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Introduction: prevalence of atrial fibrillation (AF) in the population continues to rise steadily due to the rapid aging of the population [1]. The search for the morphological substrate of AF has been going on for more than half a century. Left atrial remodeling has become such an important aspect in the pathogenesis of AF that some authors advocate the definition of atrial cardiomyopathies [3].

Aim: was to examine the impact of various imaging techniques on the detection of atrial fibrosis and their key role in the treatment of atrial fibrillation.

Conclusions: currently, radiological imaging techniques are available for clinical practice and provide additional possibilities in the assessment of left anterior segment function in AF. Morpho-functional changes in the left atrium can have a great impact on the global hemodynamic function of the left atrium, and as a consequence, these changes can be a significant predictor of the risk of AF progression and stroke development. Morpho-functional changes in the left atrium can have a great impact on the global hemodynamic function of the left atrium, and as a consequence, these changes can be a significant predictor of the risk of AF progression and stroke development.




Article describes cases of detection of viral pneumonia in patients who underwent additional examination before planned hospitalization for surgical treatment in the presence of negative test results for the SARS-CoV-2 virus.

Aim: was to detect early computed tomography (CT) signs of COVID-19 during admission to hospital, in case of presence of normal clinical and laboratory data and negative results of PCR test.

Material and methods: image analysis of CT examinations of chest organs in patients admitted for surgical treatment for various osteoarticular pathologies, for the period of 3 months, was carried out in radiology department.

Results: during CT examination of chest organs, in 9,1% patients, signs of viral pneumonia were revealed, including those caused by SARS-CoV-2, in condition of negative results of PCR tests, immunoserological tests for the presence of immunoglobulins M and G to SARS-CoV-2.

Conclusion: computed tomography of lungs can be considered the «gold standard» of diagnostics, which makes it possible to detect early subclinical inflammatory changes in lungs, in particular, in pneumonia associated with COVID-19, which is the main task during a pandemic.




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.



1.     The top ten cuases of death, WHO fact sheets 2020.

2.     Shapoval IN, Nikitina SYu, Ageeva LI, et al. Zdravoochranenie v Rossii. 2019 [In Russ].

3.     Aigner A, Grittner U, Rolfs A, et al. Contribution of established stroke risk factors to the burden of stroke in young adults. Stroke. 2017; 48: 1744-1751.

4.     Gafarova AV, Gromova EA, Panov DО, et al. Social support and stroke risk: an epidemiological study of a population aged 25-64 years in Russia/Siberia (the WHO MONICA-psychosocial program). Neurology, Neuropsychiatry, Psychosomatics. 2019; 11(1): 12-20 [In Russ].

5.     Putaala J. Ischemic Stroke in Young Adults. Continuum. 2020; 26(2): 386-414.

6.     Si Y, Xiang S, Zhang Y. et al. Clinical profile of etiological and risk factors of young adults with ischemic stroke in West China. Clinical Neurology and Neurosurgery. 2020; 193.

7.     Ekker MS, Boot EM, Singhal AB, et al. Epidemiology, aetiology, and management of ischaemic stroke in young adults. The Lancet Neurology. 2018; 17(9): 790-801.

8.     Chi X, Zhao R, Pei H, et al. Diffusion-weighted imaging-documented bilateral small embolic stroke involving multiple vascular territories may indicate occult cancer: A retrospective case series and a brief review of the literature. Aging Med. 2020; 3(1): 53-59.

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.



1.     Петровский Б.В., Константинов Б.А., Нечаенко М.А. Первичные опухоли сердца. М.: Медицина, 1997; 152.

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.

5.     Marshall WHJr., Steiner RM, Wexler L. Tumor vascularity in left atrial myxoma demonstrated by selective coronary arteriography. Radiology. 1969; 93(4): 815-816.

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



Background: pulmonary embolism (PE), is one of the most common cardiopulmonary pathologies in the world, has a high risk of developing after major operations on the osteoarticular system. Mortality from PE remains high, ranking third after myocardial infarction and stroke.

Aim: was to identify tomographic signs of PE in patients with osteoarticular pathology in the postoperative period.

Materials and methods: we analyzed results of computed angiopulmonography of 11 patients with suspicion on pulmonary embolism who were operated on osteoarticular pathology at the Federal Center for Traumatology, Orthopedics and Endoprosthetics of the Ministry of Health of the Russian Federation (Cheboksary). Patients showed such indirect signs of PE as discshaped atelectasis of lung tissues, expansion of diameter of pulmonary trunk and right pulmonary artery, signs of congestion in pulmonary circulation and pulmonary hypertension. Direct radiological signs included occlusion of a branch of pulmonary artery by thrombus.

Results: in 91% of examined patients, occlusion of branch of pulmonary artery by thrombus was detected, in 82% of cases - the defeat of branches of right pulmonary artery. Embolism at the level of lobar arteries was detected in 30%, segmental branches - in 60% of patients; signs of pulmonary embolism of one of subsegmental branches of right pulmonary artery - in one patient (10%). Bilateral thrombosis was observed in two patients, including massive bilateral PE in one case. One patient had discoid atelectasis of lung tissues. Expansion of diameter of pulmonary trunk and right pulmonary artery was observed in 78% of patients with PE, signs of congestion in pulmonary circulation - in 27% of cases, pulmonary hypertension - in 73% of cases.

Conclusion: visualization of direct and indirect signs of pulmonary embolism during computed pulmonary angiography confirmed the diagnosis in all examined patients. The detection of blood clots in pulmonary arteries themselves is the main criterion in making the final diagnosis.





1.     Nikolaev NS, Trofimov NA, Kachaeva ZA, et al. Prevention and treatment of pulmonary thromboembolism in traumatology and orthopedics. Tutorial. Cheboksary: Publishing house of the Chuvash University, 2020; 108 [In Russ].

2.     Krivosheeva EN, Komarov AL, Shakhnovich RM, et al. Clinical analysis of a patient with antiphospholipid syndrome and submassive pulmonary embolism. Aterotromboz. 2018; (1): 76-87 [In Russ].

3.     Hepburn-Brown M, Darvall J, Hammerschlag G. Acute pulmonary embolism: a concise review of diagnosis and management. Internal Medicine Journal. 2019; 49(1): 15-27.

4.     Ostapenko EN, Novikova NP. Pulmonary embolism: modern approaches to diagnosis and treatment. Ekstrennaya meditsina. 2013; 1(5): 84-110 [In Russ].

5.     Sinyukova AS, Kiseleva LP, Kupaeva VA. A clinical case of recurrent pulmonary embolism and the complexity of the diagnostic search. Sovremennaya meditsina: aktual'nye voprosy. 2015; (42-43): 24-31 [In Russ].

6.     Bagrova IV, Kukharchik GA, Serebryakova VI, et al. Modern approaches to the diagnosis of pulmonary embolism. Flebologiya. 2012; 6(4): 35-42 [In Russ].

7.     Kuznetsov AB, Boyarinov GA. Early diagnosis of pulmonary embolism (review). Sovremennye tekhnologii v meditsine. 2016; 8(4): 330-336 [In Russ].

8.     Bershteyn LL. Pulmonary embolism: clinical manifestations and diagnosis in the light of the new recommendations of the European Society of Cardiology. Kardiologiya. 2015; 55(4): 111-119 [In Russ].

9.     Sakharyuk AP, Shimko VV, Tarasyuk ES, et al. Pulmonary embolism in clinical practice. Byulleten' fiziologii i patologii dykhaniya. 2015; (55): 48-53 [In Russ].

10.   M Al-hinnawi A-R. Computer-Aided Detection, Pulmonary Embolism, Computerized Tomography Pulmonary Angiography: Current Status. Intech Open. 2019; 19.

11.   Gilyarov MYu, Konstantinova EV. How do new approaches to the treatment of pulmonary embolism affect disease outcome? Meditsinskiy sovet. 2017; (7): 48-55 [In Russ].

12.   Konstantinides S. Guidelines on the diagnosis and management of acute pulmonary embolism. The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur. Heart J. 2014; (35): 3033-3080.

13.   Tagalakis V, Patenaude V, Kahn SR, Suissa S. Incidence of and mortality from venous thromboembolism in a real-world population: the Q-VTE Study Cohort. Am J Med. 2013; 126(832): 13-21.



Introduction: left atrial (LA) volumes measured during different phases of the cardiac cycle can be used for the evaluation of the LA functional properties before and after catheter ablation (CA). Increase of LA ejection fraction (EF) supposed to be early and more sensitive marker of LA reverse remodeling process, than LA volume and can be important for assessing the effectiveness of CA.

Aim: was to estimate volumetric parameters and function of LV before and after cryo- and radiofrequency catheter ablation of pulmonary veins in patients with paroxysmal atrial fibrillation.

Materials and methods: 21 patients with paroxysmal atrial fibrillation (AF) were included in study. All patients underwent multidetector computed tomography (MDCT) of pulmonary veins (PV) and LA before CA and 12±2 months after CA. 3-dimensional images at phases 0%, 40%, 75% of the cardiac cycle were used to assess LA functional properties.

Results: LA maximal volume before CA was increased insignificantly in patients with AF recurrence (124,52±38,22 ml vs. 117,89±23,94 ml, p>0,05). In patients without recurrence after CA, LA volumes decreased slightly (LA max 115,31±20,13 ml, p>0,05, LA min 73,43±14,91 ml, p>0,05), while in patients with recurrence increased (LA max 130,88±25,20 ml, p<0,05, LA min to 94,92±31,75 ml, p<0,05). Global LA ejection fraction was less in patients without recurrence before CA (22,37%±4,69 vs. 31,31%±9,89, p=0,013), but increased significantly after CA, while in patients with recurrence global LA EF was without relevant changes (36,54%±3,27 vs. 28,89%±9,41, p=0,011).

Conclusion: improved left atrial mechanical function was demonstrated in patients without any recurrence after ablation. The anatomic and functional reverse remodeling was not significant in patients with atrial fibrillation recurrence.




1.     Lippi G, Sanchis-Gomar F, Cervellin G. Global epidemiology of atrial fibrillation: An increasing epidemic and public health challenge. Int J Stroke. 2021; 16(2): 217-221.

2.     Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021; 42(5): 373-498.

3.     Hindricks G, Sepehri Shamloo A, Lenarczyk R, et al. Catheter ablation of atrial fibrillation: current status, techniques, outcomes and challenges. Kardiol Pol. 2018; 76(12): 1680-1686.

4.     Artjuhina EA, Revishvili ASh. New technologies in the treatment of cardiac arrhythmias. Vysokotehnologichnaja medicina. 2017; 1: 7-15 [In Russ].

5.     Darby AE. Recurrent Atrial Fibrillation After Catheter Ablation: Considerations For Repeat Ablation And Strategies To Optimize Success. J Atr Fibrillation. 2016; 9(1): 1427.

6.     Murray MI, Arnold A, Younis M, et al. Cryoballoon versus radiofrequency ablation for paroxysmal atrial fibrillation: a meta-analysis of randomized controlled trials. Clin Res Cardiol. 2018; 107(8): 658-669.

7.     Kuck KH, Brugada J, F?rnkranz A, et al. Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation. N Engl J Med. 2016; 374(23): 2235-2245.

8.     Mathew ST, Patel J, Joseph S, et al. Atrial fibrillation: mechanistic insights and treatment options. Eur J Intern Med. 2009; 20(7): 672-81.

9.     Vasamreddy CR, Lickfett L, Jayam VK, et al. Predictors of recurrence following catheter ablation of atrial fibrillation using an irrigated-tip ablation catheter. J Cardiovasc Electrophysiol. 2004; 15(6): 692-697.

10.   Tops LF, Bax JJ, Zeppenfeld K, et al. Effect of radiofrequency catheter ablation for atrial fibrillation on left atrial cavity size. Am J Cardiol. 2006; 97(8): 1220-1222.

11.   Tsao HM, Hu WC, Wu MH, et al. The impact of catheter ablation on the dynamic function of the left atrium in patients with atrial fibrillation: insights from four-dimensional computed tomographic images. J Cardiovasc Electrophysiol. 2010; 21(3): 270-277.

12.   Abhayaratna WP, Seward JB, Appleton CP, et al. Left atrial size: physiologic determinants and clinical applications. J Am Coll Cardiol. 2006; 47(12): 2357-2363.

13.   Hoit BD. Left atrial size and function: role in prognosis. J Am Coll Cardiol. 2014; 63(6): 493-505.

14.   Costa FM, Ferreira AM, Oliveira S, et al. Left atrial volume is more important than the type of atrial fibrillation in predicting the long-term success of catheter ablation. Int J Cardiol. 2015; 184: 56-61.

15.   Avelar E, Durst R, Rosito GA, et al. Comparison of the accuracy of multidetector computed tomography versus two-dimensional echocardiography to measureleft atrial volume. Am J Cardiol. 2010; 106(1): 104-109.

16.   K?hl JT, L?nborg J, Fuchs A, et al. Assessment of left atrial volume and function: a comparative study between echocardiography, magnetic resonance imaging and multi slice computed tomography. Int J Cardiovasc Imaging. 2012; 28(5): 1061-1071.

17.   Hof I, Chilukuri K, Arbab-Zadeh A, et al. Does left atrial volume and pulmonary venous anatomy predict the outcome of catheter ablation of atrial fibrillation? J Cardiovasc Electrophysiol. 2009; 20(9): 1005-1010.

18.   Abecasis J, Dourado R, Ferreira A, et al. Left atrial volume calculated by multi-detector computed tomography may predict successful pulmonary vein isolation in catheter ablation of atrial fibrillation. Europace. 2009; 11(10): 1289-1294.

19.   Amin V, Finkel J, Halpern E, et al. Impact of left atrial volume on outcomes of pulmonary vein isolation in patients with non-paroxysmal (persistent) and paroxysmal atrial fibrillation. Am J Cardiol. 2013; 112(7): 966-970.

20.   Lemola K, Sneider M, Desjardins B, et al. Effects of left atrial ablation of atrial fibrillation on size of the left atrium and pulmonary veins. Heart Rhythm. 2004; 1(5): 576-581.

21.   Park MJ, Jung JI, Oh YS, et al. Assessment of the structural remodeling of the left atrium by 64-multislice cardiac CT: comparative studies in controls and patients with atrial fibrillation. Int J Cardiol. 2012; 159(3): 181-186.

22.   Lemola K, Desjardins B, Sneider M, et al. Effect of left atrial circumferential ablation for atrial fibrillation on left atrial transport function. Heart Rhythm. 2005; 2(9): 923-928.

23.   Perea RJ, Tamborero D, Mont L, et al. Left atrial contractility is preserved after successful circumferential pulmonary vein ablation in patients with atrial fibrillation. J Cardiovasc Electrophysiol. 2008; 19(4): 374-379. 



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.




1.     WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Swerdlow S.H., Campo E., Harris N.L., Jaffe E.S., Pileri S.A., Stein H., Thiele J. (Eds). Revised 4th edition. Lyon: IARC Press, 2017; 585.

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.

4.     FSBI «National Medical Research Center of Oncology named after N.N. Blokhin »of the Ministry of Health of Russia Diagnostics and treatment. Types of diseases. Lymphomas, (date of access 08.07.20) [In Russ.].

5.     Psyrri A, Papageorgiou S, Economopoulos T. Primary extranodal lymphomas of stomach: clinical presentation, diagnostic pitfalls and management. Annals of Oncology. 2008; 19(12): 1992-1999.

6.     Ghai S, Pattison J, Ghai S et al. Primary gastrointestinal lymphoma: spectrum of imaging findings with pathologic correlation. Radiographics. 2007; 27(5): 1371-1388.

7.     Juarez-Salcedo LM, Sokol L, Chavez JC, Dalia S. Primary Gastric Lymphoma, Epidemiology, Clinical Diagnosis, and Treatment. Cancer Control. 2018; 25(1): 1073274818778256.

8.     NORD: National Organization for Rare Disorders. Rare Disease Database. Primary Gastric Lymphoma. Luh JY Nabavizadeh N, Thomas CR. Jr., (date of access 20.07.2020).

9.     De Jong PA, Van Ufford HMQ, Baarslag H-J et al. CT and 18F-FDG PET for noninvasive detection of splenic involvement in patients with malignant lymphoma. American Journal of Roentgenology. 2009; 192(3): 745-753.

10.   Ingle SB, Hinge CR. Primary splenic lymphoma: Current diagnostic trends. World J Clin Cases. 2016 December 16; 4(12): 385-389.

11.   Dobrovolskiene L, Balukeviciute J, Maksimaitiene J. Virskinimo trakto limfomu radiologine diagnostika [Radiographic diagnosis of gastrointestinal lymphoma]. Medicina(Kaunas). 2002; 38(2):165-171.

12.   Chien SH, Liu CJ, Hu YW, et al. Frequency of surveillance computed tomography in non-Hodgkin lymphoma and the risk of secondary primary malignancies: A nationwide population-based study. Int J Cancer. 2015 Aug 1; 137(3): 658-665.

13.   Chernobai TN, Golovko TS. Radiation diagnosis of extranodal lymphomas. Clinical oncology. 2017; 4(28): 73-76 (date of access 8.07.2020) [In Ukr.].

14.   Frampas E. Lymphomas: Basic points that radiologists should know. Diagnostic and Interventional Imaging. February 2013; 94(2): 131-144.



Aim: was to analyze the risk of malignancy incidence as a result of exposure of small doses of diagnostic radiation when examining patients on computed tomography (CT).

Material and methods: a retrospective study was conducted on the base of analysis of information from archival protocols for examinations of patients living in Ozersk city and examined in computed tomography department of the Chelyabinsk Regional Clinical Hospital for the period 1993-2004. Study includes generalized material containing data from several population registers of the Laboratory of Radiation Epidemiology of the South Ural Institute of Biophysics.

Results: study revealed the presence of a statistically insignificant excess of the risk of incidence of malignancy among patients who underwent a CT study from the beginning of the appearance of this type of study in hospitals in the Chelyabinsk region until the end of the first stage of epidemiological surveillance - December 31, 2004.

Conclusion: obtained results are interesting for various categories of specialists: radiologists, radiation epidemiologists, radiobiologists and radiation hygiene specialists. Further research is needed with an extension of the retrospective observation period.



1.     Collection of legislation of the Russian Federation. Federal Law 21.11.2011 No. 323-FZ «On Principles of the Protection of Citizens' Health in the Russian Federation». Part 4, article 34 [In Russ]. 

1.     Narkevich BYa, Dolgushin BI. Radiation safety assurance in computed tomography and interventional radiology. REJR. 2013; 2 (3): 7–19.

2.     Brenner DJ, Hall EJ. Computed tomography – an increasing source of radiation exposure. N Engl J Med 2007; 357: 2277-2284.

3.     Order of the Ministry of Health of the Russian Federation No. 298 of July 31, 2000, dated January 9, 1996, No. 3-FZ (Federal Law) «On Approval of the Regulation on the Unified State System of Control and Accounting for iIndividual Exposures of Citizens» [In Russ]. 

4.     Decree of the Government of the Russian Federation dated 16.06.97 No. 718 «On the procedure for creating a unified state system for monitoring and recording individual doses to citizens» [In Russ]. 

5.     Koshurnikova NA, Kabirova NR, Bolotnikova MG, et al. Description of the register of persons, had lived in childhood near the Mayak Production Association. Medical Radiology and Radiation Safety. 2003; 2: 27-34 [In Russ].

6.     Koshurnikova NA, Shilnikova NS, Okatenko PV, et al. Characteristics of cohort of workers of «Mayak» PO. Medical radiology and radiation safety. 1998; 43 (6): 43–57 [In Russ].

7.     United Nations Scientific Committee on the Effects of Atomic Radiation. Sources and effects of ionizing radiation: United Nations Scientific Committee on the Effects of Atomic Radiation: UNSCEAR 2012 report to the General Assembly. Scientific Annexes. New York. United Nations; 2015.

8.     Abramson, JH. WINPEPI updated: computer programs for epidemiologists, and their teaching potential. Epidemiologic Perspectives & Innovations. 2011; 8:1

10.   Preston DL. Epicure User’s Guide. USA: 330.

11.   Howe GR. Lung Cancer Mortality between 1950 and 1987 after Exposure to Fractionated Moderate-Dose-Rate Ionizing Radiation in the Canadian Fluoroscopy Cohort Study and the Comparison with Lung Cancer Mortality in the Atomic Bomb Survivors Study. Radiation Research. 1995; 142: 295-304.

12.   Ivanov VK, Kashcheev VV, Menyaylo SYu, et al. Radiation risk of medical exposure. Radiation and risk. 2012; 21 (4): 7-23 [In Russ].

13.   Pearce MS, Salotti JA, Little MP, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumors: a retrospective cohort study. The Lancet. 2012; 380.

14.   Shilnikova NS, Preston DL, Ron E, et al. Cancer Mortality Risk among Workers at the Mayak Nuclear Complex. Radiation Research. 2003; 159: 787–798.

15.   Lebedev NI, Osipov MV, Babintseva NA, et al. Register of patients undergoing CT scan - examinations in the department of radiation diagnostics of the Central Medical Center-71, Ozersk. REJR. 2017; 7 (2): 110-116 [In Russ].

16.   Finashov LV, Kuznetsova IS, Sokolnikov ME. Prostate cancer incidence among workers with work-related exposure of radiation at the Mayak Production Association. Radiation and Risk, 2019; 28 (4): 54–64 [In Russ].

17.   Fomin EP, Osipov MV. Pooled database of Ozyorsk population exposed to computed tomography. REJR 2019; 9 (2):234-239.



Introduction: development of software and hardware capabilities of modern computing systems has enabled three-dimensional (3D) modeling and 3D printing technology (medical prototyping) to become available for a wide range of healthcare specialists. Commercial software used for this purpose remains unavailable to private physicians and small institutions due to the high cost. However, there are freeware applications and affordable 3D printers that can also be used to create medical prototypes.

Aim: was to describe stages of creating of physical 3D models based on medical imaging data and to highlight main features of specialized software and to make an overview of main types of 3D printing used in medicine.

Material and methods: article describes process of creation of medical prototype, that can be divided on three main stages: 1) acquisition of medical imaging, obtained by ‘volumetric’ scanning methods (computed tomography (CT), magnetic-resonance imaging (MRI), 3D ultrasound (3D US)); 2) virtual 3D model making (on the basis of visualisation data) by segmentation, polygonal mesh extraction and correction; 3) 3D printing of virtual model by the chosen method of additive manufacturing, with or without post-processing.

Conclusion: medical prototypes with sufficient precision and physical properties are necessary for understanding of anatomical structure and surgical crew training and can be made with use of freely available software and inexpensive 3D printers.



1.     Luo H, Meyer-Szary О, Wang Z, Sabiniewicz R, Liu Y. Three-dimensional printing in cardiology: current applications and future challenges. Cardiol. J. 2017; 24 (4): 436–444.

2.     Vukicevic M, Mosadegh B, Min J K, Little S H. Cardiac 3D printing and its future directions. JACC Cardiovasc. Imaging. 2017; 10 (2): 171–184.

3.     Meier LM, Meineri ·M, Hiansen JQ, Horlick EM. Structural and congenital heart disease interventions: the role of three-dimensional printing. Neth Heart J. 2017; 25 (2): 65–75.

4.     Witschey WR, Pouch AM, McGarvey JR, Ikeuchi K, Contijoch F, Levack MM, Yushkevick PA, Sehgal CM, Jackson BM, Gorman RC, Gorman JH. Three-dimensional ultrasound-derived physical mitral valve modeling. Ann. Thorac. Surg. 2014; 98 (2): 691–694.

5.     Vukicevic M, Puperi DS, Grande-Allen KJ, Little SH. 3D Printed Modeling of the Mitral Valve for Catheter-Based Structural Interventions. Ann. Biomed. Eng. 2017; 45 (2): 508–519.

6.     Parimi M, Buelter J, Thanugundla V, Condoor S, Parkar N, Danon S, King W. Feasibility and Validity of Printing 3D Heart Models from Rotational Angiography. Pediatr. Cardiol. 2018; 39 (4): 653–658.

7.     Abudayyeh I, Gordon B, Ansari MM, Jutzy K, Stoletniy L, Hilliard A. A practical guide to cardiovascular 3D printing in clinical practice: Overview and examples. J. Interv. Cardiol. 2018; 31 (3): 375–383.

8.     Ripley B, Levin D, Kelil T, Hermsen JL, Kim S, Maki JH, Wilson GJ. 3D printing from MRI Data: Harnessing strengths and minimizing weaknesses. J.of Magnetic Resonance Imaging. 2016; 45 (3): 1–11.

9.     Wang J, Coles-Black J, Matalanis G, Chuen J. Innovations in cardiac surgery: techniques and applications of 3D printing. J. 3D Print. Med. 2018; 2 (4): 179–186.

10.   Nagibovich OA, Svistov DV, Peleshok SA, Korovin AE, Gorodkov EV. Appliance of 3D printing technology in medicine. Klin. patofiz. 2017; 23 (3): 14–22 [In Russ].

11.   Bagaturiya GO. Prospects for the use of 3D printing in planning of surgical operations. Med.: teorija i praktika. 2016; 1 (1): 26–35 [In Russ].

12.   Kim GB, Lee S, Kim H, Yang DH, Kim Y-H, Kyung YS, Kim C-S, Choi SH, Kim BJ, Ha H, Kwon SU, Kim N. Three-Dimensional Printing: Basic Principles and Applications in Medicine and Radiology. Korean J. of Radiol. 2016; 17): 182.

13.   Shi D, Liu K, Zhang X, Liao H, Chen X. Applications of three-dimensional printing technology in the cardiovascular field. Inter. and Emergency Med. 2015; 10: 769–780.

14.   Byrne N, Forte MV, Tandon A, Tandon A, Valverde I, Hussain T. A systematic review of image segmentation methodology, used in the additive manufacture of patient specific 3D printed models of the cardiovascular system. JRSM Cardiovasc. Disease. 2016; 5 (0): 1–9.

15.   Valverde I. Three-dimensional printed cardiac models: applications in the field of medical education, cardiovascular surgery, and structural heart interventions. Revista Espaсola de Cardiologнa (English Edition). 2017; 70 (4): 282–291.

16.   Karyakin NN, Shubnyakov II, Denisov AO, Kachko A V, Alyev RV, Gorbatov RO. Regulatory concerns about medical device manufacturing using 3D printing: current state of the issue. Travmatol. i ortop. Ross. 2018; 24 (4): 129–136 [In Russ].



Aim: was to evaluate the effectiveness of carotid arterial revascularization by stenting of internal carotid arteries (ICA) in patients with a previous ischemic stroke.

Materials and methods: in FSBI «Treatment and rehabilitation center» of the Ministry of Health of Russia,104 patients on treatment and rehabilitation after previous ischemic stroke, underwent stenting of symptomatic atherosclerotic stenosis of the ICA. The average time since stroke was 67 days (from 28 to 273 days). ICA stenting was performed according to generally accepted standards with the mandatory use of intravascular protective devices against cerebral embolism. In most patients we used a filter protection system (77 observations), and for stenosis of more than 95% and in the presence of an unstable atherosclerotic plaque, a proximal defense system was used (27 patients). In some cases, if the situation required it, a combination of protective devices was used (5 observations). A few days before upcoming operation, all patients were evaluated for microcirculation and perfusion in brain tissue using single photon emission computed tomography (SPECT), followed by analysis of results and comparison with SPECT data in the postoperative period.

Results: when analyzing 30 days after stenting, there were no fatal outcomes. In one case (0.96%) after stenting of the subtotal stenosis of the ICA, a hemorrhagic stroke on the ipsilateral side developed on the fifth day. In another case, intraoperative embolism of the ophthalmic artery occurred on the side of the operation with partial loss of vision field.

In the long-term period (4 years and 7 months), the number of undesirable events was 2%. In one case (0.96%), the patient died of ischemic stroke on the ipsilateral side after 3 years and 2 months after stenting. In another case, patient after 1 year and 2 months had an ischemic stroke on the side of the operation. Thus, the total number of complications associated with ICA stenting (30-day period + long-term period) was 3.8%.

When evaluating results of stenting by the SPECT method, the state of cerebral perfusion was assessed using perfusion maps in two modes and by axial perfusion sections.

In all observations after stenting, improvement of cerebral perfusion was noticed, regardless of the side and severity of ICA stenosis and the presence of focal postischemic changes. Visually, perfusion sections show a general increase in cerebral blood perfusion (CBP), a decrease in one-sided focal deficiency of CBP . Same results were obtained for relative cortex perfusion (relCP) in four regions and in vascular basins.

Comparing results, obtained by the number of undesirable events (strokes, restenosis and death) with the four-year data of the analysis of the international CREST study, the complication rate in our group is significantly lower (3.8% versus 8.6% in the CREST stenting group and 8.4% in carotid endarterectomy group CREST).

Conclusion: carotid stenting is an effective method of treatment of atherosclerotic lesions of main cerebral arteries in patients with previous stroke. The effectiveness of this type of treatment is confirmed by a positive clinical result and with the help of modern diagnostic methods, in particular SPECT.



1.     Damulin IV, Parfenov VA, Skoromets AA, Yah NN. Circulatory disorders in the brain and spinal cord. In the book: «Diseases of the nervous system. A guide for doctors». Yakhno N.N., Shtulman D.R. (ed.). 2003; 231302 [In Russ].

2.     Thom T, Haase N, Rosamond W et al. Heart disease and stroke statistics - 2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006;113:e85-151.

