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Introduction: a case report of successful treatment of an extremely rare pathology (0,27-0,34%) - acute occlusion of both internal carotid arteries (ICA) is presented.

Aim: was to show possibilities of endovascular surgery in the diagnosis and treatment of acute ischemic stroke (AIS) in patients with bilateral acute ICA occlusion.

Materials and methods: a 38-year-old patient was hospitalized by ambulance with the diagnosis of AIS. Multispiral computed tomography (MSCT) revealed left ICA occlusion in the C2-C5 segment. Selective angiography of ICA was performed: right ICA - non-occlusive thrombosis C2-C3 segments; left ICA - thrombotic occlusion in C1 segment.

Results: thrombaspiration was performed from the left ICA and right ICA; full recovery of antegrade cerebral blood flow was achieved in both ICA, according to the modified treatment in cerebral infarction score (mTICI) - 3. Patient was discharged after 28 days. At the time of discharge, the modified Rankin Scale (mRS) score was 3. 6 months after discharge mRS was 1.

Conclusions: Selective angiography of both ICA in a patient with AIS enabled to detect right ICA thrombosis not detected by MCT, which in its turn changed the treatment tactics of the patient. Aspiration thromebctomy from both internal carotid arteries allowed to achiev full recovery of antergrade cerebral blood flow of both internal carotid arteries.



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9.     Dietrich U, Graf T, Sch?bitzb WR. Sudden coma from acute bilateral M1 occlusion: successful treatment with mechanical thrombectomy. Case Rep Neurol. 2014; 6: 144-148.

10.   Pop R, Manisor M, Wolff V. Endovascular treatment in two cases of bilateral ischemic stroke. Cardiovasc Intervent Radiol. 2014; 37: 829-834.

11.   Larrew T, Hubbard Z, Almallouhi al. Simultaneous bilateral carotid thrombectomies: a technical note. Oper Neurosurg. 2019; 5(18): 143-148.

12.   Storey C, Lebovitz J, Sweid A, et al. Bilateral mechanical thrombectomies for simultaneous MCA occlusions. World Neurosurg. 2019; 132: 165-168.

13.   Braksick SA, Robinson CP, Wijdicks EFM. Bilateral middle cerebral artery occlusion in rapid succession during thrombolysis. Neurohospitalist. 2018; 8: 102-103.

14.   Jeromel M, Milosevic Z, Oblak J. Mechanical recanalization for acute bilateral cerebral artery occlusion - literature overview with a case. Radiology and Oncology. 2020; 54(2): 144-148.



Introduction: the main methods for diagnosing cardiac neoplasms, allowing to determine the localization, size, involvement of heart structures, to suggest the nature of the pathological process and to plan treatment tactics, are: echocardiography (EchoCG), contrast multispiral computed coronary angiography (MSCT CAG), magnetic resonance imaging (MRI) and positron emission computed tomography (PET CT). At the same time, any additional information about the pathological process can improve the quality of diagnosis and treatment. So, for example, selective coronary angiography (CAG), which in this case can be performed to clarify the coronary anatomy and exclude concomitant coronary atherosclerosis, in hands of attentive and experienced specialist of endovascular diagnostic and treatment methods can make a significant contribution to understanding the nature of blood supply of heart neoplasm, thereby bringing closer the formulation of the correct diagnosis and, ultimately, improving results of surgical treatment.

Aim: was to study the nature of blood supply of heart myxoma based on results of a detailed analysis of data of selective coronary angiography in patients with this pathology.

Material and methods: since 2005, 20 patients underwent surgery to remove heart myxoma. The average age of patients was 56,6 + 8,0 (43-74) years. According to data of ultrasound examination, sizes of myxomas ranged from 10 to 46 mm in width and from 15 to 71 mm in length (average size ? 25,6 ? 39,1 mm). In 2/3 of all cases (15 out of 20,75%), the fibrous part of the inter-atrial septum (fossa oval region) was the base of myxomas. In 8 of 20 (40%) cases, tumor prolapse into the left ventricle through structures of the mitral valve was noted in varying degrees. In order to exclude coronary pathology, CAG was performed in 14 cases, in the rest - MSCT CAG.

