Abstract:

Aim: was to evaluate the safety and efficacy of delayed endovascular treatment without stent implantation in ST-elevation myocardial infarction (STEMI) caused by massive thrombotic load and ectasia of infarct-related coronary artery.

Material and methods: out of 4263 primary percutaneous coronary interventions (PCI) performed for STEMI for the period from January 2016 to September 2021, retrospective analysis included data of 21 patients with ectasia of infarct-related coronary artery and massive thrombotic load (TTG ? 3).

Results: method of delayed endovascular treatment, without stent implantation, in STEMI caused by massive thrombotic load and ectasia of infarct-related coronary artery, allowed to significantly improve parameters of epicardial coronary blood flow according to  TIMI and CFTC scales in 71% and 67% of examined patients (p <0,001, p=0,001); increase myocardial perfusion according to MBG in 62% of patients (p=0,001); reduce the severity of thrombotic load according to TTG scale in 71% of the subjects (p=0,001).

Conclusion: in patients with ST-elevation myocardial infarction caused by massive thrombotic load and ectasia of infarct-related coronary artery, the strategy of delayed endovascular treatment with-out stent implantation is safe and effective at the hospital stage.

Abstract:

Aim: was to develop a score scale for the prediction of complete tumor necrosis to assess the potential effectiveness of radiofrequency ablation of colorectal cancer focals in liver, on the base of results of the use of radiological diagnostic methods.

Materials and methods: a comparative analysis of results of radiological diagnosis of solitary colorectal cancer metastases in liver was carried out in 51 patients, depending on their characteristics before and at different times after radiofrequency ablation (RFA).

The survey and interventions were carried out between 2014 and 2020 in accordance with standards of treatment approved in Belarus. Ultrasound and CT with bolus contrast enhancement were used as radiation diagnostic methods.

The initial morphological parameters of tumor focals were evaluated according to results of ultrasound examination. CT with bolus contrast was used to control the effectiveness of RFA (determining the frequency of complete tumor necrosis): on the day of discharge of patients from the hospital, after 1 month, and then - once every 3 months (quarterly) during the year.

Results: the dependence of the effectiveness of RFA (frequency of complete tumor necrosis) on initial characteristics of solitary focals of colorectal cancer in liver was revealed and confirmed by results of a comparative statistical analysis. On the basis of obtained data, a score scale for predicting the effectiveness of RFA was developed and validated. The sensitivity of the new technique was 80,0%; specificity - 82,9%.

Conclusion: for the first time, a scale for the prediction of complete tumor necrosis was developed to assess the potential effectiveness of radiofrequency ablation of solitary colorectal cancer focals in liver.

ROC-analysis of the scale validation results showed that the sensitivity and specificity of the model are sufficient for its application in practice: 80,0% and 82,93%, respectively.

References

1.     Hideo T, Eren B. Role of thermal ablation in the management of colorectal liver metastasis. Hepatobiliary Surg. Nutr. 2020; 9(1): 49-58.

https://doi.org/10.21037/hbsn.2019.06.08

2.     Machi J, Oishi AJ, Nancy LF, Robert HO. Sonographically guided radio frequency thermal ablation for unresectable recurrent tumors in the retroperitoneum and the pelvis. J. Ultrasound. Med. 2003; 22(5): 507-13.

https://doi.org/10.7863/jum.2003.22.5.507

3.     Furrukh J, Cameron S, Iswanto S. The use of thermal ablation in the treatment of colorectal liver metastasis-proper selection and application of technology. Hepatobiliary Surg. Nutr. 2021; 10(2): 279-280.

https://doi.org/10.21037/hbsn-21-54

4.     Vasiniotis KN, Kaye EA, Sofocleous CT. Image-Guided Thermal Ablation for Colorectal Liver Metastases. Tech. Vasc. Interv. Radiol. 2020; 23(2): 100672.

https://doi.org/10.1016/j.tvir.2020.100672

5.     Rafael D-N, Stephen F, Hassan M, Graeme P. Defining the Optimal Use of Ablation for Metastatic Colorectal Cancer to the Liver Without High-Level Evidence. Curr. Treat. Options. Oncol. 2017; 18(2): 8.

https://doi.org/10.1007/s11864-017-0452-6

6.     Мурашко К.Л., Сорокин В.Г., Громов Д.Г. Методы локального воздействия на очаговые образования печени, применяемые в онкорадиологии. Диагностическая и интервенционная радиология. 2020;14: 60-66.

Murashko KL, Sorokin VG, Gromov DG. Metody lokal'nogo vozdejstviya na ochagovye obrazovaniya pecheni, primenyaemye v onkoradiologii. Diagnosticheskaya i intervencionnaya radiologiya. 2020; 14: 60-66 [In Russ].

https://doi.org/10.25512/DIR.2020.14.2.07

7.     Binbin J, Hongjie L, Kun Y, Zhongyi Z. Ten-Year Outcomes of Percutaneous Radiofrequency Ablation for Colorectal Cancer Liver Metastases in Perivascular vs. Non-Perivascular Locations: A Propensity-Score Matched Study. Front. Oncol. 2020; 16(10): 553556.

https://doi.org/10.3389/fonc.2020.553556

8.     Lu DSK, Steven SR, Limanond P, et al. Influence of large peritumoral vessels on outcome of radiofrequency ablation of liver tumors. J. Vasc. Interv. Radiol. 2003; 14(10): 1267-74.

https://doi.org/10.1097/01.rvi.0000092666.72261.6b

9.     Lu DS, et al. Effect of vessel size on creation of hepatic radiofrequency lesions in pigs: Assessment of the “heat sink” effect. Am. J. Roentgenol. 2002; 178: 47-51.

https://doi.org/10.2214/ajr.178.1.1780047

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15.   Young C, Soung WJ, Jae YJ, Yong JK. Recent Updates of Transarterial Chemoembolilzation in Hepatocellular Carcinoma. Int. J. Mol. Sci. 2020; 31; 21(21): 8165.

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https://doi.org/10.1148/rg.345140054

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https://doi.org/10.1016/j.lpm.2019.10.011

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https://doi.org/10.1155/2016/9251375

Abstract:

Aim: was to evaluate the feasibility and effectiveness of using transperineal access for sanitation of «deep» exudative pelvic lesions in patients after gynecological operations.

Materials and methods: results of percutaneous drainage with perineal access of «deep» – perirectal postoperative exudative pelvic lesions in 18 patients after extirpation of the uterus in oncological pathology were subjected to retrospective analysis. Exudative formations in the pelvis were detected during continuous postoperative ultrasound screening of operated patients starting from 3rd day of the postoperative period, taking into account clinical data.

Perineal access was used in patients with verification of the nature of the pathological contents and subsequent drainage of the pathological exudation zone by 8fr drains with form memory using Seldinger method.

Results: manipulation was successful in all 18 patients. In 5 cases, a lyzed pelvic hematoma was drained, and in 13 cases, an abscess was drained. In three cases, the connection of the abscess cavity with the lumen of the rectum was revealed. There were no complications due to manipulation. The drainage period was 6-7 days for hematoma and 10-16 days for abscess without internal fistula. If there is a connection with the lumen of the rectum, the drainage period was 21 days, the drainage was removed with x-ray confirmed closure of the internal fistula.

Conclusion: our first positive experience of using transperineal access for the rehabilitation of intrapelvic exudative complications of the postoperative period in oncogynecological patients inspires cautious optimism, expands the arsenal of mini-invasive methods of treatment of intra-pelvic postoperative exudative complications, but undoubtedly requires further research for optimal integration of the technique into the practice of oncogynecology and x-ray surgery departments.

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Abstract:

Aim: was to make preclinical and imaging tests of the trans-1,2-diaminocyclohexane-N,N,N',N'-tetraacetic acid (DCTA) complex as a universal contrast agent for MRI and single-photon emission imaging, with Mn (Cyclomang) and ^99mTc- (Cyclotech), respectively.