3.     Kleindorfer D, Panagos P, Pancioli A et al. Incidence and short term prognosis of transient ischemic attack in a population-based study. Stroke. 2005;36: 720-723.

4.     Gusev EI, Skvortsova VI, Stakhovskaya LV. The problem of stroke in the Russian Federation: a time of active joint action. Zhurn. nevrol. and a psychiatrist. 2007; 8: 4-10 [In Russ].

5.     Gusev EI, Skvortsova VI, Stakhovskaya LV. Epidemiology of stroke in the Russian Federation. appendix of the Journal. nevrol. and a psychiatrist. them. SS Korsakova. 2003; 8: 4-9 [In Russ].

6.     Pinchuk EA. «Epidemiology and secondary prevention of ischemic stroke in a large industrial and cultural center» Diss. Cand. med. sciences. Ekaterinburg, 2004;136-137 [In Russ].

7.     Kadykov AS. Prevention of repeated ischemic stroke. AS Kadykov, NV Shakhparonova. Consilium medicum. 2006; 2: 96-99 [In Russ].

8.     Pokrovsky AV, KiyashkoVA. Ischemic stroke can be prevented. Rus. med. Journal. 2003; 11 (12): 691-695 [In Russ].

9.     Parfenov VA, Gurak SV. Repeated ischemic stroke and its prevention in patients with arterial hypertension. Zhurn. nevrol. and psychiatrist. them. SS Korsakova. Stroke. 2005; 14: 3-7 [In Russ].

10.   Sacco RL, Adams R, Albers G et al. Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke: Co-Sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline. Stroke. 2006; 37: 577 - 617.

11.   Touze E, Varenne O, Chatellier G et al. Risk of myocardial infarction and vascular death after transient ischemic attack and ischemic stroke: a systematic review and meta-analysis. Stroke. 2005; 36:2748-2755.

12.   Kjellstrom T, Norrving B, Shatchkute A. Helsingborg Declaration 2006 on European Stroke Strategies. Helsingborg Declaration 2006 On European Stroke Strategies; pp. 9-12. Cerebrovasc Dis. 2007; 23(2-3): 231-41.

13.   European Carotid Surgery Triallists Collaborative Group: NRC European Carotid Surgery Trial; Interim results for symptomatic patients with severe (70-99%) or with mild (0-29%) carotid stenosis. Lancet. 1991; 337:1235-1243.

14.   North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effects of carotid endarterectomy in symptomatic patients with high-grade stenosis. N Engl J Med. 1991; 325:445-453.

15.   Asymptomatic Carotid Atherosclerosis Study. Clinical advisory: Carotid endarterectomy for patients with asymptomatic internal carotid artery stenosis. Stroke. 1994; 25:2523-2524.

16.   Brott TG, Hobson RW 2nd, Howard G, Roubin FS, et al. "CREST Investigators. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med. 2010 Jul 1;363(1):11-23.

17.   Brown MM, Mas JL, Ringleb PA, Hacke W. Carotid artery stenting versus surgery: adequate comparisons? Lancet Neurol. 2010 , 9:341-342.

18.   Volzhenin VE, Dolinina EG, Dontsov AE et al. The state of cerebral blood flow according to SPECT, MRI and MPA. Thes. doc. 2nd Congress of the Russian Society of Nuclear Medicine. Modern problems of nuclear medicine and pharmaceuticals. Obninsk, 2000; 174-175 [In Russ].


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.



1.     Kornienko VN, Pronin IN. Diagnostic Neuroradiology. vol. 1. M.: Medlit, 2008; 339-382 [In Russ].

2.     Hughes JD, Bond KM, Mekary RA, et al. Estimating the global incidence of aneurysmal subarachnoid hemorrhage: a systematic review for central nervous system vascular lesions and meta-analysis of ruptured aneurysms. World Neurosurg. 2018; 115: 430-447.

3.     Krylov VV, Dash'yan VG, Shetova IM, et al. Neurosurgical care in patients with vascular diseases of the brain in the Russian Federation. Nejrohirurgiya. 2017; 4: 11-20 [In Russ].

4.     Passier PE, Visser-Meily JM, Rinkel GJ, et al. Life satisfaction and return to work after aneurysmal subarachnoid hemorrhage. J Stroke Cerebrovasc. Dis. 2011; 20(4): 324-329.

5.     Lovelock CE, Rinkel GJE, Rothwell PM. Time trends in outcome of subarachnoid hemorrhage: populationbased study and systematic review. Neurology. 2010; 74(19): 1494-1501.

6.     Krylov VV, Prirodov AV Risk factors for surgical treatment of middle cerebral artery aneurysms in acute hemorrhage. Nejrohirurgiya. 2011; 1: 31-41 [In Russ].

7.     Korja M, Kivisaari R, Rezai Jahromi B, Lehto H. Natural history of ruptured but untreated intracranial aneurysms. Stroke. 2017; 48(4): 1081-1084.

8.     Krivoshapkin AL, Byval'cev VA, Sorokovikov VA. Natural course and risk of rupture of cerebral aneurysms. Klinicheskaya nevrologiya. 2010; 1: 32-35 [In Russ].

9.     Lasheras JC. The biomechanics of arterial aneurysms. Annu. Rev. Fluid Mech. 2007; 39: 293-319.

10.   Etminan N, Buchholz BA, Dreier R, et al. Cerebral aneurysms: formation, progression, and developmental chronology. Transl Stroke Res. 2014; 5(2): 167-173.

11.   Nasr DM, Fugate J, Brown RD. The Genetics of Cerebral Aneurysms and Other Vascular Malformations. In: Sharma P, Meschia J (ed.) Stroke Genetics. Springer, Cham. 2017; 53-78.

12.   Broderick JP, Brown Jr RD, Sauerbeck L, et al. Greater rupture risk for familial as compared to sporadic unruptured intracranial aneurysms. Stroke. 2009;40(6): 1952-1957.

13.   Thompson BG, Brown Jr RD, Amin-Hanjani S, et al. Guidelines for the management of patients with unruptured intracranial aneurysms: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015;46(8): 2368-2400.

14.   Krylov VV, Dash'yan VG, Shatohin TA, et al. Surgical treatment of intracranial aneurysms in Russian Federation. Zhurnal Voprosy nejrohirurgii imeni NN Burdenko. 2018; 82(6): 5-14 [In Russ].

15.   Ishmuhametov AI, Abakumov MM, Sharifullin DA, Mufazalov FF. X-ray computed tomography for trauma and acute disease. Ufa: OOO MDM-ARK, 2001; 111-119 [In Russ].

16.   Ujiie H, Tamano Y, Sasaki K, et al. Is the aspect ratio a reliable index for predicting the rupture of a saccular aneurysm? Neurosurgery. 2001; 48(3): 495-502.

17.   Cebral JR, Castro MA, Burgess JE, et al. Characterization of cerebral aneurysms for assessing risk of rupture by using patient-specific computational hemodynamics models. AJNR Am J Neuroradiol. 2005; 26(10): 2550-2559.

18.   Yang ZL, Ni QQ, Schoepf UJ, et al. Small intracranial aneurysms: diagnostic accuracy of CT angiography. Radiology. 2017; 285(3): 941-952.

19.   Kleinloog R, De Mul N, Verweij BH, et al. Risk factors for intracranial aneurysm rupture: a systematic review. Neurosurg. 2018; 82(4): 431-440.

20.   Marcolini E, Hine J. Approach to the Diagnosis and Management of Subarachnoid Hemorrhage. West J Emerg Med. 2019; 20(2): 203-211.

21.   Troshin VD, Pogodina TG. Emergency Neurology: a guide. M.: Medicinskoe informacionnoe agentstvo, 2016; 322-325 [In Russ].

22.   Danilov VI. Intracranial non-traumatic hemorrhage: diagnosis and indications for surgical treatment. Nevrologicheskij vestnik. 2005; 37(1-2): 77-84 [In Russ].

23.   Krylov VV, Prirodov AV, Kuznecova TK. Surgical methods for the prevention and treatment of vascular spasm in patients after rupture of cerebral aneurysms. Nejrohirurgiya. 2014; (1): 104-115 [In Russ].

24.   Fisher CM, Kistler JP, Davis JM. Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning. Neurosurgery. 1980; 6(1): 1-9.

25.   Johnston SC, Dowd CF, Higashida RT, et al. Predictors of rehemorrhage after treatment of ruptured intracranial aneurysms: the Cerebral Aneurysm Rerupture After Treatment (CARAT) study. Stroke. 2008; 39(1): 120-125.

26.   Krylov VV, Dash'yan VG, Grigor'ev IV, et al. Results of surgical treatment of patients with ruptured aneurysms of pericallous artery. Nejrohirurgiya. 2018; 2:17-26 [In Russ].

27.   Konovalov AN, Krylov VV, Filatov YuM, et al. Recommendatory management protocol for patients with subarachnoid hemorrhage due to rupture of cerebral aneurysms. Voprosy nejrohirurgii im. NN Burdenko. 2006; (3): 3-10 [In Russ].

28.   Lebedev VV, Ishmuhametov AI, Krylov VV, et al. The role of computed tomography of the brain in the acute rupture of arterial aneurysms. Med. radiologiya. 1993; 5: 9-12 [In Russ].

29.   Dubosh NM, Bellolio MF, Rabinstein AA Edlow JA. Sensitivity of early brain computed tomography to exclude aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. Stroke. 2016; 47(3): 750-755.

30.   Kidwell CS, Wintermark M. Imaging of intracranial haemorrhage. Lancet Neurol. 2008; 7(3): 256-267.

31.   Verma RK, Kottke R, Andereggen L, et al. Detecting subarachnoid hemorrhage: comparison of combined FLAIR/SWI versus CT. Eur J Radiol. 2013; 82(9): 1539-1545.

32.   Martin SC, Teo MK, Young AM, et al. Defending a traditional practice in the modern era: the use of lumbar puncture in the investigation of subarachnoid haemorrhage. Br J Neurosurg. 2015; 29(6): 799-803.

33.   Meurer WJ, Walsh B, Vilke GM, Coyne CJ. Clinical guidelines for the emergency department evaluation of subarachnoid hemorrhage. J Emerg Med. 2016; 50(4): 696-701.

34.   Epanova AA. Clinic and comparative evaluation of various methods of radiation diagnostics in the detection of cerebral aneurysms. Sibirskij medicinskij zhurnal (Tomsk). 2007; 22(S2):103-107 [In Russ].

35.   Menke J, Larsen J, Kallenberg K. Diagnosing cerebral aneurysms by computed tomographic angiography: meta-analysis. Ann Neurol. 2011; 69(4): 646-654.

36.   Agid R, Lee SK, Willinsky RA, et al. Acute subarachnoid hemorrhage: using 64-slice multidetector CT angiography to «triage» patients’ treatment. Neuroradiology. 2006; 48(11):787-794.

37.   McCormack RF, Hutson A. Can computed tomography angiography of the brain replace lumbar puncture in the evaluation of acute-onset headache after a negative noncontrast cranial computed tomography scan? Acad Emerg Med. 2010;17(4):444-451.

38.   Epanova AA. Complex radiation diagnostics of aneurysms and vascular malformations of the brain: Cand. med. sci. diss. Moscow, 2010; 124 [In Russ].

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].



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.



1.     Braithwaite B, J Cheshire N, M Greenhalgh R, Grieve R. IMPROVE Trial Investigators. Endovascular strategy or open repair for ruptured abdominal aortic aneurysm: oneyear outcomes from the IMPROVE randomized trial. Eur Heart J. 2015; 36(31): 2061-2069.

2.     Bown MJ. Meta-Analysis of 50 Years of Ruptured Abdominal Aortic Aneurysm the growth rate of small abdominal aortic aneurysms: A randomized placebocontrolled trial (AARDVARK). Eur Heart J. 2016; 37(42):3213-21.

3.     Kabardieva MR, Komlev AE, Kuchin IV, Kolmakova TE, Sharia MA, Imaev TE, Naumov VG, Akchurin RS. Abdominal aortic aneurysm: the view of a cardiologist and cardiovascular surgeon. Atherosclerosis and dyslipidemia. 2018; 33(4):17-24 [In Russ].

4.     Toghill BJ, Saratzis A, Liyanage LS, Sidloff D, Bown MJ. Genetics of Aortic Aneurysmal Disease. eLS: John Wiley & Sons, Ltd. Circulation. 2016; 133(24): 2516-2528.

5.     Kazanchian PO. Ruptures of abdominal aortic aneurysms. PO Kazanchian, VA Popov, PG Sotnikov. M.: Publisher MEI, 2006: 254 [In Russ].

6.     Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, Evangelista A, Falk V, Frank H, Gaemperli O, Grabenwoger M, Haverich A, Iung B, Manolis AJ, Meijboom F, Nienaber CA, Roffi M, Rousseau H, Sechtem U, Sirnes PA, Allmen RS, Vrints J; ESC Committee for Practice Guidelines. 2014 ESC guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J. 2014: 35(41): 2873-2926.

7.     Moll FL, Powell JT, Fraedrich G, Verzini F, Haulon S, Waltham M, van Herwaarden JA, Holt PJ, van Keulen JW, Rantner B, Schlosser FJ, Setacci F, Ricco JB; European Society for Vascular Surgery. Management of abdominal aortic aneurysms clinical practice guidelines of the European Society for Vascular Surgery. Eur J Vasc Endovasc Surg. 2011; 4: 1-58.

8.     Akchurin RS, Imaev TE. Vascular diseases. Aortic aneurysms. RS Akchurin, TE Imaev. Cardiology guidelines, edited by EI Chazov; 4: 548 [In Russ].

9.     National recomendations on management of patient with abdominal aorta aneurysms. Angiology and vascular surgery. 2013; 19(2) (appendix) [In Russ].

10.   Polyakov RS, Abugov SA, Charchian ER, Pyreckiy MV, Saakyan YM. Selection of patients for endovascular prosthetics of abdominal aorta. Medical alphabet. 2016; 1 (11) (274): 33-37 [In Russ].

11.   Kuchin IV, Imaev TE, Lepilin PM, Kolegaev AS, Komlev AE, Ternovoy SK, Akchurin RS. Recent state of a problem in endovascular treatment of infrarenal abdominal aortic aneurysm. Angiology and vascular surgery. 2018; 24 (3): 60-66 [In Russ].

12.   Lindholt JS, Bjorck M, Michel JB. Anti-platelet treatment of middle-sized abdominal aortic aneurysms. Curr Vasc Pharmacol. 2013; 11(3): 305-13.

13.   Chaikof EL. The Care of Patients with an Abdominal Aortic Aneurysm: The Society for Vascular Surgery Practice Guidelines. EL Chaikof, DC Brewster, RL Dalman [et al.] J. Vasc. Surg. 2009; 50(4): Suppl. 2-49.

14.   Hirsch AT, Haskal ZJ, Hertzer NR [et al.] Practice Guidelines for the Management of Patients with Peripheral Arterial Disease. Circ. 2006; 113: 463-654.

15.   Johnston KW, Rutherford RB, Tilson MD. Suggested Standards for Reporting on Arterial Aneurysms. Subcommittee on Reporting Standards for Arterial Aneurysms, Ad Hoc Committee on Reporting Standards, Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery. J. Vasc. Surg. 1991; 13 (3): 452-458.

16.   Ashton HA, Buxton MJ, Day NE, Kim LG, Marteau TM, Scott RA, et al., Multicentre Aneurysm Screening Study Group. The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomised controlled trial. Lancet. 2002;360(9345):1531-9. doi: PubMed.

17.   Johansson M, Zahl PH, Volkert Siersma V, Jorgensen KJ, Marklund B, Brodersen J. Benefits and harms of screening men for abdominal aortic aneurysm in Sweden: a registry-based cohort study. Lancet. 2018; 391(10138): 2441-2447.

18.   Anjum A, Powell JT Is the incidence of abdominal aortic aneurysm declining in the 21st century? Mortality and hospital admissions for England & Wales and Scotland. Eur J Vasc Endovasc Surg. 2012; 43: 161-166.



Aim: was to estimate condition of aorta branches in case of aortic dissection, using multislice computed tomography (MSCT): we estimated frequency and type of changes of main branches of the aorta involved in the dissection.

Material and methods: a retrospective analysis of 104 patients with aortic dissection (AD) was performed. All patients were admitted to Scientific-Research Institute of Emergency Medicine named after N.V Sklifosovsky All studies were carried out on a multispiral (80x0.5) tomograph in early stages of the disease.

Results: MSCT method allowed to obtain data of the high frequency of transition of aortic dissection to main branches (63.5%), mainly to iliac arteries (81% and 77% of aortic dissection type A and B respectively), both in isolation and in combination with other branches. However, the frequency of occurrence of hemodynamically significant stenosis, both static and dynamic, was significantly higher in groups of visceral branches and brachiocephalic arteries (82% and 71%, respectively).

Conclusion: the CT method allows to evaluate in detail the lumen of the aorta and branches of aorta, and to determine type and degree of stenosis of aortic branches involved in the dissection. Revealed patterns of combining of involvement in different groups of aortic branches in the pathological process, allow to procced more optimized diagnostic search for complications of dissection, including MSCT.



1.     Hirst Ae Jr, Johns Vj Jr, Kime Sw Jr. Dissecting aneurysm of the aorta: A Review of 505 cases. Medicine (Baltimore). 1958;37(3):217-279. PMID: 13577293 195809000-00003 

2.     Litmanovich D, Bankier AA, Cantin L, Raptopoulos V. Boiselle PM. CT and MRI in Diseases of the Aorta. Am J Roentgenol. 2009;193(4):928-940. PMID:19770313

3.     Wheat MW Jr. Acute dissecting aneurysms of the aorta: diagnosis and treatment-1979. Am Heart. 1980; 99(3):373-387. PMID:7355699 0002-8703(80)90353-1

4.     Borst HG, Heinemann MK, Stone CD. Surgical treatment of aortic dissection. Churchill Livingstone International; 1996.

5.     Ternovor SK, Sinitsyn VE. Spiral and electron beam angiography. Moscow: Vidar; 1998. [In Russ]. 

6.     Gamzaev AB ogly, Pichugin VV, Dobrotin SS. Diagnosis, surgical treatment tactics and methods for ensuring operations for aortic dissection. In: Medvedev AP, Pichugin VV. Emergency heart surgery: current and unresolved issues. Nizhny Novgorod; 2015.p.237-281. [In Russ]. 

7.     Belov YuV, Komarov RN, Stepanenko AB, Gens AP Savichev DD. Common sense in determining indications for surgical treatment of thoracoabdominal aortic aneurysms. Pirogov Russian Journal of Surgery. 2010;(6):16-20. [In Russ].

8.     Braverman AC. Acute Aortic Dissection. Clinician Update. Circulation. 2010; 122(2): 184-188. PMID: 20625143

9.     Barmina TG, Zabavskaya OA, Sharifullin FA, Abakumov MM. Possibilities of spiral computed tomography in the diagnosis of damage to the thoracic aorta. Medical Visualization; 2010;(6):84-88. [In Russ].

10.   Strayer RJ, Shearer PL, Hermann LK. Evaluation, and early management of acute aortic dissection in the ED. Curr Cardiol Rev. 2012;8(2): 152-157. PMID:22708909

11.   Vu KN, Kaitoukov Y Morin-Roy F, Kauffmann C, Giroux MF, Therasse E, et al. Rupture signs on computed tomography, treatment, and outcome of abdominal aortic aneurysms. Insights Imaging. 2014;5(3):281-293. PM ID: 24789068 https://d0i.0rg/10.1007/s13244-014-0327-3

12.   Chiu KW, Lakshminarayan R, Ettles DF. Acute aortic syndrome: CT findings. Clin Radiol.2013;68(7):741-748. PMID:23582433 001

13.   Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo R, Eggebrecht H, et al. 2014 ESC guidelines on the diagnosis and treatment of aortic diseases. Europ Heart J. 2014 35(Is 41 ):2873-2926. PMID:25173340

14.   Lansman SL, Saunders PC, Malekan R, Spielvogel D. Acute aortic syndrome. J Thorac Cardiovasc Surg. 2010; 140 (6Suppl): S92-97. PMID:21092805

15.   Bonaca MP, O'Gara PT. Diagnosis and management of acute aortic syndromes: dissection, intramural hematoma, and penetrating aortic ulcer. Curr Cardiol Rep. 2014;16(10):536. PMID:25156302 10.1007/s11886-014-0536-x

16.   Tsai TT, Nienaber C, Eagle KA. Acute Aortic Syndromes. Circulation. 2005; 112(24): 3802-3813. PMID: 16344407

17.   Strayer RJ, Shearer PL, Hermann LK. Screening. evaluation, and early management of acute aortic dissection in the ED. Curr Cardiol Rev. 2012;8(2): 152-157. PMID: 22708909 157340312801784970

18.   Husainy MA, Sayyed F, Puppala S. Acute aortic syndromepitfalls on gated and nongated CT scan. Emerg Radiol. 2016;23(4):397-403. PMID:27220654

19.   Olsson C, Hillebrant CG, Liska J, Lockowandt U, Eriksson P, Franco-Cereceda A. Mortality in acute type A aortic dissection: validation of the Penn classification. Ann Thorac Surg. 2011 ;92(4):1376-1382. PMID:21855849

20.   Kruger T, Conzelmann LO, Bonser RS, Borger MA, Czerny M, Wildhirt S, et al. Acute aortic dissection type A. Br J Surg. 2012;99( 10): 1331-1344. PMID:22961510

21.   Toda R, Moriyama Y Masuda H, Iguro Y Yamaoka A, Taira A. Organ malperfusion in acute aortic dissection. Jpn J Thorac Cardiovasc Surg. 2000;48(9):545-550.PMID: 11030124

22.   Hallinan J, Anil G. Multi-detector computed tomography in the diagnosis and management of acute aortic syndromes. World J Radiol. 2014;6(6):355-365. PMID: 24976936

23.   Erbel R, Aboyans V, Boileau C, et al. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases. Kardiol Pol. 2014;72(12):1169-252. PMID:25524604

24.   Rubin GD. Helical CT angiography of the thoracic aorta. J Thorac Imaging. 1997;12(2): 128-149. PMID:9179826 199704000-00011 



Aim: was to determine characteristic signs of instability and threatening rupture of abdominal aortic aneurysms, detected by computed tomography (CT) according to analysis of modern literature.

Materials: international clinical recommendations and studies of 36 domestic and foreign authors on the diagnosis of abdominal aortic aneurysms (AAA) using computed tomography (CT) were studied. We studied publications that describe the pathogenetic mechanisms of AAA rupture, structural changes in the aortic wall and surrounding tissues, which can be regarded as signs of the formation of aneurysm rupture.

Conclusion: according to literature, specific CT signs of aortic wall instability and data on the high diagnostic value of some of them are presented. Methodological aspects of the analysis of CT data are described for large aneurysms and complex configurations.



1.      Pokrovskij A.V. (red.). Clinical Angiology: practical guide in in 2 vol. M.: Medicina. 2004. [In Russ]

2.      Davis C.A. Computed tomography for the diagnosis and management of abdominal aortic aneurysms. Surg. Clin. North Am. 2011; 91(1): 185-193.

3.      National guidelines for the management of patients with abdominal aortic aneurysms. Angiologiya i serdechno-sosudistaya hirurgiya. 2013; 19 (2, Pril.): 72. [In Russ]

4.      Prokop M., Galanski M. (red.). Spiral and multilayer computed tomography: in 2 vol. 3-e izd. M.: MEDpress- info. 2011. [ [In Russ]

5.      Pleumeekers H.J., Hoes A.W., van der Does E., et al. Aneurysms of the abdominal aorta in older Aneurysms of the abdominal aorta in older adults. The Rotterdam Study. Am. J. Epidemiol. 1995; 142 (12): 1291-1299.

6.      Singh K., Bonaa K.H., Jacobsen B.K., et al. Prevalence and risk factors for abdominal aortic aneurysms in a ence and risk factors for abdominal aortic aneurysms in a population-based study: the Tromsu Study. Am. J. Epidemiol. 2001; 154 (3): 236-244.

7.      Ahmed M.Z., Ling L., Ettles D.F. Common and uncommon CT findings in rupture and impending rupture of abdominal aortic aneurysms. Clin. Radiol. 2013; 68(9): 962-971.

8.      Genovese E.A., Fonio P, Floridi C. et al. Abdominal vascular emergencies: US and CT assessment. Crit. Ultrasound J. 2013; 5(Suppl 1): S10.

9.      Wadgaonkar A.D., Black J.H. 3rd, Weihe E.K. et al. Abdominal aortic aneurysms revisited: MDCT with multi-planar meconstructions for identifying indicators of instability in the pre- and postoperative patient. Radiographics. 2015; 35 (1): 254-268.

10.    Vorp D. Biomechanics of abdominal aortic aneurysm. J. Biomech. 2007; 40(9): 1887-1902.

11.    Fillinger M.F., Racusin J., Baker R.K. et al. Anatomic characteristics of ruptured abdominal aortic aneurysm on conventional CT scans: Implications for rupture risk. J. Vasc. Surg. 2004; 39 (6): 1243-1252.

12.    Hinchliffe R.J, Alric P, Rose D. et al. Comparison of morphologic features of intact and ruptured aneurysms of infrarenal abdominal aorta. J. Vasc. Surg. 2003; 38(1): 88-92.

13.    Johnson P.T., Fishman E.K. IV contrast selection for MDCT: current thoughts and practice. AJR Am. J. Roentgenol. 2006; 186 (2): 406-415.

14.    Brewster D.C., Cronenwett J.L., Hallett J.W. Jr et al. Guidelines for the treatment of abdominal aortic aneurysms. Report of a subcommittee of the Joint Council of the American Association for Vascular Surgery and Society for Vascular Surgery. J. Vasc. Surg. 2003; 37(5): 1106-1117.

15.    Vu K.N., Kaitoukov Y, Morin-Roy F. et al. Rupture signs on computed tomography, treatment, and outcome of abdominal aortic aneurysms. Insights Imaging. 2014; 5 (3): 281-293.

16.    Halliday K.E., al-Kutoubi A. Draped aorta: CT sign of contained leak of aortic aneurysms. Radiology. 1996; 199(1): 41-43.

17.    Yuksekkaya R., Koner A.E., Celikyay F. et al. Multidetector computed tomography angiography findings of chronic-contained thoracoabdominal aortic aneurysm rupture with severe thoracal vertebral body erosion. Case Rep. Radiol. 2013; 2013: 596517.

18.    Schwartz S.A., Taljanovic M.S., Smyth S. et al. CT findings of rupture, impending rupture, and contained rupture of abdominal aortic aneurysms. AJR Am. J. Roentgenol. 2007; 188 (1): W57-62.

19.    Mehard W.B., Heiken J.P., Sicard G.A. High-attenuating crescent in abdominal aortic aneurysm wall at CT: a sign of acute or impending rupture. Radiology. 1994; 192(2): 359-362.

20.    Radiological diagnosis of diseases of the heart and blood vessels: a national guide. (edited by L.S. Kokova). M.: GEHOTAR-Media. 2011; 256. [ [In Russ]

21.    Erbel R., Aboyans V., Boileau C. et al. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur. Heart J. 2014; 35 (41): 28732926.

22.    Vorp D.A., Raghavan M.L., Webster M.W. Mechanical wall stress in abdominal aortic aneurysm: Influence of diameter and asymmetry. J. Vasc. Surg. 1998; 27(4): 632639.

23.    Fillinger M.F., Raghavan M.L., Marra S.P. et al. In vivo analysis of mechanical wall stress and abdominal aortic aneurysm rupture risk. J. Vasc. Surg. 2002; 36(3): 589-597.

24.    Kontopodis N., Metaxa E., Papaharilaou Y et al. Advancements in identifying biomechanical determinants for abdominal aortic aneurysm rupture. Vascular. 2015; 23(1): 65-77.

25.    Doyle B.J., Callanan A., Burke P.E. et al. Vessel asymmetry as an additional diagnostic tool in the assessment of abdominal aortic aneurysms. J. Vasc. Surg. 2009; 49(2): 443-454.

26.    Giannoglou G., Giannakoulas G., Soulis J. et al. Predicting the risk of rupture of abdominal aortic aneurysms by utilizing various geometrical parameters: Revisiting the diameter criterion. Angiology. 2006; 57(4): 487-494.

27.    Georgakarakos E., Ioannou C.V., Kamarianakis Y et al. The role of geometric parameters in the prediction of abdominal aortic aneurysm wall stress. Eur. J. Vasc. Surg. 2010; 39(1): 42-48.

28.    Moxon J.V., Adam Parr, Emeto T.I. et al. Diagnosis and monitoring of abdominal aortic aneurysm: Current status and future prospects. J. Curr. Probl. Cardiol. 2010; 35: 512-548.

29.    Polzer S., Gasser T.C., Swedenborg J., Bursa J. The impact of intraluminal thrombus failure on the mechanical stress in the wall of abdominal aortic aneurysms. Eur. J. Vasc. Endovasc. Surg. 2011; 41 (4):467-473.

30.    Hunter G.C., LeongS.C., Yu G.S. Aortic blebs: Possible site of aneurysm rupture. J. Vasc. Surg. 1989; 10(1): 93-99.

31.    Rakita D., Newatia A., Hines J.J. et al. Spectrum of CT findings in rupture and impending rupture of abdominal aortic aneurysms. RadioGraphics. 2007; 27(2): 497-507.

32.    Oldenburg W.A., Almerey T. Erosion of lumbar vertebral bodies from a chronic contained rupture of an abdominal aortic pseudoaneurysm. J. Vasc. Surg. Cas. Innovat. Techn. 2016; 2(4): 197-199.

