ABSTRACT:

Article presents a literature review on the role of magnetic resonance imaging (MRI) of sacroiliac joints in the diagnosis of ankylosing spondylitis.

Aim: was to analyze domestic and foreign literature sources that reflect the state of the problem and aspects of radiodiagnostics of sacroiliac joints in patients with ankylosing spondylitis.

Materials and methods: article contains analysis of 29 literature sources of leading domestic and foreign scientific journals.

Results: for a reliable diagnosis of ankylosing spondylitis, the presence of x-ray confirmed sacroiliitis is a prerequisite. However, difficulties in confirming or absence of sings of sacroiliitis on radiography at the beginning of the disease leads to a delay in the diagnosis of ankylosing spondylitis, which is established for 5-10 years after first clinical signs of the disease. Magnetic resonance imaging allows us to evaluate changes in sacroiliac joints in early stages of the disease and prevent the development of significant structural changes that lead to early disability of patients. MR-symptoms of active inflammation of sacroiliac joints in ankylosing spondylitis include: edema of the bone marrow (ostitis) in subchondral parts of iliac bones and sacrum, edema of the capsule (capsulitis) and periarticular ligaments (enteritis) joint, as well as synovitis, accompanied by synovial effusion into the joint cavity. MR-symptoms of structural changes in sacroiliac joints in ankylosing spondylitis include: bone erosion, sclerosis, fat deposits of the bone marrow, bone bridges, ankyloses.

Conclusion: magnetic resonance imaging currently occupies a leading position in the early diagnosis of ankylosing spondylitis, which allows us to identify active inflammatory and structural changes in sacroiliac joints.

References

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25.   Levshakova AV, Bochkova AG, Bunchuk NV. Magnetic resonance imaging in the diagnosis of sacroiliitis in patients with ankylosing spondylitis. Medicinskaya vizualizaciya. 2008; 2: 97–103 [In Russ].

26.   Rudwaleit M, Jurik AG, Hermann KG et al. Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI group. Ann Rheum Dis. 2009; 68 (10):1520–1527.

27.   Rudwaleit M, Landewe R, van der Heijde D et al. SpondyloArthritis international Society (ASAS) classification criteria for axial spondyloarthritis (Part II): Validation and final selection. Ann Rheum Dis. 2009; 68: 777–83.

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Abstract

Scientific and technical progress of modern surgical treatment of foot pathology poses new diagnostic tasks for radiologists. Opening of the functional MSCT (fMSCT) of the foot with weight-bearing significantly changed the treatment protocol of patients with acquired foot deformities.

Purpose: to conduct a comparative analysis of the angular parameters on x-ray images anc weight-bearing fMSCT images of the foot in patients with acquired adult flat feet.

Materials and methods: 45 patients (88 feet) were examined, who underwent x-ray examination of the foot with weight-bearing and weight-bearing fMSCT of the foot. On the received images were examined angular indicators of a foot and was carried out statistical comparison of the received results.

Results: after processing the measurement data of fMSCT and x-ray examination it was found that statistically significant differences in the standard definition of the angular parameters of the foot is not determined. To compare the values obtained by radiographic method and fMSCT was used paired Student's t-test. To determine the presence or absence of dependence of the difference of measurements obtained by the two methods from the average values of these measurements were constructed graphs of Bland-Altman. Evaluation of the longitudinal arch angle of the foot showed that all measurements are within the 95% predictive interval. The index of the calcaneal inclination angle, the individual values of the difference were outside the borders of the 95% predictive interval, but do not depend on the measurements.

Conclusion: comparative analysis showed the statistical insignificance of differences in the average values of individual angular indicators measured in the two groups (radiography and fMSCT) The data obtained in the course of the study allow us to assert the possibility of using the fMSCT of the foot with the load as a modern reliable method for assessing the angular parameters of the foot in order to determine the degree of flat deformation.