Material and Methods: the complex of trans-1,2-diaminocyclohexane-N,N,N',N'-tetraacetic acid (DCTA) was synthesized at the department of organic chemistry of National Research Tomsk Polytechnic university, using the original technology in the nanopowder phase using manganese (II) carbonate, or generator eluate ^99mTc, and NaH₂DCTA, resulting in a 0.5 M solution of Мn-DCTA or ^99mTc-DCTA. LD50 values were determined in experiments on laboratory mice. A visualization study was performed in 4 cats and 3 dogs with malignant neoplasms of chest organs and in one dog with a tumor of the left pontocerebellar angle. All of them underwent consecutively MRI with contrast enhancement with Mn-DCTA and SPECT - with ^99mTc-DCTA.

Results: for Cyclotech LD50 >18/ml/kg, for 0.5 M Mn-DCTA (Cyclomang) solution, the LD50 index significantly exceeds 16.9 ml/kg BW. Changes in the content of manganese in the blood plasma of rats when they were administered Mn-DCTA, did not occur. LD50 values allow us to assign the drug in accordance with Russian regulation GOST 12.1.007-76. to group 4 (low-hazard substances). In both cases, in the range of physiological pH, the thermodynamic stability constant is >19.3. In studies in animals with MRI, the enhancement index of T1-weighted spin-echo image of the tumor in all cases exceeded 1.7 (mean 1.82±0.10). When calculating the «tumor/back-ground» index for ^99mTc-DCTA, it was 2.6-7.3 (mean 4.12±1.05).

Conclusion: DCTA complexes with manganese (II) - for enhancement in MRI and with ^99mTc- for SPECT- have very close pharmacokinetic properties, are non-toxic, do not dissociate in physiological environments and can be further used for contrast enhancement in multimodal MRI-SPECT studies. Chelate agents of the ^99mTc with thermodynamic stability constants over 16 may be employed in the nearest future as important source for the development of paramagnetic contrast agents binding Mn.

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Abstract

Article provides a literature review on problems of diagnosing of intracranial aneurysms (IA) rupture and its complications.

Aim: was to study relevant data on the use of computed tomography (CT), as well as other imaging methods, in patients with ruptured aneurysms in the acute period.

Materials and methods: a search was conducted for publications on this topic, dating up to December 2019, using main Internet resources: PubMed databases, scientific electronic library (Elibrary), Scopus, ScienceDirect, Google Scholar.

Results: we analyzed 45 literature sources, covering the period from 1993 to 2019, which include 3 meta-analyzes, 5 descriptions of studies evaluating the effectiveness of various visualization methods for ruptured IA. Both foreign and Russian publications were involved.

Conclusion: native CT is the leading visualization method to detect hemorrhages in nearest hours after the rupture of IA. CT angiography in combination with digital subtraction angiography (DSA), according to the vast majority of authors, allows to make thorough preoperative planning in the shortest time, as well as to identify unruptured aneurysms. Based on the obtained data, it is advisable to conduct a study to assess the role of CT in the acute period of IA rupture, as well as in the diagnosis of complications in the early postoperative period.

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39.   Grigor'eva EV, Polunina NA, Luk'yanchikov VA, et al. Features of CT angiography and the construction of 2D and 3D reconstructions of preoperative planning in patients with intracranial aneurysms. Nejrohirurgiya. 2017; (3): 88-95 [In Russ].

40.   Klimov AB, Ryabuhin VE, Kokov LS, Matveev PD. The use of stent-grafts in treatment of cerebral aneurysms. Diagnosticheskaya i intervencionnaya radiologiya. 2016; 10(3): 51-56 [In Russ].

41.   Krylov VV, Grigor'eva EV, Hamidova LT, et al. Comparative analysis of computed tomography and intracranial Doppler ultrasonography data in patients with cerebral angiospasm. Nevrologicheskij zhurnal. 2016; 21(6):344-352 [In Russ].

42.   Saribekyan AS, Balickaya NV, Rumyancev YuI, et al. The significance of the study of cerebral blood flow by CT perfusion in assessing the risk of developing cerebral ischemia in patients with ruptured intracranial arterial aneurysms. Voprosy nejrohirurgii im. NN Burdenko. 2019; 83(3): 17-28 [In Russ].

43.   Greenberg ED, Gobin YP, Riina H, et al. Role of CT perfusion imaging in the diagnosis and treatment of vasospasm. Imaging Med. 2011; 3(3): 287-297.

44.   Krylov VV, Dash'yan VG, Shatohin TA, et al. Choice of terms for open surgical treatment of patients with rupture of cerebral aneurysms complicated by massive basal subarachnoid hemorrhage (Fisher 3). Nejrohirurgiya. 2015; 3: 11-17 [In Russ].

45.   Kokov LS. Diagnostic and interventional radiology: today and tomorrow. Zhurnal im. NV Sklifosovskogo Neotlozhnaya medicinskaya pomoshch'. 2019; 8(2): 120-123 [In Russ].

Abstract:

Background: the optimal method for radiological diagnosis of prostate cancer (PCa) in planning multifocal biopsy is multiparametric magnetic resonance imaging (mpMRI)

Aim: was to improve the diagnosis of clinically significant PCa (csPCa) in patients with a negative primary biopsy, proceeding from mpMRI findings analysis based on results of the repeated procedure (24 cores) with targeted sampling of suspicious lesions.

Materials and methods: 732 patients were examined, 714 of them had been included in data of analysis. Prostatic mpMRI found suspicious foci with PI-RADS 3-5 in 396/714 (55.5%) patients. Results: The detection of PCa with a Gleason score of >7, PI-RADS 4 and 5 accounted for 65.9% and 80.0%, respectively Diagnostic sensitivity of mpMRI with a PI-RADS >4 in the diagnosis of PCa in patients with suspicious foci (n=396) was 83.6%, specificity - 84.9%; in the whole of 714 patients it was 46.4% and 86.7%, with a Gleason score of >7 - 75.3% and 89.3%, respectively In 73/290 (25.2%) patients with PI-RADS 3-5, PCa was detected in a systematic rather than in targeted biopsy, 17/73 (23.3%) of them having Gleason score >7. In 70/318 (22.0%) patients with PI-RADS 1-2, PCa was detected in systematic biopsy, in 11/70 (15.7%) cases Gleason score being >7.

Conclusion: mpMRI diagnostic accuracy for csPCa in patients with negative primary biopsy making it possible to refrain from repeated biopsy in males with PI-RADS 1-3; if repeated biopsy is necessary, the systematic one may be recommended.

References

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Abstract:

Between May 2005 and March 2007, catheter-port systems were placed in 20 pts for continuous hepatic artery infusion chemotherapy in the treatment of unresectable colorectal liver metastases. Carboplatin (or oxaliplatin) plus 5-fluorouracil and systemic leucovorin were administered. No complications occurred during the implantation procedures. The mean number of intrahepatic chemotherapy cycles per patient was 10 (4-25). The mean follow-up period was 412 (100-853) days. During the follow-up period, complications occurred in 9 patients (45%), but surgical or interventional radiological correction was successful in all but one case. At present, 14 patients are alive within 4 and 41 months and continue to receive intraarterial chemotherapy, while 6 patients died in 5 to 21 months from tumor progression. The common 1 -year survival is 90% (18 patients). Percutaneous implantation is potentially effective treatment for patients with CLM.

Reference 

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13.   Yamagami T., Kato T., Iida S. et al. Interventional radiologic treatment for hepatic arterial occlusion afterrepeated hepatic arterial infusion chemotherapy viaimplanted port-catheter system. J. Vasc. Interv. Radiol.2004; 15 (6): 633-639.