33.    Endovascular aneurysm repair vs. open repair in patients with abdominal aortic aneurysm (EVAR trial 1): randomized control trial. Lancet. 2005; 365: 2179-2186.

34.    Zarins C.K., White R.A., Fogarty T.J. Aneurysm rupture after endovascular repair using the aneurx stent graft. J. Vasc. Surg. 2000; 31(5): 960-970.

35.    Zarins C.K., White R.A., Hodgson K.J. et al. Endoleak as a predictor of outcome after endovascular aneurysm repair: AneuRx multicenter clinical trial. J. Vasc. Surg. 2000; 32(1): 90-107.

36.    Bernhard V.M., Mitchell R.S., Matsumura J.S. et al. Ruptured abdominal aortic aneurysm after endovascular repair. J. Vasc. Surg. 2002; 35(6): 1155-1162.



Aim: was to define possibilities of multispiral computed tomography (MSCT) in assessment of condition of aorta and it's branches, during preparation for reconstructive surgery in patients with horseshoe kidney.

Material and methods: for the period 2015-2018, 415 patients were examined during preparation for aortic reconstructive surgery. Patient underwent target ultrasonic diagnostics, followed by computed tomography made on 256-slice Philips iCT, before and after injection of contrast agent. We used a special program for comparing various phases of the study ("Fusion") for better visualization of arterial vessels of kidney, aorta and renal excretory system. In 5 cases, a combination of aortic pathology with abnormal horseshoe kidney was revealed.

Results: in all cases we revealed branched type of blood supply of abnormal kidney A total of 5 patients had 25 renal arteries. In 4 cases we revealed branched type of renal veins, its total ammount was 20. Duplication of upper urinary tract was found in 1 case. From the surveyed group, 3 patients out of 5 were operated. Intraoperatively all data detected by CT scan regarding the condition of the aorta, the position of the kidney, the number of renal vessels were confirmed.

Conclusion: MSCT allows detailly assessment of anatomical features of abnormal horseshoe kidney and facilitates subsequent surgical intervention in patients with a rare combination of aortic pathology and a horseshoe kidney.



1.       Kirkpatrick J.J., Leslie S.W. Horseshoe Kidney. In: StatPearls [Internet], 2018.

2.       Gianfagna F., Veronesi G., Bertu L, et al. Prevalence of abdominal aortic aneurysms and its relation with cardiovascular risk stratification: protocol of the Risk of Cardiovascular diseases and abdominal aortic Aneurysm in Varese (RoCAV) population based study. BMC Cardiovasc Disord. 2016;16(1):243. Published 2016 Nov 29. doi:10.1186/s12872-016-0420-2.

3.       Joanna Mikolajczyk-Stecyna, Aleksandra Korcz, Marcin Gabriel et al. Risk factors in abdominal aortic aneurysm and aortoiliac occlusive disease and differences between them in the Polish population. Scientific Reports (2013) volume3: 3528.

4.       Davidovic L Markovic M, Ilic N et al. Repair of abdominal aortic aneurysms in the presence of the horseshoe kidney. IntAngiol. 2011 Dec;30(6):534-40.

5.       Kumar Y, Hooda K, L.i S., Goyal P, et al. Abdominal aortic aneurysm: pictorial review of common appearances and complications. Ann TranslMed. 2017;5(12):256.

6.       Stephen P Reis, Bill S. Majdalany, Ali F. AbuRahma et al., ACR Appropriateness Criteria Pulsatile Abdominal Mass Suspected Abdominal Aortic Aneurysm. J Am Coll Radiol 2017;14:S258-S265

7.       CHekhoeva O.A., Buryakina S.A., Alimurzaeva M.Z., Gontarenko V.N. Aneurysm of the infrarenal aorta in combination with a horseshoe-shaped kidney: case report. Medicinskaya vizualizaciya №3 2016. C.: 63-70. [In Russ.] 

8.       B.V. Fadin, A.B. Mal'gin, S.V. Berdnikov i dr. Aneurysm of the abdominal aorta in combination with a horseshoe-shaped kidney. ZHurnal angiologiya i sosudistaya hirurgiya . 2002 TOM 8 №3 Str. 113-119. [In Russ.]

9.       Ignat'ev I.M., Volodyuhin M.YU., Zanochkin A.V. Endoprosthetics of the abdominal aortic aneurysm in a patient with a horseshoe-shaped kidney. Arhitektura zdorov'ya. [Internet souce] tekushchee-izdanie/zdorove-i-meditsina/klinicheskie- issledovaniya/11-endoprotezirovanie-anevrizmy-bryush- noj-aorty-u-patsienta-s-podkovoobraznoj-pochkoj

10.     Troickij V.I., Habazov R.I., Lysenko E.R. i dr. Surgical treatment of abdominal aortic aneurysm in a patient with a horseshoe-shaped kidney. Angiologiya i sosudistaya hirurgiya. 2003; 9 (2): 122-125. [In Russ.]



Background: expansion of tourism business in countries of South and Southeast Asia, Africa, and South America led to the appearance of rare parasitic diseases in Russia, Europe, and the United Kingdom. In our country, more than 1.3 million patients with various parasitosis are officially registered annually, among which there is an increase in the incidence of intestinal protozoa.

Aim: was to show features of the diagnosis of acute manifestations of necrotic amebic colitis, which simulated severe intoxication with manifestation of clinics of acute surgical disease and intestinal bleeding

Material and methods: using the example of case report of a 70-year-old woman, the possibility of complex diagnostics using abdominal ultrasound, abdominal computed tomography, colonoscopy with biopsy of intestinal ulcers and parasitological research methods is shown. Results: detoxification, anti-inflammatory therapy in a surgical hospital and instrumental examination allowed us to objectively evaluate and conduct targeted therapy avoiding serious complications.

Discussion: primary lesions with acutely occurring both local and general body reactions lead to severe intoxication, which does not allow to exclude acute surgical pathology, and in some cases dictate the need for urgent surgical intervention.

Differential diagnosis of an amoeba with a colon cancer only on the basis of x-ray symptoms is almost impossible. Specific anti-ameba therapy leads to the disappearance of amoeba.

Conclusion: only on the basis of a complex of clinical and epidemiological data, ultrasound, CT, colonoscopy, histological analysis and parasitological methods of research, pathology can be correctly identified. 



1.      Bronshtejn A.M., Malyshev N.A., Luchshev V.I. Amebiasis: clinical features, diagnosis, treatment. Klinicheskaya mikrobiologiya i antimikrobnaya himioterapiya. 2001; 3(3): 215-222 [In Russ.].

2.      Gostishchev V.K., Khrupkin V.I., Afanas'ev A.N., Gorbacheva I.V. The complicated intestinal amebiasis in emergency surgery. Xirurgiya. 2009; (5): 4-9 [In Russ.].

3.      Lisicyn K.M., Revskoj A.K. Urgent abdominal surgery for infectious and parasitic diseases. M: Medicina, 1988: 237-271 [In Russ.].

4.      Petridou C, Al-Badri A, Dua A, et al. Learning points from a case of severe amoebic colitis. Infez Med. 2017; 25(3): 281-284. PMID: 28956549

5.      Cook G.C. Parasitic infections of gastrointestinal tract: a worldwide clinical problem. Curr Opin Gastroenterol.1989; 2(Is1): 126-139.

6.      Ozereczkovskaya N.N. Organ pathology in the acute stage of tissue helminthiases: the role of blood and tissue eosinophilia, immunoglobulinemia E, G4 and factors that induce an immune response. Medicinskaya parazitologiya iparazitarny'e bolezni. 2000; (3): 3-8 [In Russ.].

7.      Romanenko N.A. Modern tasks of sanitary parasitology. Medicinskaya parazitologiya i parazitarny'e bolezni. 2001; (4): 25-29 [In Russ.].

8.      Sergiev V.P, Filatov N.N. Infectious diseases at the turn of the century: an awareness of the biological threat. Moskva: Nauka, 2006; 572 s [In Russ.].

9.      Kry'lov M.V. The determinant of parasitic protozoa (human, domestic animals and agricultural plants). Sankt-Peterburg: ZIN, 1996; 602 s [In Russ.].

10.    Eryuxin I.A., Xrupkij V.I. (red.) Experience of medical support of troops in Afghanistan 1979-1989 V. 2: Organization and scope of surgical care for the wounded. Moskva, 2002: 379-386 [In Russ.].

11.    Scherbakov I.T., Leonteva N.I., Chebyshev N.V., i dr. Pathomorphology of colonic mucosa in patients with chronic post-parasitic colitis. Aktual'ny'e voprosy' infekcionnojpatologii. 2014; 95(6): 934- 938 [In Russ.].

12.    Ellyson J.K, Bezmalinovic Z., Parks S.N, Lewis F.R. Necrotizing amebic colitis: a frequently fatal complication. Am J Surg. 1986; 152(1): 21-26. PMID: 3728812.

13.    Shirley DA, Moonah S. Fulminant amebic colitis after corticosteroid therapy: a systematic review. PLoS Negl Trop Dis. 2016; 10(7): e0004879.

14.    Guzeeva T.M. Status the incidence of parasitic diseases in the Russian Federation and tasks in terms of the reorganization of the service. Medicinskaya parazitologiya i parazitarny'e bolezni. 2008; (1): 3-11 [In Russ.].

15.    Weitzel T, Carbera J, Rosas R, et al. Enteric multiplex PCR panels: A new diagnostic tool for amoebic liver abscess? New Microbes New Infect. 2017; 18: 50-53. PMID: 28626584 DOI:10.1016/j.nmni.2017.05.002.

16.    Abbas М.А., Mulligan D.C., Ramzan N.N., et al. Colonic perforation in unsuspected amebic colitis. Dig Dis Sci. 2000; 45(9): 1836-1841. PMID: 11052328.

17.    Sinharay R., Atkin G.K., Mohamid W., Reay-Jones N. Caecal amoebic colitis mimicking a colorectal cance. J Surg Case Rep. 2011; (11): 1. PMID: 24972391 DOI:10.1093/jscr/2011.11.1.

18.    Delabroussea E., Ferreirab F., Badeta N., et al. Coping with the problems of diagnosis of acute colitis. Diagn Intervent Imaging. 2013; 94(7-8): 793—804. PMID: 23751227 DOI:10.1016/j.diii.2013.03.012. 



Aim: was to improve diagnostics of neck vessels' damage, by methods of traditional and CT-angiography

Material and methods: 65 injured patients with suspected damage of neck major vessels underwent examination. 52 persons had open traumas of the neck, 13 persons had closed traumas of the neck. Radiological diagnostics included CT-angiography and traditional angiography Main aim of examination was in determination of damage including both vessels and other structures of the neck, their localization and the nature of damage.

Results: CT-angiography gave possibilities:

           to give exact characterictics of all traumatic injures of the neck and to choose the group of patients with vessel traumas (23 patients)

           to define exactly the nature of the damage of neck vessels (aneurysm, thrombosis, rupture);

           to control the effectiveness of the surgical intervention.

Traditional angiography was applied in 10 observations of the traumatic aneurysm of neck vessel, for search of the additional diagnostic information. In comparison with results of CT- angiography any other precise information was not received.

Conclusions: analysis of the traditional and CT-angiography diagnostic possibilities of vessels damage, accompanying cervical trauma demonstrated high effectiveness of both methods. Traditional angiography should be used in absence of CTA in diagnostic arsenal. 



1.      Korzhuk M.S., Kozlov K.K., Tkachev A.G. at al. Problems of medical care for injuries of major vessels of the neck. Sovremennye problemy nauki i obrazovaniya. 2014; 6: 1039 [In Russ].

2.      Mosyagin V.B., Slobozhankin A.D., Chernysh A.V et al. Experience in surgical treatment of closed lesions of major vessels of the neck. Vestnik Rossijskoj voenno-medicinskojakademii. 2013; 1 (41): 80-83 [In Russ].

3.      Vereshchagin S.V., Ahmad M.M.D., Kucher V.N. et al. The first experience of endovascular treatment of posttraumatic false aneurysms of aortic arch branches. Endovaskulyarna nejrorentgenohirurgiya. 2014; 2 (8): 64-70 [In Russ].

4.      Abakumov M.M. Multiple and combined wounds of the neck, chest, abdomen. Rukovodstvo dlya vrachej. 2013; 688 [In Russ].

5.      Mosyagin V.B, Chernysh A.V, Ryl'kov V.F. et al. Experience of surgical treatment of wounds of the neck. Vestnik Rossijskoj voenno-medicinskoj akademii. 2012; 3 (39): 86-90 [In Russ].

6.      Shabonov A.A., Trunin E.M. Treatment of wounds and injuries of major vessels of the neck. Vestnik Avicenny. 2011; 2 (47): 135-141 [In Russ].

7.      Sayyed Ehtesham Hussain Naqvi, Eram Ali, Mohammed Haneef Beg et al. Successful Resuscitation of a Cardiac Arrest following Slit Neck and Carotid Artery Injury: A Case Report. Journal of Clinical and Diagnostic Research. 2016; 10 (6): 25-27.

8.      Halimova A.A. Post-traumatic dissection of vertebral and major arteries as a complication of mechanical injury of the carotid artery on the background of a light traumatic brain injury. Nejrohirurgiya i nevrologiya Kazahstana. 2012; 4 (29): 29-32 [In Russ].

9.      Komelyagin D.Yu., Dubin S.A., Vladimirov F.I. et al. Clinical case of treatment of a patient with post-traumatic arteriovenous fistula in the neck. Detskaya hirurgiya. 2015;19 (5): 50-53 [In Russ].

10.    Griessenauer C.J., Foreman P.M, Deveikis J.P. et al. Optical coherence tomography of traumatic aneurysms of the internal carotid artery: report of 2 cases. J Neurosurg. 2016; 124 (2): 305-9.

11.    Shtejnle A.V., Alyab'ev F.V., Duduzinskij K.Yu. at al. History of surgery damages blood vessels of the neck. Sibirskij medicinskij zhurnal. 2008; 23 (2): 87-97 [In Russ]



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. 



1.      Fitzgibbon GM, Kafka HP, Leach AJ, Keon WJ, Hooper GD, Burton JR. Coronary bypass graft fate and patient outcome: angiographic follow-up of 5,065 grafts related to survival and reoperation in 1, 388 patients during 25 years. J Am Coll Cardiol. 1996; 28: 616-626.

2.      Loop FD, Lytle BW, Cosgrove DM, Stewart RW, Goormastic M, Williams GW, Golding LA, Gill CC, Taylor PC, Sheldon WC. Influence of the internal mammary artery graft on 10-year survival and other cardiac events. N Engl J Med 1986; 314: 1-6.

3.      Ropers D, Pohle FK, Kuettner A, Pflederer T, Anders K, Daniel WG, Bautz W, Baum U, Achenbach S. Diagnostic accuracy of noninvasive coronary angiography in patients after bypass surgery using 64-slice spiral computed tomography with 330-ms gantry rotation. Circulation. 2006;114: 2334-2341.

4.      Dikkers R, Willems TP, Tio RA, Anthonio RL, Zijlstra F, Oudkerk M. The benefit of 64-MDCT prior to invasive coronary angiography in symptomatic post-CABG patients. Int J Cardiovasc Imaging. 2007; 23(3): 369-377.

5.      Lee R, Lim J, Kaw G, Wan G, Ng K, Ho KT. Comprehensive noninvasive evaluation of bypass grafts and native coronary arteries in patients after coronary bypass surgery: accuracy of 64-slice multidetector computed tomography compared to invasive coronary angiography. J Cardiovasc Med (Hagerstown). 2010; 11(2): 81-90.

6.      Laynez-Carnicero A, Estornell-Erill J, Trigo-Bautista A, Valle-Mutz A, Nadal-Barangй M, Romaguera-Torres R, Planas del Viejo A, Corb-Pascual M, Payб-Ser- rano R, Ridocci-Soriano F. Non-invasive assessment of coronary artery bypasss grafts and native coronary arteries using 64-slice computed tomography: comparison with invasive coronary angiography. Revista espanola de cardiologia. 2010; 63(2): 161-169.

7.      Heye T, Kauczor HU, Szabo G, Hosch W. Computed tomography angiography of coronary artery bypass grafts: robustness in emergency and clinical routine settings. Acta Radiol. 2014; 55(2): 161-170.

8.      Bourassa MG. Fate of venous grafts: the past, the present and the future. J Am Coll Cardiol. 1991; 5: 1081-1083.

9.      Nikonov ME. Possibilities of multispiral computed tomography in assessing the patency of coronary grafts in early and late periods in patients undergoing aortic and mammarocoronary bypass graft surgery. REJR. 2013; 3 (1): 18-27 [In Russ].

10.    ACC/AHA/ACP — ASIM Practice guidlines. ACC/AHA/ACP — ASIM Guidelines for the management of patients with chronic stable angina. Am Coll Cardiac. 1999; 33(7): 2092-2097.

11.    Tochii M, Takagi Y Anno H, Hoshino R, Akita K, Kondo H, Ando M. Accuracy of 64-slice multidetector computed tomography for diseased coronary artery graft detection. Annals of Thoracic Surgery. 2010; 89(6): 1906-1911.

12.    Shimanovsky NL. Safety of iodine-containing radiopaque agents in the light of new recommendations from international associations of experts and clinicians. REJR. 2012; 2 (1): 12-19 [In Russ].

13.    Campbell PG, Teo KS, Worthley SG, Kearney MT, Tarique A, Natarajan A, Zaman AG. Non-invasive assessment of saphenous vein graft patency in asymptomatic patients. Br J Radiol. 2009 Apr; 82(976):291-5. doi: 10.1259/bjr/19829466.

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.

17.    Deb S, Cohen EA, Singh SK, Une D, Laupacis A, Fremes SE RAPS Investigators. Radial artery and saphenous vein patency more than 5 years after coronary artery bypass surgery: results from RAPS (Radial Artery Patency Study). J Am Coll Cardiol. 2012 Jul 3;60(1):28-35. doi: 10.1016/j.jacc.2012.03.037.



Background: leiomyosarcoma of veins is a rare group of sarcomas of mesenchymal origin, which develops from smooth muscle cells of vascular . Vascular leiomyosarcoma occurs in 2-5% and have a slow growth. It is rather difficult to diagnose this disease on the basis of only clinical symptoms, most often patients are worried about oedema and pain in lower limbs. To establish the diagnosis, it is necessary to use data of instrumental methods of examination, such as ultrasound, magnetic resonance imaging (MRI) and multispiral computed tomography (MSCT) with intravenous contrast enhancement, which allow to determine the tumor localization, prevalence, involvement of the vessel wall in the process, as well as to exclude distant metastases. The final diagnosis is made according to immunohistochemical studies.

Aim: was to study the importance of radiadiagnostics methods in case of such rare disease as leiomyosarcoma of the external iliac vein.

Material and methods: 67-year-old woman with complaints of oedema of the lower limb, was examined: an ultrasound study of inferior vena cava and veins of lower limbs, magnetic resonance imaging (MRI) and multispiral computed tomography (MSCT) with contrast enhancement, fine-needle aspiration biopsy Patient underwent operation: «removal of the pelvic retroperitoneal tumor with resection of the external iliac vein' segment and pelvic lymph node dissection.» Histological examination: leiomyosarcoma, G2 FNCLCC.

Results: control MSCT - data on the recurrence of the iliac vein tumor and metastatic lesion of organs of chest, abdominal and pelvic cavity were not obtained.

Conclusions: a complex of diagnostic methods allows you to properly diagnose. And among these methods, multiphase computed tomography is one of the best imaging method, which shows not only the localization of the tumor, but also helps in staging, excluding or confirming vein thrombosis, solving the issue of resectability of the tumor and identifying distant metastasis. 



1.      Le Minh T, Cazaban D, Michaud J. et al. Great saphenous vein leiomyosarcoma: a rare malignant tumor of the extremity-two case reports. Ann Vasc Surg. 2004; 18(2): 234-236.

2.      Yucel Yankol, Nesimi Mecit, Turan Kanmaz et al. Leiomyosarcoma of the retrohepatic vena cava: Report of a case treated with resection and reconstruction with polytetrafluoroethylene vascular graft. Ulus Cerrahi Derg 2015; 31: 162-165.

3.      Tripodi E, Zanfagnin V, Fava C. et al. Leiomyosarcoma of the Right Iliac Veins presenting as a pelvic mass: a case report. Obstet. Gynecol. cases Rev. 2015; 2 (3): 1-4.

4.      Mei Zhang, MDa, Feng Yan et al. Multimodal ultrasonographic assessment of leiomyosarcoma of the femoral vein in a patient misdiagnosed as having deep vein thrombosis: a case report. Medicine. 2017: 96(46): 1-5.

5.      Pavlov A.YU., Garmash S.V., Isaev T.K. i dr. Sovremennye predstavleniya o lejomiosarkomah ven zabryushinnogo prostranstva. Obzor klinicheskih sluchaev. [Modern ideas about leiomyosarcoma veins retroperitoneal space. Review of clinical cases.] Onkourologiya. 2016; 12(2): 92-96 [in Russ].

6.      Watanabe K, Tajino T, Sekiguchi M. et al. h-Caldesmon as a Specific Marker for Smooth Muscle Tumors. Am. J. Clin. Pathol. 2000; 113 (5): 663-668.

7.      Weiss SW, Goldblum JR. Enzinger and Weiss's Soft Soft Tissue Tumors. 6th ed. Philadelphia. 2014; 549-568.

8.      Gonzales-Cantu Ye.M., Tena-Suck M.L., Serna-Reyna S. et al. Leiomyosarcoma of vascular origin: case report. Case Rep. in Clinical Pathology. 2015; 2(4): 60-64

9.      Мацко Д.Е. Современные представления о морфологической классификации сарком мягких тканей и их практическое значение. Практическая онкология. 2013; 14 (2): 77-86.

10.    Чуканов Е., Никитина О., Марио Таха. Лейомиосаркома нижней полой вены. Променева дагностика, променева терапiя. 2014; 4: 69-72.

11.    Ahluwaliya A., Saggar K., Sandhu P. et al. Primary leiomyosarcoma of inferior vena cava: an unusual entity.. Indian Journal of Radiology and Imaging. 2002; 12(4): 515-516.

12.    Dzsinich C., Gloviczki P., Van Heerden J. A. et al. Primary venous leiomyosarcoma: a rare but lethal disease. Journal of Vascular Surger. 1992; 15(4): 595-603.

13.    Kaprin A.D., Galkin V.N., Zhavoronkov L.P., Ivanov V.K., Ivanov S.A., Romanko Yu.S. Synthesis of basic and applied research is the basis of obtaining high-quality findings and translating them into clinical practice. Radiation and risk. 2017; 26(2): 26-40.



Background: the cause of the development of traumatic hernias of the diaphragm is its damage due to open or closed injury In modern conditions, the diaphragm injury is most common trauma in falling from height and car accidents (multiple trauma), and can be unnoticed in againts the background of other injuries.

The dislocation of abdominal organs into the pleural cavity occurs in various, sometimes long, time periods after trauma. This situation is determined by the gradual increase in the size of the defect due to the difference in pressure in the abdominal and pleural cavities.

Aim: was to study the importance of radiodiagnosis of traumatic hernias of the diaphragm.

Materials and methods: two rare clinical cases of traumatic diaphragmatic hernias are presented. In one observation - a woman of 81 years, in the second - a 66 years old man. Results: a woman with a history of trauma as a result of a car accident 10 years ago, basec on a comprehensive survey, revealed posttraumatic hernia of the right half of the diaphragm with a dislocation into the pleural cavity of the small and large intestine.

In the second case report (male), an old rupture of the left half of the diaphragm of unknowr prescription of injury was revealed with the dislocation of the greater part of the intestine and the left kidney

Conclusion. To diagnose traumatic hernias of the diaphragm, a comprehensive examination of patients is necessary. Plain radiography can detect the dislocation of abdominal organs into the pleural cavity, and examination of the gastrointestinal tract with a water-soluble contrast drug is a violation of the passage.

Multi-slice computed tomography (MSCT) in case of such pathology, has a greater importance, because thin sections give the highest resolving power. The construction of multiplanar reformation allows obtaining more complete information on the dislocation of organs, visualizing the defect of the diaphragm and determining its exact localization.



1.      Abdominalnaia travma. Rukovodstvo dlia vrachei [Abdominal trauma. Guide-book for doctors](Pod red. A.S. Ermolova). M.: Vidar-M. 2010; 386-399. [In Russ].

2.      Korabelnikov I.D. Travmaticheskie diafragmalnye gryzhi [Traumatic diaphragmatic hernias] (Pod red. V.A. Chernavskogo). M.: Medgiz. 1951; 5-62 [ In Russ].

3.      Borisov A.E., Kubachev K.G., Kukushkin A.V. i dr. Diafragmalnye gryzhi. Diagnostika i khirurgicheskoe lechenie [Diaphragmatic hernias. Diagnosis and surgical treatment.] Vestnik khirurgii im. 1.1. Grekova. 2012; 171 (6): 38-42 [In Russ].

4.      Plekhanov A.N. Khirurgiia travmaticheskikh diafragmalnykh gryzh [Surgery of traumatic diaphragmatic hernias.] Vestnik khirurgii im 1.1. Grekova. 2012; 171(5): 107-110 [In Russ].

5.      Aliev S.A., Bairamov N.Iu., Aliev E.S. Osobennosti diagnostiki i taktiki khirurgicheskogo lecheniia razryvov diafragmy pri zakrytoi sochetannoi travme grudi i zhivota [Features of diagnosis and tactics of surgical treatment of diaphragm ruptures with closed combined injury of chest and abdomen.]. Vestnik khirurgii im. 1.1. Grekova. 2014; 173 (4): 66-72 [In Russ].

6.      Thiam O., Konate I., Gueye M.L. et al. Traumatic diaphragmatic injuries: epidemiological, diagnostic and therapeutic aspects. Springer Plus. 2016; 5 (1): 1614. doi: 10.1186/s40064-016-3291-1.

7.      Al Skaini M.S., Sardar A., Haroon H. et al. Traumatic diaphragmatic hernia: delayed presentation with tension viscerothorax - lessons to learn. Ann R Coll Surg Engl. 2013; 95 (2): 27-29. doi: 10.1308/ 003588413X 13511609955337.

8.      Fischer N.J., Aiono S. Delayed presentation of a traumatic diaphragmatic hernia presenting as a large bowel obstruction: a case report. ANZ J Surg. 2016; 86 (1-2): 9798. doi: 10.1111/ans.125968.

9.      Kubachev K.G., Kukushkin A.V, Zaitsev D.A. Diagnostika i khirurgicheskoe lechenie ushchemlennykh diafragmalnykh gryzh [Diagnosis and surgical treatment of strangulated diaphragmatic hernias.]. Vestnik SPbGU. 2012; Ser. 11. Vyp. 1: 89-97 [In Russ].

10.    Chikinev Iu.V., Drobiazgin E.A. Posttravmaticheskie diafragmalnye gryzhi (diagnostika i lechenie) [Post-traumatic diaphragmatic hernia (diagnosis and treatment).]. Acta Biomedical Scientifica. 2017; 2 (6): 163-166. [In Russ].

11.    Aissa A., Hassine A., Hajji H. et al. Complication rare d'une hernie diaphragmatique gauche post-traumatique. Rev Pneumol Clin. 2013; 69(6): 331-335. doi: 10.1016/j.pneumo.2013.04.006.

12.    Hajong R., Baruah A. Post-traumatic diaphragmatic hernia. Indian J Surg. 2012; 74 (4): 334-335. doi: 10.1007/s12262-012-0418-7.

13.    Ercan M., Aziret M., Karaman K. et al. Dual mesh repair for a large diaphragmatic hernia defect: An unusual case report. Int J Surg Case Rep. 2016; 28: 266-269. doi: 10.1016/j.ijscr. 2016.10.015.

14.    Al-Koudmani I., Darwish B., Al-Kateb K., Taifour Y Chest trauma experience over eleven-year period at al-mouassat university teaching hospital-Damascus: a retrospective review of 888 cases. J Cardiothorac Surg. 2012; 7: 35. doi: 10.1186/1749-8090-7-35.

15.    Akar E., Kaya H. Traumatic rupture of the diaphragm: A 22-patient experience. Biomedical Research. 2017; 28 (20): 8706-8710.

16.    Mikheev A.V., Trushin S.N., Bazzaev T.M. i dr. Ushchemlennaia pravostoronniaia travmaticheskaia diafragmalnaia gryzha [Strangulated right-sided traumatic diaphragmatic hernia.]. Al'manakh instituta khirurgii im. A.V. Vishnevskogo. 2017; 2: 148-149 [In Russ].

17.    Plaksin S.A., Kotelnikova L.P Dvustoronnie posttravmaticheskie diafragmalnye gryzhi [Two-sided post-traumatic diaphragmatic hernia.]. Vestnik khirurgii im. 1.1. Grekova. 2015; 174 (1): 47-51 [In Russ].

18.    Gali B.M., Bakari A.A., Wadinga D.W., Nganjiwa U.S. Missed diagnosis of a delayed diaphragmatic hernia as intestinal obstruction: a case report. Niger J Med. 2014; 23 (1): 83-85.

19.    Demuro J.P A delayed traumatic diaphragmatic hernia presenting with a bowel obstruction 20 years postinjury. J Clin Diagn Res. 2013; 7(4): 736-738. doi: 10.7860/JCDR/2013/4755.2898.

