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Abstract: The work was aimed at determining the possibilities of multislice computed tomography (MSCT) in diagnosis and staging of acute pyelonephritis (AP) for studying the role of concomitant congenital renal anomalies in development of AP and therapeutic decision-making. A total of 59 patients presenting with AP and suspected pyodestructive complications were subjected to MSCT, with 7 seven of these having undergone it twice in order to control therapeutic efficacy. The study showed that ultrasonography as well as excretory urography are not always informative enough as to the possibility of revealing purulent forms of an inflammatory process having developed on the background of renal developmental defects, especially anomalies of the shape, localization, and structure. The obtained findings made it possible to define proper indications for performing MSCT in patients with AP. Improved diagnosis achieved by means of MSCT made it possible to decrease the number of operations and avoid unnecessary nephrectomies. Reference 1. Буйлов В.В., Крупин И.В., Тюзиков И.А. Алгоритмы ультразвукового сканирования экскреторной урографии при острых формах пиелонефрита (Екатеринбург, 15 - 18 октября 1996). М., 1996; 26-27. 2. Быковский В.А. Ультразвуковая диагностика острого пиелонефрита и его хирургических осложнений у детей. Дисс. канд. мед. наук. М., 1996. 3. Игнашин Н.С. Ультрасонография в диагностикеи лечении урологических заболеваний. М., 1997. 4. Пытель А.Я., Пытель Ю.А. Рентгендиагностика урологических заболеваний. М., 1966; 480. 5. Хитрова А.Н. Клиническое руководство по ультразвуковой диагностике. Т. 1 (Под ред. В.В. Митькова). М.: Издательский дом Видар-М, 1996; 200-256. 6. MМrild S., HellstrЪm M., Jacobsson B., et al: Influence of bacterial adhesion on ureteral width in children with acute pyelonephritis. J. Pediatr. 1989a; 115: 265-268. 7. Morin D., Veyrac C., Kotzki P., et al: Comparison of ultrasound and dimercaptosuccinic acid scintigraphy changes in acute pyelonephritis. Pediatr. Nephrol. 1999; 13:219-222. 8. Schaeffer A.J. Infections of the Urinary Tract. Campbell`s urology. 8th ed. Philadelphia, Saunders. 2002; (l): 515-603. 9. Shortliffe L. M. D. Urinary tract infections in infants and children. Campbell`s urology. 8th ed. Philadelphia, Saunders. 2002; (3): 1846-1885. 10. Назаренко Г.И., Хитрова А.Н., Краснова Т.В. Допплерографические исследования в уронефрологии. М.: Медицина, 2002; 49-55. 11. Чалый М.Е. Оценка органного кровообращения при урологических заболеваниях с применением эходопплерографии. Дисс. докт. мед. наук. М., 2005. 12. Чалый М.Е., Амосов А.В., Газимиев М.А. Диагностика острого пиелонефрита в послеоперационном периоде с применением цветной эходопплерографии. Материалы Пленума правления Российского общества урологов. (Киров, 20-22 июня). М., 2000; 105-106. 13. Dacher J.N., Pfister С, Monroe M., et al: Power Doppler sonographic pattern of acute pyelonephritis in children: Comparison with CT. AJR Am. J. Roentgenol. 1996; 166: 1451-1455. 14. Синякова Л.А. Гнойный пиелонефрит (современная диагностика и лечение). Дисс. докт. мед. наук. М., 2002. 15. Little P.J., McPherson D.R., Wardener H.E.: The appearance of the intravenous pyelogram during and after acute pyelonephritis. Lancet., 1965; 1: 1186. 16. Silver T.M., Kass E.J., Thornbury J.R., et al: The radiological spectrum of acute pyelonephritis in adults and adolescence. Radiology. 1976; 118: 65. 17. Barth K.H., Lightman N.I., Ridolfi R.L., et al: Acute pyelonephritis simulating poorly vascularized renal neoplasm, non-specificity of angiographic criteria. J. Urol. 1976; 116: 650. 18. Teplick J.G., Teplick S.K., Berinson H., et al: Urographic and angiographic changes in acute unilateral pyelonephritis. Clin. Radiol. 1978. 19. Тиктинский О.Л., Калинина С.Н. Пиелонефриты. СПб.: СПбМАПО, Медиа Пресс. 1996. 20. Baumgarten D.A., Baumgarten B.R. Imaging and radiologic management of upper urinary tract infec tions. Uroradiology. 1997; 24: 545. 21. Schaefer-Prokop C., Prokop M. Spiral and multislice tomography. Computed tomography of the body. Thieme, Stuttgard - New York. 2003; 641-678. 22. Фоминых Е.В. Мультиспиральная компьютерная томография в диагностике заболеваний мочевых путей. Дисс. канд. мед. наук, М., 2004.
Article exists only in Russian.