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17.   Chen Y., He X., Chen W. et al. Percutaneous implantation of a port-catheter system using the left subclavian artery. Cardiovasc. Intervent. Radiol. 2000; 23 (1): 22-25.

18.   Proietti S., De BaereT., Bessoud B. et al. Intervetionalmenagement of gastroduodenal lesions complicating intra-arterial hepatic chemotherapy. Eur. Radiol. 2007;17 (8): 2160-2165.

Abstract:

At 246 patients with coarctation of the aorta the ultrasonic semiotics of disease has been investigated. Are systematized echocardiographycal attributes of defect: are determined direct and indirect (displays directly reflecting morphology), the estimation of their sensitivity and specificity is lead. The certain combination of the specified attributes has allowed to allocate three variants of a ultrasonic picture coarctation of the Aorta, reflecting various anatomic forms of defect. The semiotics and diagnostic attributes of each ultrasonic variant of defect is described by echocardiography. 

Reference 

1.     Шиллер Н., Осипов М. А. Клиническая эхокардиография. М. 1993.

2.     Митьков В. В., Сандриков В. А. Клиническое руководство по ультразвуковой диагностике в 5 т. М.: Видар. 1998; 5: 96-297.

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5.     Фейгенбаум X. Ультразвуковая диагностика. М.: Медицина. 1999; 1123-1145.

Abstract:

The systolic pressure gradient at the level of aortic narrowing, determined by non-invasive methods was measured in 110 patients with aortic coarctation and compared with its value in direct measurement before and during various terms after correction of the defect. It was determined that Doppler ultrasonography of arteries of the limbs is the most informative non-invasive method of assessing the degree of narrowing/restoration of the aortic isthmus. Also showed was various informative value of Doppler cardiography as a method aimed at evaluating the efficacy of removing the defect in patients with good, satisfactory and poor therapeutic outcomes. 

Reference

1.     Углов Ф.Г., Некласов Ю.Ф., Герасин В.А. Катетеризация сердца и селективная ангиокардиография. Л., 1974.

2.     Покровский А.В. Клиническая ангиология. - М.: Медицина, 1979; 63-83.

3.     Lerberg D. В., Hardesty R. L., Siewers R. D., Zuberbuhler J. R. Coarctation of the aorta in Infants and Children: 25 Years of Experience. Ann. Thorac. Surg. 1982; 33 (2): 159-170.

4.     Фейгенбаум Х. Ультразвуковая диагностика. М.: Медицина, 1999; 1123-1145.

5.     Шиллер Н., Осипов М.А. Клиническая эхокардиография. М.: 1993.

6.     Stephen F.K., et al. Quantitative echo cardiographic analysis of the aortic arch predicts outcome of balloon angioplasty of native coarctation of the aorta. Circulation. 1996; 94: 1056-1062.

7.      Шахов Б.Е., Рыбинский А.Д., Шарабрин Е.Г. Критерии оценки результатов коррекции коарктации аорты. Нижегород. мед. журнал. 2003; 3: 7-11.

8.      Рыбинский А.Д. Отдаленные результаты хирургического лечения коарктации аорты в возрастном аспекте. Дисс. канд. мед. наук. Горький. 1977.

Abstract:

Palliative surgery plays a major role as a stage of congenitalheart disease treatment.Palliative endovascular interventions are safe n neonates. Such treatment can stabilize patients and adequately prepare them for radical operation and in some cases it is an alternative to classic bypass methodic.

References

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2.    Rosano A. et al. Infant mortality and congenital anomalies from 1950 to 1994. An international perspective. J. Epidemiol. Community Health. 2000; 54: 660-666.

3.    Шарыкин А.С. Врожденные пороки сердца. Руководство для педиатров, кардиологов, неонатологов. М.: изд-во «Теремок». 2005; 8-14, 224-234.

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5.    Lacour-Gayet F., Anderson R.H. A uniform surgical technique  for transfer of both simple and complex patterns of the coronary arteries during the arterial switch procedure. Cardiol. in the Young. 2005; 15 (1): 93-101.

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7.    Zales V.R., Muster A.J. Ballon dilatation angioplasty for the management of aortic coarctation. In C. Mavroudis, C.L. Backer et al. Coarctation and interrupted aortic arch. Cardiac surgery. State of art review. Philadelphia. Huley & Belfus. 1993; 7: 133.

8.    Chen Q., Parry A.J. The current role of hybrid procedures in the stage 1 palliation of patient with hypoplastic left heart syndrome. Eur. J.Cardiolthorac. Surg. 2009; 36: 77-83.

9.    Michel-Behnke I. et al. Stent implantation in the ductus arteriosus for pulmonary blood supply in congenital heart disease. Catheter. Cardiovasc. Interv. 2004; 61  (2): 242-252. 10.  

10.  Bisoi A.K. et al. Primary arterial switch operation in children presenting late with d-transposition of great arteriaes and intact ventricular septum. When is it too late for a primary arterial switch operation? Eur. J. Cardiothorac. Surg. 2010; 38: 707-713.

Abstract:

For today it is possible to allocate two basic strategies of images primary analysis during virtual colonoscopy (VC): it means interpretation on the basis of 2D and 3D reconstruction data

Purpose. Was to compare 2D and 3D analysis programs during VC: they were compared on interpretation time,on sensitivity of polyp's detection

Materials and methods. The research consisted of 80 patients. All detected new growth during VC were put into protocols of interpretation, with instructions of quantity, form and size

All the patients were underwent VC, including biopsy and further histological research Also, time spent for analysis of each research was fixed

Conclusions. Sensitivity of 3D virtual dissection during primary imaging analysis in almost the same in comparison with 2D, but interpretation time is higher in 2D.  

References 

1.    Barish   M.A.,   Soto  J.A.,   Ferrucci  J.T. Consensus on current clinical practice of virtual colonoscopy. Am. J. Roentgenol. 2005; 184: 786-792.

2.    Pickhardt PJ. et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N. Engl. J. Med. 2003; 349: 2191- 2200.

3.    Taylor S.A. et al. Polyp detection with CT colonography. Primary 3D endoluminal analysis versus primary 2D transverse analysis with computer-assisted reader software. Radiology.2006; 239: 759-767.

4.    Yasumoto T. et al. Assessment of two 3D MDCT colonography protocols for observation of colorectal polyps. Am. J. Roentgenol. 2006; 186: 85- 89.

5.    Sorstedt E. et al. Computed tomographic colonography. Сomparison of two workstations. Acta. Radiol. 2005; 46: 671-678.

6.    Macari M. et al. Comparison of time-efficien CT colonography with two- and three-dimensional colonic evaluation for detecting colorectal polyps. Am. J.Roentgenol. 2000; 174: 1543-1549.

7.    Hoppe H. et al. Virtual colon dissection with CT colonography compared with axial interpretation and conventional colonoscopy. Preliminary results. Am. J. Roentgenol. 2004;182: 1151-1158.

8.    Paik D.S. et al. Visualization modes for CT colonography using cylindrical and planar map projections. J.Comput. Assist. Tomogr. 2000; 24: 79-188.

9.    Rottgen R. et al. Colon dissection. А new three-dimensional reconstruction tool for computed tomography colonography. Acta. Radiol. 2005; 46: 222-226.

10.  Dekel D., Durgan J., Fleiter T. Virtual endo-scopy (patent pending). Publication no 2006/000925. Geneva, Switzerland: World Intellectual Property Organization. 2006.

11.  Хомутова Е.Ю. и др. Устройство для раздувания толстой кишки. Патент на полезную модель № 71072 от 14.05.2007 г. 2008.

12.  Juchems M.S. et al. CT colonography. Сomparison of a colon dissection display versus 3D endoluminal view for the detection of polyps. Eur. Radiol. 2006; 16: 68-72.