Results: of 14 patients with myxoma who underwent selective coronary angiography, 12 (85,7%) patients had distinct angiographic signs of vascularization. In all 12 cases, the sinus branch participated in the blood supply of myxoma, begins from the right coronary artery (RCA) in 10 cases: in 7 case it begins from proximal segment of the RCA and, in 3 cases, from the posterior-lateral branch (PLB) of the RCA. In one case, the source of blood supply of neoplasm was the sinus branch extending from PLB of dominant (left type) circumflex artery of the left coronary artery (PLB CxA LCA). In one case, the blood supply to the neoplasm involved branches both from the RCA and CxA, mainly from the left atrial branch of CxA. Moreover, in all 12 cases, sinus branch formed two branches: branch of sinus node itself and left atrial branch. It was the left atrial branch that was the source of blood supply of myxoma. Analysis of angiograms in patients with myxoma of LA showed that left atrial branch in terminal section formed a pathological vascularization in the LA projection, accumulating contrast-agent in the capillary phase (MBG 3-4). In addition to newly formed vascularization, lacunae of irregular shape were distinguished, the size of which varied from 2 to 8 mm along the long axis. In 8 cases, hypervascular areas with areas of lacunar accumulation of contrast-agent showed signs of paradoxical mobility and accelerated onset of venous phase. In two cases, there were distinct angiographic signs of arteriovenous shunt. In 2 cases (when the size of the myxoma did not exceed 15-20 mm according to EchoCG and CT), angiographic signs allowing to determine the presence of LA myxoma were not so convincing: there was no lacunar accumulation of contrast-agent; small (up to 10 mm) hypervascular areas were noticed, the capillary network of which stood out against the general background of uniform contrasting impregnation and corresponded to MBG grade 1-2.

Conclusion: according to our data, angiographic signs of vascularization of myxomas are detected in most cases with this pathology (85,7%). The source of blood supply, in the overwhelming majority of cases, is branch of coronary artery, which normally supplies the structure of the heart, on which the basement of the pathological neoplasm is located. The aforementioned angiographic signs characteristic of myxomas deserve the attention of specialists in the field of endovascular diagnosis and treatment and should be described in details in protocols of invasive coronary angiography.



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Petrovskiy BV, Konstantinov BA, Nechaenko MA. Primary heart tumors. M.: Medicina, 1997 [In Russ].

2.     Balci AY, Sargin M, Akansel S, et al. The importance of mass diameter in decision-making for preoperative coronary angiography in myxoma patients. Interact Cardiovasc Thorac Surg. 2019; 28(1): 52-57.

3.     Omar HR. The value of coronary angiography in the work-up of atrial myxomas. Herz. 2015; 40(3): 442-446.

4.     Gupta PN, Sagar N, Ramachandran R, Rajeshekharan VR. How does knowledge of the blood supply to an intracardiac tumour help? BMJ Case Rep. 2019; 12(2): 225900.

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6.     Lee SY, Lee SH, Jung SM, et al. Value of Coronary Angiography in the Cardiac Myxoma. Clin Anat. 2020; 33(6): 833-838.



Aim: was to demonstrate possibilities of timely radiological diagnosis and treatment of spinal tuberculosis in a patient with a single lung after pleuropneumonectomy for fibrocavernous pulmonary tuberculosis.

Materials and methods: patient, 26 y.o. female, country inhabitant, grocery store clerk. She was hospitalized to the National Medical Research Center for Phthisiopulmonology and Infectious Diseases of the Ministry of Health of the Russian Federation with a diagnosis: “Tuberculosis spondylitis Th12-L2, focal tuberculosis S2 of the single right lung in the infiltration phase. M.Tb(-). Pleuropneumonectomy for fibrocavernous tuberculosis of left lung (December 18, 2018)”. To clarify etiology and lesion volume and to determine surgical treatment tactics, multispiral computed tomography (MSCT) of lungs and thoracolumbar spine and subsequent percutaneous trephine biopsy of the L1 vertebra were performed.

Results: according to MSCT data, destruction of Th12-L1-2 vertebral bodies was revealed; in single right lung, medium-intensity focal lesion with a diameter of 5 mm in C1, a small calcinate in C2, and a subpleural focal lesion in C4 were visualized. Small-focal dissemination was observed throughout the entire length of single lung. Bacteriological study of biological material taken during trephine biopsy revealed the growth of Mycobacterium tuberculosis, confirmed by diagnostics of polymerase chain reaction (PCR). Taking into account the pulmonary pathology, operation was performed in the volume of resection of Th12-L1-2 bodies and antero-lateral spinal fusion with a Mesh body replacement implant with bone autoplasty from left-side access, transpedicular fixation (TPF) of Th11-L3 with a four-screw structure under intraoperative radiation control. As a result of treatment, patient was discharged in a satisfactory condition.