Abstract: Radiofrequency (RF) ablation is a minimally invasive method. Application of RF ablation allowed to expand indications for more radical treatment of kidney tumors in patients, whom traditional nephrectomy or kidney resection are impossible, due to extremely adverse somatic status Efficiency and safety of RF ablation are significantly increased if preceded in combination with superselective occlusion of blood vessels, supplying the tumor. We possess the experience of application of superselective embolization in combination with RF ablation of two patients with kidney tumors. In both cases a good result of combined treatment has been observed. This combination (superselective embolization + RF ablation) can be an alternative to open operation on kidney in number of patients, expanding the arsenal of modern minimally invasive kidney tumor's treatment methods. Reference 1. Pavlov AJu., Klimenko A. A., Momdzhan B.K., Ivanov S.A. Radiochastotnaja intersticial'naja termoabljacija (RChA) raka pochki. [Radiofrequency interstitial termal ablation of renal cancer]. Jeksperimental'naja i klinicheskaja urologija. 2011; 2(3): 112-113 [In Russ]. 2. European Network of Cancer Registries. Eurocim version 4.0. European incidence database V2.3, 730 entity dictionary (2001). Lyon, 2001. 3. Zlokachestvennye novoobrazovanija v Rossii v 2008 g. (zabolevaemost' i smertnost'). [Malignant neoplasms in Russian Federation in 2008 (morbidity and mortality)]. Pod red. V.I. Chissova, V.V. Starinskogo, G.V. Petrovoj. M. FGU «MNIOI im. P.A. Gercena Rosmedtehnologij». 2010 [ In Russ]. 4. Chow W.H., Devesa S.S., Warren J.L., Freumeni J.FJr. Rising incidence of renal cell carcer in the United States. JAMA. 1999; 281:1628-31. 5. Nguyen M.M., ill I.S., Ellison L.M. The evolving presentation of renal carcinoma in the United States: trends from the Surveillance, Epidemiology, and End Results program. J. Urol. 2006; 176: 2397-400; discussion 2400. 6. Kummerlin I.P., ten Kate F.J., Wijkstra H., de la Rosette J.J., Laguna M.P. Changes in the stage and surgical management of renal tumours during 1995-2005: an analysis of the Dutch national histopathology registry. BJU Int. 2008; 102 (8): 946-51. Epub 2008 Jun 28. 7. Ankem M.K., Nakada S.Y. Needle-nephron-sparing surgery. BJU Int. 2005; 95 (2): 46-51. 8. Havranek E., Anderson C. Future prospects for nephron conservation in renal cell carcinoma. In: Kirby R.S., O’Leary M.P., editors. Hot topics in urology. Amsterdam. The Netherlands: Elsevier. 2004; 227-38. 9. Marberger M., Mauerman J. Energy ablation nephron-sparing treatment of renal tumors. AUA Update Series. 2004; 23:178-83. 10. Reddan D.N., Raj G.V., Polascik TJ. Management of small renal tumors: an overview. Am. J. Med. 2001; 110: 558-62. 11. Weld K.J., Landman L. Comparison of cryoablation, radiofrequency ablation and high-intensity focused ultrasound for treating small renal tumors. BJU Int. 2005; 96:1224-9. 12. Uzzo R.G., Novick A.C. Nephron sparing surgery for renal tumors: indications techniques and outcomes. J. Urol. 2001; 166:6-18. 13. Dolgushin B.I., Kosyrev VJu., Ramprabanant S. Radiochastotnaja ablacija v onkologii. Prakticheskaja onkologija. 2007; 8(4): 219-227 [In Russ]. 14. Vogl TJ., Helmberger T.K., Mack M.G., Reiser M.F. (Eds.) Percutaneous Tumor Ablation in Medical Radiology. ISBN 978-3-540-22518-8 Springer. Berlin. Heidelberg. New York. 2008. 15. Winthrop H. Hal, John P. McGahan, Daniel P. Link and Ralph W. deVere White. Combined Embolization and Percutaneous Radiofrequency Ablation of a Solid Renal Tumor. AJR. 2000; 174:1592-1594. 16. Yamakado K., Nakatsuka A., Kobayashi S., Akeboshi M., Takaki H., Kariya Z., Kinbara H., Arima K., Yanagawa M., Hori Y., Kato H., Sugimura Y., Takeda K. Radiofrequency ablation combined with renal arterial embolization for the treatment of unresectable renal cell carcinoma larger than 3.5 cm: initial experience. Cardiovasc. Intervent. Radiol. 2006; 29(3): 389-94. 17. Klingler H.C., Marberger M., Mauermann J. et al. ’Skipping’ is still a problem with radiofrequency ablation of small renal tumours. BJU Int. 2007; 99: 998-1001. 18. Goldberg S.N., Gazelle G.S., Mueller P.R. Thermal ablation therapy for focal malignancy: A unified approach to underlying principles, techniques and diagnostic imaging guidance. Am. J. Roentgenol. 2000; 174: 323-31. 19. Lee M. Ellis, Steven A. Curley, Kenneth K. Tanabe. Radiofrequency Ablation for Cancer.Current Indications, Techniques, and Outcomes. 2004; Springer-Verlag New York, Inc. 20. Salagierski M., Salagierski M. Radiofrequency ablation partial nephrectomy: a new method of nephron-sparing surgery in selected patients. Int. J. Urol. 2006; 13(11): 1456-9. 21. Veltri A., Garetto I., Pagano E., Tosetti I., Sacchetto P., Fava C. Percutaneous RF termal ablation of renal tumors: is US guidance really less favorable than other imaging guidance techniques? Cardiovasc. Intervent. Radiol. 2009; 32(1): 76-85. Epub 2008 Aug 15. 22. Schirmang T.C., Mayo-Smith W.W., Dupuy D.E., Beland M.D., Grand D.J. Kidney neoplasms: renal halo sign after percutaneous radiofrequency ablation-incidence and clinical importance in 101 consecutive patients. Radiology. 2009; 253(1): 263-9. Epub 2009 Jul. 31.