Am. Coll. Cardiol. 2003; 41: 1561-1567.

16.   Debl K., Djavidani B., Buchner S., Lipke C., Nitz W., Feuerbach S., Riegger G., Luchner A. Delayed hyperenhancement in magnetic resonance imaging of left ventricular hypertrophy caused by aortic stenosis and hypertrophic cardiomyopathy: visualisation of focal fibrosis. Heart. 2006; 92: 1447-1451.

17.   Dumont C.A., Monserrat L., Soler R., Rodriguez E.,Fernandez X., Peteiro J., Bouzas B., Pinon P., Castro-Beiras A. Clinical significance of late gadolinium enhancement on cardiovascular magnetic resonance inpatients with hypertrophic cardiomyopathy. Rev. Esp.Cardiol. 2007; 60: 15-23.

Abstract:

The work was aimed at determining the possibilities of multislice computed tomography (MSCT) in diagnosis and staging of acute pyelonephritis (AP) for studying the role of concomitant congenital renal anomalies in development of AP and therapeutic decision-making. A total of 59 patients presenting with AP and suspected pyodestructive complications were subjected to MSCT, with 7 seven of these having undergone it twice in order to control therapeutic efficacy. The study showed that ultrasonography as well as excretory urography are not always informative enough as to the possibility of revealing purulent forms of an inflammatory process having developed on the background of renal developmental defects, especially anomalies of the shape, localization, and structure. The obtained findings made it possible to define proper indications for performing MSCT in patients with AP. Improved diagnosis achieved by means of MSCT made it possible to decrease the number of operations and avoid unnecessary nephrectomies.  

Reference

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           22.   Фоминых Е.В. Мультиспиральная компьютерная томография в диагностике заболеваний мочевых путей. Дисс. канд. мед. наук, М., 2004.

Article exists only in Russian.

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 

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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.

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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.

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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

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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.

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

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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.

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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.

Article exists only in Russian.

Abstract:

Aim. Was to analyze possibilities of CT diagnostics of patients with chronic diseases and cancer of pancreas.

Materials and methods. We have analyzed 42 patients with cancer of pancreas and chronic pancreatitis. 20 patients had verified cancer (10 male and 10 female aged 47-82 yrs) and 22 patients with chronic pancreatitis (16 male and 6 female aged 29-63 yrs). All the patients underwent CT for diagnosis specification, estimation of pancreas condition and stage of disease.

Results. Sarcopenia was detected in 14 patients (70%) with pancreas cancer (9 of 10 male, 5 of 10 female). There was no significant difference in postoperative complications. Complications were marked in 11 of 20 pts (55%), including 8 of 14 patients (57%) with sarcopenia. Postoperative morbidity marked in 3 cases sarcopenia was detected in 15 patients (68%) with chronic pancreatitis (13 of 16 male, 2 of 6 female). There was no postoperative morbidity or complications in this groups of patients.

Results. CT in good for standard diagnostics of pancreas diseases and can estimate sarcopenia degree. Due to obtained data the level of carcopenia in surgically treated patients with pancreas cancer and chronic pancreatitis reaches 70%. Application of CT gives new possibilities in diagnostics of metabolic disorders in patients with severe chronic pancreatitis and pancreas cancer.
 

References 

1.    Заводчиков А.А., Башкина А.С., Лаврухина А.А. и др. Пути противодействия саркопении. Лечебная физкультура и спортивная медицина. 2011; 50-59.

2.    Morley J.E., Thomas D.R., Wilson M.M. Cachexia: pathophysiology and clinical relevance. Am. J. Clin. Nutr. 2006; 83: 735-743.

3.    Tan B.H., Fearon K.C. Cachexia. Prevalence and impact in medicine. Curr. Opin. Clin. Nutr. Metab. 2008; 11: 400-407.

4.    Klaude M. et al. Proteasome proteolytic activity in skeletal muscle is increased in patients with sepsis. London. Clin. Sci. 2007; 112: 499-450.

5.    Dodson S. et al. Muscle wasting in cancer cachexia. Clinical implications, diagnosis and emerging treatment strategies. Annu. Rev. Med. 2010; 62 (8): 1-15.