Conclusions: presented case report demonstrates the importance of timely radiological diagnosis in patients with combined infectious lesions of lungs and spine for obtaining of complete information about the state of respiratory and bone systems, using MSCT and interventional radiology methods and for determination of pathological process etiology. It made it possible to perform timely diagnosis and complex surgical intervention with the most sparing and light surgical access to affected vertebrae in tuberculosis spondylitis from the side of previous pleuropneumonectomy.





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2.     Giller DB, Giller GV, Imagozhev YG. Surgical collapse in the treatment of single lung tuberculosis. Khirurgiia. 2021; (1): 15-21 [In Russ].

3.     Mushkin AYu, Vishnevskiy AA, Peretsmanas EO, et al. Infectious Lesions of the Spine: Draft National Clinical Guidelines. Khirurgiya pozvonochnika. 2019; 16(4): 63-76 [In Russ].

4.     Sovetova NA, Vasileva GYu, Soloveva NS. Tuberculous spondylitis in adults (clinical and radiographic manifestation). Tuberkulez I bolezni legkikh. 2014; (10): 33-37 [In Russ].

5.     Dunn RN, Ben Husien M. Spinal tuberculosis: review of current management. Bone Joint J. 2018; 1(100-B(4)): 425-431. 1040.R1



Diagnostic criteria for extranodal lymphoma (non-Hodgkin's lymphoma) are well known and described in the literature. However, primary extranodal lymphomas are rare and pose problems for differential diagnosis with primary or secondary lesions.

In the presented clinical case of a woman, 58 years old, with primary extranodal lymphoma of the stomach and spleen, an incorrect preoperative diagnosis was made: a tumor of the stomach and spleen abscess. It was mainly due to the presence of pain in the epigastric region and hospitalization for "severe acute biliary pancreatitis" in anamnesisd. Similar complaints and a "blurry" picture of manifestations of lymphoma did not allow her to be suspected preoperatively. The tumor nature of the focal lesion of the stomach was not in doubt, while the underestimation of MRI data, combined with the anamnesis, led to the erroneous diagnosis o f" spleen abscess". Patient underwent surgical operation: extended combined gastrectomy, distal resection of pancreas, splenectomy “en-bloc”, lymphadenectomy, cholecystectomy, “Roux-Y" reconstruction.

The clinical picture of extranodal lymphoma depends on its primary localization and the degree of its spread. Clinical manifestations of primary lymphoma of the stomach and spleen are often non­specific, therefore, against the background of previously transferred diseases of the hepatopancreatobiliary zone and their residual manifestations, an erroneous assessment of the situation is possible. In the presence of focal lesions, it is advisable to be more attentive to results of radiology examination, which can provide comprehensive information about their nature.




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2.     Manzella A, Borba-Filho P, D'Ippolito G, Farias M. Abdominal manifestations of lymphoma: spectrum of imaging features. ISRN Radiol. 2013; 2013: 483069.

3.     Lee W-K, Lau EWF, Duddalwar VA, et al. Abdominal manifestations of extranodal lymphoma: spectrum of imaging findings. American Journal of Roentgenology. 2008; 191(1): 198-206.

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Aim: was to determine the role of radiation and interventional methods of diagnosis and treatment of traumatic pelvic bleeding.

Material and methods: for the period 2016 -2019, we analyzed results of diagnosis and treatment of 37 patients with pelvic injuries, complicated by intra-pelvic bleeding. CT scanning of retroperitoneal pelvic hematoma (RPH) was performed in all cases, results of calculations were compared with the surgical classification of I.Z. Kozlova (1988) on the spread of retroperitoneal hemorrhage and volume of blood loss in pelvic fractures. MSCT-A was performed in 16 (45%) injured. Digital subtraction angiography (DSA) was performed in 10 (27%) cases, of which after MSCT-A – in 4 cases, and as the primary method for the diagnosis of arterial bleeding – in 6 cases.

Results: according to MSCT, the frequency of minor hemorrhages was 18 (50%), medium 16 (43%), large 3 (8%). CT calculation of the volume of small hemorrhages ranged from 92 to 541 cm3, medium – 477-1147 cm3, large –1534 cm3 and more. MSCT-A revealed signs of damage of arteries of the pelvic cavity: extravasation of contrast medium – in 4, cliff and «stop-contrast» – in 1, post-traumatic false aneurysm – in 1, displacement and compression of the vascular bundle – in 4 observations. DSA revealed signs of damage of vessels of the pelvis: extravasation of contrast medium – 3, angiospasm – 2 and occlusion – 2 observations. According to results of angiography, embolization of damaged arteries was performed in 5 observations.