13.  Pickhardt P.J. et al. Flat colorectal lesions in asymptomatic adults. lmplications for screening with CT virtual colonoscopy. Am. J. Roentgenol. 2004; 183: 1343-1347.

Abstract:

Front abdominal wall (FAW) flap – is known to be the best method of mammary gland restoration. Classical TRAM flap are replaced by muscle-saving analogs. To decrease the risk of FAW weakness autotransplantates made of skin, hypodermic cellulose and vessels have been developed. Such flaps are optimal for mammary gland restoration, but, unfortunately, their practical usage is complicated due to technical difficulties, linked with microsurgical technique for anastamosis. Anatomic variability of blood system also complicates their usage. CT-angiography of FAW – is known to be recently used method in patients going to have restoration of mammary gland with FAW-anastamosis flap, in order to define epigastric artery inferior (EAI). The article consists of the scientific work comparative analysis, which are devoted to the preoperative FAW vessels features estimation. There are developed CT-angiographic modes, which allows to obtain high-quality EAI and all its branches visualization, almost in 100% cases and that provides an opportunity to decrease patient’s beam loading. Obtained EAI topographic data can decrease the time of intervention.  

References

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3.     Боровиков А.М. Восстановление груди после мастэктомии. М.: Губернская медицина. 2000; 96.

4.     Maurice Y. Nahabedian. Breast reconstruction. А review and rationale for patient selection. Plast. Reconstr. Surg. 2009; 124 (1): 55–62.

5.     Blondeel P.N. et al. The donor site morbidity of free DIEAP flaps and free TRAM flaps for breast reconstruction. Br. J. Plast. Surg. 1997;50: 322–330.

6.     Gill P.S. et al. A 10-year retrospective review of 758 DIEP flaps for breast reconstruction. Plast. Reconstr. Surg. 2004; 113: 1153–1160.

7.     Nahabedian M.Y. et al. Breast reconstruction with the free TRAM or DIEP flap. Patient selection, choice of flap and outcome. Plast. Reconstr. Surg. 2002; 110: 466–477.

8.     Spiegel A.J., Khan F.N. An intraoperative algorithm for use of the SIEA flap for breast reconstruction. Plast. Reconstr. Surg. 2007; 120: 1450–1459.

9.     Holm C. et al. The versatility of the SIEA flap. А clinical assessment of the vascular territory of the superficial epigastric inferior artery. J.Plast. Reconstr. Aesthet. Surg. 2007; 60:946–951.

10.   Blondeel P.N. et al. Doppler flowmetry in the planning of perforator flaps. Br. J. Plast. Surg. 1998; 51: 202–209.

11.   Hallock G.G. Doppler sonography and color duplex imaging for planning a perforator flap. Clin. Plast. Surg. 2003; 30: 347–357.

12.   Giunta R.E., Geisweid A., Feller A.M. The value of preoperative Doppler sonography for planning free perforator flaps. Plast. Reconstr. Surg. 2000; 105: 2381–2386.

13.   Moon H.K. and Taylor G.I. The vascular anatomy of rectus abdominis musculocutaneous flaps based on the deep superior epigastric system. Plast. Reconstr. Surg. 1988; 82: 815.

14.   Phillips T.J. et al. Abdominal wall CT angiography. А detailed account of a newly established preoperative imaging technique. Radiology. 2008; 249 (1): 32–44.

15.   Masia J. et al. Multidetector-row computed tomography in the planning of abdominal perforator flaps. J. Plast. Reconstr. Aesthet. Surg. 2006; 59: 594–599.

16.   Alonso-Burgos A. et al. Preoperative planning of deep inferior epigastric artery perforator flap reconstruction with multislice-CT angiography. Imaging findings and initial experience. J. Plast. Reconstr. Aesthet. Surg. 2006; 59: 585–593.

17.   Rozen W.M. et al. Preoperative imaging for DIEA perforator flaps. A comparative study of computed tomographic angiography and Doppler ultrasound. Plast. Reconstr. Surg. 2008; 121: 9–16.

18.   Rozen W.M. et al. The DIEA branching pattern and its relationship to perforators. The importance of preoperative computed tomographic angiography for DIEA perforator flaps. Plast. Reconstr. Surg. 2008; 121: 367–373.

19.   Xin Minqiang et al. The value of multi-detector-row CT angiography for preoperative planning of breast reconstruction with deep inferior epigastric arterial perforator flaps. British Journal of Radiology. 2010; 83: 40–43.

20.   Masia J.

Abstract:

Purpose. Was to determine the possibilities of transrectal ultrasound research (TUR) in grayscale-mode with the use of ultrasound angiography in diagnostics of rectitis and in monitoring its treatment in patients with prostate cancet (PC) after radiation therapy.

Materials and methods. The research consists of 62 patients with verified localized prostatic cancer (T13N01M0), which have already obtained conformed radiation therapy (RT) as a radical strategy. To estimate expressive radiation reaction patients were underwent transrectal ultrasound research before, during and after (in 3, 6, 12 months) radiation therapy. During the experiment, using grayscale-mode, the thickness of rectum front wall, its structure and echogenicity, and prostata capsula propria (lat.) tracking were estimated in dynamics. Vascularization of rectum front wall and pararectal cellulose was also analyzed in dynamics. Results of transrectal ultrasound were compared with clinical symptoms during the whole period of supervision, and were registered on the basis of patient’s personal note during and after treatment.

Results. Based on patients complaints we have noticed development of radiation rectitis (radiation therapy after-effect) which can be registered as higher thickness of rectum front wall, changes in its structure, decreasement of echogenicity and increased vascularization. The major part of patients with these changes noticed that such symptoms were therapeutically eliminated during supervision. Such echo-graphic changes won’t appear in case of prostate cancer progression and it can be used as a differential diagnostics between radiation therapy after-effect and prostate cancer growth.

Conclusion. Transrectal ultrasound allows to visualize early radiation rectitis implications in patients with prostatic cancer during radiation theraphy, and can promote the necessary treatment correction and advanced symptomatic therapy. 

References

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2.    Гранов А.М., Матякин Г.Г., Зубарев А.В. и др. Возможности современных методов лучевой диагностики и лечения рака предстательной железы. Кремл. мед. клин. вест. 2004; 16: 9–12.

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Abstract:

Purpose. Was to evaluate possibilities of FDCTA as a method of colorectal liver metastases (CLM) detection and differentional diagnostics.

Materials and methods. FD-CT-A was performed to examine 41 patients. Patients with lobe CLM (n =15) were included into the 1-st group. Purpose was to exclude metastatic lesions of contralateral lobe before surgical treatment. Patients with bilobar metastatic spread (n = 26) were included into the 2-nd group. Purpose was to detect metastases before and during regional therapy. Scanning was performed on the hybryde angiographic system Innova-4100 «GЕ Нealthcare, USA» with 5 sec scanning time, fov 23 × 23 cm, delay from 10 to 22 sec during hepatic arteriography 15–40 ml Ultravist-370 «Bayer Schering Pharma, Germany» with rate 2–4 ml/sec.

Results. In the first group 40 CLM were detected. The number of metastases in each patient ranged from 1 to 12 (mean – 3). The size of metastases ranged from 9,1 mm to 150,0 mm (mean – 36,7 mm, median – 30,2 mm). 14 of all CLM (35%) were 20 mm and less. Right hemyhepatectomy was provided for 6 patients, left hemyhepatectomy – for one. In the second group 282 CLM were detected. The number of metastases in each patient ranged from 2 to 31 (mean – 11). The size of metastases ranged from 3,2 mm to 81,0 mm (mean – 17,4 mm, median – 12,7 mm). 209 of all CLM (74%) were equal or smaller then 20 mm in diameter.

Conclusion. FD-CT-A is the perspective method for detection and differentional diagnostics of CLM.
 