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Abstract:

We present a clinical case, demonstrating the importance of x-ray technician compliance with rules of laying when performing x-ray examination of the mammary glands. According to the plain analog mammography with low quality, with positioning of not of all parts of the breast - the pathology was not revealed. In repeated mammographic study, conducted by all rules and all methodological aspects, in the upper-outer quadrant of the right breast, nodular newgrowth category BI-RADS 4c, highly suspicious on breast cancer was revealed. After the expansion of the diagnostic algorithm by echography and core-biopsy, low-differentiated breast cancer with high mitotic activity was verified.

Referenses

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3.      Chernaya AV. Comparative analysis of informative value of digital mammography and mammoscintigraphy in breast cancer diagnostics. Dis. kand. med. nauk. SPb.: FGBU «NMITsO im. N. N. Petrova» MZ RF, 2018; 112 p [In Russ].

4.      Zuy VS, Solov'ev VI, Alieva FV., Garmot'ko AA, Nikitonova NV. Diagnostic sectoral resection as a method for verifying breast cancer in the Smolensk region (20102014). Vestnik Smolenskoy gosudarstvennoy meditsinskoyakademii. 2018; 17(2): 148-151 [In Russ].

5.      Rozhkova N I. The priority of women's health in the national program for the development of oncological services. Medicinskijalfavit. 2018; 2(29), (366): 6-9 [In Russ].

6.      Vasil’ev AYu., Мanuylova ОО. Stereoscopic mammography. An alternative method for the breast cancer early diagnosis. Radiologiya-praktika. 2017; 61(1): 6-14 [In Russ].

7.      Pavlova T V, Vasil'ev A Yu, Manuylova O O. Method of Сone-Вeam Breast Computed Tomography (Literature Review). Radiologiya - praktika. 2019;73(1): 21-27 [In Russ].

8.      Shumakova TA, Solntseva IA, Safronova OB, Savello VE, Serebryakova SV. The practical application of the international classification of Bi-RADS in mammology practice. Rukovodstvo dlya vrachey. SPb NII skoroy pomoshchi im. I.I.Dzhanelidze. SPb., 2018; 217 p. [In Russ].

9.      Sadykov S S, Bulanova Yu A, Zakharova E А. Methods of breast cancer detection. Algoritmy, metody i sistemy obrabotkidannykh. 2012;19(1): 168-178 [In Russ].

10.    Myakin'kov V B. World radiological experience. Radiologicheskiy visnik. 2012;44(3): 43-47 [In Russ].

Abstract:

Accurate and timely diagnosis of benign renal tumors is often complicated, mainly because of the large variety of manifestations. 102 patients with various renal tumors were included in the study; in 9 of them (8.8%) tumors were verified as benign. Specimen were obtained by surgical tumor excision (8 cases), and ultrasound guided needle biopsy (1 case). The importance of pre-operative CT and MRI is shown for accurate diagnosis of benign renal tumors, in particular, angiomolipoma and multilocular cystous nephroma. Authors also discussed complicacies in radiodiagnostics of benign renal tumors.

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Abstract:

Arm. In order to improve the quality of severe pelvis fractures' diagnostics, detection of pelvic organs' lesion, preoperative examination and monitoring of treatment, we have made a retrospective analysis of radiological data of 70 patients (46 males, 24 females) aged between 24 and 54 years who were treated in emergency departments of hospital.

Results. The diagnostic efficiency of X-rays for injuries of the pelvis in case of lesions of the acetabulum is less than MDCT (specificity - 70.4%, accuracy - 61.3%, sensitivity - 56.3%). At the same time, traditional X-rays should only be used to diagnose fractures without displacement and for the control of metal after the surgery It is established that multidetector CT is the method of choice and the first stage in the diagnosis of associated injuries and hidden pelvic fractures, and has the best indicators of diagnostic value (specificity - 69% accuracy - 95% predictive of a positive result - 90%).

Conclusion. It was established that radiography is a method of screening and monitoring of treatment in patients with injuries of the pelvic ring and acetabulum, and in the first place during the provision of urgent specialist care. However, existing X-ray examination methods are not sufficiently informative, particularly in the diagnosis of posterior half-ring damage and hip; early and complete radiodiagnostics of pelvic and intrapelvic organs' injures is the leader in terms of examination of patients. A differentiated approach to the assessment of individual semiotic signs of pelvic fractures with MSCT improves informative value not only from the standpoint of initial diagnostics, but also helps to predict possible complications.

