Abstract:

Recent decades exhibit a tendency to the rise of gynecological malignant tumors occurence, which makes a substantial contribution to women mortality rate. Wide application of surgery makes it crucial to specify the nature of a lesion, its location, and the degree of the neighboring tissue and lymphatic nodes involvement. Early recognition, accurate staging and localization, and timely recurrent tumor detection are the primary tasks of radiodiagnostics. Computed tomography and magnetic resonance imaging show good results in gynecological tumors detection.

Clinical application of new radiological methods develops the diagnostic accuracy, decreases the number of errors and improves the survival rate. The basic radiological diagnostic procedures and the possibilities of their clinical application are discussed in the article in a form of the survey of literature.

Reference

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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:

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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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.  

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Article exists only in Russian.

Article exists only in Russian.

Abstract:

Purpose. Оf the study was to determine abilities of multislice spiral tomography (MSCT) in detection coronary artery disease (CAD) in patients with atypical angina..

Material and methods. Sixty patients (39 men) with atypical chest pain and suspected ischemic heart disease underwent complex diagnostic strategy. Value of MSCT in detection of significant (more than 50%) coronary artery stenoses was assessed by segmental analysis, vascular bed involvement, and patient analysis.

Results. Significant CAD in 8% of patients with atypical angina was revealed. In 98,7% (58 of 60 cases) MSCT allowed to specify coronary anatomy. In 53 (88,3%) of patients no significant CAD was found, in 5 cases (8,3%) MSCT confirmed significant coronary artery stenoses. Sensitivity, specificity, positive and negative prognostic value of MSCT were correspondingly 100%, 99,3%, 71,4%, 100% in segmental analysis (n = 295). Vascular territory involvement analysis (n = 91) showed 100% sensitivity, 97,7% specificity, positive prognostic value 71,4% and negative prognostic value 100%.

Conclusions. High prognostic value, as well as high sensitivity and specificity of MSCT allow us to include this method into the CAD diagnostic algorithm in patients with atypical chest pain. This method is highly reliable in eliminating of significant CAD and detecting coronary artery stenoses.

References 

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2.      Терновой  С.К.,  Синицын В.Е.,  Гагарина Н.В. Неинвазивная диагностика атеросклероза и кальциноза коронарных артерий.М.: Атмосфера. 2003; 144.

3.      Hoffman M.H. et al. Noninvasive coronary angiography with multislice computed tomography. JAMA. 2005; 293: 2471-2478.

4.      Leber A.W. et al. Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography. A comparative study with quantitative coronary angiography and intravascular ultrasound. J. Am. Coll. Cardiol. 2005; 46: 147-154.

5.      Leschka S. et al. Accuracy of MSCT coronary angiography with 64-slice technology: first experience. Eur. Heart. J. 2005; 26: 1482-1487.

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

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

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10.    Patel M.R. et al. Low diagnostic yield of elective coronary angiography. N. Engl.J. Med. 2010; 362: 886-895.

11.    Leber A.W. et al. Diagnostic accuracy of dual-source multi-slice CT-coronary angiography in patients with an intermediate pretest likelihood for coronary artery disease. Eur. Heart. J. 2007; 28: 2354-2360.

12.    Hausleiter J. et al. Non-invasive coronary computed tomographic angiography for patients with suspected coronary artery disease. Тhe Coronary Angiography by Computed Tomography with the Use of a Submillimeter resolution (CACTUS) trial. Eur. Heart. J. 2007; 28: 3034-3041.

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14.    Hoffmann U. et al. Predictive value of 16-slice multidetector spiral computed tomography to detect significant obstructive coronary artery disease in patients at high risk for coronary artery disease. Patient-versus segment-based analysis. Circulation. 2004; 110: 2638-2643.

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.

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

Abstract:

Joint trauma is one of the major causes of the temporary disability in economically and socially active groups of population. Definitive preoperative diagnosis allows correct surgery planning, decrease sick-lists duiauon and niipiove quality of patients' life. MRI is the method of chice for pre-operative examination of the knee joint. However it is associated with high variability of diagnostic effectiveness. In this paper we focus on principal diagnostic errors of the technique and provide recommendations for the appropriate application of MRI on the basis of mul-ticentre experience.

References 

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Article exists only in Russian.

Abstract:

Surgical treatment of aortic valve pathology is an actual problem of modern medicine. Aortic valve pathology is widely spread in population on a stable high level. Due to a large amount of patients with no possibility of open surgical treatment of aortic valve pathology modern hybrid methods of treatment, such as transcatheter aortic valve implantation are being actively proposed and modified.

MSCT angiography before transcatheter aortic valve implantation is obligatory procedure. Data obtained by MSCT is extremely necessary to define the possibility and the access path of transcatheter aortic valve implantation. MSCT allows to select the size and type of aortic valve prosthesis.

Appearance of modern MSCT scanners with 320-640 row of detectors will increase the leading role of MSCT in preoperative inquiry of patients with planned transcatheter aortic valve implantation.

References

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Abstract:

Background and purpose: flow-diverting devices are increasingly used for the treatment of giant and wide neck cerebral aneurysms. The aim of the research was to evaluate the feasibility of computed tomography angiography CTA in the postoperative evaluation of aneurysms treatec with Pipeline Embolization Device (PED).

Materials and methods: fifteen patients with 19 aneurysms treated by total of 17 PED were examined by means of CTA. Postprocessing of CTA acquisitions were done at workstation using maximum intensity projections, multiplanar reformations, curved planar reformations and volume rendering of PED region and other intracranial arteries. The position of PED and dergree of aneurysm occlusion were evalluated.

Results: CTA follow-up of at least 26 months demonstrated complete occlusion of aneurysms treated with the PED in 9 cases (50%). There were 2 cases (11,1%) of proximal stent migration and 2 cases (11,1%) of stent narrowing due to incomlete expansion. Flow reduction was observed in 4 aneurysms (22,2%). CTA was accurate in determining the position of PED and evaluating the patency of aneurysm.

Conclusions: CTA can be used as a reliable tool for postoperative evaluation of aneurysms treated with PED defining the stent position and aneurysmal flow reduction. Postprocessing using curved planar reformations with window width 1000-2500 and level 600-800 is optimal for stent visualization.  

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