References 

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Abstract:

Purpose. Was to estimate the efficiency of MRI in specified diagnostics of colorectal cancer (CRC) local spread (distal parts of a rectum anc anal channel cancer). To develop diagnostic criteria of tumor local spread, lymph nodes' lesion and involvement of surrounding tissues and organs.

Materials and methods. Research included 25 patients with verified CRC. For specificied diagnostics of cancer local spread patients underwent MRI before and after paramagnetic contrast enhanced. All researches were spent on magnetic-resonance tomography platform GE Signa 1,5T.

Results. We have revealed and studied all the types of CRC local spread in connection with TNM classification due to MRI.

Conclusion. MRI gives the full information about tumor local spread. Application of paramagnetics gives additional information about expression degree of invasive process. MRI is effective technique as a diagnostic procedure during preoperative preparation.

References 

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4.    Хубезов Д.А., Пучков К. В., Колесникова Н. О. Эффективность МРТ в дооперационном стадировании рака прямой кишки. Колопроктология. 2009; 2 (28): 38-41.

5.    Brown G. et al. Effectiveness of preoperative staging in rectal cancer. Digital rectal examination, endoluminal ultrasound or magnetic resonance imaging. Br. J. Cancer. 2004; 5(1): 23-29.

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20.  Yasui O., Sato M., Kamada A. Diffusion-weighted imaging in the detection of lymph node metastasis in colorectal cancer. Tohoku. J. Exp. Med. 2009l; 218 (3): 177-183.

Abstract:

MRI in aortic coarctation pre-operative assessment is safe, prompt, non-invasive and can be used instead of conventional angiography. Synchronization of MRI data acquisition to the cardiac cycle eliminates breathing and motion artifacts, and allows non-contrast enhanced imaging. The latter is essential in pediatric practice. 

References 

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10.  Синицин    В.Е.,    Дадвани    С.А.,    Артюхина Е.Г.  и др.  Компьютерная томографическая    ангиография    в    диагностике атеросклеротических поражений аорты и   артерий   нижних   конечностей.   Ангиология   и   сосудистая   хирургия.    2000;   6:37-44.

11.  Синицин В.Е., Дадвани С.А., Мершина Е.А. и др. Магнитно-резонансная ангиография в диагностике и хирургическом лечении заболеваний брюшной аорты и артерий нижних конечностей. Ангиология и сосудистая хирургия. 2001; 7: 23-33.

Abstract:

Background: this report describes our experience in CT-perfision (CTP) use for evaluation of rectal tumors neoadjuvant treatment effectiveness. Tumor response for combination of radiation and chemotherapy was related to CTP pattern.

Material and Methods: five patients aged 48 - 62 years with rectal adenocarcinomas histologically verified (4 patients of T3N0M0 stage and 1 patient T3N1 M0) were included. All of them had combined neoadjuvant radiotherapy and chemotherapy followed by surgery. Before and after neoadjuvant treatment virtual colonoscopy (VCS) with CTP was done in all the cases prior to surgical intervention.

Results and Conclusions: comparing perfusion pattern in rectal tumor and in normal tissue, we saw blood volume (BV) to be significantly increased, and mean transit time (MTT) moderately shortened in tumor tissues. Tumor tissue BV in neoadjuvant therapy responders was much higher than in those for whom the therapy appeared to be ineffective. On combination of radio- and chemotherapy, BVin tumor tissue significantly decreased, and MTT elongated.

References

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2.      Чиссов В.И.,  Дарьялова С.Л.  Избранные лекции  по  клинической  онкологии.  М.2000; 736.

3.      Bellomi M. et al. CT Perfusion for the Monitoring of Neoadjuvant Chemotherapy and Radiation Therapy in Rectal Carcinoma. Initial Experience. Radiology. 2007; 244: 486-493.

4.      Sahani V. et al. Assessing Tumor Perfusion and Treatment Response in Rectal Cancer with Multisection CT. Initial Observations. Radiology. 2005; 234: 785-792.

5.      Yee J. Virtual colonoscopy. Ed. by Galdino G.2008; 219.

6.      Хомутова Е.Ю. и др. Устройство для раздувания толстой кишки. Патент на полезную модель № 71072 от 14-05-2007 г. 2008.

7.      Силантьева Н.И., Цыб А.Ф. и др. Компьютерная томография в онкопроктологии.М.: 2007; 144.

Abstract:

Introduction. The RECIST criteria, which are routinely used to assess results of treatment of colorectal liver metastases with the transarterial chemoembolization (TACE), are not based on the identification of the tumor necrosis, and therefore their objectivity is questionable.

Aim: was to develop method of assessment of tumor response, based on tumor necrosis after TACE.

Materials and Methods: own technique of assessment of the tumor responce, based on measurement of computed tomography density of metastatic lesions in native and post-contrast phases, before and after treatment («criteria of N») is offered. Data of 13 patients who have undergone treatment of metastases of a colorectal cancer in a liver by the TACE method with application of microspheres «DC Beads» and irinotekan are analysed. Comparison of results of treatment according to criteria of RECIST and «criteria of N» is carried out.

Results: аccording to RECIST criteria stable disease was achieved in 11(85%) patients, and 2(15%) patients had a partial response. Neither complete response, nor progressive disease was observed. Later, progressive disease occurred in 11 patients. The period from the start of treatment until progression fixation averaged 7-9 months. According to the «N criteria», 4 (31%) patients had a complete response, 6(46%) patients had a partial response: and in 3(23%) patients we detected stable disease. Then progressive disease was monitored in all 13 patients, the period from the start of treatment until the progression fixation averaged 3-6 months. In 4 cases the progression process according to «N criteria» was detected earlier than by RECIST criteria.

Conclusion: The usе of RECIST criteria may underestimate the objective response to treatment, and as a result - the progression of disease later on. The proposed method of tumor response assessment, based on the analysis of tumor necrosis («the N criteria»), proves to be more productive. 

References

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2.     Vogl T.J., Zangos S., Balzer J.O., Thalhammer A., Mack M.G. Transarterial chemoembolization of liver metastases: indication, technique, results. Rofo. 2002; 174(6): 675-683.

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5.     Ji S.H., Park Y.S., Lee J., Lim D.H., Park B.B., Park K.W., Kang J.H., Lee S.H., Park J.O., Kim K., Kim W.S., Jung C., im Y.H. Kang W.K., Park K. Phase ii study of irinotecan, 5-fluorouracil and leucovorin as first-line therapy for advanced colorectal cancer. Jpn. J. Clin. Oncol. 2005; 35(4): 214-217.

6.     Kemeny N., Garay C.A., Gurtler J., Hochster H., Kennedy P., Benson A., Brandt D.S., Polikoff J., Wertheim M., Shumaker G., Hallman D., Burger B., Gupta S. Randomized multicenter phase ii trial of bolus plus infusional fluorouracil/leucovorin compared with fluorouracil/leucovorin plus oxaliplatin as third-line treatment of patients with advanced colorectal cancer. J. Clin.Oncol. 2004; 22(23): 4753-4761. Erratum in: J. Clin. Oncol. 2005; 23(1): 248.

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9.     Martin R.C., Joshi J., Robbins K., Tomalty D., Bosnjakovik P., Derner M., Padr R., Rocek M., Scupchenko A., Tatum C. Hepatic intra-arterial injection of drug-eluting bead, irinotecan (DEBiRi) in unresectable colorectal liver metastases refractory to systemic chemotherapy: results of multi-institutional study. Ann. Surg. Oncol. 2011; 18(1): 192-198.

10.   Narayanan G., Barbery K., Suthar R., Guerrero G., Arora G. Transarterial chemoembolization using DEBiRi for treatment of hepatic metastases from colorectal cancer. Anticancer Res. 2013; 33(5): 2077-2083.