Conclusion: MSCT is a highly sensitive method in assessing the distribution and calculation of RPH volume. The presence of a hematoma volume of more than 50-100 cm3, regardless of the type of pelvic damage, was an indication for MSCT. In patients with stable hemodynamics, DSA was used as a clarifying diagnostic method; in patients with unstable hemodynamics, it was used as the main method for diagnosis and treatment of injuries of pelvic vessels. Damage of pelvic vessels detected by angiography was observed predominantly in unstable pelvic fractures, accompanied by medium and large retroperitoneal pelvic hemorrhages.



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2.     Smolyar AN. Retroperitoneal hemorrhage in pelvic fractures. Hirurgiya. 2009; 8: 48-51 [In Russ].

3.     Fengbiao Wang, Fang Wang. The diagnosis and treatment of traumatic retroperitoneal hematoma. Pakistan Journal of Medical Sciences. 2013 Apr; 29(2): 573-576.

4.     Dorovskih GN. Radiation diagnosis of pelvic fractures, complicated by damage of pelvic organs. Radiologiya-praktika. 2013; 2: 4-15 [In Russ].

5.     Vasil'ev AV, Balickaya NV. Radiation diagnosis of pelvic injuries resulting traffic accidents. Medicinskaya vizualizaciya. 2012; 3: 135-138 [In Russ].

6.     Mahmoud Hussami, Silke Grabherr, Reto A Meuli, Sabine Schmidt. Severe pelvic injury: vascular lesions detected by ante- and post-mortem contrast mediumenhanced CT and associations with pelvic fractures. International Journal of Legal Medicine. 2017; 131: 731-738.



Aim: was to study features of the clinical course, instrumental and biochemical parameters of patients with atherosclerotic aneurysmal expansion of the abdominal aorta on the base of retrospective analysis and prospective observation to determine indications for timely surgical correction.

Materials and methods: patients with the maximum diameter of the infra-renal abdominal aorta from 26 to 50mm (n=60) without primary indications for surgical treatment (endovascular abdominal aortic aneurysm repair) were selected for the prospective follow-up group. For the period of 2 years, all patients from prospective group underwent duplex scanning of the abdominal aorta every 6 months and multislice computed tomography (MSCT) of the aorta – once a year. The retrospective analysis included results of preoperative clinical-instrumental and laboratory examination of patients (n=55) who underwent endovascular aneurysm repair (EVAR) of the abdominal aorta with a maximum diameter of the infra-renal abdominal aorta more than 50mm.

Results: when comparing clinical, instrumental and biochemical parameters in patients with abdominal aortic aneurysm (AAA) before surgery and atherosclerotic aneurysmal abdominal aortic expansion of different degrees, not requiring surgical correction at the time of inclusion, it was shown that patients with AAA, statistically significantly differed from patients with AAA in clinical symptoms (pulsation and abdominal pain), burdened heredity, the number of smokers. There were no statistically significant differences in the severity of coronary and peripheral atherosclerosis. When comparing results of ultrasound duplex scanning and MSCT to estimate linear dimensions of the abdominal aorta in the group of patients with aneurysmal dilation and in the group of patients with abdominal aortic aneurysm, the comparability of results has been revealed. Prospective observation of patients with abdominal aortic aneurysmal dilation revealed predictors of disease progression: age less than 65 years, diameter of the upper third of the abdominal aorta more than 23mm, maximum diameter of the abdominal aorta more than 43mm, length of aneurismal dilation more than 52mm.

Conclusion: obtained results allowed to determine most informative indicators and criteria for the progression of atherosclerotic aneurysm expansion of the abdominal aorta, to determine further tactics of treatment, including the need for surgical correction of this pathology.



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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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Aim: was to evaluate the efficacy of MSCT in assessment of long-term graft patency after coronary artery bypass graft surgery (CABG).

Material and methods: 25 patients with multi-vessel coronary artery disease were included in the research. To assess the 5-year graft patency, MSCT arteriography was performed.

Results: a total of 96 grafts (22 left internal thoracic artery (LITA) and 74 saphenous venous grafts (SVG)) were analyzed using MSCT There were 12 venous sequential grafts and 19 venous Y-shaped grafts determined. During the assessment of graft patency, 13 occlusions of venous grafts and 1 hemodynamically significant stenosis were detected. Occlusion and hemodynamically significant stenosis of mammary grafts were not observed.