20.    De Nadai T.R., Lopes J.C., Inaco Cirino C.C. et al. Diaphragmatic hernia repair more than four years after severe trauma: Four case reports. Int J Surg Case Rep. 2015; 14: 72-76. doi: 10.1016/j.ijscr.2015.07.014.

21.    Wadhwa R., Ahmad Z., Kumar M. Delayed traumatic diaphragmatic hernia mimicking hydropneumothorax. Indian J Anaesth. 2014; 58 (2): 186-189. doi: 10.4103/ 0019-5049.130825.

22.    Falidas E., Gourgiotis S., Vlachos K., Villias C. Delayed presentation of diaphragmatic rupture with stomach herniation and strangulation. Am J Emerg Med. 2015; 33 (9): 1329. e1-3. doi: 10.1016/j.ajem.2015.02.052.

23.    Gao J.M., Du D.Y, Li H. et al. Traumatic diaphragmatic rupture with combined thoracoabdominal injuries: Difference between penetrating and blunt injuries. Chin J Traumatol. 2015; 18 (1): 21-26.

24.    Liao C.H., Chu C.H., Wu YT. et al. The feasibility and efficacy of laparoscopic repair for chronic traumatic diaphragmatic herniation: introduction of a novel technique with literaturereview. Hernia. 2016; 20 (2): 303-309. doi: 10.1007/s10029-015-1405-2.



Aim: was to evaluate possibilities of dual-energy multislice computed tomography (MSCT) in determining the composition of kidney stones.

Materials and methods: a dual-energy MSCT was performed in 60 patients with urolithiasis of different locations (63.3% male, 36.7% female). Two groups of patients were identified: with mixed (simultaneously, the patient was diagnosed with stones of urate and non-urate structure) and nonurate composition of stones. Out of 60 patients, 16 (10 patients from a mixed group and 6 from a

non-urate) were subjected to chemical analysis of stones by IR-spectrometry and X-ray phase analysis. Obtained data were compared with data of the dual-energy MSCT Results: in most cases (93,7 %), results of the chemical analysis of stones confirmed the structure of uroliths obtained by the dual-energy MSCT method.

Conclusions: The method of dual-energy multislice computed tomography is effective in determining the composition of stones of the urinary system, appears to be a promising method in the diagnosis of urolithiasis, and expands possibilities of modern urology in planning patients with urolithiasis.



1.      Akopyan A.V., Zorkin S.N., Vorobyova L.E., Shakhnovsky D.S., Mazo A.M. Ocenka sostava konkrementa v lechenii mochekamennoj bolezni. [Evaluation of the concrement in the treatment of urolithiasis.] Detskaya khirurgiya. 2015; 19(1): 42-45 (in Rus).

2.      Turk C., Knoll Т., Petrik А., Sarica K., Straub M., Seitz C. Guidelines on urolithiasis. European Association of Urology. 2014; 128 p.

3.      Suslyaeva N.M. Vozmozhnosti luchevyh metodov issledovaniya v diagnostike visceral'nogo ozhireniya. [Possibilities of radiation research methods in the diagnosis of visceral obesity.] Bulleten Sibirskoy Meditsini. 2010; 9(5): 121-128 (in Rus).

4.      Klimkova M.M., Sinitsin V.V., Mazurenko D.A., Bernikov E.V. Vozmozhnosti luchevyh metodov Perspektivy primeneniya dvuhehnergeticheskoj komp'yuternoj tomografii v diagnostike mochekamennoj bolezni i opredelenii himicheskogo sostava mochevyh kamnej (obzor literatury). v diagnostike visceral'nogo ozhireniya. [Prospects for the use of dual-energy computed tomography in the diagnosis of urolithiasis and the determination of the chemical composition of urinary stones (literature review).] Medical Imaging. 2016; 6: 84-92 (in Rus).

5.      Graser A. Dual energy CT characterization of urinary calculi: initial in vitro and clinical experience. Invest Radiol. 2008; 43(2): 112-119.

6.      Kapsargin F.P., Dyabkin E.V., Berezhnoy A.G. Sovremennye podhody hirurgicheskogo lecheniya mochekamennoj bolezni. [Modern approaches to the surgical treatment of urolithiasis.] Novosti khirurgii. 2013; 21(1): 101-106 (in Rus).

7.      Yanenko E.K., Merinov D.S., Konstantinova O.V., Epishov V.A., Kalinichenko D.N. Sovremennye tendencii v ehpidemiologii, diagnostike i lechenii mochekamennoj bolezni. [Modern trends in the epidemiology, diagnosis and treatment of urolithiasis]. Eхperim. I klinich. urology. 2012; 3: 19-24 (in Rus).

8.      Gucuk. A., Uyeturk U. Usefulness of hounsfield unit and density in the assessment and treatment of urinary stones. World J. Nephrol. 2014; 3(4): 282-286.

9.      Kapanadze L.B., Serova N.S., Rudenko V.I. Aspekty primeneniya dvuhehnergeticheskoj komp'yuternoj tomografii v diagnostike mochekamennoj bolezni. [Aspects of the use of dual-energy computed tomography in the diagnosis of urolithiasis.] Russian electronic journal of radiation diagnostics. 2017;1(3):165-173 (in Rus).

10.    Kambadakone A.R., Eisner B.H., Catalano O.A., Sahani D.V. New and evolving concepts in the imaging and management of urolithiasis: urologists' perspective. Radiographics. 2010; 30(3):603-623. DOI: 10.1148/rg. 303095146.

11.    Eliahou R., Hidas G., Duvdevani M., Sosna J. Determination of renal stone composition with dual-energy computed tomography: an emerging application. Seminars in Ultrasound, CT and MRI. 2010; 31(4): 315-320. DOI: 10.1053/j.sult.2010.05.002.

12.    Leng S., Huang A., Cardona J.M., Duan X., Williams J.C., McCollough C.H. Dual-Energy CT for Quantification of Urinary Stone Composition in Mixed Stones: A Phantom Study. American Journal of Roentgenology. 2016;207: 321-329. DOI: 10.2214/AJR.15.15692.

13.    Yadav B., Maharjan S. Characterization of Urinary Tract Stones with Dual Energy Computed Tomography. Radiography Open. 2017; 3(1): 11. DOI: 10.7577 /radopen.2001



Background: article describes possibilities of computed tomography (CT) in diagnosis of wide specter of acute surgical diseases.

Materials and methods: basing on CT data of 645 patients (period jan.2015-feb.2016, S.P Botkin Clinical Hospital) an analysis was made: analyzed frequency of different nosologies in practice of doctors in CT department of emergency hospital, discussed results of method.

Results: most frequent diseases: acute intestinal obstruction - 238 cases (37%), acute pancreatitis and pancreonecrosis - 168 cases (26%), urolithiasis - 84 cases (13%), traumatic injuries of abdominal organs - 51 cases (8%), other diseases - 104 cases (16%).

Conclusion: taking into consideration non-specific clinical features of acute abdomen that doesn't need urgent operation, CT appeared to be an indespensable diagnostic method in planing of treatment in group of such patients. Complex approach in diagnosis can decrease a level of unreasonable operations and increase level of medical care quality.



1.      Ziedses des Plantes CM, van Veen MJ, van der Palen J, Klaase JM, Gielkens HA, Geelkerken RH. The Effect of Unenhanced MRI on the Surgeons' DecisionMaking Process in Females with Suspected Appendicitis. World J Surg. 2016; 40(12):2881-2887.

2.      Shabunin A.V., Arablinskij A.V, Bedin V.V., Sidorova Ju.V., Lukin A.Ju., Shikov D.V. Klinicheskaja ocenka dannyh KT i MRT pri ostrom pankreatite [Clinical analysis of CT and MRI data in acute pancreatitis]. Rossijskij jelektronnyj zhurnal luchevoj diagnostiki. 2015; 18(2): 20-32 [In Russ].

3.      Gadeev A.K., Dzhordzhikija R.K., Lukanihin V.A., Ignat'ev I.M., Bredihin R.A., Damocev V.A. Nereshennye voprosy neotlozhnoj sosudistoj hirurgii [Indeterminate issues of urgent vascular surgery]. Vestnik sovremennoj klinicheskoj mediciny. 2013; 6: 137-142. [In Russ].

4.      Hubutija M.Sh., Jarcev P.A., Ermolov A.S., Guljaev A.A., Samsonov V.T., Levitanskij V.D. Neotlozhnaja laparoskopicheskaja hirurgija [Urgent laparoscopic surgery]. Zhurnal im. N.V. Sklifosovskogo Neotlozhnaja medicinskaja pomoshh'. 2011; 1: 36-39 [In Russ].

5.      Weir-McCall J., Shaw A., Arya A., Knight A., HowlettD.C. The use of preoperative computed tomography in the assessment of the acute abdomen. The Annals of The RoyalCollege of Surgeons of England. 2012; 94(2): 102-107.

6.       A.D., Vilson Dzh.I., Medvedev V.E. Radiologicheskij monitoring i rezul'taty miniinvazivnogo lechenija abscessov pecheni [Radiological monitoring and results of minimally invasive management of liver abscesses]. Promeneva diagnostika, promeneva terapija. 2015; 2: 50-56. [In Ukr].

7.      Parfenov V.E. i dr. Informacionnye materialy po neotlozhnoj hirurgicheskoj pomoshhi pri ostryh hirurgicheskih zabolevanijah organov brjushnoj polosti v Sankt-Peterburge za 2015 god [Information materials of urgent surgical treatment in acute surgical abdominal diseases in Saint Petersburg, 2015]. Sankt-Peterburg, 2016; 1-16 [In Russ].

8.      Vlasov A.P., Kukosh M.V., Saraev V.V. Diagnostika ostryh zabolevanij zhivota [Diagnostics of acute abdominal diseases ]. rukovodstvo. M., 2012: 448 [In Russ].

9.      Charyshkin A.L., Jakovlev S.A. Problemy diagnostiki i lechenija ostrogo appendicita [Problems in diagnostics and treatment of acute appendicitis ]. Ul'janovskij mediko-biologicheskij zhrnnal. 2015; 92-100 [In Russ].

10.    Jagin M.V. Diagnostika i lechenie neoslozhnennyh destruktivnyh form ostrogo appendicita [Diagnostics and treatment of uncomplicated destructive forms of acute appendicitis]. ZhurnalEducatio. 2015; 9-3(2): 135 [In Russ].

11.    Ramalingam V., Bates D.D., Buch K., Uyeda J., et. al. Diagnosing acute appendicitis using a nonoral contrast CT protocol in patients with a BMI of less than 25. Emerg Radiol. 2016 Oct;23(5):455-62. doi: 10.1007/s10140- 016-1421-2. Epub 2016 Jul 8.



Study presents data about bone quality in patients before and after lengthening of shin by transosseous osteosynthesis method.

Materials and methods: 168 patients with shortening or limb deformity, before treatment and after lengthening, underwent multislice computed tomography, with estimation of anatomical and radiological-morphological features of shin.

Results: according to data of X-ray examination and MSCT, patients with diagnosed achondroplasia, congenital or acquired shortenings - have initial restructuring of meta-diaphyseal tibial bone, that worsen during lengthening. Patients with subjectively insufficient growth, radiological-morphological changes developed in knee joint during lengthening, which appeared as bone density 

reduction, appearence of resorption areas, architectonics change and persisted in late period in patients older 35 years. Cortical plate density of tibial diaphysis in patients with shortening of different etiology, during MSCT, was characterized by age, nosological and topographic features and is one of the important parameter of the bone quality before and during treatment stages. Maximum density is marked in the middle third of diaphysis. Density and structure of cortical plate are changed during lengthening. Severe cortical plate density reduction is up to 350 HU on the line of maternal bone and regenerate.

Conclusion: bone quality in patients with different etiology of shin shortening, is determined by structure of meta-diaphyseal bone and structural and density features of cortical plate anc determine, in the greater degree, strength bone criteria changing during lengthening of shin.



1.      Aleksandrov Yu.M., Alekberov D.A., D'yachkov K.A. Rengenomorfologicheskie osobennosti dlinnykh kostey i perestroyka ikh struktury pri ustranenii deformatsii kolennykh sustavov u detey s posledstviyami gematogennogo osteomielita [Roentgenomorphological features of long bones and reorganization of their structure when correction of the knee deformities in children with hematogenous osteomyelitis consequences]. Vestnik khirurgii im. Grekova. 2014;173(2):61-65 [In Russ].

2.      Rodionova S.S., Torgashin A.N., Solod E.N. et al. Strukturnye parametry proksimal'nogo otdela bedrennoy kosti v otsenke ee prochnosti [Structural parameters of the proximal femur in the evaluation of its strength]. Vestnik travmatologii i ortopedii im. N.N. Priorova. 2014; (1):77-81 [In Russ].

3.      Bala Y, Chapurlat R., Cheung A.M. et al. Risedronate slows or partly reverses cortical and trabecular microarchitectural deterioration in postmenopausal women. J. Bone Miner. Res. 2014; 29 (2):380-388.

4.      Baum T, Grande Garcia E., Burgkart R. et al. Osteoporosis imaging: effects of bone preservation on MDCT- based trabecular bone microstructure parameters and finite element models. BMC Med. Imaging. 2015; 15:22.

5.      Garkavenko Yu.E., Yanakova O.M., Bergaliev A.N. Kompleksnyy monitoring protsessov osteogeneza distraktsionnogo regenerata u detey s posledstviyami gematogennogo osteomielita pri udlinenii nizhnikh konechnostey [Complex monitoring of the processes of distraction regenerated bone osteogenesis in children with hematogenous osteomyelitis consequences during the lower limb lengthening]. Travmatologiya i ortopediya Rossii. 2011;1(59):106-111 [In Russ].

6.      Gostishchev V.K., Lipatov K.V., Pisarenko L.V. et al. Prognozirovanie izmeneniy prochnosti dlinnykh trubchatykh kostey v khirurgii khronicheskogo osteomielita [Predicting changes in long tubular bone strength in chronic osteomyelitis surgery]. Khirurgiya. Zhurn. im. N.I. Pirogova. 2010;(2):4-6 [In Russ].

7.      D'yachkov K.A., D'yachkova G.V., Novikov K.I. et al. Dinamika pokazateley kostnoy plotnosti bedrennoy i bol'shebertsovoy kostey u bol'nykh posle udlineniya nizhney konechnosti [Dynamics of femoral and tibial bone density values in patients after lower limb lengthening]. Ilizarovskie chteniya: materialy nauch.-prakt. konf. [Ilizarov readings: materials of scientific-practical conference]. Kurgan. 2012; 107-108 [In Russ].

8.      Stupina T.A., Shchudlo N.A., Petrovskaya N.V. et al. Gistomorfometricheskiy analiz sustavnogo khryashcha i sinovial'noy obolochki kolennogo sustava pri metadiafizarnom udlinenii goleni: (eksperimental'no-morfologicheskoe issledovanie) [Histomorphometrical analysis of the knee articular cartilage and synovium for metadiaphyseal lengthening of the leg: (an experimental and morphological study)]. Travmatologiya i ortopediya Rossii. 2013;1:80-86 [In Russ].

9.      Ahmed L.A., Shigdel R., Joakimsen R.M. et al. Measurement of cortical porosity of the proximal femur improves identification of women with nonvertebral fragility fractures. Osteoporos. Int. 2015; 26 (8): 2137-2146.

10.    Bala Y, Bui Q.M., Wang X.F. et al. Trabecular and cortical microstructure and fragility of the distal radius in women. J. Bone Miner. Res. 2015; 30(4): 621-629.

11.    Baumgartner R., Heeren N., Quast D. et al. Is the cortical thickness index a valid parameter to assess bone mineral density in geriatric patients with hip fractures? Arch. Orthop. Trauma Surg. 2015;135(6): 805-810.

12.    D'yachkov K.A., D'yachkova G.V. Remodelirovanie kosti pri udlinenii konechnosti: kolichestvennaya i kachestvennaya otsenka [Bone remodeling during limb lengthening: a qualitative and quantitative evaluation]. Zhurn. klinich. i eksperiment. ortopedii im. G.A. Ilizarova (Geniy Ortopedii). 2015; 4: 53-60 [In Russ].

13.    Nikitinskaya O.A. Rol' kortikal'noy kosti i ee mikrostruktury v prochnosti kosti [The role of cortical bone and its microstructure in bone strength]. Consilium Medicum. 2010; 12 (2): 132-135 [In Russ].

14.    Chuyko A.N., Kopytov A.A. Komp'yuternaya tomografiya i osnovnye mekhanicheskie kharakteristiki kostnykh tkaney. [Computed tomography and basic mechanical features of bone tissues] Med. vizualizatsiya. 2012;1:102-107 [In Russ].

15.    Chappard D., Bas^ M.F., Legrand E. et al. New laboratory tools in the assessment of bone quality. Osteoporos. Int. 2011; 22(8):2225-2240.

16.    Chen H., Zhou X., Shoumura S. et al. Age- and gender-dependent changes in three-dimensional microstructure of cortical and trabecular bone at the human femoral neck. Osteoporos. Int. 2010;21(4):627-636.

17.    Burr D.B. Bone quality: understanding what matters. J. Musculoskel. Neuronal Interact. 2004;4(2):184- 186.

18.    Hernandez C.J., Keaveny T.M. A biomechanical perspective on bone quality. Bone. 2006; 39(6): 11731181.

19.    Misch C.E. Bone density: A key determinant for clinical success. In: Contemporary Implant Dentistry. 2nd ed. (Ed. by C.E. Misch). St Louis: Mosby. 1999;109-118.

20.    Rebaudi A., Trisi P., Cella R., Cecchini G. Preoperative evaluation of bone quality and bone density using a novel CT/microCT-based hard-normal-soft classification system. Int. J. Oral Maxillofac. Implants. 2010;25(1):75- 85.

21.    D'yachkov K.A., D'yachkova G.V., Aranovich A.M. et al. Dinamika remodelirovaniya kosti u bol'nykh akhondroplaziey posle udlineniya nizhnikh konechnostey po dannym MSKT [Dynamics of bone remodeling in patients with achondroplasia after lower limb lengthening according to MSCT data]. Geniy ortopedii. 2014;4:67-71 [In Russ].

22.    Ogarev E.V., Morozov A.K. Diagnosticheskie vozmozhnosti mul'tispiral'noy komp'yuternoy tomografii v otsenke sostoyaniya tazobedrennogo sustava u detey i podrostkov [Diagnostic potentials of multispiral computed tomography in the evaluation of the hip condition in children and adolescents]. Vestnik travmatologii i ortopedii im. N.N. Priorova. 2013; 4: 68-75 [In Russ].

23.    Chang G., Honig S., Liu Y et al. 7 Tesla MRI of bone microarchitecture discriminates between women without and with fragility fractures who do not differ by bone mineral density. J. Bone Miner. Metab. 2015; 33(3): 285-293.

24.    Tjong W., Nirody J., Burghardt A.J. et al. Structural analysis of cortical porosity applied to HR-pQCT data. Med. Phys. 2014;41(1):013701.

25.    Wichmann J.L., Booz C., Wesarg S. et al. Quantitative dual-energy CT for phantomless evaluation of cancellous bone mineral density of the vertebral pedicle: correlation with pedicle screw pull-out strength. Eur. Radiol. 2015; 25(6): 1714-1720.

26.    Griffith J.F., Genant H.K. New imaging modalities in bone. Curr. Rheumatol. Rep. 2011;13(3):241-250.

27.    Gee C.S., Nguyen J.T., Marquez C.J. et al. Validation of bone marrow fat quantification in the presence of trabecular bone using MRI. J. Magn. Reson. Imaging. 2015; 42(2): 539-544.

28.    Rubin G.D. Computed tomography: revolutionizing the practice of medicine for 40 years. Radiology. 2014; 273, 2 Suppl.: S45-S74.

29.    D'yachkov K.A., D'yachkova G.V., Kutikov S.A. Sposob opredeleniya lokal'noy plotnosti korkovoy plastinki dlinnykh kostey [A technique for determination of the local density of long bone cortical plate]. Patent RF, No 2539424, 2015 [In Russ].

30.    D'yachkov K.A., D'yachkova G.V., Aleksandrov Yu.M. Sposob opredeleniya stepeni rezorbtsii kortikal'noy plastinki kosti posle distraktsionnogo udlineniya konechnosti [A technique for determination of the degree of bone cortical plate resorption after limb distraction lengthening]. Patent RF, No 2484772, 2013 [In Russ].



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

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



1.     Альбицкий В.Ю. и др. Репродуктивное здоровье и поведение женщин в России. Казань: Медицина. 2001; 25-27.

2.     Parker S.L. et al. Cancer statistics. Cancer. J. Clin.1996; 65: 5-27.

3.     Берека Дж. и др. Гинекология по Эмилю Новаку. Пер. с англ. М. 2002; 731-770.

4.     Карселадзе А.И. Морфология эпителиальныхяичников. Дис. д-ра мед. наук. М. 1989; 10-12.

5.     Хендлер Ф. Карцинома яичников. Пер. с англ.М. 2004; 1045-1067.

6.     Онкологическая гинекология. Тексты клинических лекций. М.: Изд-во Университетадружбы народов. 1985; 256.

7.     БолдогоеваИ.М. Совершенствование инструментальных методов в диагностике ракаяичников. Дис. кан. мед. наук. Уфа. 2007.

8.     Жорданиа К.И. Некоторые аспекты диагностики и лечения рака яичников. Русскиймедицинский журнал. 2003; 5: 7-8.

9.     Озолиня Л.А. и др. Цитостатики при ракеяичников и решение проблемы безопасности их применения для медицинского персонала. Русский врач. 2004; 3: 5-6.

10.   Bourne Т.Н., Reynolds K., Campbell S.Ovarian cancer screening. Curr. Opin. Radiol.1991; 3 (2): 216-224.

11.   Урманчеева А. Ф., Кутушева Г. Ф. Диагностика и лечение опухолей яичника. Монография. М. 2003.

12.   Edelman R. et al. Clinical MagneticResonance Imaging. Philadelphia: W.B.Saunders. 2006; 3: 2974-3002.

13.   Урманчеева А.Ф., Мешкова И.Е. Вопросыэпидемиологии и диагностики рака яичников. Практическая онкология. 2000; 4: 8-20.

14.   Reznek Rodney et al. Cancer of the Ovary.Cambridge university press. 2007-2177.

15.   BerekJ.S., Hacker N.F. Ovarian and fallopiantubes. In: C.M. Haskell (ed.). CancerTreatment (4th ed.). Philadelphia: W. B.Saunders. 1995.

16.   Hamm B., Ferstner R. MRI and CT of thefemele pelvis. Germany: Springer. 2007; 50-75.

17.   Sohaib S. A., Sahdev A., Van Trappen P. O. etal. Characterization of adnexal mass lesionson MR imaging. Am. J. Roentgenol. 2003; 180:1297-1304.

18.   Kurjak A. et al. Transvaginal ultrasound colorflow and Doppler waveform of the post-menopausal adnexal mass. Obstet. Gynecol.1992;80: 917-921.

19.   Brown D.L., Frates M.C., Laing F.C. et al. Ovarian masses: can benign and malignant lesions be differentiated with color and pulsed Doppler US? Radiology. 1994; 190: 330-336.

20.   Демидов В.И. и др. Пограничные опухоли,рак и редкие опухоли яичников. М. 2005;5-106.

21.   Marret H., Sauget S., Giraudeau B. et al.Contrast-enhanced sonography helps in discrimination of benign from malignant adnexal masses. J. Ultrasound. Med. 2004; 23:1629-1639.

22.   Hillaby K. et al. The value of detection ofnormal ovarian tissue (the «ovarian crescentsign») in the differential diagnosis of adnexalmasses. Ultrasound. Obstet. Gynecol. 2004; 23:63-67.

23.   Guerriero S., Alcazar J.L., Ajossa S. et al.Comparison of conventional colour Dopplerimaging and power Doppler imaging for thediagnosis of ovarian cancer: results of aEuropean study. Gynecol. Oncol. 2001; 83:299-304.

24.   Low R.N., Carter W.D., Saleh E et al. Ovariancancer: comparison of findings with perfluorocarbon-enhanced MR imaging, In-111-CYT-103 immunoscintigraphy and CT. Radiology.1995; 195: 391-400.

25.   Williams S.D. Germ cell tumors. In: R.F. Ozols(ed.), Ovarian Cancer. Philadelphia: W.B.Saunders. 1992; 967-974.

26.   Thurnher S., Hodler J., Baer S. et al.Gadolinium-DOTA enhanced MR imaging ofadnexal tumors. J. Comput. Assist. Tomogr. 1990;14: 939-949.

27.   Rohren E.M., Turkington T.G., Coleman R.E.Clinical applications of PET in oncology.Radiology. 2004; 231: 305-332.

28.   Therasse S. G. et al. New guidelines to evaluate the response to treatment in solid tumors.European Organization for Research andTreatment of Cancer, National CancerInstitute of the United States, NationalCancer Institute of Canada. J. Natl. Cancer.Inst. 2000; 92: 205-216.

29.   Avril А., Sassen S., Schmalfeldt B. et al.Prediction of response to neoadjuvantchemotherapy by sequential F-18-fluorodeoxyglucose positron emission tomography in patients with advanced-stage ovarian cancer.J. Clin. Oncol. 2005; 23: 7445-7453.

30.   Willemse P.H. et al. Interaperitoneal humanrecombinant interferon alfa-2b in minimal residual ovarian cancer. Eur. J. Cancer. 1990; 26: 353-358.

31.   Yamashita Y., Torashima M., Hatanaka Y. et al.Adnexal masses: accuracy of characterizationwith transvaginal US and precontrast andpostcontrast MR imaging. Radiology. 1995;194: 557-565.

32.   Forstner R., Hricak H., Powell C.B. et al.Ovarian cancer recurrence: value of MRimaging. Radiology. 1995; 196: 715-720.

33.   Komatsu T. et al. Adnexal masses: transvaginalUS and gadolinium-enhanced MR imaging assessment of intratumoral structure. Radiology. 1996; 198: 109-115.

34.   Low R.N., Saleh F., Song S.Y. et al. Treatedovarian cancer: comparison of MR imagingwith serum CA-125 level and physical examination - a longitudinal study. Radiology. 1999;211:519-528.

35.   Prayer L., Kainz C., Kramer J. et al. CT andMR accuracy in the detection of tumorrecurrence in patients treated for ovariancancer. J. Comput. Assist. Tomogr. 1993; 17:626-632.



Technological advance in multislice computed tomography (MSCT) set the radiologists all over the world thinking of its application in patients with ischemic heart disease. Proved diagnostic efficiency of 64-slice MSCT coronary angiography nominates the technique to be a first-line screening method for coronary atherosclerosis: it allows quick, accurate, and non-invasive imaging and quantitative assessment of coronary lesions. Though the indications for MSCT has already defined, there still are contro-versies about its place in diagnostic strategy. The aim of our study was to picture the state-of-the-art MSCT capabilities, focusing on MSCT coronary angiography and its place in contemporary clinical medicine.



1.     Achenbach S. et. al. Top 10 indications forcoronary СТА. Supplement to Applied Radiology.2006; 35 (12): 22-31.

2.     Gaspar T., Halon R., Rubinshtein N. Clinicalapplications and future trends in cardiacСТА. Eur. Radiol. Suppl. 2005; 15 (l4): 10-14.

3.     Jacobs J.E. How to perform coronaryСТА: A to Z, Supplement to Applied Radiology.2006; 12: 10-17.

4.     Синицын В.Е., Воронов Д.А., Морозов С.П.Степень кальциноза коронарных артерийкак прогностический фактор осложнений сердечно-сосудистых заболеваний без клинических проявлений: результаты метаанализа. Терапевтический архив. 2006; 9: 22-27.

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

6.     Синицын В.Е., Устюжанин Д.В. КТ-ангиография коронарных артерий. Кардиология. 2006; 1: 20-25.

7.     Ehara M., Surmely J.F., Kawai M. et al.Diagnostic accuracy of 64-slice computedtomography for detecting angiographicallysignificant coronary artery stenosis in an unselected consecutive patient population:Comparison with conventional invasiveangiography. Circ.J. 2006; 70: 564-571.

8.     Leschka S. et al. Accuracy of MSCT coronaryangiography with 64-slice technology: firstexperience. Eur. Heart. J. 2005; 26: 1482-1487.

9.     Wann S. Cardiac CT for risk stratification,Supplement to Applied. Radiology. 2006; 12: 41-44.

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

11.   Rienmuller R., Brekke O., Kampenes V.B. et al. Dimeric versus monomeric nonionic contrast agents in visualization of coronary arteries. Eur.J. Radiol. 2001; 38 (3): 173-178.

12.   Dewey M. et al. Head-to head comparison of multislice computed tomography angiography and exercise electrocardiography for diagnosis of coronary artery disease. Eur. Heart. 2007; 10, 28 (20): 2485-2490.

13.   Schlosser T., Konorza T., Hunold P. et al. Noninvasive visualization of coronary artery bypass grafts using 16-detector row computed tomography. JACC. 2004; 44: 1224-1229.

14.   Chabbert V., Carrie D., Bennaceur M. et al. Evaluation of in-stent restenosis in proximal coronary arteries with multidetector computed tomography (MDCT). Eur Radiol. 2007; 17: 1452-1463.

15.   Schijf J.D., Bax J.J., Jukema J.W. et al. Feasibility of assessment of coronary stent patency using 16-slice computed tomography. Am.J. Cardiol. 2004; 94: 427-430.

16.   Mahnken A.H., Buecker A., WildbergerJ.E. et al. Coronary artery stents in multislice computed tomography: in vitro artefact evaluation. Invest Radiol. 2003; 39: 27-33.