11.   Martin R.C., Howard J., Tomalty D., Robbins K., Padr R., Bosnjakovic P.M., Tatum C. Toxicity of irinotecan-eluting beads in the treatment of hepatic malignancies: results of a multi-institutional registry. Cardiovasc Intervent Radiol. 2010; 33(5): 960-966.

Abstract:

Background: balloon angioplasty for coarctation of the aorta (CoA) in teenagers and adults is sometimes limited by significant residual pressure gradient (>20 mm Hg) in cause of vesse «elastic recoil». To avoid this complication intervention cardiologists use self- and balloon-expandable endovascular stents. In this report we demonstrate our experience in such method of aortic coarctation repair.

Materials and methods: in our instituton since December 2008 to Desember 2013 85 teenagers and adult patients were treated by endovascular stent placement to coarctatec aortic segment. The age of patients was 10 to 60 years (mean 20,3+7,4), weight 20 to 90 kgs (mean 53,2+14,6). Mean systolic arterial pressure was 166+7mm Hg. (range 140 to 200), mean systolic pressure gradient (SPG) was 60,6+9,0 mm Hg (range 25 to 85). The mean cross section at baseline of coarctation was 19,6±6,1 mm2 (range 1 to 95). 61 patients had native coarctation and 3 recoarctation after previous surgical repair. In 21 cases coartation was in combination with other cardiac pathology - patent ductus arteriosus (PDA), restrictive VSD, aortric and mitral valve lesions, and coronary vessel pathology Seven patients had hemodynamically significant aortic atresia. We used 20 Palmaz P-4014, 18 Genesis XD PG-2910 (Cordis Jonson & Jonson) and 45 - CP, CP covered stents, one - Intratherapeutic Doublestrut (EV3), and one Advanta V12 (Atrium) covered stent.

Results: 90 stents were implanted in 85 patients. Procedure was successful in all but one cases, one patient with postsurgical recoarctation had residual systolic pressure gradient > 25 mm Hg after stent placement. The peak systolic gradient decreased from a mean value of 60 mm Hg.(range 25 to 85) to a mean 7 mm Hg (range 0 to 25). Systolic blood pressure normalized in 64 cases, twenty one patients require additional drug therapy Coarctation site cross section increased from a mean of 19,6 mm2 to 236,3 mm2. PDA was closed simultaneously with the stenting by coils, and for eleven patients with other cardiac malformations endovascular coarctation repair was as a first step in complex cardiac surgical treatment. In one case of 56 years old male we had acute aortic dissection which was stabilized without surgical intervention. Two patients with complete hemodynamically significant aortic atresia developed stent fracture, which was recognized on CT scan 6 months after procedure. In one case it was treated with covered stent placement. In another patient stent fragment was treated surgically We had three stent migration with their safe deployment in thoracic aorta and followed by successful repair of aortic narrowing with additional stent.

Conclusion: stent implantation for aortic coarctation is safe and effective procedure. The early and intermediate term result are encouraging, with relatively low incidence of complication in teenagers and adult patients. 

References

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4.     Forbes T.J. Procedural Results and Acute Complications in Stenting Native and Recurrent Coarctation of the Aorta in Patients Over 4 Years of Age A Multi-Institutional Study. Cath. and Cardiovascular. Interventions. 2007; 70: 276-285.

5.     Golden А^. Coarctation of the Aorta: Stenting in Children and Adalts. Cath. and Cardiovascular Interventions. 2007; 69: 289-299.

6.     Chessa M., Carrozza M., Butera G., Piazza L., Carminati M. Results and mid-long-term follow-up of stent implantation for native and recurrent coarctation of the aorta. European Heart Journal. 2005; 26: 2728-2732.

7.     Rosenthal E. Stent implantation for aortic coarctation: the treatment of choice in adults? J. Am. Coll. Cardiol. 2001;38: 1524-1527.

8.     Beaton A.Z. Relation of Coarctation of the Aorta to the Occurrens of Ascending Aortic Dilation in Children and Young Adults With Bicuspid Aortic Valves. Am. J. Cardiol. 2009; 103: 266-270.

9.     Qureshi S.A. Stenting in aortic coarctation and transverse arch/isthmus hypoplasia; Percutaneous Interventions for Congenital Heart Disease, 2007: 475-489.

10.   Duke C., Rosenthal E. and Qureshi S.A. The efficacy and safety of stent redilatation in congenital heart disease. Heart. 2003;89: 905-912.

11.   Basil Vasilios Thanopoulos, Nicholaos Eleftherakis, Konstadinos Tzanos, Stent Implantation for Adult Aortic Coarctation. J. Am. Coll. Cardiol. 2008; 52: 1815-1816. 

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.  

References

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2.     V^uela F., Duckwiler G., Mawad M. Guglielmi detachable coil embolization of acute intracranial aneurysm: perioperative anatomical and clinical outcome in 403 patients. J. Neurosurgery. 2008; 108(4): 832-9.

3.     Kallmes D.F., Ding YH., Dai D., Kadirvel R., Lewis D.A., Cloft H.J. A new endoluminal, flow-disrupting device for treatment of saccular aneurysms. Stroke. 2007; 38(8): 2346-52.

4.     Lylyk P, Miranda C., Ceratto R., et al. Curative endovascular reconstruction of cerebral aneurysms with the Pipeline embolization device: the Buenos Aires experience. Neurosurgery. 2009; 64: 632- 42, discussion 642-43, quiz N636.

5.     Cloft H.J., Joseph G.J., Dion J.E. Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation: a meta-analysis. Stroke. 1999; 30(2): 317-20.12.

6.     Mayberg M.R., Batjer H.H., Dacey R., Diringer M., Haley E.C., Heros R.C., Sternau L.L., Torner J., Adams H.P Feinberg W. et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage. A statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke. 1994; 25(11): 2315-28.

7.     Min J.K., Swaminathan R.V., Vass M., Gallagher S., Weinsaft J.W. High-definition multidetector computed tomography for evaluation of coronary artery stents: comparison to standard-definition 64-detector row computed tomography. Cardiovasc. Comput. Tomogr. 2009; 3(4): 246-51.

8.     Sun Z., Davidson R., Lin C.H. Multi-detector row CT angiography in the assessment of coronary in-stent restenosis: a systematic review. Eur. J. Radiol. 2009; 69(3): 489-95.

9.     Szikora I., Guterman L.R., Wells K.M., Hopkins L.N. Combined use of stents and coils to treat experimental wide-necked carotid aneurysms: preliminary results. AJNR Am. J. Neuroradiol. 1994; 15(6):1091-102.

10.   Ternovoy S.K., Akchurin R.S., Fedotenkov I.S., Veselova T.N., Nikonova M.E., Shiryaev A.A. Neinvazivnaya shuntografiya metodom mul’tispiral’noy komp’yuternoy tomografii. REJR. 2011; 1(1): 26-32 [In Russ].

11.   Lieber B.B., Stancampiano A.P, Wakhloo A.K. Alteration of hemodynamics in aneurysm models by stenting: influence of stent porosity. Ann. Biomed. Eng. 1997; 25(3): 460-9.

12.   Szikora I., Berentei Z., Kulcsar Z., et al. Treatment of intracranial aneurysms by functional reconstruction of the parent artery: the Budapest experience with the Pipeline embolization device. AJNR Am. J. Neuroradiol. 2010; 31:1139-47.

13.   McAuliffe W., Wycoco V., Rice H., Phatouros C., Singh T.J., Wenderoth J. Immediate and midterm results following treatment of unruptured intracranial aneurysms with the pipeline embolization device. AJNR Am. J. Neuroradiol. 2012; 33(1):164-70.

14.   Saatci I., Yavuz K., Ozer C., Geyik S., Cekirge H.S. Treatment of intracranial aneurysms using the pipeline flow-diverter embolization device: a single-center experience with long-term follow-up results. AJNR Am. J. Neuroradiol. 2012; 33(8):1436-46.