Conclusion: MSCT arteriography, allows to determine occlusive and hemodynamically significant stenoses of SVG. Results of study shows the prevalence of SVG occlusions and stenosis over arterial grafts. CT angiography can be highly informative for assessing the patency of grafts in late periods after CABG. 



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14.    Frazier AA, Qureshi F, Read KM, Gilkeson RC, Poston RS, White CS. Coronary artery bypass grafts: assessment with multidetector CT in the early and late postoperative settings. Radiographics. 2005 Jul-Aug; 25(4): 881-896. Review.

15.    Tinica G, Chistol RO, Enache M, Leon Constantin MM, Ciocoiu M, Furnica C. Long-term graft patency after coronary artery bypass grafting: Effects of morphological and pathophysiological factors. Anatol J Cardiol. 2018 Nov;20(5):275-282. doi: 10.14744/AnatolJCardiol.2018. 51447.

16.    Drouin A, Noiseux N, Chartrand-Lefebvre C, Soulez G, Mansour S, Tremblay JA, Basile F, Prieto I, Stevens LM. Composite versus conventional coronary artery bypass grafting strategy for the anterolateral territory: study protocol for a randomized controlled trial. Trials. 2013 Aug 26; 14: 270. doi: 10.1186/1745-6215-14270.

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The report is about giant false aneurysm of an extracranial part of the left internal carotid artery (ICA) in a patient aged one year and nine months. The reason of the complexity of diagnostics in this case was that the dissection of the ICA with formation of false aneurysm imitated the peritonsillar abscess' clinic. We have not found any descriptions of a similar cases of patients at such an early age in modern literature.



1.      Nikitina T.G., Kochurkova E.G., Petrosyan K.V., Alekyan B.G. Application of a stent-graft to correct a false aneurysm of the internal carotid artery. Creative. cardiol. 2015; 1: 66 [In Russ].

2.      Kalashnikova L.A. Dissection of arteries, blood supplying the brain, and disorders of cerebral circulation. Ann. clin. and exper. neurology. 2007; 1 (1): 41-49 [In Russ].

3.      Schievink W.I. Spontaneous dissection of the carotid and vertebral arteries. N. Engl. J. Med. 2001; 344: 898— 906.

4.      Fullerton HJ, JohnstonSC, Smith WS. Arterial dissection and stroke in children. Neurology, 2001; 57: 1155-1160.

5.      Kalashnikova L.A., Dobrynina L.A., Chechetkin A.O., Dreval M.V., Krotenkova M.V., Zakharkina M.V. Disorders of cerebral circulation in the dissection of the internal carotid and vertebral arteries. Algorithm of diagnostics. Nerve. disease. 2016; 2: 10-15 [In Russ].

6.      Kieslich M., Fiedler A., Heller C. et al. Minor head injury as cause and co-factor in the aetiology of stroke in childhood: a report of eight cases. J. Neurol. Neurosurg. Psychiatry 2002; 73: 13-6.

7.      Seerig M.M., Chueiri L., Jacques J. et alt. Bilateral Peritonsillar Abscess in an Infant: An Unusual Presentation of Sore Throat. Case Rep Otolaryngol. 2017; 2017: 467015.

8.      Mazur E, Czerwinska E, Korona-Gtowniak I, Grochowalska A, Koziot-Montewka M. Epidemiology, clinical history and microbiology of peritonsillar abscess. Eur J Clin Microbiol Infect Dis. 2015 Mar; 34(3):549-54.  



The article aimes at determining the scope of multyspiral computer tomography (MSCT) in diagnostics of iatrogenic traumas of ureter and ureterovaginal fistulae (UVF) and establishing the efficiency of mini-invasive method of treatment UVF. The study covered 9 patients suffering the iatrogenic trauma of ureter, 8 of which have passed through MSCT. The mini-invasive methodic was applied to these patients and let the researchers restore the ureter tissue after the iartogenic trauma and eliminate the UVF without performing any open operations.



1.     Вайнберг З.С. Травма органов мочеполовой системы. Москва, Медпрактика-М, 2006 гл.10.

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5.     Петров СБ., Шпиленя Е.С., Какушадзе З.А., Богданов А.Б. Повреждения мочеточников в гинекологической и акушерской практике. Журн. акушерства и жен. болезней. 2000; (49) 4: 31 - 34.

6.     Переверзев А.С. Актуальные проблемы оперативной урогинекологии. Современные проблемы урологии: Материалы VI Международного конгрессса урологов. Харьков, Факт., 1998; 3-9.