17.   Cademartiri F., Marano R., Runza G. et al. Non-invasive assessment of coronary stent patency with multislice CT: preliminary experience. Radiol. Med. (Torino). 2005; 109 (5-6): 500-507.


In this paper the use of spiral computed tomography (SCT) in dental implantation is discussed. It is shown that scanning itself and, what is even more important, post-processing of the images should be planned individually for each patient. SCT is declared to be a substantial part of the diagnostic strategy in patients with upper and lower dental arches defects, and with complete adentia. It is also crucial in assessment of long-term results of sinus lift procedure, and for detection of immediate and remote dental implant complications. 





1.     Адонина О.В. Долгалев А.А., Епанов В.А., Гречишников. Клинико-рентгенологичеекая оценка результатов операции внутрикостной имплантации с поднятием дна.верхнечелюстных пазух: дис. канд. мед. наук. М. 2004; 147.

2.     В.И. Компьютерная оценка состояния челюстных костей при планировании дентальной имплантации. Актуальные проблемытеории и практики в стоматологии. 1998;237-240.

3.     Долгалев А.А., Епанов В.А., Гречишников В.И. Компьютерная оценка состояния челюстных костей при планировании дентальной имплантации. Актуальные проблемы теории и практики в стоматологии. 1998;237-240.

4.     Лосев Ф.Ф., Пьянзин В.И., Буланников А.С.Применение компьютерных технологий вдентальной имплантологии при планировании ортопедического лечения после множественного удаления зубов. Труды II Всероссийского конгресса по дентальной имплантологии. Самара, 2002; 73-75.

5.     Abrahams J.J. Dental implants and multiplanar imaging of jaw. Gt. Louis; Mosby Head and Neck imaging. 1996; 362-363.

6.     Clark D.E., Danforth R.A., Barnes P.W., Durtch M.L. Radiation absorbed from dental implant radiography, CT scan, and panoramic, and intra-oral-tehniques. J. Oral. Implantol. 1990; 16: 156-164.

7.     Fanuscu M.J., Lida K., Caputo A.A. et al. Load tranter by an implant in a sinus-gratted maxillary model. J. Oral. Maxillofac. Implants. 2003; 18(5): 667-674.

8.     Mupporapu M., Singer S.R. Implant imaging for dentist.J. Can. Dent. Assoc. 2004; 70 (1): 32-35.

9.     Ronhman S. Dental application of computerized tomography surgical planning for implant placement. Quintessence Publishing. 1998; 246.

10.   Stephen L.G., Rothman M.D. Dental application of computerized. Tomography surgical planning for implant placement. USA. 1998; 360.



In this study the potentialities of quantitative computed tomography (QCT) in bone densitometry is reported. QCT was performed in patients receiving glucocorticoid therapy and in postmenopausal women (55 patients all in all). Special software was used for the mineral density loss assessment: surrounding tissues were automatically subtracted, and calculating of the vertebral body density done in cross-sectional view. QCT allows specifying pathological changes in any vertebral structures and so serves as a good contribution to the diagnosis of osteoporosis. 





1.     Иванов Е.Г. Диагностика и лечение остеопороза. AW.J. Med. 2001; 90: 170-210.

2.     Насонов Е.Л., Скрипникова И.А., Насонова В.А. Проблема остеопороза в ревматологии. М.: Стин. 1997.


3.     Andresen R., Haidekker M. A., Radmer S.,Banzer D. CT determination of bone mineraldensity and structural investigations on the axial skeleton for estimating the osteoporosis-related fracture risk by means of a risk score. Br.J. Radiol. 1999; 72 (858): 569-578.



4.     Genant H. K., Guglielmi G., Jergas M. et al. Bone Densitometry and Osteoporosis. Springer. 1998; 604.


5.     Белосельский Н. Н. Рентгеновская морфометрия позвоночника в диагностике остеопороза. Остеопороз и остеопатии. 2000.

6.     Скрипникова И.А. Профилактика и лечение остеопороза. Материалы итоговойконференции по остеопорозу. Амстердам.1996.

7.     Consensus development conference: diagnosis, prophylaxis and treatment of osteoporosis. Am. J. Med. 1993; 94: 646-650.

8.     Древаль А.В., Марченкова Л.Д., Мылов Н.М. Сравнительная информативность денситометрии осевого и периферического скелета и рентгенографии в диагностике постменопаузального остеопороза. Остеопороз и остеопатии. 1998; 2: 48-53.

9.     Оценка риска переломов и ее применение для скрининга постменопаузального остеопороза. Доклад Рабочей группы ВОЗ. Женева. 1994; 184.

10.   Benitez С. L., Schneider D. L., Barrett-Connor E., Sartoris D. J. Hand ultrasound for osteoporosis screening in postmenopausal women. Osteoporos. Int. 2000; 11 (3): 203-210.

11.   Krane St. M. Assessment of mineral and matrix turnover. In: B. Frame, J.T. Potts et al. Clinical disorders of bone and mineral metabolism. Excerpta medica. Internat. Congress Series 617. Amsterdam. Oxford, Princeton. 1983; 95-98.



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.  





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.



Methods of beam diagnostics play an important role in examination of patients with dental anomalies. Reliably establish dental anomaly is possible due to radiological examination. However, according to orthopantomography not always possible to identify the true cause of the anomaly, correct localization of abnormal tooth, preservation of periodontal ligament. All this leads to an incorrect treatment planning and the occurance of complications; in this regard all of our patients underwent addition cone-beam computed tomography Under our observation were 60 patients aged 15-30 years with a complex form anomaly of the position and the eruption of teeth. Half of patients had an anomaly of upper canines, remaining patients, the anomaly of upper premolars, canines and premolars in the mandible. The main cause of anomalies of teeth was due to lack of space in the dentition, less abnormalities were associated with the presence of obstacles in the way of the eruption, with congenital abnormalities of the maxillofacial region.

Possibilities of orthodontic and surgical interventions are limited and therefore it is very important accurate and reliable diagnosis of abnormalities. Cone-beam computed tomography allows to obtain all necessary information about the position of the tooth in the bone, its structure, shape, spatial relationship with roots of adjacent teeth and important anatomic structures, which makes it possible to properly plan for the further treatment strategy and reduce the risk of possible complications.



1.     Persii L.S. Vidy zubocheljustnyh anomalij i ih klassificirovanie. [Types of dentoalveolar anomalies and their classification]. M.: MGMSU. 2002: 32 [In Russ].

2.     Uiljam R. Profit. Sovremennaja ortodontija. Per. s angl. jaz.: (Pod red. Persina L.S.) [Contemporary orthodontics] M.: MEDpress-inform, 2006; 95-123 [In Russ].

3.     Horoshilkina FJa. Ortodontija. Defekty zubov, zubnyh rjadov, anomalii prikusa, morfofunkcional'nye narushenija v cheljustno-licevoj oblasti i ih kompleksnoe lechenie [The defects of teeth, dentition, abnormal bite, morpho-functional disorders in the maxillofacial region, and their combined treatment]. M.: Medicinskoe informacionnoe agentstvo. 2006: 544 [In Russ].

4.     Shuk Mazen. Kliniko-rentgenologicheskaja diagnostika i apparaturno-hirurgicheskoe lechenie retencii klykov [Clinical and radiographic diagnosis and surgical treatment for hardware-retention canines]:Avtoref. Dis. kand. med. Nauk [thesis PhD] Tver'. 2004: 102 [In Russ].

5.     Flint, DJ. A diagnostic comparison of panoramic and intraoral radiographs. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 1998; 85(6): 731-5.

6.     Vasil'ev AJu., Vorob'ev Ju.I., Serova N.S. Luchevaja diagnostika v stomatologii [Radiodiagnostics in dentistry.] M.: GJeOTAR-Media. 2008: 201-220 [In Russ].

7.     Minjaeva V.A. Posledstvija rannej utraty zubov u detej bez zamewenija defektov ortopedicheskimi apparatami [The consequences of early loss of teeth in children without defects in replacement orthopedic devices]. Stomatologija detskogo vozrasta i profilaktika. 2003; 1(2): 61-64 [In Russ].

8.     Sergeeva L.B. Peremewenie treh retinirovannyh klykov v zubnoj rjad s pomowju nesemnoj ortodon gicheskoj tehnikoj [Moving the three impacted canine tooth in the series with non-removable orthodontic appliances]. Ortodontija. 2001; 3: 40-41. [In Russ].

9.     Fridrih A. Pasler, Hajko Vissler. Rentgenodiagnostika v praktike stomaloga. Per. s nem. jaz. (Pod red. Rabuhinoj N.A.) [X-ray diagnostics in the practice of stomaloga. (Translated from German. lang. (Eds. Rabuhinoy NA)] M.: MED- press-inform. 2007: 118-131 [In Russ].

10.   Chaushu S. The use of panoramic radiographs to localize displaced maxillary canines. Oral Surg.Oral Med. Oral Pathol. Oral Radiol. Endod. 1999; 88(4): 511-516.

11.   Garcia M.A.S., Wolf U., Heinicke F. Cone-beam computed tomography for routine orthodontic treatment planning: A radiation dose evaluation. American Journal ofOrthodontics and Dentofacial (Orthopedics. 2008; 133(5): 640.e1-640.e5.

12.   Haney E., Gansky S.A., Lee J.S. et al. Comparative analysis of traditional radiographs and cone-beam computed tomography volumetric images in the diagnosis and treatment planning of maxillary impacted canines. American Journal of Orthodontics and Dentofacial Orthopedics. 2010; 137(5): 590-597.

13.   Volchek D.A. Sovremennye metody obsledovanija pacientov s retenciej klykov verhnej cheljusti [Modern methods of examination of patients with retentions canines of the upper jaw.] Ortodontija. 2006; 1: 24-26 [In Russ].

14.   Chibisova M.A. Algoritmy obsledovanija pacientov pri primenenie dental'noj ob#emnoj tomografii v ambulatornoj stomatologicheskoj praktike [Algorithms for evaluation of patients with the use of dental volumetric imaging in ambulatory dental practice]. Dental Market. 2010; 76-78 [In Russ].

15.   Danforth R.A. Cone beam volume tomography: an imaging option for diagnosis of complex mandibular third molar anatomical relationships. J. Calif. Dent Assoc. 2003; 31(11): 847- 852.

16.   Dodson T.B. Role of computerized tomography in management of impacted mandibular third molars. NY State Dent. J. 2005; 71(6): 32-35.

17.   Mah J.K., Alexandroni S. Cone-Beam Computed Tomography in the Management of Impacted Canines. Seminars in Orthodontics. 2010; 16(3): 199-204.




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.



1.     Gumanenko E.K., Shapovalov V. M., Dulaev A.K., Dudykin A.V. Sovremennye podhody k lecheniju postradavshih s nestabil'nymi povrezhdenijami tazovogo kol'ca. [Current approaches to the treatment of patients with unstable pelvic ring injuries] Voenno-med. zhurnal. 2003; 4: 17. [In Russ].

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].

3.     Balogh Z., Voros E., Suveges G. Stent graft treatment of an external iliac artery injury associated with pelvic fracture. A case report. J. Borne Joint Surg. Am. 2003; 5: 919-922.

4.     Serebrjakova S.V. Spiral'naja komp'juternaja tomografija v diagnostike povrezhdenij vertluzhnoj vpadiny (S.V. Serebrjakova, V. M. Cheremisin, O. F. Pozdnjakova) [Spiral computed tomography in the diagnosis of acetabulum lesions]. Materialy Nevskogo radiologicheskogo foruma «Iz buduwego v nastojawee». SPb, 2003; 113-115 [In Russ].

5.     Djatlov M. M. Luchevaja diagnostika povrezhdenij tazovogo kol'ca v ostrom periode perelomov vert- luzhnoj vpadiny. [Radiological diagnosis of pelvic ring injuries in acute acetabular fractures]. Ortop., travm im Priorova 2003; 3: 72-74 [In Russ].

6.     Miller P. R, Moore P. S., Mansell E., Meredith J. W. С External fixation or arteriogram in bleeding pelvic fracture: initial therapy guided by. Clin. Imaging. 2003; 18(4): 533-536.

7.     Loberant N., Goldfeld M. A pitfall in triple contrast CT of penetrating trauma of the flank. Clin. Imaging. 2003; 27(5): 351-352.

8.     Tile M. Fracture of pelvis. The Rationale of operative Fracture Care. Spinger Verlag. 1987: 441.



Aim: was to evaluate diagnostic significance of current methods of radiological diagnostics in examination of patients with Monckeberg's sclerosis of the femoral artery

Material and methods: lower limb arteries and femoral bone of patient with Monckeberg's sclerosis of the femoral artery, femoral neck pseudarthrosis, 8 cm lower limb shortening, Cushing syndrome, secondary steroid osteoporosis, diabetes, hypercorticism and hyperparathyroidism were examined before and after double staged treatment using methods of radiography, ultrasonography and multi-slice CT (MSCT).

Results: the study of the femoral artery using ultrasonography and MSCT, processing the data with special filter, indicated patent femoral artery lumen, structure of sclerotic middle coat of the artery similar to the bone structure (layer of lateral cortical plate, osteon layer and the layer of the medial cortical plates) and did not reveal sonographic «drop-out defects». Healing of the femoral neck pseudarthrosis and 5 cm femoral lengthening was achieved in the patient.

Conclusion: data obtained by MSCT and USD gave possibility to perform doubles-staged surgical intervention, to achieve healing of the femoral neck non-union and to lengthen the limb for 5 cm. 



1.    Monckeberg J.G. Virchows Arch. (Pathol. Anat.). 1903; Bd. 171:141-167.

2.    Egorov I.V. Senil'nyi aortal'nyi stenoz: sovremennoe sostoianie problemy (k 110-letiiu publikatsii I.G. Menkeberga) [Senile aortic stenosis: current state of the problem (to the 100th anniversary of J.G. Monckeberg’s publication)]. Consilium Medicum. 2014; (1):17-23 [In Russ].

3.    Molitvoslovova N.A., Galstian G.R. Rol' distal'noi diabeticheskoi polineiropatii v razvitii mediakal'tsinoza u patsientov s sakharnym diabetom [The role of distal diabetic polyneuropathy in mediacalcinosis development in patients with diabetes mellitus]. Sakhar. diabet. 2012; (2):64-69 [In Russ].

4.    Sergoventsev A.A. Kal'tsinirovannyi aortal'nyi stenoz: itogi 15-letnego izucheniia v Rossii [Calcified aortic stenosis: results of 15-year studying in Russia]. Rus. med. zhurn. 2013; 27:1314-1319 [In Russ].

5.    Castling B., Bhatia S., Ahsan F. Menckeberg's arteriosclerosis: vascular calcification complicating microvascular surgery. Int J Oral Maxillofac Surg. 2015 Jan; 44(1):34-36.

6.    Sage AP, Tintut Y Demer LL. Regulatory mechanisms in vascular calcification. Nat Rev Cardiol. 2010 Sep;7(9): 528-36.

7.    Kurabayashi M.Vascular Calcification - Pathological Mechanism and Clinical Application - Role of vascular smooth muscle cells in vascular calcification. Clin Calcium. 2015 May; 25(5):661-669.

8.    Wu M., Rementer C., Giachelli C.M. Vascular Calcification: An Update on Mechanisms and Challenges in Treatment. Calcif Tissue Int. 2013; 93(4): 365-273.

9.    Persy V., D’Haese P. Vascular calcification and bone disease: the calcification paradox // Trends Mol. Med.- 2009.- Vol. 15 (9).- P 405-416;

10.  Tsai CW, Kuo CC, Hwang JJ. Menckeberg's sclerosis. Acta Clin Belg. 2010 Sep-Oct;65(5):361.

11.  Sagalovsky S. Bone remodeling: cellular-molecular biology and cytokine RANKL-RANK-Osteoprotegerin (OPG) system and growth factors. Crimean J. Exp. Clin. Med. 2013; 3 (1-2):36-44.

12.  Paccou J., Brazier M., Mentaverri R., Kamel S., Fardellone P, Massy Z.A. Vascular calcification in rheumatoid arthritis: prevalence, pathophysiological aspects and potential targets. Atherosclerosis. 2012; 224:283-290.

13.  Ando G., Tripodi R., Vizzari G., Trio O. Calcific Monckeberg's arteriosclerosis: an uncommon cause of radial access failure. Int J Cardiol. 2015 Mar 1;182:211-2.

14.  Bittencourt M.S. The Denser the Merrier? The Developing Story of Vascular Calcification. Circ Cardiovasc Imaging. 2016; Nov; 9(11).

15.  Vasuri F., Fittipaldi S., Pacilli A., Buzzi M., Pasquinelli G. The incidence and morphology of Monckeberg's medial calcification in banked vascular segments from a monocentric donor population. Cell Tissue Bank. 2016 Jun; 17(2):219-223.

16.  Micheletti R.G., Fishbein G.A., Currier J.S., Fishbein M.C. Menckeberg sclerosis revisited: a clarification of the histologic definition of Monckeberg sclerosis. Arch Pathol Lab Med. 2008 Jan; 132(1):43-7.

17.  Henaut L., Mentaverri R., Liabeuf S., Bargnoux A.S., Delanaye P, Cavalier Й., Cristol J.P, Massy Z., Kamel S. Groupe de Travail Biomarqueurs des Calcifications Vasculaires de la SFBC et de la Societe de Nephrologie.. Pathophysiological mechanisms of vascular calcification. Ann Biol Clin (Paris). 2015 May-Jun; 73(3):271-87.

18.  Top C., 3ankir Z., §ilit E., Silit E., Yildirim S., Danaci M. Monckeberg's sclerosis: an unusual presentation. Angiology. 2002; 53:483-486.

19.  Lanzer P, Boehm M.,Sorribas V., Thiriet M., Janzen J., Zeller T., St Hilaire C., Shanahan C. Medial vascular calcification revisited: review and perspectives. Eur Heart J. 2014 Jun 14; 35(23):1515-1525.

20.  Tahmasbi-Arashlow M., Barghan S., Kashtwari D., Nair M.K. Radiographic manifestations of Menckeb



Timely diagnosis of iatrogenic injury of kidneys remains a challenge. Article is devoted to the study of diagnostic possibilities of radiological methods in the evaluation of patients with iatrogenic injuries of kidneys and postoperative complications in urology.

Materials and methods: study included 38 patients with kidney injury and postoperative complications, which were treated at the urological departments, were studied diagnostic capabilities of intravenous urography, ultrasound, CT Defined indicators of efficiency of MSCT in the diagnosis of these pathological conditions relative to data obtained intraoperatively (n = 16; 42,1%) and during follow-up (n= 22; 57,9%). According to research MSCT has the best indicators of the diagnostic value (sensitivity - 97%, specificity - 98%).

Results: defined indicators of efficiency of MSCT in the diagnosis of these pathological conditions relative to data obtained intraoperatively (n = 16; 42,1%) and during follow-up (n= 22; 57,9%). According to research MSCT has the best indicators of the diagnostic value (sensitivity - 97%, specificity - 98%). 



1.    Russian Electronic Journal of Radiology. 2013; 3(4):88-93. Nechiporenko A.S., Nechiporenko A.N., Varec I.G. Komp'juternaja tomografija v diagnostike zakrytoj travmy pochek. [CT in diagnostics of renal blunt trauma]. Russian Electronic Journal of Radiology. 2013; 3(4):88-93 [In Russ].

2.    Komjakov B. K., Soroka I. V., Savello V. E. i dr. Osobennosti kliniko-luchevoj diagnostiki oslozhnenij sochetannyh povrezhdenij pochek v raznye periody travmaticheskoj bolezni. [Features of clinical and beam diagnostics of complications of combined renal trauma in different terms of traumatic disease]. Biomedicinskij zhurnal 2011; 12:1450-1466 [In Russ].

3.    Merinov D.S., Pavlov D.A., Fatihov R.R. i dr. Miniinvazivnaja perkutannaja nefrolitotripsija: delikatnyj i jeffektivnyj instrument v lechenii krupnyh kamnej pochek. [Miniinvasive percutaneous nephrolitotripsia: delicate and effective way to treat large renal stones]. Jeksperimental'naja i klinicheskaja urologija. 2013; 3:94-98 [In Russ].

4.    Mudraja I.S., Gurbanov Sh.Sh., Merinov D.S. Peristal'tika mochetochnika u pacientov s kamnjami pochki i urodinamika verhnih mochevyvodjashhih putej posle perkutannoj nefrolitolapaksii. [Peristalsis of the ureter in patients with renal stones and urodynamics of the upper urinary tract after percutaneous nephrolitholapaxy]. Jeksperimental'naja i klinicheskaja urologija. 2014; 1:67-71 [In Russ].

5.    Rossolovskij A.N., Chehonackaja M.L., Zaharova N.B. i dr. Dinamicheskaja ocenka sostojanija pochechnoj parenhimy u bol'nyh posle distancionnoj udarno-volnovoj litotripsii kamnej pochek. [Dynamic assessment of renal parenchyma in patients after extracorporeal shock wave lithotripsy of kidney stones]. Vestnik urologii. 2014; 2:3-14 [In Russ].

6.    Janenko Je.K., Katibov M.I., Merinov D.S. i dr. Prognosticheskie faktory dlja jeffektivnosti i bezopasnosti perkutannoj nefrolitotripsii krupnyh i korallovidnyh kamnej edinstvennoj pochki. [Prognostic factors for the efficacy and safety of percutaneous nephrolithotripsy of large and coral stones of a single kidney]. Jeksperimental'naja i klinicheskaja urologija. 2015; 3:42-47 [In Russ].


We performed the analysis of published data on the use of multislice computed tomography in diagnostics of coronary heart disease. The data on the development of the method, indicated that it its diagnostic efficiency is related to technological improvements, accompanied by the appearance of each successive generation of multislice computed tomography We described possibilities of using of scanners from 16 to 230-slice, devices with two sources of energy, advantages of «dual energy» regime application in the coronary disease diagnostics. Given constraints on the method diagnostic efficacy - artifacts associated with the movement and severe calcification. It is indicated that the implementation of the method in cardiology practice promotes its consideration as a promising alternative to invasive diagnostic coronary angiography, it is suggested becoming of further development of the technology that will allow multislice computed tomography to become the main method of diagnosis of coronary heart disease and other cardiovascular diseases.  



1.    Paul J.F., Dambrin G., Caussin C. et al. Sixteen-slice computed tomography after acute myocardial infarction: from perfusion defect to the culprit lesion. Circulation. 2003; 108: 373-374.

2.    Sun Z., Choo G.H., Ng K.H. Coronary CT angiography: current status and continuing challenges. Br. J. Radiol. 2012; 85: 495-510.

3.    Costello P., Lobree S. Subsecond scanning makes CT even faster. Diag. Imaging. 1996; 18: 76-79.

4.    Taguchi K., Aradate H. Algorithm for image reconstruction in multi-slice helical CT. Med. Phys. 1998; 25: 550-561.

5.    Flohr T.G., Schaller S., Stierstorfer K. et al. Multidetector row CT systems and image-reconstruction techniques. Radiology. 2005; 235: 756-773.

6.    Haberl R., Tittus J., Bohme E. et al. Multislice spiral computed tomographic angiography of coronary arteries in patients with suspected coronary artery disease: an effective filter before catheter angiography? Am. Heart J. 2005; 149: 1112-1119.

7.    Goldman L.W. Principles of CT: multislice CT. J. Nucl. Med. Technol. 2008; 36: 57-68.

8.    Lewis M., Keat N., Edyvean S. 16 Slice CT scanner comparison report version 14, 2006. Available from: URL:

9.    Achenbach S., Ropers D., Pohle F.K. et al. Detection of coronary artery stenoses using multi-detector CT with 16x0.75 collimation and 375 ms rotation. Eur. Heart J. 2005; 26: 1978-1986.

10.  Kuettner A., Beck T., Drosch T. et al. Image quality and diagnostic accuracy of non-invasive coronary imaging with 16 detector slice spiral computed tomography with 188 ms temporal resolution. Heart. 2005; 91: 938-941.

11.  Garcia M.J., Lessick J., Hoffmann M.H. Accuracy of 16-row mul-tidetector computed tomography for the assessment of coronary artery stenosis. JAMA. 2006; 296: 403-411.

12.  Flohr T.G., McCollough C.H., Bruder H. et al. First performance evaluation of a dual-source CT (DSCT) system. Eur. Radiol. 2006; 16: 256-268.

13.  Steigner M.L., Otero H.J., Cai T. et al. Narrowing the phase window width in prospectively ECG-gated single heart beat 320-detector row coronary CT angiography. Int. J. Cardiovasc. Imaging. 2009; 25: 85-90.

14.  Achenbach S., Marwan M., Schepis T. et al. High- pitch spiral acquisition: a new scan mode for coronary CT angiography. J. Cardiovasc. Comput. Tomogr. 2009; 3: 117-121.

15.  Ruzsics B., Lee H., Zwerner P. et al. Dual-energy CT of the heart for diagnosing coronary artery stenosis and myocardial ischemia-initial experience. Eur. J. Radiol. 2008; 18: 2414-2424.

16.  Jiang H.C., Vartuli J., Vess C. Gemstone-the ultimatum scintillator for computed tomography. Gemstone detector white paper. London: GEHealthcare. 2008: 1-8.

17.  Sun Z., Jiang W. Diagnostic value of multislice computed tomography angiography in coronary artery disease: a meta-analysis. Eur. J. Radiol. 2006; 60: 279-286.

18.  Pontone G., Andreini D., Bartorelli A. et al. Diagnostic accuracy of coronary computed tomography angiography: a comparison between prospective and retrospective electrocardiogram triggering. J. Am. Coll. Cardiol. 2009; 54: 346-355.

19.  Sun Z., Ng K.H. Diagnostic value of coronary CT angiography with prospective ECG-gating in the diagnosis of coronary artery disease: a systematic review and meta-analysis. Int. J. Cardiovasc. Imaging. 2012; 28: 2109-2119.

20.  Budoff M.J., Dowe D., Jollis J.G. et al. Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J. Am. Coll. Cardiol. 2008; 52: 1724-1732.

21.  Miller J.M., Rochitte C.E., Dewey M. et al. Diagnostic performance of coronary angiography by 64-row CT. N Engl. J. Med. 2008; 359: 2324-2336.

22.  Alkadhi H., Stolzmann P., Desbiolles L. et al. Low-dose, 128-slice, dual-source CT coronary angiography: accuracy and radiation dose of the high-pitch and the step-and-shoot mode. Heart. 2010; 96: 933-938.

23.  Hou Y, Yue Y, Guo W. et al. Prospectively versus retrospectively ECG-gated 256-slice coronary CT angiography: image quality a


Literature report provides a critical analysis of the literature on the use of multislice computec tomography (MSCT) as an alternative to conventional autopsy in forensic examination in case of sudden death associated with target-organ damage in arterial hypertension (AH). The review was made using Internet resources: Scientific Electronic Library (elibrary), SciVerse (ScienceDirect), Scopus, PubMed, and Discover. The review includes only those articles that discuss both advantages and limitations of MSCT in the posthumous forensic sudden death of adults.

During analysis of the available literature, authors discuss the problem of posthumous use of MSCT imaging in arterial hypertension complications: myocardial infarction, brain stroke, aneurysm rupture and separation of the aortic wall. Authors tried to answer the question about possibilities of posthumous MSCT as an alternative to the traditional autopsy

Conclusion: native MSCT is suitable for imaging of intracranial hemorrhage and differential diagnosis of traumatic brain injury Method is suitable with restrictions for diagnosis of ischemic strokes, aneurysms and aortic dissection. Possibilities of native MSCT in the diagnosis of sudden death associated with the pathology of coronary artery disease, myocardial infarction and pulmonary embolism is significantly limited. Using postmortem CTA, extends method in the diagnosis of lesions of the coronary arteries, aorta and pulmonary artery.

The main advantage of MSCT in the posthumous sudden death - the possibility of visualizing hidden mechanical damage in case of failure of the autopsy relatives. 



1.    Sudebnaja medicina i sudebno-medicinskaja jekspertiza: nacional'noe rukovodstvo [Forensic medicine and forensic examination: national leadership.]. Pod red. Ju. I. Pigolkina. M.: Gjeotar-Media, 2014;.664-679 [In Russ].

2.    Rukovodstvo po sudebnoj medicine [Guide to Forensics.]. Pod red. V. N. Krjukova, I. V. Buromskogo. M.:OAO Izdatel'stvo Norma. 2014; 364-371[In Russ].

3.    Thali M. J., Yen K., Schweitzer W., Vock P., Boesch C.,Ozdoba C., Schroth G., Ith M., Sonnenschein M., Doernhoefer T., Scheurer E., Plattner T., Dirnhofer R. Virtopsy, a new imaging horizon in forensic pathology: virtual autopsy by postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) a feasibility study. J. Forensic Sci. 2003; 48 (2): 386-403.

4.    Levy A.D., Harcke H.T., Mallak C.T. Postmortem imaging: MDCT features of postmortem change and decomposition. Am. J. Forensic Med. Pathol. 2010 Mar; 31(1):12-7.

5.    Grabherr S., Djonov V., Friess A., Thali M.J., Ranner G., Vock P., Dirnhofer R. Postmortem angiography after vascular perfusion with diesel oil and a lipophilic contrast agent. AJR. Am. J. Roentgenol. 187 (5): W515-23.

6.    Jackowski C., Persson A., Thali M.J. Whole body postmortem angiography with a high viscosity contrast agent solution using poly ethylene glycol as contrast agent dissolver. J.Forensic.Sci. 2008;53(2):465-8.