References 

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2.     Ratnikov V.A. SYNGO-MR-tehnologija: metodika i vozmozhnosti vizualizacii organov brjushnoj polo- sti i taza na vysokopol'nom (1,5 T) magnitnom tomografe «MAGNETOM SYMPHONY» [SYNGO- MR-Technology: methodology and visualization of the abdomen and pelvis in the 1.5 T magnetic tomography «MAGNETOM SYMPHONY»]. ( V.A. Ratnikov, G.E. Trufanov, S.V. Serebrjakova). Materialy Nevskogo radiologicheskogo foruma «Iz buduwego v nastojawee». SPb, 2003; 343 [In Russ].

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Abstract:

Pancreatic transcutaneous necrosectomy from postnecrotic cavities can be a mini-invasive methods of treatment. Such method leads to fast sanation of lesions and is objectivelly a good monitoring method of control.

Aim: was to demonstrate possibilities of transcutaneous pancreatic necrosectomy after spread anc infected pancreatic necrosis.

Results: one of the most illustrative cases of successful mini-invasive treatment of spread infected pancreatic necrosis using transcutaneous necrosectomy under combined control (ultrasound, X- ray and endoscopy) is presented

Conclusion: the use of mini-invasive surgical techniques such as percutaneous drainage under combined control is possbile for panreatic necroectomy in patients with spread infected pancreatic necrosis (necrotic parapancreatitis).  

References 

1.    Rossiyskoe obschestvo hirurgov, Assotsiatsiya gepa- topankreatobiliarnyih hirurgov stran SNG, Rossiyskoe obschestvo skoroy meditsinskoy pomoschi. Diagnostika i lechenie ostrogo pankreatita. (Rossiyskie klinic- heskie rekomendatsii) g. Sankt-Peterburg, 2014. (ssyilka:http://xn—9sbdbejx7bdduahou3a5d.xn-- p1ai/stranica-pravlenija/unkr/urgentnaja-abdominalnaja- hirurgija/nacionalnye-klinicheskie-rekomendaci-po-ostromu-pankreatitu.html [In Russ].

2.    KuleznyovaYu. V., MorozO. V., IzrailovR. E., SmirnovE. A., EgorovV. PChreskozhnyievmeshatelstvaprignoyno-nekroticheskih oslozhneniyahpankreonekroza. Annalyi hirurgicheskoy gepatologii. 2015; 2: 90 (ssyilka http://vidar.ru/ Article.asp?an=ASH_2015_2_90) [In Russ].

3.    Ivshin V.G., Ivshin M.V., Malafeev I.V., Yakunin A.Yu., Kremyanskiy M. A., Romanova N. N., Nikitchenko V.V. Originalnyie instrumentyii metodiki chreskozhnogo lecheniya bolnyih pankreonekrozom i rasprostranennyim parapankreatitom. Annalyi hirurgicheskoy pankreatologii. 2014; 19(1): 30-39. [In Russ].

4.    Andreev A. V., Ivshin V. G., Goltsov V. R. Lechenie infitsirovannogo pankreonekroza s pomoschyu miniinvazivnyih vmeshatelstv. Annalyi hirurgicheskoy gepatologii. 2015; 3: 110 (ssyilka http://vidar.ru/Article.asp?an=ASH_2015_ 3_110) [In Russ].

5.    Rogal M.L., Novikov S.V., Gyulasaryan S.G., Kuzmin A.M., Shlyahovskiy I.A., Bayramov R.Sh. Optimizatsiya etapov minimalno invazivnogo chreskozhnogo hirurgicheskogo lecheniya ostrogo pankreatita. Tezisyi s'ezda ROH Rostov- na-Donu. 2015, 1161-1162 [InRuss].