6.    Prado C.M. et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts. A population-based study. Lancet. Oncol. 2008; 9: 629-635.

7.    Baumgartner R.N. et al: Epidemiology of sarcopenia among the elderly in New Mexico. Am. J. Epidemiol. 1998; 147: 755-763.

8.    Janssen I., Heymsfield S.B., Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J. Am. Geriatr. Soc. 2002; 50: 889-896.

9.    Pichard C. et al. Nutritional assessment. Lean body mass depletion at hospital admission is associated with an increased length of stay. Am. J. Clin. Nutr. 2004; 79: 613-618.

10.  Cosqueric G. et al: Sarcopenia is predictive of nosocomial infection in care of the elderly. Br. J. Nutr. 2006; 96: 895-901.

11.  Metter E.J. et al. Skeletal muscle strength as a predictor of all-cause mortality in healthy men. J. Gerontol. a Biol. Sci. Med. Sci. 2002; 57: 359-365.

12.  Prado C.M. et al. Body composition as an independent determinant of 5-fluorouracil-based chemotherapy toxicity. Cli. Cancer. Res. 2007; 13: 3264-3268.

13.  Heymsfield S.B. et al. Human body composition. Advances in models and methods. Ann. Rev. Nutr. 1997; 17: 527-558.

14.  Witt H. et al. Chronic Pancreatitis. Challenges and advances in pathogenesis, genetics, diagnosis, and therapy. Gastroenterology. 2007; 132 (4): 1557-1573.

15.  Uomo G., Gallucci F., Rabitti P.G. Anorexia-cachexia syndrome in pancreatic cancer: recent development in research and management. JOP. 2006; 7: 157-162.

16.  Zamboni M. et al. Sarcopenic obesity. A new category of obesity in the elderly. Nutr. Metab. Cardiovasc. Dis. 2008; 18: 388-395.

17.  Roubenoff R. Sarcopenic obesity. Does muscle loss cause fat gain? Lessons from rheumatoid arthritis and osteoarthritis. Ann. N.-Y. Acad. Sci. 2000; 904: 553-557.

18.  Cruz-Jentoft A.J. et al. Sarcopenia. European consensus on definition and diagnosis. Age and Aging. 2010; 39: 412-423.

19.  Baracos V.E. et al. Body composition in patients with non-small cell lung cancer. A contemporary view of cancer cachexia with the use of computed tomography image analysis. Am. J. Clin. Nutr. 2010; 91: 1133-1137.

20.  Antoun S. et al. Low body mass index and sarcopenia associated with dose-limiting toxicity of sorafenib in patients with renal cell carcinoma. Ann. of Oncology. 2010; 21: 1594-1598.

21.  Mitsiopoulos N. et al. Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography. J. Appl. Physiol. 1998; 85: 115-22.

22.  Shen W. et al. Visceral adipose tissue. Relations between single-slice areas and total volume. Am. J. Clin. Nutr. 2004; 80: 271-278.

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24.  Mourtzakis M. et al. A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care. Appl. Physiol. Nutr. Metab. 2008; 33: 997-1006.

25.  Eisenhauer E.A. et al. New response evaluation  criteria  in  solid  tumours.   Revised RECIST guideline (version 1.1). Europ. J.of Cancer. 2009, 45: 228-247.

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30.  Beger H.G. et al. Diseases of the pancreas. Current surgical therapy. Berlin. Springer-Verlag Heidelberg. 2008; 301-311.

Article exists only in Russian.

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:

For long time the only method of postinfarction myocardial «scars» topical diagnostics was ECG. Contrast-enhanced magnetic resonance (CE-CMR) is considered to be a highly informative technique for location and quantification of myocardial necrotic areas, but there are few studies comparing the method with conventional ECG. CE-MR/ECG correlation was studied in 59 patients with postinfarction changes. The global concordance between CE-MR and ECG was of 80%. In 5 cases (1 - anterolateral, 2 - inferior and 2 - inferolateral). ECG-pattern was misleading.