7.    Murakami T., Uetani M., Ikematsu K., Nagasaki J.P. Postmortem CT in emergency deparment: Influence of cardiopulmonary resuscitation. European Society of Radiology. EPOS. C-1440.

8.    Shiotani S., Kohno M., Ohashi N., Yamazaki K., Itai Y Postmortemintravascularhigh-densityfluidlevel (hypostasis): CTfindings. J. ComputAssistTomogr. 2002 NovDec; 26(6):892-3.

9.    Yamazaki K., Shiotani S., Ohashi N., Doi M., Honda K. Hepatic portal venous gas and hyper-dense aortic wall as postmortem computed tomography finding. LegMed (Tokyo). 2003 Mar; 5Suppl 1:S338-41.

10.  Shiotani S., Kohno M., Ohashi N., et al. Hyperattenuating aortic wall on postmortem computed tomography (PMCT). Radiat. Med. 2002; 20(4): 201-6.

11.  Christe A., Flach P., Ross S., Spendlove D., Bol- liger S., Vock P., Thali M.J. Clinical radiology and postmortem imaging (Virtopsy) are not the same: Specific and unspecific postmortem signs. LegMed (Tokyo). 2010 Sep;12(5):215-22.

12.  Takahashi N., Satou C., Higuchi T., Shiotani M., Maeda H., Hirose Y Quantitative analysis of brain edema and swelling on early postmortem computed tomography: comparison with antemortem computed tomography. Jpn. J. Radiol. 2010 Jun;28(5):349-54.

13.  Zerbini T., Ferrazda SilvaI L.F., Gongalves Ferro A.C., et al. Differences between postmortem computed tomography and conventional autopsy in a stabbing murder case. Clinics. 2014 SroPaulo Dec; 69:10.

14.  Schnider J., Thali M. J., Ross S., Oesterhelweg L., Spendlove D., Bolliger S.A. Injuries due to Sharp trauma detected by post-mortem multislice computed tomography (MSCT): a feasibility study. Leg Med (Tokyo). 2009;11(1):4-9.

15.  Cha J.G., Kim D.H., Kim D.H., Paik S.H., Park J.S., Park S.J., et al. Utility of postmortem autopsy via whole-body imaging: initial observations comparing MSCT and 3.0T MRI findings with autopsy findings. Korean J. Radiol. 2010;11(4)395-406.

16.  Takahiro Z., Teruhiko T., Miyamoto M., Yamaguchi S., Endo T., Inaba H. Intravascular gas in multipleorgans detected by postmortem computed tomography: effect of prolonged cardiopulmonary resuscitation on organ damage in patient swith cardiopulmonary arrest. Jpn. J. Radiol. 2011; 29(2):148-51.

17.  Shiotani S., Kohno M., Ohashi N., Atake S., Yamazaki K., Nakayama H. Cardiovascular gas on non-traumatic post-mortem computed tomography (PMCT): thein- fluence of cardiopulmonaryre suscitation. Radiat. Med. 2005 Jun;23(4):225-9.

18.  Pedal I., Moosmayer A. Mallach H.J., et al. Air embolism or putrefaction? Gas analysis ndings and their interpretation. Z. Rechtsmed. 1987;99:151-67.

19.  Patzelt D., Lignitz E., Keil W., et al. Diagnostic problem of air embolism in acorpse. Beitr Gerichtl Med. 1997;37:401-5.

20.  Ruder T.D., Ross S., Preiss U., Thali M.J. Minimally invasive post-mortem CT-angiography in a case involving a gunshot wound. LegMed (Tokyo). 2010;12(2):57-112.

21.  Ward A. Forensic radiology: The role of crosssectional imaging in virtual post-mortem examinations Joshua Higginbotham-Jones. Radiography. 2014; 1(20): 87-90.

22.  Pohlsgaard C., Leth PM. Post-mortem CT-coronary angiography. Scandinavian Journal of Forensic Science. 2007;13:8-9.

23.  Grabherr S.


Aim: was to investigate possibilities of multislice computed tomography in estimation of stenosis degree in coronary arteries in patients with ischemic heart disease (IHD).

Materials and methods: we examined 64 patients (18 female, 46 male, mean age 62,4± 9,5 years), who primary had been admitted to hospital and had high risk of IHD; and those who had early diagnosed IHD of 1,2,3 and 4 functional class, they were hospitalized for condition correction. Mainly spreaded risk factor was arterial hypertention in 55 patients - (85,9%) with highest level 200/100 mm hg and minimal 140/80 mm hg. All patients underwent multislice computed tomography (MSCT) on the 256-slice tomography station «Somatom definition flash (Siemens, Germany)»: collimation 128 x 0,6, the temporal resolution of 75 ms and a spatial resolution of 0.33 mm, slice thickness of 0.6 mm, with simultaneous use of two tubes with different voltage (kV 120/100), the current mAs - with programs to reduce radiation exposure Care Dose - is calculated automatically according to the constitution of man.

Post-processing of obtained data was performed on a workstation Syngo Via, in the application of CT-Soronary with automatic longitudinal separation of each coronary artery In view of image quality was analyzed data from end-diastolic phase of the cardiac cycle (80% R-R), or evaluated complex of multiphase images. We analyze the state of the main arteries of the main coronary: left anterior descending artery, the circumflex artery and the right coronary artery (LAD, CA, RCA). We performed estimation of coronary artery stenosis of segments according to the American Heart Association (AHA). Results were displayed in percentage. Obtained data was compared with those obtained using the reference method - X-ray coronary angiography, which was performed according to standard protocol

Results: comparison of results of coronary angiography and MSCT using correlation analysis showed the presence of strong direct significant correlation coefficients in the evaluation of coronary artery disease according to two methods. It was demonstrated a high inter-operator and intraoperator reproducibility of MSCT in the study of vessels conditions. Following characteristics of the method related to the identification of coronary artery stenosis segments: sensitivity - 95.8%, specificity - 92.8%, diagnostic accuracy - 95.1%, positive predictive value - 97.9%, negative predictive value - 86.6 %.

It was concluded that the high importance of the method of MSCT in the diagnosis of cardiovascular diseases and the need for its widespread use in cardiology practice.  



1.    Chazov E.I. Perspektivyi kardiologii v svete progressa fundamentalnoy nauki. [Prospects of Cardiology in light of the progress of fundamental science.] Ter. Archive. 2009; 9 : 5-8 [In Russ.]

2.    Данилов Н.М., Матчин Ю.Г. и др. Показания к проведению коронарной артериографии. Consilium Medicum. Болезни сердца и сосудов. 2006; 1(1). Danilov N.M., Matchin Yu.G. et al. Pokazaniya k provedeniyu koronarnoy arteriografii. Consilium Medicum. Bolezni serdtsa i sosudov. [Indications for coronary arteriography. Consilium Medicum heart disease and vascular. ]2006; 1(1) [In Russ.].

3.    Sun Z., Choo G.H., Ng K.H. Coronary CT angiography: current status and continuing challenges. Br. J. Radiol. 2012; 85: 495-510.

4.    Sun Z., Aziz YF., Ng K.H. Coronary CT angiography: how should physicians use it wisely and when do physicians request it appropriately. Eur. J. Radiol. 2012; 81: 684-687.

5.    Haberl R., Tittus J., Bohme E. et al. Multislice spiral computed tomographic angiography of coronary arteries in patients with suspected coronary artery disease: an effective filter before catheter angiography. Am. Heart J. 2005; 149: 1112-1119.

6.    Steigner M.L., Otero H.J., Cai T. et al. Narrowing the phase window width in prospectively ECG-gated single heart beat 320-detector row coronary CT angiography. Int. J. Cardiovasc. Imaging. 2009; 25: 85-90.

7.    Achenbach S., Marwan M., Schepis T. et al. High-pitch spiral acquisition: a new scan mode for coronary CT angiography. J. Cardiovasc. Comput. Tomogr. 2009; 3: 117-121.

8.    Budoff M.J., Dowe D., Jollis J.G. et al. Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J. Am. Coll. Cardiol. 2008; 52: 1724-1732.

9.    Petcherski O., Gaspar T., Halon D. et al. Diagnostic accuracy of 256-row computed tomographic angiography for detection of obstructive coronary artery disease using invasive quantitative coronary angiography as reference standard. Am. J. Cardiol. 2013; 111: 510-515.

10.  De Graaf F.R., Schuijf J.D., Van Velzen J.E. et al. Diagnostic accuracy of 320-row multidetector computed tomography coronary angiography in the non-invasive evaluation of significant coronary artery disease. Eur. Heart J. 2010; 31: 1908-1915.



Aim: was to estimate possibilities of the CT in patients with anomalies of dental system and asymmetric jaws and to offer a protocol analysis of CT data.

Materials and Methods: 100 patients with anomalies of dental system were examined. They were divided into 4 groups:

- 22 patients with II class without asymmetry of jaws (22%)

- 8 patients with II class with the asymmetry of jaws (8%)

- 52 patients with III class without asymmetry of jaws (52%)

- 18 patients with III class with asymmetry of jaws (18%)

At the stage of preoperative planning, computed tomography was performed. CT protocol of jaws symmetry estimation was developed.

Results: with the help of developed СТ protocol, asymmetry of the maxilla was determined in 11 patients (11.0%): 5 patents (5.0%) with II class, 6 patients (6.0%) with III class. The number of patients with signs of asymmetry of the mandible of II class was 9 patients (9.0%), III class — 13 patients (13.0%). Obtained measurements allowed to analyze degree of asymmetry and calculate required excision and moving of jaws. For planning of surgical stage, CT data of all patients was uploaded into special program «Surgicase CMF».

Conclusions: CT gives possibilities to estimate the anatomy of the facial skeleton and its symmetry; that allows to make plan of further orthognathic surgery.  



1.    Posnick J.C. Orthognathic surgery: principles and practice. Elsevier. 2014; 1864 p.

2.    Persin L.S. Ortodontija. Sovremennye metody diagnostiki zubocheljustno-licevyh anomalij [Orthodontics. Modern methods of diagnosis maxillodental-facial anomalies.]. Moskva: OOO «IZPC «Informkniga». 2007; 248 s [In Russ].

3.    Proffit U.R. Sovremennaja ortodontija. Perevod s anglijskogo pod redakciej prof. L.S. Persina[Modern orthodontics. Under editio of prof. L.S. Persina]. M.: Medpress-inform, 2006; S559 [In Russ].

4.    Дробышев А.Ю., Анастассов Г. Основы ортогнатической хирургии. М.: Печатный город, 2007; С 55. Drobyshev A.Ju., Anastassov G. Osnovy ortognaticheskoj hirurgii[Basics of orthognathic surgery]. M.: Pechatnyj gorod, 2007; S55 [In Russ]

5.    Mani V. Surgical correction of facial deformities. JP Medical Ltd, 2010; 290 p.

6.    Ko E.W.C., Huang C.S., Chen YR.J. Characteristics and corrective outcome of face asymmetry by orthognathic surgery. J. Oral. Maxillofac. Surg. 2009; 67: 2201-2209.

7.    Bishara S.E., Burkey PS., Kharouf J.G. Dental and facial asymmetries: A review. Angle Orthod. 1994; 64: 89-98.

8.    Gordina G.S., Glushko A.V., Klipa I.A., Drobyshev A.Ju., Serova N.S., Fominyh E.V. Primenenie dannyh kompjuternoj tomografii v diagnostike i lechenii pacientov s anomalijami zubocheljustnoj sistemy, soprovozhdajushhimisja suzheniem verhnej cheljusti [The use of computed tomography data in the diagnosis and treatment of patients with anomalies of dental system, accompanied by a narrowing maxilla.]. Medicinskaja vizualizacija. 2014; 3: 104-113 [In Russ].

9.    Gateno J., Xia J.J., Teichgraeber J.F. A New ThreeDimensional Cephalometric Analysis for Orthognathic Surgery. J. Oral Maxillofac. Surg. 2012; 69: 606-622.

10.  Kau C. H., Richmond S. Three-dimensional imaging for orthodontics and maxillofacial surgery. Blackwell Publisheng Ltd., 2010; 320 p.

11.  Olszewski R., Zech F., Cosnard G. et al. Threedimensional computed tomography cephalometric craniofacial analysis: experimental validation in vitro. Int. J. Oral Maxillofac. Surg. 2007; 36: 828-833.

12.  Rooppakhun S., Piyasin S., Sitthiseriprati K., Ruangsitt C., Khongkankong W. 3D CT Cephalometric: A Method to Study Cranio-Maxillofacial Deformities. Papers of Technical Meeting on Medical and Biological Engineering. 2006; 6: 75-94, 85-89.



Aim: was to determine the level of bilateral asymmetry of mineral density of trabecular and cortical bones in lumbar spine in women as an additional diagnostic criterion for osteoporosis, using quantitative computed tomography

Material and methods: the study included 210 women, postmenopausal, who underwent bone densitometry by quantitative computed tomography Estimated total body BMD II-IV of the lumbar vertebrae (separately for trabecular and cortical bone), as well as bilateral asymmetry indices BMD - BMD ratio of the largest one-half of the vertebral BMD to the other half.

Results: with increasing age of the surveyed, noted the growth of bilateral asymmetry index values mineral density of the lumbar vertebrae for both trabecular and cortical bones. Decrease in bone mass of the lumbar vertebrae is associated with an increase in bilateral asymmetry of the BMD. The correlation between the BMD and bilateral asymmetry indices for trabecular bone was r = -0.52 (p=0.001) for cortical bone r = - 0.47 (p=0.001).

Conclusion: the index of bilateral asymmetry in bone mineral density of the vertebral bodies car serve as an additional diagnostic criterion for osteoporosis during bone densitometry by quantitative computed tomography in postmenopausal women.



1.    Hernlund E., Svedbom A., Ivergard M. et al. Osteoporosis in the European Union: Medical Management, Epidemiology and Economic Burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch. Osteoporos. 2013; 8: 136.

2.    Marshall D., Johnell O., Wedel H. Metaanalysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. Br. Med. J. 1996; 312: 1254-1259.

3.    Nguyen T., Sambrook P, Kelly P et al. Prediction of osteoporotic fractures by postural instability and bone density. BMJ. 1993; 307: 1111-1115.

4.    Siris E.S. Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. Journal of the American Medical Association. 2001; 286 (22): 2815-2822.

5.    ACR-SPR-SSR practice parameter for the performance of quantitative computed tomography (QCT) bone densitometry. Available at: /ACR/Documents/PGTS/guidelines/QCT.pdf Res. 32-2013, Amended 2014 (Res. 39).

6.    These are the Official Positions of the ISCD as updated in 2013. Available at: (accessed April 24, 2014).

7.    Zakharov I.S., Kolpinskij G.I., Shkaraburov A.S., Popova O.P. Kolichestvennaja kompjuternaja tomografija i dvuhjenergeticheskaja rentgenovskaja absorbciometrija v diagnostike postmenopauzal'nogo osteoporoza. [Quantitative computed tomography and dual-energy X-ray absorptiometry in the diagnosis of postmenopausal osteoporosis]. Diagnosticheskaja i intervencionnaja radiologija. 2015; 10 (2):19—22. [In Russ].

8.    Bansal S.C., Khandelwal N., Rai D.V. et al. Comparison between the QCT and the DEXA scanners in the evaluation of BMD in the lumbar spine. Journal of Clinical and Diagnostic Research. 2011; 5 (4): 694-699.

9.    Bauer J.S., Virmani S., Mueller D.K. Quantitative CT to assess BMD as a diagnostic tool for osteoporosis and related fractures. Medica Mundi. 2010; 54 (2): 31-37.

10.  Li N., Li X.M., Xu L. et al. Comparison of QCT and DXA: osteoporosis detection rates in post-menopausal women. International Journal of Endocrinology. 2013; March 27. Available at: /pubmed/23606843.

11.  Zaharov I



The basis of computed tomography diagnosis is the definition of densitometric parameters at different phases of the study.

Aim. Was to perform comparative analysis of computed tomography features of focal nodular hyperplasia and hepatocellular carcinoma.

Materials and methods. During the reseach clinical and morphological comparisons were performed on the base of 36 patients’ CT’s results: 21 patient with hepatocellular carcinoma (HCC) and 15 patient with focal nodular hyperplasia of the liver without associated liver cirrhosis. At the preoperative stage all patients underwent spiral computed tomography with bolus contrast enhancement (on the four phases of the study).

Results. During native phase of computed tomography HCC nodes are more often hipodense irrespective of the degree of histological differentiation and focal nodular hyperplasia - izodense. After intravenous injection of contrast agent, computed tomography picture of hepatocellular carcinoma and focal nodular hyperplasia depended on the phase of the study During the arterial phase tissue of focal nodular hyperplasia in the vast majority of cases was hiperdense relative to the surrounding liver parenchyma. Hepatocellular carcinoma had similar values much less frequently in contrast to the focal nodular hyperplasia. The venous phase was characterized by the presence of hiperdense characteristics in focal nodular hyperplasia areas and, conversely, in hepatocellular carcinoma tissue signs of hiperdense were not observed. Hyperdence formations in delayed phase of computed tomography indicate the presence of focal nodular hyperplasia, and vice versa, hypodense are sufficient to prevent its presence.

Conclusion. Estimation of densitometric parameters of focal nodular hyperplasia and hepatocellular carcinoma allows to determine features of computed tomography imaging of tumors at different phases of the examination, and this allows to make a differential diagnosis between them.





During our research we have studied x-ray and morphology features of lungs sarcoidosis (LS), levelof fibrosis disorders and rate of pulmonary hypertention (PHT) as a way of calculation pulmonary-thoracical index (PTI) during chest multi-slice computed tomography (MSCT). We have examined 50 patients aged 30-75 with different forms of lungs sarcoidosis. As a result of clinical aboratory, x-ray and morphologicaldata comparison patients were divided into 3 groups.During data analysis we found out that PHT leads to inverse connection of PTIdecrease with increase of interstitial fibrosis (the most expressed changes were in group of patients with chronic recur disease current

The analysis data allows to reveal early symptoms of PHT, that promotes well-timed tactics of treatment.



1.    Архипова Д.В., Попова Е.Н., Осипенко В.И. и др. Легочная гипертензия при интерстициальных болезнях легких. 12-й Национальный конгресс по болезням органов дыхания. Москва. 2002; 135-136.

2.    Борисов С.Е. Дифференциальная диагностика саркоидоза. Вестник НИИ фтизиопульмонологии ММА им. И.М. Сеченова. 1999; 1: 34-39.

3.    Bartz R.R., Stern E.J. Airways obstruction in patients with sarcoidosis. Expiratory CT scan findings. J. Thorac. Imag. 2000; 15 (4): 285-289.

4.    Хоменко А.Г., Озерова Л.В., Романов В.В. и др. Саркоидоз. 25-летний опыт клинического наблюдения. Проблемы туберкулеза. 1996; 6: 64-68.

5.    Tan R.T. еt al. Utility of CT scan evalution for predicting pulmonary hypertension in patients with parenchymal lung disease. Medical College of Winsconsin Lung Transplant Group. Chest.  1998; 113 (5):1250-1256.

6.    Саницкая Л.Н., Зубков А.А., Адамович В.Н. Особенности клиники и течения саркоидоза 1-й стадии. В сб. Дифференциальная диагностика саркоидоза и туберкулеза легких. Под ред. В. Н. Адамовича. М. 1998; 52-58.

7.    Соколина И.А., Дмитращенко А.А., Осипенко В.И., Шехтер А.И. Компьютер но-томографические признаки поражения плевры при саркоидозе. Международный союз по борьбе с туберкулезом и легочными заболеваниями (IUATLD). 3-й конгресс Европейского региона. Российское респираторное общество. 14-й Национальный конгресс. Сборник тезисов. Москва. 2004; 376-378.

8.    Коган Е.А., Козловская Л.В., Корнев Б.М. и др. Интерстициальные болезни легких. Под ред. Н.А. Мухина. 2007; 120-144.

9.    Hunninghake G.W. et al. Statement on sarcoidosis. Sarcoid. Vasc. Dif. L. Dis. 1999; 16 (2): 149-173.

10.  Коган Е.А., Деньгин В.В., Жак Г., Корнев Б.М. Клинико-морфологические и молекулярно-биологические особенности идиопатического фиброзирующего альвеолита и саркоидоза легких. Архив патологии. 2000; 6: 32-37.

11.  Шмелев Е.И. Дифференциальная диагностика интерстициальных болезней легких. Consil. medic. 2003; 5 (4): 176-181.

12.  Wells A.U., Padley S.P. A CT sing of chronic pulmonary arterial hypertension the ratio of main pulmonary artery to aortic diameter. J. Thorax. Imag. 1999; 14 (4): 270-278.

13.  Осипенко В.И., Попова Е.Н., Терновой С.К. и др. Способ компьютерной диагностики степени легочной гипертензии. Авт. св. № 2269931 РФ, 09.06.2004 г.




Purpose. Was to define the capability of multi-slice computed tomography angiography (MSCT-angiography) in diagnostics of arteriove-nosus conflict in patients with primary and recurrent varicocele.

Materials and methods. 46 patients with left-side varicocele were underwent MSCT-angiography: 36 had firstly diagnosed disease, 10 had recurrent types. Capability of MSCT-angiography in the zone of possible arteriovenosus conflicts was estimated on the base of imaging analysis: axial, multiplanar and 3D-imaging of left renal vein (LRV), a.mesenterica superior (AMS) in aortomesenterical zone, and crossing place of left iliaca communis vein(LICV) and right iliaca communis artery (LICA). We have investigated structure features of left testiculars vein (LTV) in patients with primary and recurrent varicocele.

Results. All the patients during axial imaging analysis we have investigated the crossing place of LRV and LICV with conflict arteries - AMS and LICA. We have revealed featured of LRV, compressed by AMS, on the base of axial and multiplanar imaging changes. Analysis of axial multiplanar and 3D-reconstruction has showed high capability in diagnostics of arteriovenosus conflict on the level LICV Study of multiplanar and CT-imaging in case of LICV valve insufficiency and different types of anatomy is possible

Conclusions. Taking into consideration diagnostic capability, technical simplicity and high sensitivity of MSCT-angiography in diagnostics of arteriovenosus conflicts in varicocele, this methodic must be included in algorithm of patients examination in case of primary and recurrent varicocele. MSCT-angiography in definition of haemodynamic types of disorders can promote the right choice of surgical correction.



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

2.    Степанов В.Н., Кадыров З.А. Диагностика и лечение варикоцеле. М. 2001; 200.

3.    Бавильский В.Ф., Суворов А.В., Иванов А.В. и др. Выбор метода оперативного лечения варикоцеле.  Урология. 2003; 6: 40-43.

4.    Гарбузов Р.В., Поляев Ю.А., Петрушин А.В. Артериовенозный конфликт и варикоцеле у подростков. Диагностическая и итервенционная радиология. 2010; 4 (3): 31-36.

5.    Мазо Е.Б., Тирси К.А., Андранович С.В., Дмитриев Д.Г. Ультразвуковой тест и скротальная допплер-эхография в предоперационной диагностике гемо-динамического типа варикоцеле. Урология и нефрология. 1999; 3: 22-26.

6.    Лопаткин Н.А., Морозов А.В., Житникова Л.Н. Стеноз почечной вены. М.: Медицина. 1984.

7.    Коган М.И., Афоко А., Тампуори Д., Асанти-Асамани А., Пипченко О.И. Варикоцеле: противоречия проблемы. Урология. 2009; 6: 67-72.

8.    Кадыров З.А. Варикоцеле. М.: Медицина. 2006.




Purpose. For basic, purpose was to develop effective methods of exact diagnostics of an acute pancreatitis (AP), to work out classifications of disease, an establishment of patients' condition definitions, and also productive supervision over dynamics of its process by means of application computed tomography (СТ) and magnetic resonance imaging (MRI). Besides, on the base of obtained data, the optimum tactics of treatment was worked out

Materials and methods. More than 500 patients with AP were underwent CT and MRI with one-stage contrast agents' injection. During the research we have applied different variations of scanning modes and parameters. Results were analyzed in connection with supervision on patients conditions. Treatment tactics depended on obtained data

Results. We have worked out effective methods of AP diagnostics, optimal parameters of research in different clinical currents and we have developed an effective tactics of treatment in patients with severe AP Besides, on the base of obtained data, the optimum tactics of treatment was worked out

Conclusions. CT with intravenous contrasting is the best method of diagnostics or supervision in dynamics, which allows to work out the most productive treatment tactics. Using CT in combination with MRI in some cases can be specifying method of diagnostics.  



1.    Араблинский А.В., Черняков P.M., Хитрова А.Н., Богданова Е.Г. Лучевая диагностика острого панкреатита. Медицинская визуализация. 2000;         1-14.

2.    Прокоп М., Галански М. Спиральная компьютерная томография. 2009.

3.    Райан С., МакНиколас М., Юстеис С. Анатомия человека при лучевых исследованиях. 2009.

4.    Шабунин А.В., Мумладзе Р.Б., Чеченин Г.М., Тавобилов М.М. Этапное хирургическое лечение острого панкреатита, панкреонекроза алкогольной этиологии. Неотложная и специализированная хирургическая помощь. 1-й конгресс московских хирургов. Тез. док. М. 19-21 мая 2005 г. М.: ГЕОС. 2005; 122.

5.    Balthazar E. CT diagnosis and staging of acute pancreatitis. RadiolClin. North. Am. 1989; 27 (1): 19-37.

6.    Balthazar E.J., Megibov A.J., Pozzi R. Mucelli Imaging of the pancreas. Medical radiology.2009.

7.    Piironen A. et al. Detection of severe acute pancreatitis by contrast enhanced magnetic resonance imaging. European Radiology. 2000; 2: 354.

8.    Balthazar E. et al. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990; 174 (2): 331-336.

9.    Bradley E.L. A clinically based classification system for acute pancreatitis. Summary of the international simposium on acute pancreatitis. Atlanta. G., Sept. 11-13. 1992: 586-590.

10.  Багненко С.Ф., Рухляда Н.В., Толстой А.Д., Гольцов В.Р. Лечение острого панкреатита на ранней стадии заболевания. НИИ СП им. И.И. Джанелидзе, С.-Пб. 2002; 24.

11.  Robinson PJ.A., Sheridan M.B. Pancreatitis computed tomography and magnetic resonance imaging. European Radiology. 2000; 3: 401.

12.  Balthazar E.J., Freeny P.C., Sonennberg E. Imaging intervention in acute pancreatitis. Radiology. 1994; 193: 197-306.

13.  Balthazar E.J. et al. Acute pancreatitis. Prognostic value of CT. Radiology. 1985; 156:767-772.

14.  Isenmann R., Rau B., Beger H.G. Infected necroses and pancreatic abscess. Surgical therapy. Kongressbd Dtsch Ges Chir Kongr. 2001; 118: 282-284.

15.  Кармазановский Г.Г., Федоров В.Д. Компьютерная томография поджелудочной

Three-dimensional computed tomography in assessment of sinus-lifting operation before dental implantation


For quoting:
Serova N.S. "Three-dimensional computed tomography in assessment of sinus-lifting operation before dental implantation". Journal Diagnostic & interventional radiology. 2010; 4(4); 41-44.



The work consists of 45 patient’s radiodiagnostics data: operation sinus-lifting has been executed before dental implantation to complete missing volume of bone fabric of maxilla alveolar process.

The analysis of cite data has shown an inefficiency of traditional ortopantomography and advantages of three-dimensional computed tomography in assessment of spent treatment.  



1.    Параскевич В.Л. Дентальная имплантация. Итоги века. Новое в стоматологии. Спец.вып. 2000; 8: 7–15.

2.    Жусев А.И. Дентальная имплантация. М.: Медицина.1999.

3.    Bremke M. et al. Digital volume tomography (DVT) as a diagnostic modality of the anterior skull base. Acta Otolaryngolog. 2009; 129 (10):1106–1114.

4.    Паслер Ф., Виссер Х. Рентгенодиагностика в практике стоматолога. М.: Медпресс-информ. 2007.

5.    Albrektsson T. et al. The long-term efficacy of currently used dental implants. А review and proposed criteria of success. Int. J. Oral. Maxillofac. Implants. 1986; 1 (1): 11–25.

6.    Nevins M., Langer B. The successful application of osseointegrated implants to the posterior jaw. А long-term retrospective study. Int. J. of Oral. Maxillofac. Implants. 1993; 8: 428–432.

7.    Cacaci C., Frank E., Bumann A. DVT-Volumentomograph. Teamwork. 2007; 10 (3): 244–254.

8.    Khoury F. Augmentation of the sinus floor with mandibular bone block and simultaneous implantation. А 6-year clinical investigation. Int. J. Oral. Maxillofac. Implants. 1999;14: 557–564.

9.    Raghoebar G.M. et al. Maxillary bone grafting for insertion of endosseous implants. Results after 12–124 months. Clin. Oral. Implants. Res. 2001; 12: 279–286.

10.  Leckholm U., Zarb G.A. Patient selection and preparation. En: P.I. Branemark, G.A. Zarb, T. Albrektsson et al. Tissue integrated prostheses: osseointegration in clinical dentistry. Quintessence. 1985; 199–209.



11.  Wörtche R. et al. Clinical application of cone beam digital volume tomography in children with cleft lip and palate. Dentomaxillofac. Radiol. 2006; 35: 88–94.





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.



1.    Гранов А.М., Таразов П.Г., Гранов Д.А. и др. Современные тенденции в комбинированном хирургическом лечении первичного и метастатического рака печени. Анн. хир.гепатол. 2002; 7 (2): 9–17.