Abstract:

A reduced level of female sex hormones at menopause leads to development of atherosclerotic manifestations as well as to reduction of bone mineral density The total estimation of changes in blood vessels and bone tissue on the basis of comparison of SCORE scale and FRAX® program ir a single two-dimensional coordinate system makes it possible to determine degree of risks of cardiovascular complications and fractures in the near future of each individual patient.

Aim: was to assess risks of cardiovascular complications and fractures in women in the early postmenopausal period based on the data of SCORE scale and FRAX® program.

Materials and methods: research included 25 women in the variable menopause period without a previous cardiovascular disease (CVD) and osteoporosis (OP). A standard clinical examination, laboratory tests of lipid spectrum, determination of pulse wave velocity, doppler ultrasound of main arteries of the head with the definition of the thickness of the intima-media complex (IMC) of common carotid arteries(CCA), dual energy X-ray absorptiometry were carried out, risk calculations on the basis of SCORE scale and FRAX® computer program were studied. Re-examination of 25 patients was carried out not less than 12 months after the cessation of menses.

Results: baseline characteristics: low risk (less than 1%) was observed in 72% of women on SCORE scale, and 100% of women (less than 10%) was observed on FRAX®. An increasing number of risk factors enhances the performance of «early» markers of atherosclerosis (CPV-13,0 + 3,4 m/s; thickness IMA of CCA-0.95+0,11 mm) and statistically significant (p <0,05) decrease of mineral bone density (BMD). In the early stage of menopause, an increase in the total risk of cardiovascular complications and fractures in coming 10 years was observed. So poor performance risk was observed in 64% of women on SCORE scale, and risk of fractures was observed in 96% of patients on FRAX®.

Conclusion: distribution of studied parameters in a two-dimensional table in accordance with results of the SCORE scale and FRAX® program revealed the prevalence of patients with low values. After 12 months, the growth of BMD was noted in the decrease of number of patients (64%) with low risks and the occurrence of women (8%) with moderate risk of fractures and no cardiovascular risk. BMD study in the early postmenopausal period found a slight decrease in BMD in 48% of women, osteopenia - 44%, osteoporosis - 8%. The comparison of results of both methods makes it possible to assess objectively risks of cardiovascular disease and risk of fractures in each individual patient in next 10 years of their lives. 

References

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2.     Nikulina N. N., Yakushin S. A., Frumento G. I."Women's health issues and their solutions. Materials of V Russian conference «Sravnitel'nyy analiz smertnosti ot ostrykh form IBS u muzhchin i zhenshchin»[Comparative analysis of mortality from acute forms of CHD in men and women]. Moscow.2011; 13-14 [ In Russ].

3.     Nikulina N. N., Yakushin S. S., Akinina, S. A. Women's health issues and their solutions.Materials of V Russian conference «Analiz urovnya vyyavlyaemosti v prakticheskom zdravoohranenii ostrykh form IBS u zhenshchin (v sravnenii s muzhchinami)»[Analysis of the detection rate in public health practice acute forms of CHD in women (compared to men)]. Moscow. 2011; 14-15 [In Russ].

4.     Kontsevaya A.V., Kalinina, A. M., Pozdnyakov Yu. M.Klinicheskaya i ehkonomicheskaya celesoobraznost' ocenki serdechno-sosudistogo riska na rabochem meste.[Clinical and economical rationales of cardiovascular risk evaluation at workplace]. Rational pharmacotherapy in cardiology. 2009; (3):36-41[In Russ].

5.     Glezer M. G., Tkacheva O. N. Scientific society of specialists on women's health «Rekomendatsii po snizheniyu obshego riska razvitiyazabolevaniy i oslozhneniy u zhenshchin)» [Recommendations for reducing overall risk of development of diseases and complications in women]. M. 2010;48 [In Russ] .

6.     Conroy R.M., Pyorala K., Fitzgerald A.P Estimation of ten-year risk off at al cardiovascular disease in Europe: the SCORE project. Eur.Heart.J. 2003; 24:987-1003.

7.     Assman G., Barter., Bellosta S., et al. Rukovodstvo po profilaktike ishemicheskoy bolezni serdtsa. Mezhdunarodnaya rabochaya gruppa po orofilaktike ishemicheskoy bolezni serdtsa [Guidelines to prevention of coronary heart disease. International working group for prevention of coronary heart disease].  Germany. STADA. Thomson Reuters. 2011; 130.