15.   Deutschmann H.A., Wehrschuetz M., Augustin M., Niederkorn K., Klein G.E. Long-term follow-up after treatment of intracranial aneurysms with the Pipeline embolization device: results from a single center. AJNR Am. J. Neuroradiol. 2012; 33(3): 481-6. 

Abstract:

Aim: was to estimate possibilities of optical coherence tomography (OCT) in diagnostics of pathology of bile ducts in combination with percutaneous transhepatic biliary drainage (PTBD).

Materials and methods: examined 5 patients with obstructive jaundice, suspected cancerous etiology OCT was performed during or 5-14 days after PTBD. For morphological confirmation of results we performed forceps intraductal biopsies.

Results: tomographic evidences of the malignant stricture were revealed in 4 (80%) patients anc in 1 patient benign stricture was determined. Diagnoses were confirmed histologically (80%) and clinically (20%). Sensitivity of the OCT was 100%.

Conclusion: percutaneous transhepatic OCT appeared to be a perspective method for differential diagnostics of biliary strictures. 

References

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2.     Shajn A.A. Rak organov pishhevarenija. [Cancer of digestive organs] Tjumen'. Skorpion. 2000; 184-188 [In Russ].

3.     Soares K.C., Kamel I., Cosgrove D.P., et al. Hilar cholangiocarcinoma: diagnosis, treatment options, and management. Hepatobiliary Surg Nutr. 2014; 3 (1): 18-34.

4.     Madariaga J.R., Iwatsuki S.,Todo S. et al. Liver resection for hilar and peripheral cholangiocarcinomas: a study of 62 cases. Annals of Surgery. 1998; 227 (1): 70-79.

5.     Heimbach J.K., Haddock M.G., Alberts S.R. et al. Transplantation for hilar cholangiocarcinoma. Liver Transplantation. 2004; 10 (2): 65 -68.

6.     Denisenko A.G. Opticheskaja kogerentnaja tomografija v diagnostike novoobrazovanij zheludochno-kishechnogo trakta. [Optical coherence tomography in diagnostics of neoplasms of digestive tract]Avtoreferat. Diss. kand. med. nauk. N. Novgorod. 2006; S 20 [In Russ].

7.     Zagajnova E.V. Diagnosticheskaja cennost' opticheskoj kogerentnoj tomografii v jendoskopii. [Diagnostic value of optical coherence tomography in endoscopy]Avtoreferat. Diss. dokt. med. nauk. N. Novgorod. 2007; S27 [In Russ].

8.     Arvanitakis M., Hookey L., Tessier G. et al. Intraductal optical coherence tomography during endoscopic retrograde cholangiopancreatography for investigation of biliary strictures. Endoscopy. 2009; 41: 696-701. [PMID: 19618343 D0I:10.1055/s-0029-1214950].

9.     de Bellis M., Sherman S., Fogel E. L. et al. Tissue sampling at ERCP in suspected malignant biliary strictures (Part 2). Gastrointest Endosc. 2002; 56: 720-730 [PMID: 12397282 DOI: 10.1067/mge.2002.129219].

10.   Ross W.A., Wasan S.M., Evans D.B. et al. Combined EUS with FNA and ERCP for the evaluation of patients with obstructive jaundice from presumed pancreatic malignancy. Gastrointest Endosc. 2008; 68: 461-466 [PMID: 18384788 DOI: 10.1016/j.gie.2007.11.033].

11.   Shahova N.M. Kliniko-jeksperimental'noe obosnovanie primenenija opticheskoj kogerentnoj tomografii v medicinskoj praktike [Clinical and experimental basics of application of optical coherence tomography in medical practice]Avtoreferat. Diss. dokt. med. nauk. N. Novgorod. 2004; 19c  [In Russ].

12.   Demin V.V., Dolgov S.A., Demin D.V. Sravnenie informativnosti opticheskoj kogerentnoj tomografii i vnutrisosudistogo ul'trazvukovogo skanirovanija dlja ocenki rezul'tatov implantacii stentov s lekarstvennym pokrytiem. Materialy V rossijskogo s'ezda intervencionnyh kardioangiologov. [Comparison of informative value of optical coherence tomography and intravascular ultrasound in estimation of results of implantation of drug-eluting stents.] Mezhdunarodnyj zhurnal intervencionnoj kardioangiologii. 2013; 35: 41- 42 [In Russ].

13.   Mahmud S.M., May G.R., Kamal M.M. et al. Imaging pancreatobiliary ductal system with optical coherence tomography: A review. World J Gastrointest Endosc. 2013; 5(11): 540-550. ISSN 1948-5190 (online).

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Abstract:

Aim: was to estimate changes in architectonic and hemodynamics of left common iliac vein (lCIV), caused by its crossing with right common iliac artery (rCIA), in patients with varicocele according to data of computed tomography angiography (CTA) and contrast venography.

Materials and methods: we analyzed results of CTA and contrast venography in the area of arte-riovenous crossing: 37 patients with newly diagnosed and 45 with recurrent varicocele. Analysis of topical changes was made on data of axial tomography, multiplanar and 3D reconstructions. Hemodynamic changes in lCIV, were determined by dynamic venogram and results of mesurement of pressure gradient between lCIV and vena cava inferior (VCI).

Results: it was found that CTA is the most informative for visualizing of lCIV narrowing caused by its compression by rCIA. This is due to the possibility of obtaining a same contrasting imaging of vessels involved in arteriovenous «conflict». Multiple view scanning reconstruction revealed a correlation between size of the lumbosacral angle and the degree of compression of lCIV caused by arteriovenous conflict. CT angiography with the use of utility model, allowed to change the state of the arteriovenous crossing, showed compression instability Dynamic contrast venography showed angiographic features typical for lCIV compression, and also visualized venous collaterals that compensate blood-flow disorders. Conducting direct measurement of venous pressure gradient in compression area allowed us to estimate the degree of hemodynamic changes in lCIV and explore the mechanism of compression generated by pulsating blood flow of rCIA.

Conclusions: severity of compression of lCIV at arteriovenous «conflict» is affected by constitutionally-static angle between L5-S1 vertebral bodies. Compression degree of lCIV is not constant and may vary depending on the patient's body position. Compression of lCIV promotes collateral blood flow through veins of sacral and external lumbar drainage. The more expressed compression of lCIV the more developed collateral blood flow in both drainage systems. Developed collaterals compensate hypertension caused by compression of lCIV Estimation of venous blood flow disorders, in case of varicocele, and choice of method of surgical treatment should be based on data from X-ray contrast studies and results of tensometry conducted at the area of arteriovenous «conflict» of lCIV.  

References

1.    Strahov S.N. Varikoznoe rasshirenie ven grozdevidnogo spleteniya i semennogo kanatika (varikotsele) [Varicose of internal spermatic vein and spermatic cord (varicocele)]. M. 2001; 235S [In Russ].

2.    Stepanov V.N., Kadyirov Z.A. Diagnostika i lechenie varikotsele [Diagnostics and treatment of varicocele]. M., 2001; 200S[In Russ].

3.    Lopatkin N.A., Morozov A.V., Jitnikova L.N. Stenoz pochechnoy venyi [Stenosis of renal veins]. M.: Meditsina. 1984; 102 S [In Russ].

4.     Coolsaet B.L. The varicocele sindrom: venographi determining the optimal ievel for surgical management. J. Urol. 1980; 124: 833-834.

5.     May R., Thurner J. The cause of predominantly sinistral occurrence of thrombosis of the pelvic veins. Minerva Cardioangiol. 1957; 3: 346-9.

6.     Cockett F.B. Thomas M.L. Negus D. Iliac vein compression: its relation to iliofemoral thrombosis and the postthromdotic syndrome. BMJ. 1967; 2: 14-19.