2.    Paschos K., Bird N. Current diagnostic and therapeutic approaches for colorectal cancer liver metastasis. Hippokratia. 2008; 12 (3): 132–138.

3.    Kanematsu M. et al. Imaging liver metastases: review and update. Eur. J. Radiol. 2006; 58 (2): 217–228.

4.    Scaife C.L. et al. Accuracy of preoperative imaging of hepatic tumors with helical computed tomography. Ann. Surg. Oncol. 2006; 13 (4): 542–546.

5.    Regge D. et al. Diagnostic accuracy of portalphase CT and MRI with mangafodipirtrisodium in detecting liver metastases from colorectal carcinoma. Clinical. Radiology. 2006; 61 (4): 338–347.

6.    Kim K.W. et al. Small (≤ 2 cm) hepatic lesions in colorectal cancer patients. Detection and characterization on mangafodipir trisodium-enhanced MRI. AJR. 2004; 182 (5): 1233–1240.

7.    Bartolozzi C. et al. Detection of colorectal liver metastases. A prospective multicenter trial comparing unenhanced MRI, MnDPDP-enhanced MRI, and spiral CT. Eur. Radiol. 2004; 14 (1): 14–20.

8.    Wiering B. et al. Comparison of multiphase CT, FDGPET and intraoperative ultrasound in patients with colorectal liver metastases selected for surgery. Ann. Surg. Oncol. 2007; 14 (2): 818–826.

9.    Kalender W.A., Kyriakou Y. Flatdetector computed tomography (FDCT). Eur. Radiol. 2007;17 (11): 2767–2779.

10.  Buhk J. et al. Angiographic computed tomography is comparable to multislice computed tomography in lumbar myelographic imaging. J. Comput. Assist. Tomogr. 2006; 30 (5):739–741.

11.  Housseini A.M. et al. Comparison of three dimensional rotational angiography and digital subtraction angiography for the evaluation of the liver transplants. Clinical. Imaging. 2009; 33 (2): 102–109.

12.  Rooij W.J. et al. 3D rotational angiography. The new gold standard in the detection of additional intracranial aneurysms. Am. J.Neuroradiol. 2008; 29 (5): 976–79.

13.  Meyer B.C. et al. Visualization of Hypervascular Liver Lesions During TACE. Comparison of Angiographic CArm CT and MDCT. AJR. 2008; 190 (4): 263–269.

14.  Orth R.C. et al. Carm conebeam CT: general principles and technical considerations for use in interventional radiology. J. Vasc. Interv.Radiol. 2008; 19 (6): 814–821.

15.  Irie K. et al. DynaCT softtissue visualization using an angiographic Carm system. Initial clinical experience in the operating room. Operative Neurosurg. 2008; 62 (3): 266–272.

16.  Meyer B.C. et al. Contrastenhanced abdominal angiographic CT for intraabdominal tumor embolization. A new tool for vessel and soft tissue visualization. Cardiovasc. Intervent. Radiol. 2007; 30 (4): 743–749.

17.  Meyer B.C. et al. The value of combined soft tissue and vessel visualisation before transarterial chemoembolisation of the liver using Carm computed tomography. Eur.Radiol. 2009; 19 (9): 2302–2309.

18.  Hirota S. et al. Conebeam CT with flatpanel detector digital angiography system/ Early experience in abdominal interventional procedures. Cardiovasc. Intervent. Radiol. 2006; 29 (6): 1034–1038.

19.  Wallace M.J. et al. Threedimensional Carm conebeam CT. Applications in the interventional suite. J. Vasc. Interv. Radiol. 2008;19 (6): 799–813.

20.  Raman S.S. et al. Improved characterization of focal liver lesions with liverspecific gadoxetic acid disodiumenhanced magnetic resonance imaging: a multicenter phase 3 clinical trial. J. Comput. Assist. Tomogr. 2010; 34 (2): 163–172.

21.  lrie T. et al. CT evaluation of hepatic tumors.Сomparison of CT with arterial portography, CT with infusion hepatic arteriography, and simultaneous use of both techniques. AJR. 1995; 164 (6): 1407–1412.

22.  Kanematsu M. et al. Detection and characterization of hepatic tumors: value of combined helical CT hepatic arteriography and CT during arterial portography. AJR. 1997; 168 (5): 1193–1198.

23.  Matsui O. et al. Liver metastases from colorectal cancers. Detection with CT during arterial portography. Radiology. 1987; 165 (1): 65–69.

24.  Soyer P. et al. Hepatic metastases from colorectal cancer: detection and falsepositive findings with helical CT during arterial portography. Radiology. 1994; 193 (1): 71–74.

25.  Valls C. et al. Helical CT versus CT arterial portography in the detection of hepatic metastasis of colorectal carcinoma. AJR. 1998; 170 (5): 1341–347.

26.  Semelka R.C. et al. Liver metastases: comparison of current MR techniques and spiral CT during arterial portography for detection in 20 surgically staged cases. Radiology. 1999;213 (1): 86–91.

27.  Schwartz L. et al. Prospective, blinded comparison of helical CT and CT arterial portography in the assessment of hepatic metastasis from colorectal carcinoma. World. J. Surg.2006; 30 (10): 1892–1901.



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.  



1.    Слободин К.Э. Лучевая диагностика по вреждений глаз. СПб. 2007.

2.    Красильников Р.Г., Варуск С.В., Жупан Б.Б. Возможности использования компьютерной и магнитнорезонансной томографии в диагностике повреждений орбит и глаза и их осложнений. Современные аспекты военной медицины. Киев. 2007; 12: 16–24.

3.    Александров Н.М., Аржанцев П.3. Травмы челюстнолицевой области. М. 1986.

4.    Слободин К.Э. Принципы, современные возможности и перспективы лучевой диагностики в офтальмологической практике. М. Вестник рентгенологии и радиологии. 2001; 1: 55–61.

5.    Бровкина А.Ф. Болезни орбиты. М. 2008.

6.    Бабий Я.С., Болгова И.М., Удовиченко В.В. Лучевые методы диагностики при заболеваниях глаза и орбиты. М. Вестник Российского научного центра рентгенологии. 2004; 3.

7.    Труфанов Г.Е., Бурлаченко Е.П. Лучевая диагностика заболеваний глаза и глазницы. СПб. 2009.

8.    Бровкина А.Ф., Яценко О.Ю., Мослехи Ш. и др. Оценка корреляции данных КТ и УЗИ при исследовании толщины экстраокулярных мышц у больных отечным экзофтальмом. М. Клиническая офтальмология. 2008; 2: 61.

9.    Бровкина А.Ф., Яценко О.Ю., Аубакирова А.С., Мослехи Ш. Компьютернотомографическая анатомия орбиты с позиции клинициста. Вестник офтальмологии. 2008; 124 (1): 11–14.

10.  Ozgen A., Ariyurec M. Normative measurements of orbital structures using CT. Am. J. Roentgenol. 1998; 170 (4): 1093–1096.

11.  Furuta M. Measurement of orbital volume by computed tomography. Еspecially on the growth of the orbit. Jpn. J. Ophthalmol. 2001; 45 (6): 600–606.

12.  Demer J.L., Miller J.M. Magnetic Resonance Imaging of the Functional anatomy of the Superiror Oblique Muscle. Investigative Ophthalmology & Visual Science. 1995; 36 (5): 209–913.

13.  Horton J.C. et al. Magnetic resonance imaging of superior oblique muscle atrophy in acquired trochlear nerve palsy [letter].

14.  Am. J. Ophthalmol. 1990; 110: 315–316.

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.




The article provides a case report of the patient with mediastinitis. This case report shows the importance of multispiral computed tomography in the diagnostics of tumors of this localization, demonstrates the need of proper preparation of patient for examination and use of CT with intravenous contrast enhancement, multiplanar reconstruction images to obtain information about the nature of blood flow, determining the structure of esophagus walls and the ratio of detected changes with surrounding organs and vascular structures, which is particularly important for treatment planning.



1.    Arslan E., Sank M., Iюэk A.F. et al. Treatment for esophageal perforations: analysis of 11 cases. Ulus. Travma Acil. Cerrahi. Derg. 2011; Nov 17(6): 516-20.

2.    Lyman D. Spontaneous esophageal perforation in a patient with mixed connective tissue disease. Open Rheumatol. J. 2011; 5: 138-43.

3.    S. M.P., Soares E.F., Santos C.A. et al. Risk factors for mediastinitis after coronary artery bypass grafting surgery. Rev. Bras. Cir. Cardiovasc. 2011; 26(1): 27-35.

4.    Komarov B.D., Kanshin N.N., Abakumov M.M. Povrezhdenija pishhevoda. [Injures of esophagus ]- М.: Medicina, 1981; 175. [In Russ]

5.    Petrov B.A. Khirurgija pishhevoda. [Surgery of the esophagus] Khirurgija. 1967; 10; 9-15

6.    Toshhakov R.A., Nechiporenko I.N., Putenikhin S.V. Mediastinit i rezul'taty ego khirurgicheskogo lechenija. [Mediastinitis and the results of surgical treatment] Zdravookhranenie Turkmenistana. 1992; 4; 41-43. [In Russ]

7.    Randjelovic T., Stamenkovic D. Mediastinitis-diagnosis and therahy. Acta Chir. Iugosl.2001 ; 48; 3; 55-59.

8.    Santiago E. Rossi, H. Page McAdams, Melissa L. Rosado-de-Christenson, Teri J. Franks, Jeffrey R. Galvin. Fibrosing Mediastinitis. RadioGraphics. 2001; 21: 737-757.

9.    Strohm P., Muller C., Jonas J., R. Bahr Esophageal perforation. Etiology, diagnosis, therapy. Chirurg. 2002; 73 (3): 217-222.

10.  Abakumov M.M. Mekhanicheskie povrezhdenija pishhevoda: [The mechanical damage to the esophagus]:14.00.27 - Khirurgija . NII SP im. N.V. Sklifosovskogo. М., 1979; 434 [In Russ]

11.  Ivanov A.Ja. Abscessy i flegmony sredostenija. [Mediastinal abscess and phlegmon] Medgiz, 1959;147 [In Russ].

12.  Komarov B.D., Abakumov M.M., Pogodina A.N. Ostryjj gnojjnyjj mediastinit (klinika, diagnostika, lechenie). [Acute purulent mediastinitis (clinical picture, diagnosis, treatment)] Khirurgija. 1985; 10; 151-152 [In Russ].

13.  Braxton J.H., Marrin C.A., McGrath P.D. еt ак Mediastinitis and long-term survival after coronary artery bypass graft surgery. Ann. Thorac. Surg. 2000; 70 (6): 2004-7

14.  Vancjan Eh.N. , Chernousov A.F., Chissov V.I. Povrezhdenija pishhevoda pri buzhirovanii. [Damage to the esophagus during bougienage] Khirurgija.1976; 4: 83-88 [In Russ].

15.  Kvardakova O.V Znachenie rentgenologicheskogo issledovanija v ocenke techenija gnojjnogo mediastinita. [The value of radiologic studies to evaluate the flow of purulent mediastinitis ] Date of last access: March 19, 2012 at link: [In Russ].

16.  Shraer, T.I. Taktika khirurga pri perforacii grudnogo otdela pishhevoda. [Tactics of the surgeon with thoracic esophageal perforation.] Grudnaja khirurgija.1966; 5: 82-88 [In Russ].

17.  Demetriades D., Theodorou D., Cornwell E .et al. Evaluation of penetrating injuries of the neck: prospective study of 223 patients. World J. Surg.1997; 21(1): 41-47.

18.  Hunt D.R., Wills V.L.. Weis B. еt ак Management of esophageal perforation after pneumatic dilation for achalasia. Ulus. Travma Derg. 2001; 7(1): 22-7.

            19.  Robicsek, F. Postoperative sterno

Cyst lymphangioma of spleen, complexities of diagnostics


For quoting:
Tumanova U.N., Shirokov V.S., Berelavichus S.V., Karmazanovsky G.G. "Cyst lymphangioma of spleen, complexities of diagnostics". Journal Diagnostic & interventional radiology. 2013; 7(1); 51-58.



The article presents literature data about splenic lesions, their morphological characteristics and occurrence. Methods of diagnostics of such lesions are considered. Rarely met pathology as lymphangioma of spleen is discussed. Article describes peculiarities of clinical and morphological classifications of lymphangiomas with different locations, their morphological structure, clinical features of this disease in children and adults. Detailed diagnostic algorithm for detection of splenic lymphangioma is described. Possibilities and advantages of modern methods of diagnostic testing, perspective and the leading role CT and MRI are described. Complexities in diagnostics were noted during the research; optimal combinations of diagnostic methods for better verification of such spleen lesions, for estimation of certain anatomical relation with other structures and tissues, spread of the affected area, as well as an assistance in definition of surgical tactics and volume of intervention, based on data were offered. Application of new technologies with the use SCT-dimensional reconstruction of the affected organ and area of further operation, and the 3D planning of intervention, conducting virtual operations for the optimal access, volume of interventions on the base of individual characteristics of vascular and anatomical features of the patient - gives significant advantages. Review of possible treatment methods is presented. As a case report we used obtained data of 26-years woman with identified during ambulatory ultrasound diagnostics lymphangioma of spleen. In conclusion it is pointed that early and accurate diagnostics is important for prevention of complications and for reduce of operational trauma.



1.    Kubyshkin V.A., Ionkin D.A. Opuholi i kisty selezenki [Tumors and cysts of spleen] M.: Medpraktika- M, 2007 [In Russ].

2.    Cappellani A., Zanghi A., Di Vita M. et al. Spontaneous rupture of a giant hemangioma of the liver. Ann. Ital. Chir. 2000; 71: 379-383.

3.    Daltrey I.R., Johnson C.D. Cystic lymphangioma of the pancreas. Postgrad. Med. J. 1996; 72(851): 564-566.

4.    Panferova T.R. Jehografija v kompleksnoj diagnostike zabrjushinnyh vneorgannyh opuholej u detej . [Ultrasonography in complex diagnostics of retroperitoneal extraorganic tumors in children] Avto-ref. dis. kand. med. nauk. M., 1998 [In Russ].

5.    Brian K.P., Goh M., Y-Meng Tan et al. Intra-abdominal and retroperitoneal ymphangiomas in pediatric and adult patients. WTd J. Surg. 2000; 29: 837-840.

6.    Konen O., Rathans V., Dingy E. et al. Childhood abdominal cystic lymphangioma. Pediatr. Radiol. 2002; 32: 88-94.

7.    Christie J.P., Karlan M.S. Lymphangioma of the pancreas with symptoms of «acute surgical abdomen». Calif Med. 1969; 111(1): 22-24.

8.    Umap P. Intra! abdominal cystic lymphangioma. IndianJ. Cancer 1994; 31: 111-113.

9.    Volobuev N.N., Tihonov K.S., Minajkin V.I. Gigantskaja kistoznaja limfangioma brjushnoj polosti. Hirurgija. [Giant cystic lymphangioma of abdominal cavity] 1989;5: 127-128 [In Russ].

10.  Faul J.L., Berry G.J., Colby T.V. et al. Thoracic lymphangiomas, lymphangiectasis, lymphangiomatosis and lymphatic dysplasia syndrome. Am. J. Respir. Crit. Care Med. 2000; 161: 1037-1046.

11.  Wegner G. Veber Lymphangiome. Arch. Klin. Chir. 1877; 20: 641.

12.  Matjunin V.V. Limfangiomy cheljustno-licevoj oblasti u detej. [Lymphangiomas of maxillofacial area in children] Dissertation for degree of Doctor of Philosophy. M., 1993;150 [In Russ].

13.  Takeuchi Y., Fujinami S., Kitagawa S. et al. Laparoscopic observation of retroperitoneal cystic lymphangioma. J. Gastroenterol. Hepatol. 1994; 9(2): 198-200.

14.  Bliss D.P. Jr., Coffin C.M., Bower R.J. et al. Mesenteric cysts in children. Surgery. 1994; 115: 571-577.

15.  Hancock B.J., St. Vil D., Luks F.I. et al. Complication of lymphangiomas in children. J. Pediatr. Surg. 1992; 27(2): 220-226.

16.  Kurtz R.J., Heimann T.M., Holt J. et al. Mesenteric and retroperitoneal cysts. Ann. Swrg. 1986; 203: 109-111.

17.  Chou Y.H., Tiu C.M., Lui W.Y. et al. Mesenteric and omental cysts: an ultrasonographic and clinical study of 15 patients. Gastrointest. Radiol. 1991; 16: 311-314.

18.  Stepanova Ju.A. Diagnostika neorgannyh zabrjushinnyh obrazovanij po dannym kompleksnogo ul'trazvukovogo issledovanija: [Diagnostics of retroperitoneal newgrowth: complex US diagnostics.] Dissertation for degree of Doctor of Philosophy.M., 2002 [In Russ].

19.  Karmazanovskij G.G., Fedorov V.D. Kompjuternaja tomografija podzheludochnoj zhelezy i organov zabrjuwinnogo prostranstva [CT of pancreas and retroperitoneal organs]. M.: Paganel', 2000 [In Russ].

20.  Melihova M.V. Differencial'no diagnosticheskie vozmozhnosti spiral'noj kompjuternoj tomografii s boljusnym kontrastnym usileniem pri neorgannyh zabrjushinnyh obrazovanijah. [MCST with bolus contrast encashment in differential diagnostics of extraorganic retroperitoneal newgrowth.] Dissertation for degree of Doctor of Philosophy. M., 2005 [In Russ].

21.  Leung T.K., Lee C.M., Shen L.K., Chen Y.Y. Differential diagnosis of cystic lymphangioma of the pancreas based on imaging features. J. Formos. Med. Assoc. 2006; 105(6): 512-517.

22.  Khandelwal M., Lichtenstein G., Morris J. et al. Abdominal lymphangioma masquerading as a pancreatic cystic neoplasm. J. Clin. Gastmenterol. 1995; 20: 142-144.

23.  Casadei R., Minni F., Selva S. et al. Cystic lymphangioma of the pancreas: anatomoclinical, diagnostic and therapeutic consideration regarding three personal observations and review of the literature. Hepatogastroenterology. 2003; 50(53): 1681-1686

Role of multispiral ct in diagnostics of coronary artery aterosclerotic disease in patients with atypical angina


For quoting:
Maryasheva Yu.A., Veselova T.N., Fedotenkov I.S., Arhipovaі I.M., Ageev I.M., Sinitsynі V.E., Ternovoy S.K. "Role of multispiral ct in diagnostics of coronary artery aterosclerotic disease in patients with atypical angina". Journal Diagnostic & interventional radiology. 2010; 4(3); 19-27.



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

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

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

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



1.      Синицын В.Е., Устюжанин Д-В. КТ-ангио-графия коронарных артерий. Кардиология. 2006; 1: 20-25.

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

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

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

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

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

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

8.      Kopp A.F. et al. Coronary arteries: retrospectively ECG-gated multi-detector row CT angiography with selective optimization  of the image reconstruction window. Radiology. 2001; 221:683-688.

9.      Austen W.G. et al. A reporting system on patients evaluated for coronary artery disease. Report of the Ad-Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery.   Circulation.   1975;  51:5-40.

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

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

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

13.    Goldstein J.A. et al. A randomized controlled trial of multi-slice coronary computed tomography for evaluation of acute chest pain. J. Am. Coll. Cardiol. 2007; 49: 863-871.

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




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.



1.      Bosset J."F. et al. Chemotherapy with Preoperative Radiotherapy in Rectal Cancer. N. Engl. J. Med. 2007; 357 (7): 728.

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.




Recently one can see higher incidence rate of fatty liver. The purpose of our study was to examine the abilities of raiodiagnostics (computed tomography and bolus contrast-enhanced CT angiography) in patients with different stages of non-alcoholic hepatic steatosis. Seventy four patients with morphologically verified diagnosis of non-alcoholic hepatic steatosis were included into the study. Hepatic parenchyma density was assessed quantitatively, as well as blood flow parameters at time-dencity curve in stages 1 (initial), 2 (moderate), and 3 (severe) of the disease. It was shown that hepatic time-dencity curve in patients with fatty liver was lower than splenic one. Thus, computed tomography and CT angiography are highly informative methods in diagnostics of hepatic steatosis, defying not only presence of the disease, but differentiating its stage and optimizing the therapeutic strategy.



1.    Буеверов А.О. Некоторые патогенетические и клинические вопросы неалкогольного стеатогепатита. В кн. Клинические перспективы гастроэнтерологии, гепато-логии А.О. Буеверова, М.В. Маевской. 2003; 3: 2-7.





2.    Северов М.В. Неалкогольная жировая болезнь печени. В кн. Практическая гепа-тология под ред. акад. Н.А. Мухина. 2004; 145-149.





3.    Подымова С.Д. Болезни печени. Руководство для врачей. 2-е изд., перераб. и доп. М.: Медицина. 1993; 267-278.





4.    LudvigJ., Viggiano T.R., McGill D.B., Oh B.J. Nonalcoholic   steatohepatitis.   May   Clinic experiences with a hitherto unnamed disease. Мayo Clin. Proc. 1980; 55: 434-438.





5.    Ивашкин И.Т. Неалкогольный стеатогепатит. Российский медицинский журнал. 2000; 2:41-46.





6.    Логинов А.С., Аруин Л.И., Шепелева С.Д., Ткачев В.Д. Пункционная биопсия в диагностике хронических заболеваний печени.Тер. арх. 1996; 68 (2): 5-8.





7.    Логинов А.С., Аруин Л.И. Возможности и ограничения морфологической диагностики заболеваний печени.  Тер. арх. 1980; 2:3-8.





8.    Joe D. Diagnosis of fatty liver disease: is biopsy necessary? D. Joy, V.R. Thava, B.B. Scott. Eur. J.   Gastroenterol. Hepatol.  2003;   15   (5):         13.539-543.





9.    Кармазановский Г.Г., Вилявин М.Ю., Никитаев Н.С. Компьютерная томография печени  и желчных путей.  М.:   «ПАГАНЕЛЬ-БУК». 1997; 357.



10.  Мизандари М., Мтварадзе А., Урушадзе О. ,Маисая К., Тодуа Ф. Комплексная лучевая  диагностика диффузной патологии печени.   Медицинская   визуализация.   2002;   1:60-66.



11.  Габуния Р.И., Колесникова Е.К. Компьютерная томография в клинической диагностике. Руководство. М.: Медицина.   1995;234.



12.  Китаев В.М., Белова И.Б., Китаев СВ. Компьютерная томография при заболеваниях печени. М. 2006; 110-115.



13.  Лучевая диагностика заболеваний печени (МРТ, КТ, УЗИ, ОФЭКТ и ПЭТ) под ред. проф. Г.Е. Труфанова. М.: Изд. Группа «ГЭОТАР-Медиа». 2007; 193.



14.  Berland L.L. Slip-ring and conventional dynamic hepatic CT: contrast material and timing consideration. Radiology. 1995; 195: 1-8.



15.  Яковенко Э.П., Григорьев П.Я., Агафонова Н.А. и др. Метаболические заболевания печени: проблемы терапии. Фарматека. 2003; 10: 47-53.


16.  Петухов В.А., Каралкин А.В., Ибрагимов Т.И. и др. Нарушение функции печени и дисбиоз при жировом гепатозе и липидном дистресс-синдроме и их лечение препаратом Дюфалак (лактулоза). Российский гастроэнтерологический журнал. 2001; 2: 93-102.




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

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

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



1.     Nkomo V.T., Gardin J.M., Skelton T.N. Burden of valvular heart diseases: a population-based study. Lancet 2006; 368: 1005-1011.

2.     Charlson E., Legedza A.T.R., Hamel M.B. Decisionmaking and outcomes in severesymptomatic aortic stenosis. J. Heart Valve Dis. 2006; 15: 312-321.

3.     Iung B., Baron G., Butchart E.G., Delahaye F.. Gohlke-Barwolf C., Levang O.W., Tornos P., Vanoverschelde J.L., Vermeer F., Boersma E., Ravaud P, Vahanian A. A prospective survey of patients with valvular heart disease in Europe: the Euro Heart Survey on Valvular Heart Disease. Eur. Heart J. 2003; 24: 1231-1243. 

4.     Varadarajan P., Kapoor N., Bansal R.C., Pai R.G. Clinical profile and natural history of 453 nonsurgically managed patients with severe aortic stenosis. Ann. Thorac. Surg. 2006; 82: 2111-2115.

5.     Andersen H.R., Knudsen L.L., Hasenkam J.M. Transluminal implantation of artificial heart valves. Description of a new expandable aortic valve and initial results with implantation by catheter technique in closed chest pigs. Eur. Heart J. 1992; 13:704-708.

6.     Cribier A., Eltchaninoff H., Bash A., Borenstein N., Tron C., Bauer F., Derumeaux G., Anselme F., Laborde F., Leon M.B. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation. 2002; 106: 3006-3008.

7.     Webb J.G., Pasupati S., Humphries K., Thompson C., Altwegg L., Moss R., Sinhal A., Carere R.G., Munt B., Ricci D., Ye J., Cheung A., Lichtenstein S.V. Percutaneous transarterial aortic valve replacement in selected high-risk patients with aortic stenosis. Circulation. 2007; 116: 755-763.

8.     Callander V. Computed tomography. M. Technosphere, 2006. C-17-23 [In Russ.]

9.     Ternovoy S.K., Sinitsyn V.E. Spiral CT and cathode ray angiography. M. Vidar, 1998. C-23-47 [In Russ.]

10.   Sinitsyn V.E., Achenbach S. Electron Beam Computed Tomography. In: M.Oudkerk (ed). Coronary Radiology. Berlin: Springer, 2004.

11.   Bridgewater B., Keogh B., Kinsman R., Walton P Sixth national adult cardiac surgical database report. 2008 [cited 2011 Feb 9].

12.   Ludman PF. British Cardiovascular Intervention Society audit returns: adult interventional procedures Jan 2009 to Dec 2009. BCIS Meeting; 2010 Oct: Cardiff, Wales. Рр17-34.



Aim: was to evaluate the use of intraoperative ultrasound in examination of patients with liver cancer compared with preoperative diagnostic methods.

Materials and methods: the study involved 650 patients who received surgical treatment for the period 1998-2013 years. During surgical intervention, all patients underwent intraoperative ultrasonography (IOUS) of the liver.

Results: results of preoperative examination methods were compared with intraoperative data, IOUS and histological examination. Sensitivity and accuracy of IOUS is above all methods of preoperative diagnosis, surgical palpation and is 99.7% and 94.9%, respectively Analyzed causes of mistakes of preoperative methods. These related: long time interval before surgical intervention, diameter of formations less then 2 cm, chemotherapy, presence of concomitant cirrhosis, different location of lesions (subcapsular, on the capsular and on the diaphragm of the liver), benign or non-tumorous liver lesions. Changes of operation volume occurred in 38 % cases, 20 % of them - on the base IOUS data.

Conclusions: IOUS provides decisive diagnostic information for the surgeon during the operation which may lead to changes of operation volume, and thus affect outcomes of the disease. Contrast resolution IOUS is actual when oncological operations on the liver are made. Ultrasound professionals should be master of IOUS techniques due to the increasing necessity of its use in clinics dealing with oncological surgery of the liver. 



1.     Machi J., Oishi A.J., Furumoto N.L., Oishi R.H. Intraoperative ultrasound. Surg. Clin. North. Am. 2004; 84:1085-1111.

2.     Torzilli G., Makuuchi M. Intraoperative ultrasonography in liver cancer. Surg. Onco.l Clin.N Am. 2003; 12: 91-103.

3.     Komarov I.G., Komov D.V., Metastazy zlokachestvennyh opuholej bez vyjavlennogo pervichnogo ochaga. [Metastases of malignant tumors without identified primary lesion.]. M, «Triada H», 2002, 63-105 [InRuss].

4.     Kruskal J.B., Kane R.A. Intraoperative  US of the liver: techniques and clinical applications. Radiographics. 2006 Jul-Aug; 26(4):1067-84. 

5.     Silas A.M., Kruskal J.B., Kane R.A. Intraoperative ultrasound. Radiol. Clin. North. Am. 2001; 39:429-448.

6.     Lordan J.T., KaranjiaN.D. ‘Close shave’in liver resection for colorectal liver metastases. Eur. J. Surg. Oncol. 2010; 36:47-51.

7.     Tinkle C.L., Haas-Kogan D. Hepatocellular carcinoma: natural history, current management, and emerging tools. Biologics. 2012; 6:207-19.

8.     Xu L.H., Cai S.J., Cai G.X., Peng W.J. Imaging diagnosis of colorectal liver metastases. World J. Gastroenterol. 2011; 17(42):4654-9.

9.     Schmidt J., Strotzer M., Fraunhofer S. et al. Intraoperative ultrasonography versus helical computed tomography and computed tomography with arterioportography in diagnosing colorectal liver metastases: lesion-by-lesion analysis. World J. Surg. 2000; 24:43-47.

10.   Kulig J., Popiela T., Ktek S., et al. Intraoperative ultrasonography in detecting. Scand. J. Surg. 2007; 96: 51-5.

11.   Hata S., Imamura H., Aoki T., et al. Value of visual inspection, bimanual palpation, and intraoperative ultrasonography during hepatic resection for liver metastases of colorectal carcinoma. World J. Surg. 2011 Dec; 35(12):2779-87.