8.     Skripnikova I. A. Osteoporosis and osteopathy. Abstracts of the IV Russian Congress on osteoporosis «Chto svyazyvaet osteoporoz i serdechno-sosudistyye zabolevaniya, obuslovlennyye aterosklerozom (CCZ-AS)?»[What connects osteoporosis and cardiovascular disease caused by atherosclerosis (CVD-al)?]. Moscow. 2010; (1):66. [In Russ].

9.     Ershova O. B. Kommentarii k prakticheskomu ispol'zovaniyu Rossiyskikh klinicheskikh rekomendaciy po osteoporozu. [Comments to the practical use of the Russian clinical recommendations for osteoporosis]. Osteoporosis and osteopathy. Scientific-practical journal. 2010; (1):34-46 [In Russ].

10.   Skripnikova I. A., Oganov R.G. Osteoporoz i serdechno-sosudistyye zabolevaniya, obuslovlennyye aterosklerozom, u zhenshchin postmenopauzal'nogo perioda: obshchnost' povedencheskikh i social'nykh faktorov riska. [Osteoporosis and cardiovascular diseases caused by atherosclerosis, postmenopausal women: a community behavior al and social risk factors]. Osteoporosis and osteopathy. 2009; (2):5-9 [In Russ].

Abstract:

A standard X-ray is still the most affordable method of evaluation of patients, including those with spinal diseases since 1895 when X-rays were found and were introduced into general practice. In the standard X-ray examination of the spine and all the anatomical structures located at different depths and different distances, projected onto x-ray film or a screen in the form of planar image. In order to neutralize these drawbacks and to improve visualization, various tomographic techniques have been developed. The most modern and promising diagnostic method is a multisection linear imaging (tomosynthesis), in which a single pass X-ray tube is a series of slices. Digital X-ray tomography with multislice linear are used as a rule, in the world, for examination of breast and lungs. The article presents data on the different types of X-ray tomography in evaluation of patients with tuberculous spondylitis.

Abstract:

Aim: was to compare results of bone densitometry techniques, conducted by quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) in postmenopausal women.

Material and methods: the study included 210 women in postmenopausal period, who were divided by age into four groups: 50-59 years, 60-69 years, 70-79 years, 80 years and older. All patients underwent densitometry of the lumbar spine by quantitative computed tomography anc dual-energy X-ray absorptiometry in the range of 1-2 weeks.

Results: in the evaluation of bone mineral density by methods of QCT and DXA in the age group 50-59 years, there were no significant differences in results of densitometry During of QCT, osteoporosis was diagnosed in 20.5%, during DXA - 15.1% of patients. Since the age of 60 years and older - incidence of osteoporosis by QCT was higher than in the DXA. Evaluation of correlation indicators QCT and DXA, in all four groups showed a positive association of moderate strength, which decreases with increasing age (I group: r=0.68, p=0.001; II group: r=0.57, p=0.001; III group: r=0.40, p=0.003; IV group: r=0.40, p=0.04).

Conclusion: after 60 years, the incidence of osteoporosis, shown by quantitative computed tomography is higher in comparison with dual-energy X-ray absorptiometry.

Abstract:

Purpose. Was to estimate the efficiency and sensitivity of X-ray-contrast (XRC), CT-angiography (CTAG) and colored duplex scanning (CDS) n diagnostics of patients with chronic abdominal ischemia (CAI)

Materials and methods. We have analyzed 1848 XRC, 436 CTAG and 181 CDS of patients with unpaired visceral artery branches of the abdominal aorta diseases, suffering from CAI.

Results. Due to CTAG, XRC and CDS we have revealed different levels of artery defeats, and also different types of stenotic and occlusion defeat.

Conclusions. CTAG is an effective screening method, and CDS - is an effective method of final diagnostics. Both of these methods should be included into algorithm CAI patients examination. 