7.     Franke J.J., Smith J.A. Surgery of urether. Campbell's Urologie Walsh P.C. et al. - 7 th Ed., Vol.3., Philadelphia: WB.Saunders, 1998; 3062-3084.

8.     Bright ТС Emergency management of the injured ureter. Urol Clin North Am. 1982;9(2):285 - 291.

9.     Комяков Б.К., Гулиев Б.Г., Новиков А.И., Дорофеев С.Я., Лебедев М.А., Аль-Исса А. Оперативное лечение повреждений мочевых путей и их последствий в  акушерско-гинекологической  практике. Акушерство и гинекология 2004; 39 - 42.

10.   Еургеле Т., Симич П. Риск мочеточнико-пузырных повреждений в хирургии живота и таза. Бухарест 1972; 165-170.

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Aim: was to increase efficacy of diagnostics of oculomotor muscles injury in pre- and postoperative period with use of multislice computed tomography (MSCT).

Material and methods: for the petiod 2015-2016, 63 patients with maxillofacial trauma were admitted to the I.M.Sechenov hospital, within 24-48 hours after injury (55 males and 8 females, aged 18-59 years). All patients underwent MSCT of facial skeleton at the day of admittion and on 7-10 day after surgical treatment. Patients examination was made on 640-slice CT scanner and was added by multiplannar and 3D-reconstruction

Results: preoperative MSCT revealed oculomotor muscles injury in 29 patients (46%). Muscles injuries were presented with herniation into the maxillary sinus (n=20, 32%), damaged lateral, inferior and medial muscles by small bone fragments (n=17, 27%), unilateral thickening of muscles in 13 patients (21%).

Postoperative MSCT revealed oculomotor muscle damage caused by incorrectly implantation of prostheses of inferior orbital wall in 7 cases (11%).

Conclusion: MSCT is the modality of choice in pre- and postoperative diagnostics in patients with oculomotor muscles injury. MSCT provides the effective diagnostic solution in prevention of possible ocular movement impairment.  



1.    Natsional’nie rukovodstva po luchevoi diagnostike i terapii (pod red.S.K.Ternovogo). [National guidance of radiology and radiotherapy. (Ed. By S.K. Ternovoy)] М.: GEOTAR- Media, 2013; 1000S. [In Russ].

2.    Nikolaenko V.P., Astakhov Yu.S. Orbital’nie perelomi: rukovodstvo dlya vrachei [Orbital fractures: guidance for the clinicians.] St. Petersburg: Eco-Vector; 2012; 303-328 [In Russ].

3.    Serova N.S. Luchevaya diagnostika sochetannikh povrezhdeniy kostey litsevogo cherepa i orbiti. [Radiodiagnostics of complex trauma of facial skeleton and orbit.] Cand. Diss. О. 2006 [In Russ].

4.    Pavlova O.Yu, Serova N.S. Protokol multispiral’noi komp’uternoi tomografii v diagnotike travm srednei zoni litsa. [MSCT diagnostic protocol in trauma of mid-face.] REJR 2016; 6(3):48-53. [In Russ].

5.    Chupova N.A. Funktsional’naya multispiralnaya komp’uternaya tomografia v otsenke mishts glaza pri mehanicheskom povrezhdenii. [Functional multislice computed tomography in assessment of oculomotor muscles within trauma.] Cand. Diss. М. 2013; 141S. [In Russ].

6.    Pavlova O.Y., Serova N.S. Mnogosrezovaya komp’uternaya tomografia v diagnostike perelomov glaznits. [Multislice computed tomography in the diagnosis of orbital fractures.] Journal of radiology. 2015; 3:12-17 [In Russ].

7.    Stuchilov V.A., Nikitin A.A. Optimizatsia diagnostiki I hirurgicheskogo lechenia bol’nikh pri perelomakh glaznits. Posobie dlya vrachei [Optimization of diagnostics and surgical treatment in orbital fractures. Guidance for the clinicians.] М.: 2015, 36S. [In Russ].

8.    Mikhaylyukov V.M., Davidov D.V., Levchenko O.V. Posttravmaticheskie defekti I deformatsii glaznitsi. Osobennosti diagnostiki I printsipi lechenia (obzor literaturi). Golova I sheya. [Posttraumatic orbital defects and deformations. Diagnostics features and treatment principles (literature review). Head and neck.] Rossijskoe izdanie. Zhurnal Obsherossijskoi obshestvennoi organizatsii «Federatsia spetsialistov po lecheniyu zabolevaniy golovi I shei». 2013; 2: 40-48 [In Russ].