12.   Patel N.A., Roh M.S. Utility of intraoperative liver ultrasound. Surg.Clin. North Am. 2004 Apr; 84(2):513-24.

13.   Kaczmarek B., Petka B., Ostrowski M. Usefulness of intraoperative ultrasonography of the liver in patients with colorectal adenocarcinoma. Pol. Merkur. Lekarski. 2003 Mar; 14(81):229-32.

14.   Spiliotis J., Rouanet P., Deschamps F., et al. Accuracy of intraoperative ultrasonography in diagnosing liver metastasis from colorectal cancer: evaluation with postoperative follow-up results. World J. Surg. 1992 May-Jun; 16(3):545-6.

15.   Piccolboni D., Ciccone F., Settembre A., Corcione F. Liver resection with intraoperative and laparoscopic ultrasound: report of 32 cases. Surg. Endosc. 2008; 22:1421-1426.

16.   Lordan J.T., Stenson K.M., Karanjia N.D. The value of intraoperative ultrasound and preoperative imaging, individually and in combination, in liver resection for metastatic colorectal cancer. Ann. R. Coll. Surg. Engl. 2011 Apr; 93(3):246-9.

17.   Yang S., Hongjinda S., Hanna S.S. et al. Utility of preoperative imaging in evaluating colorectal liver metastases declines over time. HPB (Oxford). 2010 Nov; 12(9):605-9.

18.   Lin L.W., Ye Z., Xue E.S., et al. Intraoperative ultrasonography in hepatobiliary surgery. Hepatobiliary Pancreat Dis Int. 2002; 1:425-8.

19.   Van Vledder M.G., Pawlik T.M., Munireddy S. et al. Factors determining the sensitivity of intraoperative ultrasonography in detecting colorectal liver metastases in the modern era. Ann. Surg. Oncol. 2010 Oct; 17(10):2756-63.

20.   Stone M.D., Kane R., Bothe A. Jr., et al. Intraoperative ultrasound imaging of the liver at the time of colorectal cancer resection. Arch. Surg. 1994; 129:431-435.

21.   Sahani D.V., Kalva S.P., Tanabe K.K. et al. Intraoperative US in patients undergoing surgery for liver neoplasms: comparison with MR imaging. Radiology. 2004 Sep; 232(3):810-4.

22.   Bloed W., van Leeuwen M.S., Borel Rinkes IH. Role of intraoperative ultrasound of the liver with improved preoperative hepatic imaging. Eur. J. Surg. 2000; 166:691-695.

23.   D'Hondt M., Vandenbroucke-Menu F., Preville- Ratelle S. et al. Is intra-operative ultrasound still useful for the detection of a hepatic tumour in the era of modern preoperative imaging? HPB (Oxford). 2011 Sep; 13(9):665-9.

24.   Kruskal J.B., Kane R.A. Intraoperative  US of the liver: techniques and clinical applications. Radiographics. 2006 Jul-Aug; 26(4):1067-84.

25.   Cabula C., Nicolosi A., Calo P.G., et al. Intraoperative ultrasonography in the diagnosis of liver metastasis from gastrointestinal neoplasms. Minerva Chir. 1993; 48:1189-92.

26.   Boutkan H., Luth W. Meyer S., et al. The impact of intraoperative ultrasonography of the liver on the surgical strategy of patients with gastrointestinal malignancies and hepatic metastases. Eur. J. Surg. Oncol. 1992; 18: 342-346.

27.   Clarke M.P., Kane R.A., Steele G. Jr., et al. Prospective comparison of preoperative imaging and intraoperative ultrasonography in the detection of liver tumors. Surgery. 1989 Nov; 106(5):849-55.

28.   Kruszewski W.J., Walczak J., Szajewski M., et al., The value of intraoperative liver ultrasound assessment using an intraabdominal probe during laparotomy performed for oncological reasons. Pol. Przegl. Chir. 2013 Feb 1; 85(2):78-82.

29.   Liu L., Miao R., Yang H., et al. Prognostic factors after liver resection for hepatocellular carcinoma: a single-center experience from China. Am. J. Surg. 2012, 203:741-750. 

30.   Liska V., Treska V., Holubec L., et al. Recurrence of colorectal liver metastases after surgical treatment: multifactorial study. Hepatogastroenterology. 2007 Sep; 54(78):1741-4.

31.   Tao L.Y, He X.D., Qu Q., et al. Risk factors for intrahepatic and extrahepatic cholangiocarcinoma: a case-control study in China. Liver Int. 2010; 30: 215-221.

32.   Kane R.A., Hughes L.A., Cua E.J., et al. The impact of intraoperative ultrasonography on surgery for liver neoplasms. J. Ultrasound Med. 1994; 13:1-6. 

33.   Solomon M.J., Stephen M.S., Gallinger S., White G.H. Does intraoperative hepatic ultrasonography change surgical decision making during liver resection? Am. J. Surg. 1994; 168:307-310.

34.   Cervone A., Sardi A., Conaway G.L. Intraoperative ultrasound (IOUS) is essential in the management of metastatic colorectal liver lesions. Am. Surg. 2000; 66:611-615.

35.   Conlon R., Jacobs M., Dasgupta D., Lodge J.P. The value of intraoperative ultrasound during hepatic resection compared with improved preoperative magnetic resonance imaging. Eur. J. Ultrasound. 2003; 16:211-216.

36.   Zacherl J., Scheuba C., Imhof M., et al. Current value of intraoperative sonography during surgery for hepatic neoplasms. World J.Surg. 2002; 26:550-554.

37.   Luck A.J., Maddern G.J. Intraoperative abdominal ultrasonography. Br. J. Surg. 1999 Jan; 86(1):5-16.

38.   Paul M.A., Mulder L.S., Cuesta M.A. et al. Impact of intraoperative ultrasonography on treatment strategy for colorectal cancer. Br. J. Surg. 1994; 81:1660-1663.

39.   Leen E., Angerson W.J., O’Gorman P., et al. Intraoperative ultrasound in colorectal cancer patients undergoing apparently curative surgery: correlation with two year follow-up. Clin. Radiol. 1996; 51:157-159.

40.   Stone M.D., Kane R., Bothe A. Jr., et al. Intraoperative ultrasound imaging of the liver at the time of colorectal cancer resection. Arch. Surg. 1994; 129:431-435.



Article presents data of modern literature concerning diagnostic efficiency of computed tomography and CT-angiography in diagnostics of acute disorders of mesenterial blood circulation. Article describes various groups of instrumental diagnostic signs indicating directly or indirectly on acute thrombotic and thromboembolic occlusion of mesenterial.

According to huge ammount of authors, CT-angiography can be considered as the first step in instrumental diagnostics of acute disorder of mesenterial blood circulation, due to demonstrated sensitivity and specificity, comparable in comparison with a standard angiography. 



1.     Pokrovskij A.V., Judin V.I. Ostraja mezenterial'naja neprohodimost'. Klinicheskaja angiologija: rukovodstvo pod redakciej Pokrovskogo A.V[Acute mesenterial obstruction. Clinical angiology: Manual, edited Pokrovskij A.V.]. V 2-h t. M.: Medicina. 2004; 2: 626-645 [In Russ].

2.     Burns B.J., Brandt L.J. Intestinal ischemia. Gastroenterol. Clin, North Am. 2003; 32 (4): 1127-1143.

3.     Cho J.S., Carr J.A., Jacobsen G. et al. Long-term outcome after mesenteric artery reconstruction: a 37-year experience. J. Vasc, Surg, 2002; 35 (3): 453-460.

4.     Oldenburg W.A., Lau L.L., Rodenberg T.J. et al. Acute mesenteric ischemia: a clinical review. Arch, Intern, Med, 2004; 164 (10): 1054-1062.

5.     Wang J.Y., Cheng K.I., Yu F.J. et al. Analysis of the correlation of plasma NO and ET-1 levels in rats with acute mesenteric ischemia. J. Invest. Surg. 2006; 19 (3): 155-161.

6.     Mamode  N., Pickford I., Leiberman P. Failure to improve outcome in acute mesenteric ischaemia: seven-year review. Eur. J. Surg. 1999; 165 (3): 203-208.

7.     Corcos O., Castier Y., Sibert A. et al. Effects of a Multimodal Management Strategy for Acute Mesenteric Ischemia on Survival and Intestinal Failure. Clin, Gastroenterol. Hepatol. 2012; 11 (2): 158-165.

8.     Ryer E.J., Kalra M., Oderich G.S. et al. Revascularization for acute mesenteric ischemia. J. Vasc. Surg. 2012; 55 (6): 1682-1689.

9.     Ozturk G., Aydinli B, Atamanalp S.S. et al. Acute mesenteric ischemia in young adults. Wien. Med. Wochenschr. 2012; 162 (15): 349-353.

10.   Schoots I.G., Koffeman G.I., Legemate D.A. et al. Systematic review of survival after acute mesenteric ischaemia according to disease aetiology. Br. J. Surg. 2004; 91 (1): 17-27.

11.   Zelenkov N.P., Mel'janov A.V., Esikov Ju.V. i soavt. Uspeshnoe hirurgicheskoe lechenie ostrogo narushenija mezenterial'nogo krovoobrashhenija [Successful surgical treatment of acute mesenterual blood circulation]. Materialy Mezhdunarodnogo hirurgicheskogo kongressa «Novye tehnologii v medicine». Rostov-na-Donu. 2005; 379 [In Russ].

12.   Savel'ev V.S., Petuhov V.A., Son D.A. i soavt. Novyj metod jenterosorbcii pri sindrome kishechnoj nedostatochnosti. [New method of internal absorbtion in patients with intestinal insufficiency] Annalyhirurgii. 2005; 1: 29-32 [In Russ].

13.   Murray S.P., Ramos T.K., Stoney R.J. Surgery of coliac and mesenteric arteries. In.: Enrico Ascher ed. Hamovici's Vascular Surgery, 5th edition. Blackwell Publishing. 2004; 72: 861-874.

14.   O'Mahony G.D., Gallucci M.R., Cordova-Fraga T. et al. Biomagnetic investigation of injury currents in rabbit intestinal smooth muscle during mesenteric ischemia and reperfusion. Dig. Dis. Sci. 2007; 52 (1): 292-301.

15.   Pompermayer K., Amaral F.A., Fagundes C.T. et al. Effects of the with glibenclamide, an ATP-sensetive potassium channel blocker, on intestinal ischemia and reperfusion injury. Eur. J. Pharmacol. 2007; 556 (1): P. 215-22.

16.   Kassahun W.T., Schulz T., Richter O. et al. Unchanged high mortality rates from acute occlusive intestinal ischemia: six year review. Langenbecks Arch. Surg. 2008; 393 (2): 163-171.

17.   American Gastrointestinal Association Medical Position Statement: guidelines on intestinal ischemia. Gastroenterology, 2000; 118: 951-953.

18.   Duber C., Wustner M., Diehl S.J. et al. Emergency diagnostic imaging in mesenteric ischemia. Chirurg. 2003; 74 (5): 399-406.

19.   Lock G. Acute mesenteric ischemia: classification, evaluation and therapy. Acta Gastroenterol, Belg, 2002; 65 (4): 220 - 225.

20.   Park W.M., Gloviczki P., Cherry K.J. et al. Contemporary management of acute mesenteric ischemia: factors associated with survival. J. Vasc, Surg, 2002; 35 (3): 445-452.

21.   Van Beers B.E., Danse E.M. Vascular lesions of the liver and gastrointestinal tract. Acta Gastroenterol. Belg. 2002; 65 (4): 226-229.

22.   Kortmann B., Klar E. Recognizing acute mesenteric ischaemia too late: reasons and diagnostic approach from a surgical point of view. Zentralbl. Chir. 2005; 130 (3): 223 - 226.

23.   Staib L. Intestinal ischemia - surgeon's view. Schweiz. Rundsch. Med. Prax. 2006; 95 (44): 1717-1721.

24.   Ataev S.D., Abdullaev M.R., Ataev D.S. Ostrye narushenija mezeneterial'nogo krovoobrashhenija [Acute mesenterial blood circulation disorders]. Materialy Mezhdunarodnogo hirurgicheskogo kongressa «Novye tehnologii v medicine». Rostov-na-Donu. 2005: 378 [In Russ].

25.   Savel'ev V.S., Spiridonov I.V., Boldin B.V. Ostrye narushenija mezenterial'nogo krovoobrashhenija. Infarkt kishechnika [Acute mesenterial blood circulation disorders. Intestinal infarction.]. Rukovodstvo po neotlozhnoj hirurgii pod redakciej Savel'eva V.S. M.: Triada H. 2005; 281-302 [In Russ].

26.   Alhan E., Usta A., Cekic A. et al. A study on 107 patients with acute mesenteric ischemia over 30 years. Int. J. Surg. 2012; 10 (9): 510-513.

27.   Hellinger J.C. Evaluating mesenteric ischemia with multidetector-row CT angiography. Tech. Vasc. Intev Radiol, 2004; 7(3): 160-166.

28.   Horton K.M., Fishman E.K. Multidetector CT angiography in the diagnosis of mesenteric ischemia. Radiol, Clin, North. Am. 2007; 45: 275-288.

29.   Shih M.C., Angle J.F., Leung D.A. et al. CTA and MRA in mesenteric ischemia: part 2, Normal findings and complications after surgical and endovascular treatment. Am. J. Roentgenol. 2007; 188 (2): 462-471.

30.   Smerud M.J., Johnson C.D., Stephens D.H. Diagnosis of bowel infarction: a comparison of plain films and CT scans in 23 cases. Am. J. Roentgenol. 1990; 154: 99-103.

31.   Turkbey B., Akpinar E., Cil B. et al. Utility of multidetector CT in an emergency setting in acute mesenteric ischemia. Diagn. Interv. Radiol. 2009; 15 (4): 256-261.

32.   Menke J. Diagnostic accuracy of multidetector CT in acute mesenteric ischemia: systematic review and meta-analysis. Radiology. 2010; 256 (1): 93-101.

33.   Zalcman M., Sy M., Donkier V. et al. Helical CT sings in the diagnosis of intestinal ischemia in small-bowel obstruction. Am. J. Roentgenol. 2000; 175: 1601-1607.

34.   Zandrino F., Musante F., Gallesio I. et al. Assessment of patients with acute mesenteric ischemia: multislise computed tomography sings and clinical performance in a group of patients with surgical correlation. Minerva Gastroenterol. Dietol. 2006; 52 (3): 317-325.

35.   Arroja B., Canhoto C., Silva F. et al. Acute mesenteric ischemia. Rev. Esp. Enfem. Dig. 2010; 5: 327-328.

36.   Ha H.K., LeeS.H., Rha S.E. et al. Radiologic features of vasculitis involving the gastrointestinal tract. Radiographics. 2000; 20: 779-794.

37.   Rosow D.E., Sahani D., Strobel O. et al. Imaging of acute mesenteric ischemia using multidetector CT and CT angiography in a porcine model. J. Gastrointest. Surg. 2005; 9 (9): 1262 - 1274.

38.   Johnson J.O. Diagnosis of acute gastrointestinal hemorrhage and acute mesenteric ischemia in the era of multi-detector row CT. Radiol, Clin, North Am. 2012; 50 (1): 173-182.

39.   Yikilmaz A., Karahan O.I., Senol S. et al.. Value of multislice computed tomography in the diagnosis of acute mesenteric ischemia. Eur. J. Radiol. 2011; 80 (2): 297-302. 



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. 




1.     Pickren J.W., Tsukada Y., Lane W.W. Liver metastasis. in: Weiss L, Gilbert HA (eds) Analysis of autopsy data. GK Hall, Boston. 1982: 2-18.

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.

3.     Pwint T.P., Midgley R., Kerr D.J. Regional hepatic chemotherapies in the treatment of colorectal cancer metastases to the liver. Semin. Oncol. 2010; 37(2): 149-159.

4.     Cohen A.D., Kemeny N.E. An update on hepatic arterial infusion chemotherapy for colorectal cancer. Oncologist. 2003; 8(6): 553-566.

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.

7.     Liapi E., Geschwind J.F. Chemoembolization for primary and metastatic liver cancer. Cancer J. 2010; 16(2): 156-162.

8.     Fiorentini G., Aliberti C., Turrisi G., Del Conte A., Rossi S., Benea G., Giovanis P. intraarterial hepatic chemoembolization of liver metastases from colorectal cancer adopting irinotecan-eluting beads: results of a phase ii clinical study. in Vivo. 2007; 21(6): 10851091.

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.




According to American Cancer Society lung cancer is the main "killer" among all types of cancer, five year survival rate of these patients in less than 15%. Thorough staging is necessary to make prognosis of disease and choose the way of treatment. In 2009 International Association for the Study of Lung Cancer ( IASLC) published the 7th system of lung cancer staging based on TNM classification data. Defining of lung cancer and its staging is an interdisciplinary process. Moreover clinical, endoscopic and radiological data are used for this purpose. Among them, the multislice computed tomography is a leading method for lung cancer staging. 



1.     Sobin L.H., Gospodarovich M.K., Vittekind K. TNM-classification of malignant tumors. [TNM-classification of malignant tumors.]. Logosfera, M., 2011; 122-134 [In Russ].

2.     Robert D.Su, Nanett A.Le, Kjetlin Braun i Majil S.Krishnam. Continous medical education: basic staging of lung cancer.. Novaja TNM-klassifikacija [Continous medical education: basic staging of lung cancer.]. Radiographics 2010; 30(5):1163-1181 [In Russ].

3.     Lung Cancer Staging Essentials: The New TNM Staging System and Potential Imaging Pitfalls. RadioGraphics Sep 2010; 30(5):1163-1181.

4.     Vershchakelen J.A., Bogaert J., De Wever W. Computed tomography in staging for lung cancer. Eur. Respir. J. 2002;40-48.

5.     Edward W. Bouchard, Steven Falen, MD, Paul L. Molina. Lung cancer: A radiologic overview. Аpplied radiology. 2008; [Edward W. Bouchard, Steven Falen, Paul L. Molina. Radiology plays a critical role in the detection, diagnosis, and staging of thoracic malignancies. This article reviews the use of chest radiography (CXR), computed Issues/2002/08/Articles/Lung-Cancer-A-radiologic-overview.aspx

6.     Matias Prokop, Mihajel' Galanski. Spiral and multislice computed tomography. Kompjuternaja tomografija [Spiral and multislice computed tomography]. «MEDpress-inform» M., 2007; 2: 92-104 [In Russ].

7.     Richard Webb W., Charles B. Higgins. Thoracic imaging. Pulmonary and Cardiovasular Radiology. Lippincott Williams and Wilkins 2005; 66-111.

8.     Valerie W. Rusch, Hisao Asamura, Hirokazu Watanabe, Dorothy J. Giroux, Ramon Rami-Porta, Peter Goldstraw, on Behalf of the members of the IASLC Staging Committee. The IASLC Lung Cancer Staging Project/ A Proposal for a New International Lymph Node Map in The Forthcoming Seven Edition of the TNM Classification for Lung Cancer. Journal of Thoracic Oncology. 2009; 4(5):568-577.

9.     Tjurin I.E. «Computed tomography of thoracic organs . SPb.:JeLBI-SPb [Computed tomography of thoracic organs]. 2003; 235-265 [In Russ]. 



Acute traumatic aortic rupture is associated with extremely high mortality and requires urgent diagnosis and treatment.

Materials and methods: patient P, 33 years 28.12.2013, fall from a height of 5 floors. On the day of admittion to hospital he was hospitalized to the reanimation department with a diagnosis of «multiple trauma, traumatic shock». For nearest hours after admission MSCT of head, neck, chest organs, abdomen and pelvis were performed.

Results: in series of images of the head and neck revealed multiple fractures of facial bones anc skull base, hemo-sinus.

MSCT chest without contrast enhancement: expanding boundaries revealed the presence of the upper mediastinum content density of 65 Hounsfield units (Ed.N) around the arch and descending aorta, in tissues of the posterior mediastinum. Volume of about 35 cm3 - in the pericardial cavity, ribs on the left with a displacement of fragments, left-sided hemothorax (260 cm3). During examination of abdomen and pelvis in the native phase: in subhepatic space in the liver portal, volume of about 50 cm3 with density of blood multiple fractures of the pelvis. CT with contrast-enhanced bolus revealed uneven expansion in the thoracic aorta isthmus length of 60 mm, with the presence at this level of linear structures intraluminal wall surface (wall laceration), and a narrow zone of extravasation of the contrast agent on the inner contour of the aorta. At the lever portal detected delimited zone of active extravasation of contrast material as a result of breaking its proper hepatic artery which is essentially as a thrombosis of pseudoaneurysm with zone of thrombosis around the periphery and subcapsular rupture of the left lobe of the liver

Ultrasound examination - left-sided hydrothorax, echo signs of free fluid in the abdominal cavity, liver hematoma in the area of the portal, diffuse changes in kidneys («shock» kidney).

Patient underwent primary surgical dressing of face wounds, osteosynthesis of right femur with external fixation device (EFD). Endoprothesis of descending thoracic aorta was performed 29.12.2013. After implantation of the prothesis, celiacography was performed, in which in liver portal, in the place of proper hepatic artery division to the right and left hepatic artery - large-size false aneurysm was revealed.

CT scanning, performed on the 5th day after aortic replacement: there are signs of segmental atelectasis of the lower lobe of the left lung, minimum infiltrative changes in fiber anterior mediastinum, hematoma of the posterior mediastinum (31 cm3. Previously was 191 cm3), and hemopericardium (15 cm3 compared with 35 cm3)

In the process of dynamic observation, it was found that up to 30 days, false aneurysm of proper hepatic artery increased in size, in this regard, the patient was operated on 24.01.14.

Follow-up CT scan with contrast enhancement: branches of the hepatic artery are well visualized, artery aneurysm is not defined

12.02.14, was the dismantling of EFD and manufactured fixation of the right femur pin. After 65 days after the injury and the start of treatment the patient was discharged under the supervision of the surgeon and cardiologist in the community.



1.          Andreeva T.M. Travmatizm v Rossiyskoy Federatsii na osnove dannykh statistiki FGU «TsITO im. N.N. Priorova Rosmedtekhnologiy». [Traumatism in the Russian Federation on the basis of statistical data of FGU «TsITO im. N.N. Priorova Rosmedtekhnologiy»]. Electronic scientific journal «Social aspects of health of the population». 2010; № 4(16). [In Russ]

2.         Kolesnikov E.S. Kliniko-epidemiologicheskaya kharakteristika tyazheloy sochetannoy kranio-torakalnoy travmy v krupnom promyshlennom tsentre. Avtoreferat. Diss. kand. tekh. nauk [The kliniko-epidemiologic characteristic of a severe combined kranio-thoracic trauma in the large industrial center: Abstract Dr. techn.sci.diss.]. Omsk. 2009: 23. [In Russ].

3.          Asif Huda Ansari, Ahmed S. Ahmed, Navin P. Lal. Traumatic aortic injury: a case report. Turkish Journal of Trauma & Emergency Surgery. 2009;15(6):621-623.

4.         Victor X. Mosquera, Milagros Marini, Javier Muniz et al. Blunt traumatic aortic injuries of the ascending aorta and aortic arch: A clinical multicentre study. Injury, Int. J. Care Injured. 2013; (44): 1191-1197.

5.         Kaavya N. Reddy, Tim Matatov, Linda D. Doucet et al. Grading system modification and management of blunt aortic injury. Chinese Medical Journal. 2013;126 (3):442-445.

6.         Дж. Э. Тинтиналли, РЛ. Кроум, Э. Руиз. Неотложная медицинская помощь. Перевод с англ. В.И. Кандрора, М.В. Неверовой, А.В. Сучкова, А.В. Низового, Ю.Л. Амченкова; М.:Медицина. 2001; 334.

7.         Dzh. E. Tintinalli, R.L. Kroum, E. Ruiz. Neotlozhnaya meditsinskaya pomoshch'. Perevod s angl. V.I. Kandrora, M.V. Neverovoy, A.V. Suchkova, A.V. Nizovogo, Yu.L. Amchenkova [Emergency medicine]. Moscow. 2001: 334. [In Russ].

8.      Jun Woo Cho, M.D., Oh Choon Kwon, M.D., Sub Lee, M.D., Jae Seok Jang, M.D. Traumatic Aortic Injury: Singlecenter Comparison of Open versus Endovascular Repair. Korean J. Thorac. Cardiovasc. Surg. 2012;45:390-395.

9.      Estrera A.L., Miller C.C., Salinas-Guajardo G., Coogan S.M. et al. Update on blunt thoracic aortic injury: 15-year single-institution experience. J. Thorac. Cardiovasc. Surg. 2012; doi: 10.1016/j.jtcvs.2012.11.074. [Epub ahead of print].

10.    O’Conor C.E. Diagnosing traumatic rupture of the thoracic aorta in the emergency department. Emerg. Med. J. 2004; 21:414-419.

11.     Panagiotis N. Symbas, Andrew J. Sherman, Jeffery M. Silver et al. Traumatic Rupture of the Aorta Immediate or Delayed Repair? Ann. Surg. Jun. 2002; 235(6): 796-802.

12.     Троицкий А.В., Хабазов РИ., Лысенко Е.Р, Беляков Г.А., Грязнов О.Г., Соловьева Е.Д., Азарян А.С. Первый опыт гибридных операций при торакоабдоминальных аневризмах аорты. Диагностическая и интервенционная Радиология. 2010; 4(1): 53-66.

13.     Troickij A.V., Habazov R.I., Lysenko E.R., Beljakov G.A., Grjaznov O.G., Solov'eva E.D., Azarjan A.S. Pervyj opyt gibridnyh operacij pri torakoabdominal'nyh anevrizmah aorty[Thoracoabdominal aneurysms: first experience of operation]. Diagnosticheskaja i intervencionnaja Radiologija. 2010; 4(1): 53-66 [In Russ].

14.     Woodring J.H. The normal mediastinum in blunt traumatic rupture of the thoracic aorta and brachiocephalic arteries. J. Emerg. Med. 1990; 8: 467-476.



Aim: was to analyse possibilities of multislice computed tomography in patients with coronary vessels' pathology

Results: we performed the analysis of published data on the use of multislice computed tomography in the coronary heart disease diagnostics. Data on the development of the method are presented: it is indicated that its diagnostic efficiency is related to technological improvements, accompanied by the appearance of each successive generation of multislice computed tomography The possibilities of using scanners from 16- to 230-slice scanners with two sources of energy, advantages of «dual energy» regime of application (dual-energy CT) in the coronary disease diagnostic are considered. Given constraints of the method diagnostic efficacy - artifacts associated with movements and severe calcification.

Conclusions: implementation of the method in cardiology practice can promote its consideration as a promising alternative to invasive diagnostic coronary angiography Further development of the technology can allow multislice computed tomography to become the main method of diagnosis of coronary heart disease and other cardiovascular diseases. 



1.     Paul J.F., Dambrin G., Caussin C. et al. Sixteen-slice computed tomography after acute myocardial infarction: from perfusion defect to the culprit lesion. Circulation. 2003; 108: 373-374.

2.     Sun Z., Choo G.H., Ng K.H. Coronary CT angiography: current status and continuing challenges. Br. J. Radiol. 2012; 85: 495-510.

3.     Costello P., Lobree S. Subsecond scanning makes CT even faster. Diag. Imaging. 1996; 18: 76-79.

4.     Taguchi K., Aradate H. Algorithm for image reconstruction in multi-slice helical CT. Med. Phys. 1998; 25: 550-561.

5.     Flohr T.G., Schaller S., Stierstorfer K. et al. Multidetector row CT systems and image-reconstruction techniques. Radiology. 2005; 235: 756-773.

6.     Haberl R., Tittus J., Bohme E. et al. Multislice spiral computed tomographic angiography of coronary arteries in patients with suspected coronary artery disease: an effective filter before catheter angiography Am. Heart J. 2005; 149: 1112-1119.

7.     Goldman L.W. Principles of CT: multislice CT. J. Nucl. Med. Technol. 2008; 36: 57-68.

8.     Lewis M., Keat N., Edyvean S. 16 Slice CT scanner comparison report version 14, 2006. Available from: URL:

9.     Achenbach S., Ropers D., Pohle F.K. et al. Detection of coronary artery stenoses using multi-detector CT with 16 x 0.75 collimation and 375 ms rotation. Eur. Heart J. 2005; 26: 1978-1986.

10.   Kuettner A., Beck T., Drosch T. et al. Image quality and diagnostic accuracy of non-invasive coronary imaging with 16 detector slice spiral computed tomography with 188 ms temporal resolution. Heart. 2005; 91: 938-941.

11.   Garcia M.J., Lessick J., Hoffmann M.H. Accuracy of 16-row multidetector computed tomography for the assessment of coronary artery stenosis. JAMA. 2006; 296: 403-411.

12.   Steigner M.L., Otero H.J., Cai T. et al. Narrowing the phase window width in prospectively ECG-gated single heart beat 320-detector row coronary CT angiography. Int. J. Cardiovasc. Imaging. 2009; 25: 85-90.

13.   Flohr T.G., McCollough C.H., Bruder H. et al. First performance evaluation of a dual-source CT (DSCT) system. Eur. Radiol. 2006; 16: 256-268.

14.   Achenbach S., Marwan M., Schepis T. et al. High- pitch spiral acquisition: a new scan mode for coronary CT angiography. J. Cardiovasc. Comput. Tomogr. 2009; 3: 117-121.

15.   Ruzsics B., Lee H., Zwerner P. et al. Dual-energy CT of the heart for diagnosing coronary artery stenosis and myocardial ischemia-initial experience. Eur. J. Radiol. 2008; 18: 2414-2424.