References 

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2.    Гавриленко А.В., Косенков А.Н. Диагностика и хирургическое лечение хронической артериальной ишемии. М.: Москва.2000; 308.

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4.    Ойноткинова О.Ш., Немытин Ю.В. Атеросклероз и абдоминальная ишемическая болезнь. М.: Медицина. 2001; 311.

5.    Шальков Ю.Л. Диагностика и хирургическое лечение хронических нарушений абдоминального артериального кровотока. Дис. д-ра мед. наук. Харьков. 1970; 340.

6.    Mikkelsen W.P., Zaro J.A. Intestinal angina, report of case with preoperative diagnosis and surgical relief. New. Engl. J. Med. 1959; 260 (5): 912-914.

7.    Аракелян В.С., Макаренко В.Н., Прядко С.И., Букацелло Р.Г. Возможности компьютерной томоангиографии в диагностике поражений непарных висцеральных ветвей аорты и определение показаний к их хирургической коррекции при хронической ишемии органов пищеварения. Ангиология и сосудистая хирургия. 2009; 15 (2 - прил.): 21.

8.    Егоров В.И., Яшина Н.И., Кармазановский Г.Г., Федоров А.В. КТ-ангиография как надежный метод верификации заболеваний, вариантов строения целиако-мезентериального бассейна. Медицинская визуализация. 2009; 3: 82-94.

9.    Mitchell E.L. et al. Duplex criteria for native superior mesenteric artery stenosis overestimate stenosis in stented superior mesenteric arteries. J. Vasc. Surg. 2009; 50 (2): 335-340.

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12.  Реброва О.Ю. Статистический анализ медицинских данных. Применение пакета прикладных программ STATISTICA. М.:Мед. Сфера. 2002; 305.

Abstract:

The article describes results of analysis of five years of experience in the use of magnetic resonance angiography in the diagnosis of lesions of lower limb arteries. This method was used in survey of 489 patients with lesions of the abdominal aorta, arteries of the pelvis and lower limbs. Coverage of this study patients with abnormal lower limb arteries was 14.8%. Features of MR angiographic imaging, advantages and limitations of the method, the relationship with the method X-ray angiography are discussed.

Abstract:

The main part of the research is given to radiodiagnostics of tubercolisis lesion of backbone (traditional x-ray, ultrasound diagnostics, computed tomography, magnetic resonance imaging). We have exmined 452 patients: 40 patients (8,8%) had cervical spine lesions, 185 patients (41%) - thoracic spine lesions, thoracic-lumbar spine - 75 patients (16,8%), lumbar spine - 141 patients (31,1%), lumbar-sacral spine - 11 patients (2,5%). It is especially marked that combination of lungs tuberculosis and spondylitis is higher not only in patients with antibiotic resistant infection but n patients with tuberculosis combined with AIDS.

References 

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3.    Руководство по легочному и внелегочному туберкулезу. Под ред. Ю.Н. Левашева и Ю.М. Репина. ЭЛБИ-С.-Пб. 2008; 273-283.

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6.    Гусева Н.И., Иванов В.М., Потапенко Е.И. и др. Иммунный статус больных активным туберкулезным спондилитом. Проблемы туберкулеза и болезней легких. 2003; 6: 25-28.

7.    Селюкова Н.В. Зонография в диагностике туберкулеза позвоночника на поликлиническом этапе. Проблемы туберкулеза и болезней легких. 2008; 11, 21-23.

8.    Мердина Е.В., Митусова Г.М., Советова Н.А. Ультразвуковая диагностика забрюшинных абсцессов при туберкулезе позвоночника. Проблемы туберкулеза. 2001; 4: 19-21.

9.    Лукьяненок П.И. Магнитно-резонансная томография в диагностике туберкулезного спондилита. Руководство для врачей. 2008.