7.     Mazo E.B., Tirsi K.A., Andranovich S.V., Dmitriev D.G. Ultrazvukovoy test i skrotalnaya dopler-ehografiya v predoperatsionnoy diagnostike gemodinamicheskogo tipa varikotsele [Ultrasound test and doppler-echography of scrotum in preoperative diagnostics of hemodynamically type of varicocele]. Urologiya i nefrologiya 1999; 3: 22-26 [In Russ].

8.     Kim et al. Hemodynamic Investigation of the Left Renal Vein in Pediatric Varicocele. Doppler US, Venography and Pressure Measurements. Radiology. 2006; 241.

9.     Garbuzov R.V., Polyaev YU.A., Petrushin A.V. Arteriovenoznyiy konflikt i varikotsele u podrostkov [Arteriovenous conflict and varicocele in teenagers] Diagnosticheskaya i iterventsionnaya radiologiya 2010; 4(3): 31-36 [In Russ].

10.   Kogan M.I., Afoko A., Tampuori D., Asanti-Asamani A., Pipchenko O.I. Varikotsele: protivorechiya problemyi [Varicocele: conflict issues.]. Urologiya 2009; 6: 67-72 [In Russ].

11.   Kadyirov Z.A. Varikotsele [Varicocele]. M., 2007; 269S [In Russ].

12.   Tager I.L. Rentgenodiagnostika zabolevaniy pozvonochnika [X-ray diagnostics in diseases of vertebral colums]. M., 1983; 208S [In Russ].

13.   Reynberg S.A. Rentgenodiagnostika zabolevaniy kostey i sustavov [X-ray diagnostics in diseases of bones and joints]. M., 1964; t. II: 188-189 [In Russ].

14.   Korolyuk I.P. Rentgenanatomicheskiy atlas skeletal [Atlas of X-ray anatomy of skeleton.]. M., 1994; 192S [In Russ]. 

Abstract:

Aim: was to increase diagnostic value of cardiac CTA (CCTA) by estimation of the CCTA informative value in CA (Coronary arteries) diseases and optimization of OOTA procedure for reducing of radiation dose (RD).

Materials and methods: CCTA informative value in CA diseases was assessed on the base of data of 200 patients (average age of patients was 60,4 (from 35 to 80 years), men/women ratio: 1.94:1(132/68). Parameters of coronary stenosis severities: its localization, extension, degree and characteristics of coronary stenosis. The study was performed with GE Optima 660 128-slice scanner and Missouri Ulrich injector with bolus injecting 60-100 ml of nonionic contrast media (350 mg/ml) at 4-6 ml/sec injector rate. For data processing used: «Auto Coronary Analysis» and «Auto Ejection Fraction» programs at - AW5 workstation.

Results: discovered various severity degrees of atherosclerotic lesions based stenosis intensity up to 50% (46 /23,5%), 50-60% (65/33%), 60-70% (35/17,9%), 70-80% (26/13,5%), 80% and more (23/11,8%). CCTA data coincided with conventional coronary angiography in 89% cases. RD decreasment was achieved by: pitch change depending on heart rate, scan area optimization (reduction), kV and mAc with radiation exposure decline in CCTA to 7,0-8,0 mSv In pitch value increasing to 1,48 - RD decreased to 45% (20 mSv). In prospective synchronization with ECG, RD decreased to 65% (7-12 mSv) as X-Ray tube radiates the highest RD at 70% cardiac cycle phase (120kV/180-200mAc), in other phases (80kV/100 mAc) RD values were lower.

Conclusion: CCTA is a valid non-invasive method in CA pathology diagnostics enabling accurate identification of stenosis location, extent, degree and characteristics. Scanning protocol individualization in CCTA enables significant reduce of RD.

References

1.     Kurbanov R.D., Urinov O. Profilaktika osnovnyh faktorov riska osnova snizheniya smertnosti ot serdechnososudistyh zabolevanij. [Prophylaxis of major risk factors-basis of reduction of mortality caused by cardiovascular diseases.] Zdravoohranenie Uzbekistana. 2011; 41, 1-2. [In Russ].

2.     Boguneckiy A.A. Vozmozhnosti magnitno-rezonansnoj tomografii serdca s kontrastnym usileniem v prognozirovanii posleoperacionnoj dinamiki u pacientov s ishemicheskoj bolezn'yu serdca. [Possibilities of cardiac MRI with contrast enhancement in prognosis of post-surgical dynamics in patients with ischemic cardiovascular disease.] Rossiyskiy elektronnyiy zhurnal luchevoy diagnostiki. 2012; 85-86. [In Russ].

3.     Multi-slice and Dual-source CT in Cardiac Imaging. Eds. Ohnesorge B.M., Flohr T.G., Becker C.R. Berlin: Springer. 2006; 359 p.

4.     Fedotenkov I.S., Veselova T.N., Ternovoy S.K., Sinitsyn V.E. Rol' mul'tispiral'noj komp'yuternoj tomografii v diagnostike kal'cinoza koronarnyh arterij. [The role of multispiral computed tomography in the diagnosis of coronary artery calcification.] Cardiologicheskiy vestnik. 2007; II (XIV): 45-48.

5.     Shevchenko I.I. Sravnenie dannyh registrov ostryh koronarnyh sindromov REKORD i REKORD-2: lechenie i ego iskhody v stacionarah, ne imeyushchih vozmozhnosti vypolneniya invazivnyh koronarnyh procedur. [Comparison of the RECORD and RECORD-2 registers data of the acute coronary syndrome: treatment and it’s result in hospitals without ability to carry out invasive manipulations.] Kardiologiya. 2013; 8: 4-10. [In Russ].

6.     Oganov R.G., Pozdnyakov Ju.M., Volkov B.C. Ishemicheskaya bolezn' serdca. [Ischemic heart disease.] M.: Izdatel'skiy Dom Sinergiya, 2002; 308 p. [In Russ].

7.     Ternovoy S.K., Nikonova M.E., Akchurin R.S. et al. Vozmozhnosti mul'tispiral'noj komp'yuternoj tomografii (MSKT) v ocenke koronarnogo rusla i ventrikulografii v sravnenii s intervencionnoj koronaroventrikulografiej. [Possibilities of multispiral computed tomography (MSCT) in assessing of coronary vessels and ventriculography in comparison with interventional coronaroventriculography.] Russian electronic journal of radiation diagnostics. 2013; 3(9): 28-36 [In Russ].

8.     Sinitsyn V.E., Ustjuzhanin D.V. Mul'tispiral'naya komp'yuternaya tomografiya: issledovanie koronarnyh arterij. [Multislice computer tomography: examination of coronary arteries.] Bolezni serdtsa i sosudov. 2006; 1: 20-24. [In Russ].

9.     Coronary Radiology, 2nd edition. Eds. Oudkerk M., Reiser M.F. Berlin: Springer. 2009; 349 p.

10.   Einstein A.J., Elliston C.D., Arai A.E., Chen M.Y. Mather R., Pearson G.D., Delapaz R.L., Nickoloff E., Dutta A., Brenner D.J. Radiation dose from single-heartbeat coronary CT angiography performed with a 320-detector row volume scanner. Radiology. 2010; 254: 698-706.

11.   Vardikov D.F., Yakovleva E.K., Maystrenko D.N. Analiz densitometricheskih pokazatelej koronarnogo rusla pri stenoziruyushchih porazheniyah koronarnyh arterij i posle procedury stentirovaniya metodom ob'emnoj MSKT- koronarografii. [Analysis of densitometric parameters of coronary artery stenosis and after the stenting procedure with the method of volume MDCT coronary angiography.] Luchevaya diagnostika i terapiya. 2015; 3: 53-56. [In Russ].