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10.  Nastri A.L., Gurney B. Current concepts in midface fracture management. Curr Opin Otolaryngol Head Neck Surg. 2016; 24(4):368-75.




Aim: was to give a literature review normal coronary anatomy, described patterns of anomalous coronary arteries by using multislice computed tomography (MSCT).

Materials and methods: 1104 computed tomography coronary angiography (CCTA) was made in «Fedorovich Clinikasi» for the period of 2011-2016. The age of patients ranged from 7 to 82 years. Men were 790 (71.5%), women - 314 (28.5%). The study was carried out on the multislice spiral CT scanners Brilliance 64 and Brilliance i-CT 256 (PHILIPS).

Results. In 32 (2,9%) cases we detected anatomical variations as conus artery high take-off of a coronary ostium, myocardial bridging, shepherd's crook deformation of right coronary artery 23 (2%) patients had coronary artery anomaly (CAA) as a single coronary artery, absence of circumflex artery, hypoplasia of coronary artery, intra-atrial location, origin from the opposite coronary sinus of Valsalva, separate discharge of the LAD and circumflex from aorta, Blunt-White-Garland syndrome, coronary fistulas, aneurysms of coronary arteries. When a CAA is found, the exact origin, course and its position with other cardiac structures must be described in detail.   



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The research is devoted to study the possibilities of functional multislice computed tomography (fMSCT) in a choice of treatment strategy, its planing and volume of surgical intervention at orbital trauma damage. MSCT and fMSCT examinations of the orbit were performed in 30 patients (60 orbits).

The obtained data allowed to develop the protocol of fMSCT, to study normal functional anatomy of the eye, to estimate normal contractile ability of extraocular muscles. The research showed the necessity of using the fMSCT of the eye of orbital trauma in assessment of contractile ability of extraocular muscles and their interest in relation to the crisis area. The improvement of diagnosis reached with the help of fMSCT, has allowed to choose an optimum tactics and volume of surgical intervention.  



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15.  Koo E.Y. et al. MRI demonstrates normal contractility of superior rectus (SR) and inferior rectus (IR) in orbits with hypertropia. Ophthalmology. 1993; 100 (9A): 119.




Modern radiodiagnostics of carotid arteries (CA) defeat has very important value in such patients' treatment tactics. CA reconstruction operations are based on 3 general factors - clinic and arterial blood flow lack in dynamics, special methods of extra- and intracrania brachial arteries diagnostics, risk of arterial blood flow lack. We have pointed indications for surgical prophylactics and necessary patients diagnostic methods. 



 1.   Alsheikh-Ali A.A.  et al.  The  vulnerable atherosclerotic   plaque.    Scope    of   the literature. Ann. Intern. Med. 2010; 153 (6):       7. 387-395.

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Aim: was to perform indirect estimation of pumping function of left ventricle (LV) in patients with ischemic heart disease (IHD), before and after mini-invasive intracoronary procedures or elimination of cardiac arrhythmias, basing on condition of pulmonary circulation.

Material and methods: research includes data of 44 patients with IHD (aged 43-89), who were admitted to the hospital with acute coronary syndrome (ACS) or cardiac arrhythmia. Estimation of pulmonary flow condition in IHD patients was made basing on data of chest multislice computec tomography (MSCT), changes of density of lung parenchyma in selected volume of lung before and after coronary stenting/placement of pacemaker, disruption of ectopic lesions and conduction pathway

Results: sighs of reliable changes in pulmonary circulation as local lung pneumatization changes with increased densitometric value within 10 hounsfield units (HU) after mini-invasive surgical treatment were found in 19 patients.

Conclusions: the study has showed high sensitivity of lung MSCT in diagnostics of left ventricular disfunction within coronary blood flow changes and normalization of cardiac rhythm. 



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Aim: was to show the role and possibilities of 128-slice computed tomography (MSCT) iirfhe dynamic observation of patients; after open and endovascular surgery of lower limb's arteries;

Material and methods: 1st group - 36 patients (30,5%) who (underwent endovascular procedures;, 2nd group - 51 patients; (44,2%) who underwent open reconstructive operations;, 3rd group - 31 patients; (26,3%) after hybrid operations;. 108 patients; were examined in post-operative period (7 women, 101 men), average age was 57,28±15,08. All patients underwent MSCT-angiography on the background of the contrast bolus;. 55 patients; had standard procedure, other patients; underwent examination with low-close protocol.