    References 

1.      Myers G.B. et al. Correlation of electrocardio-graphic and pathologic findings in anteroseptal infarction. Am. Heart. J. 1948; 36:5535-5575.

2.      Myers G., Howard A.K., Stofer B.E. Correlation of electrocardiographic and pathologic findings in lateral infarction. Am. Heart. J.1948; 37: 374-417.

3.      Myers G., Howard A.K., Stofer B.E. Correlation of electrocardiographic and pathologic findings in posterior infarction. Am. Heart. J.1948; 38: 547-582.

4.      Руда М.Я., Зыско А.П.. Инфаркт миокарда. М.: Медицина. 1981.

5.      Shalev Y. et al. Does the electrocardiographic pattern of «Anteroseptal» myocardial infarction correlate with the anatomic location of myocardial injury? Am. J. Cardiol .1995; 75: 763-766.

6.      Shen W., Tribouilloy C., Lesbre J.P. Relationship between electrocardiographic patterns and angiographic features in isolated left circumflex coronary artery disease. Clin. Cardiol. 1991; 14: 720-724.

7.      Gallik D.M. et al. Simultaneous assessment of muocardial perfusion and left ventricular dysfunction during transient coronary occlusion. J. Am. Coll. Cardiol. 1995; 25:.1529-1538.

8.      Zafrir B. et al. Correlation between ST elevation and Q waves on the predischarge electro cardiogram and the extent and location of MIBI perfusion defects in anterior myocardial infarction. Ann. Noninvasive Electrocardiol. 2004; 9: 101-112.

9.      Wu E. et al. Vusualization of presence, location, and transmural extent of healed Q-wave and non-Q-wave myocardial infarction. Lancet. 2001; 357: 21--28.

10.   Moon J.C. et al. The pathological basis of Q-wave and non-Q-wave myocardial infarction: a cardiovascular magnetic resonance study. J. Am. Coll. Cardiol. 2004; 44: 554-560.

11.   Simonetti O.P. et al. An improved MR imaging technique for the visualization of myocardial infarction. Radiology. 2001; 218: 215-223.

12.   Cerqueira M.D. et al. Standardized myocardi-al segmentation and nomenclature for tomo-graphic imaging of the heart: a statement for healthcare professionals. Circulation. 2002; 105: 539-542.

13.   Kannel W.B., Abbot R.D. Incidence, precursors and prognosis of unrecognized myocardial infarction (Framingham Study). Adv. Car-diol. 1990; 37: 202-214.

14.   Sheifer S.E., Manolio T.A., Gersh B.J. Unrecognized myocardial infarction. Ann. Intern. Med. 2001; 135:. 801-811.

15 .  Беленков Ю.Н., Терновой С.К. Функциональные методы диагностики сердечно-сосудистых заболеваний. М.: «ГЭОТАР-МЕДИА». 2007.

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. 

Abstract:

Aim: was to evaluate the effeciency of adenomyosis treatment with magnetic resonance-guided focused ultrasound (MRgFUS) ablation.

Materials and methods: from March 2012 to November 2014 on the base of «Federal Center of Medicine and Rehabilitation» of Russian Ministry of Health we have examined and treated by MRgFUS ablation 50 patients with adenomyosis. Criteria for patient selection for treatment by MRgFUS ablation were: age 25-49 years, adenomyosis symptoms, confirmed diagnosis of the disease on MRI, ultrasound and gynecological examination, technical ability to perform FUS ablation. Dynamical observation after treatment included: vaginal examination, pelvic MRI with contrast performed at 3rd, 6th and 12th month after MRgFUS ablation. Also, within a specified time patients were asked to fill a questionnaire to assess the severity of adenomyosis symptoms anc quality of life (SF-36).

Results: against the background of the treatment, patients noted significant symptoms reduction. The best result was noted 3 months after treatment: 47% of women had less abundant menstruation; 26% of patients noted a decrease of pain during menstruation; 30% of patients had decreased duration of menstruation. Positive trend maintained during a year.

Control pelvic MRI after 3 months showed positive trend for majority of patients (85%): uterus size decrease (average by 30%). From 6th to 12th month of observation, it was noted that the uterus size in 73% patients increased in comparison' to the first control study (3 months after the procedure), uterus thus again starts accumulating a contrast agent in the ablation area, indicating the restoration of blood flow.