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Abstract:

Aim: was to evaluate the influence of factors on the development of diaphragmatic dysfunction ir early periods after cardiac surgery

Materials and methods: study included 830 patients after various cardiac surgery in Federal National Center of Cardiovascular Surgery (Penza, Russian Federation). In the early postoperative period (3,9 ± 0,9 days) all patients underwent chest x-ray while transporting from intensive care unit. We evaluated differences between diaphragm contors in two consecutive shots - with a deep breath and exhale fully In the early postoperative period diaphragmatic dysfunction was detected in 172 cases (20.7%). Patients were divided into 4 groups depending on the presence or absence of a violation of the diaphragm function. The criterion of selection into the group with diaphragmatic dysfunction was size of amplitude motion, less than 10 mm. 1st group with normal mobility of the diaphragm included 658 patients (79.3%). 2nd group with dysfunction of the left dome of the diaphragm - 85 patients(10.2%). 3rd group with dysfunction of the right dome - 58 patients (7%). 4th group with bilateral diaphragmatic dysfunction - 29 patients (3.5%). Logistic regression model included 4 variables, the significance of which is reflected by the published data: preparation of internal thoracic artery (ITA) for graft, valve surgery, the use of radiofrequency ablation, the use of cardiopulmonary bypass. We made a multiple logistic regressive analysis of predictors for the development of diaphragmatic dysfunction.

Results: we have found that under the influence of complex predictors, greatest chance of dysfunction was observed in the group with bilateral violation of diaphragm mobility after two-sidec separation of ITA (OR 3.4; CI 1.60, 7.25). High chances of dysfunction were observed in groups with unilateral violation of diaphragm mobility after unilateral separation of ITA. Separation of left ITA had higher chances for diaphragmal dysfunction (OR 2.7; CI 1.36; 5.37) than in case of separation of right ITA (OR 2.0; CI 1.16, 3.47). After valve operations, radiofrequency ablation, and cardiopulmonary bypass chances of diaphragmatic dysfunction was statistically insignificant (p>0.05) in all study groups.

Conclusions: diaphragmatic dysfunction develops in 3.4 times greater in case of bilateral separation of ITA. Unilateral dysfunction of the diaphragm has a great chance in case of separation of ITA: left up to 2.7 times and right up to 2 times. Influence of cardiopulmonary bypass, valve operations and radiofrequency ablation for the development of diaphragmatic dysfunction is statistically insignificant.

References

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Abstract:

Development of multilayer digital tomosynthesis technology allows you to get a more accurate imaging of internal organs and tissues in comparison with other traditional radiological methods of investigation, and that is achieved by the possibility of layered imaging of selected anatomical region.

Aim: was to analyze possibilities of digital tomosynthesis in the assessment of lung structure in normal anatomy of organs of chest cavity

Materials and methods: study include patients without lesions of the chest cavity, who underwent digital tomosynthesis in frontal and lateral projections.

Results: basing on analyzed data, we identified features of normal radiological anatomy of the chest cavity using a technique of digital tomosynthesis. Schematically clarified lobar and segmental structure of lungs, as well as airways according to layered imaging. Advantages and disadvantages of the method in imaging of lungs and mediastinal structures are shown.

Conclusion: the use of digital tomosynthesis in the evaluation of chest organs allows to determine main anatomical structures of lungs in more detail, through layered imaging and a high spatial resolution.  

References

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2.     de Koste J. R. S. et al. Digital tomosynthesis (DTS) for verification of target position in early stage lung cancer patients. Medical physics. 2013; 40(9): 091904.

3.     Dobbins III J. T. et al. Digital tomosynthesis of the chest for lung nodule detection: interim sensitivity results from an ongoing NIH-sponsored trial. Medical physics. 2008; 35(6): 2554-2557.

4.     Vikgren J. et al. Comparison of Chest Tomosynthesis and Chest Radiography for Detection of Pulmonary Nodules: Human Observer Study of Clinical Cases 1. Radiology. 2008; 249(3): 1034-1041.

5.     Quaia E. et al. Digital tomosynthesis as a problemsolving imaging technique to confirm or exclude potential thoracic lesions based on chest X-ray radiography. Academic radiology. 2013; 20(5): 546-553.

6.     Jung H. N. et al. Digital tomosynthesis of the chest: utility for detection of lung metastasis in patients with colorectal cancer. Clinical radiology. 2012; 67(3): 232-238.

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