Results: obtained images of low-close protocol had satisfactory condition of information: arterial walls were visualized well, inner lumen and para-prosthesis space, atherosclerotic lesions were also visualized. Obtained results of MSCT-angiography during low-dose protocol were confirmed ntraoperatively Obtained data of MSCT-angiography: all patients; of 1st group had passable stents; but 2 patients; who had hernodynarnically non-significant stenosis. In 2nd group 5 patents; had restenosis of prosthesis and grafts;, 20 patients; had thrombosis. In 3rd group, 2 patients; had restenosis of prosthesism femoral-popliteal segment, 13 patient had thrombosis of prosthesis/grafts, 6 patients; had restenosis of stents;, 1 patient had stent thrombosis in femoral-popliteal segment, n case of hernodynarnically significant stenosis (50%) of the stent or prosthesis in the absence of clinical manifestations; we made correction of drug therapy. If the patent had a detected boundary stenosis (50-74%) with the absence of complaints;, the patient had correction of drug therapy, with the appointment of a dynamic MSCT-angiography in 3-6 months. Patents; with occlusion of the prosthesis, or a stent with a satisfactory distal vessels clue to good collaterals; we performed thrombectomy or repeated prosthetics. Patients who according to the MDCT-angiography, had identified thrombosis of prosthesis/grafts with poor distal vessels, absence of good collaterals; and the presence of clinical manifestations; of critical ischemia - amputation of the affected limb.

Conclusion: MSCT-angiography is a highly informative method of nornnvasive imaging of patency of stent, prosthesis/graft of mam arteries; of lower limbs;. Our study showed that using of a low-close protocol is; possible for the dynamic monitoring of patents; for the detection of postoperative complications;, early diagnosis and prevention of restenosis and thrombosis of prosthesis/grafts and stents Timely diagnosis of stenosis of stents; or grafts/prostheses of mam arteries; of lower limbs can determine tactics; and stages; of surgery (endovascular treatment, and re-open reconstructive vascular surgery, thrombectomy), not leading to the patient’s; disability. 



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Aim: was to develop a classification of osteonecrosis of the midface, based on clinical and radiological examinations. Such classification can allow to make detailed planning of surgical intervention tactics and develop criteria for surgical intervention basing on the bone division of the facial skeleton, as well as to assess dynamics of changes in bones of the facial skull.

Materials and methods: the study included 87 drug-addicted patients with a diagnosis of «toxic phosphate osteonecrosis». All patients underwent clinical and radiological examination. Basing on MSCT data, tactics of surgical treatment was determined.

Results: basing on results of clinical and radiological methods of examination in 29 cases (33%) we observed toxic phosphate osteonecrosis of the upper and lower jaw. In 18 patients (21%) the disease occurred only in the upper jaw. Lesion of the upper jaw within the I and II parts below the infraorbital foramen was observed in 39 cases (45%). Lesion of the maxilla above the infraorbital foramen was determined in 8 cases (9%). In case of diffuse lesions of the maxilla in 23 cases (26%), different patterns of midface were involved in pathologic process.

Conclusion: creation and application in clinical practice of this classification of osteonecrosis of the midface bone in patients with drug-addiction on desomorphine and pervitin, based on the data of MSCT, allowed to pinpoint boundaries and the nature of the defeat of facial bones and choose the best tactics of surgical treatment in all patients. 



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6.     Malanchuk V. A., Brodeckij I.S. Kompleksnoe lechenie bol'nyh osteomielitom cheljustej na fone narkoticheskoj zavisimosti [Complex treatment of patients with osteomyelitis of jaws on background of drug-addiction]. Vestnik VGMU. 2014; 2 (13): 115-123 [In Russ].

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10.   Timofeev A.A., Dakal A.V. Klinicheskoe techenie gnojno- vospalitel'nyh zabolevanij cheljustej i mjagkih tkanej cheljustno-licevoj oblasti u bol'nyh, upotrebljajushhih narkotik «vint» [Clinical course of purulent inflammatory diseases of jaws and soft tissues of the maxillofacial area in patients using «vint»-drug]. Sovremennaja Stomatologija. 2010; 1: 96-102 [In Russ].

11.   Pogosjan Ju.M., Akopjan K.A., Gasparjan L.L.. Rentgenodiagnostika osteonekroza cheljustej u bol'nyh, upotrebljajushhih narkoticheskoe sredstvo «krokodil» [Radiographic diagnosis of jaw osteonecrosis at patients who use the drug «krokodil»]. Voprosy teoreticheskoj i klinicheskoj mediciny. 2013; 2 (78): 44-49 [In Russ].

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