References

1.     Tomassetti C., Meuleman C., Timmerman D., D'Hooghe T. Adenomyosis and subfertility: evidence of association and causation. Semin. Reprod. Med. 2013; 31(2): 101-8.

2.     Linde V.A., Tatarova N.A., Lebedeva N.E., Grishanina O.I. Epidemiologicheskie aspekty genitalnogo endometrioza (obzor literaturi). [Epidemiological aspects of genital endometriosis (review)]. Problemy reproduktsii. 2008; 14(3): 68-72. [In Russ]

3.     Maheshwari A., Gurunath S., Fatima F., Bhattacharya S. Adenomyosis and subfertility: A systematic review of prevalence, diagnosis, treatment and fertility outcomes. Human Reproduction Update. 2012; 18(4): 374-392.

4.     Naftalin J., Hoo W., Pateman K., Mavrelos D., Holland T., Jurkovic D.. How common is adenomyosis? A prospective study of prevalence using transvaginal ultrasound in a gynaecology clinic. Hum. Reprod. 2012; 27(12): 3432-9.

5.     Damirov M.M. Genitalny endometrioz - bolezn aktivnikh i delovikh zhenschin [Genital endometriosis - disease of active and business women]. M.: Binom. 2010; 191 p. [In Russ].

6.     Strizhakov A.N., Davydov A.I., Pashkov V.M., Lebedev V.A. Dobrokachestvennye zabolevaniya matki [Benign uterine diseases]. M.: GEOTAR-Media. 2011; 288 p. [In Russ].

7.     Stamatopoulos C.P., Mikos T., Grimbizis G.F, Dimitriadis A.S., Efstratiou I., Stamatopoulos P., Tarlatzis B.C. Value of magnetic resonance imaging in diagnosis of adenomyosis and myomas of the uterus. J. Minim. Invasive Gynecol. 2012; 19(5) 620-6.

8.     Sudderuddin S., Helbren E., Telesca M., Williamson R., Rockall A. MRI appearances of benign uterine disease. Clin. Radiol. 2014; 69(11): 1095-1104.

9.     Heo S.H., Lee K.H., Kim J.W., Jeong YY Unusual manifestation of endometrioid adenocarcinoma arising from subserosal cystic adenomyosis of the uterus: emphasis on MRI and positron emission tomography CT findings. Br. J. Radiol. 2011. 84(1007): e210-2.

10.   Ischenko A. I., Zhumanova E. N., Ischenko A. A., Gorbenko O. Y., Chunaeva E. A., Agadzhanyan E. S., Saveleva Y. S. Sovremennye podkhody v diagnostike i organosokhranyayuschem lechenii adenomioza [Modern approach in the diagnosis of adenomyosis and conserving therapy]. Akusherstvo, ginekologiya i reproduktsiya. 2013; 7(3): 30-34. [In Russ].

11.   Nam J.H., Lyu G.S. Abdominal Ultrasound-Guided Transvaginal Myometrial Core Needle Biopsy for the Definitive Diagnosis of Suspected Adenomyosis in 1032 Patients: A Retrospective Study. J. Minim. Invasive Gynecol. 2015 Mar-Apr; 22(3):395-402.

12.   Marret H., Bleuzen A., Guerin A., Lauvin-Gaillard M.A., Herbreteau D., Patat F., Tranquart F.; French first results using magnetic resonance-guided focused ultrasound for myoma treatment. Gynecologie. Obs. Fertil. 2011;39: 12-20.

13.   Levy G., Dehaene A., Laurent N., Lernout M., Collinet P., Lucot JP, Lions C., Poncelet E. An update on adenomyosis. Diagn. Interv. Imaging. 2013; 94(1): 3-25.

14.   Tamai K., Koyama T, Umeoka S., Saga T., Fujii S., Togashi K. Spectrum of MR features in adenomyosis. Best Pract. Res. Clin. Obstet. Gynaecol. 2006; 20(4): 583-602.