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Abstract:

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.

 

 

References

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

http://doi.org/10.5402/2013/483069

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.

http://doi.org/10.2214/AJR.07.3146

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.].

https://www.ronc.ru/grown/treatment/diseases/limfomy/

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.

http://doi.org/10.1093/annonc/mdn525

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.

http://doi.org/10.1148/rg.275065151

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

http://doi.org/10.1177/1073274818778256

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).

https://rarediseases.org/rare-diseases/primary-qastric-lymphoma

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.

http://doi.org/10.2214/AJR.08.1160

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

http://doi.org/10.12998/wjcc.v4.i12.385

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.

http://doi.org/10.1002/ijc.29433

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.].

https://www.clinicaloncology.com.ua/article/19925/luchevaya-diagnostika-ekstranodalnyx-limfom

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

http://doi.org/10.1016/j.diii.2012.11.006

 

Abstract

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.

 

References

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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].

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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.

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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: http://dx.doi.org/10.1016/S0140-6736(02)11522-4. 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.

 

Abstract

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.

 

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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 https://doi.org/10.2214/ajr.08.2166

3.     Wheat MW Jr. Acute dissecting aneurysms of the aorta: diagnosis and treatment-1979. Am Heart. 1980; 99(3):373-387. PMID:7355699 https://doi.org/10.1016/ 0002-8703(80)90353-1

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Abstract:

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

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

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

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

 

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Abstract:

The work was aimed at determining the possibilities of multislice computed tomography (MSCT) in diagnosis and staging of acute pyelonephritis (AP) for studying the role of concomitant congenital renal anomalies in development of AP and therapeutic decision-making. A total of 59 patients presenting with AP and suspected pyodestructive complications were subjected to MSCT, with 7 seven of these having undergone it twice in order to control therapeutic efficacy. The study showed that ultrasonography as well as excretory urography are not always informative enough as to the possibility of revealing purulent forms of an inflammatory process having developed on the background of renal developmental defects, especially anomalies of the shape, localization, and structure. The obtained findings made it possible to define proper indications for performing MSCT in patients with AP. Improved diagnosis achieved by means of MSCT made it possible to decrease the number of operations and avoid unnecessary nephrectomies.  

 

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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.

authors: 

Abstract:

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%). 

 

References 

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 www.medline.ru. 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].

Abstract:

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.  

 

References 

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: http://www.impactscan.org/reports/Report06012.htm

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

Abstract:

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.  

 

References 

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.

 

Abstract:

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.  

 

References 

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.

13.&

Abstract:

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.  

 

References 

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.

 

 

Abstract:

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.

 

References 

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.

 

 

Abstract:

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.

 

References

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. 

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authors: 

 

Abstract:

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. 

 

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Abstract:

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. 

 

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Abstract:

Aim: was to improve the efficiency of diagnosis of patients with coronary heart disease, by estimating of possibilities of cardiac multislice computed tomography in comparison with coronary angiography.

Materials and methods: study included 64 patients (18 women and 46 men, mean age 62,4 ± 9,5 years) with a high risk of developing coronary heart disease. In 34 patients - myocardial infarction in anamnesis (18 patients - in pool right coronary artery in 16 patients - in left anterior descending artery). Clinics of angina pectoris - in 40 patients (functional class (FC) I - 10; FC II - 22, FC III - in 6, FC IV - 2 patients). Selection criteria: the absence of disease progression for at least 6 weeks, and at least 3 months of optimal treatment. All patients underwent cardiac MSCT at 256-slice CT scanner. Obtained data was compared with data of reference method - x-ray coronary angiography.

Results: comparison of MSCT coronary angiography with invasive data showed a high comparability of results of two methods in the evaluation of coronary artery disease. It was revealed that discrepancies between cardiac MSCT and CAG in detection of hemodynamically insignificant stenoses ranging from 0 to 4%, hemodynamically significant stenoses - from 0 to 2.6%, subtotal stenosis - from 0 to 1%, occlusions - 0%. The presence of strong correlations between data of cardiac MSCT and coronary angiography of stenosis, demonstrated the high quality of MSCT imaging of coronary artery segments in the examination with a variety of modes of application method.

Conclusion: multislice computed tomography is a highly effective method for diagnosing of structural and anatomic changes of coronary arteries in patients with coronary heart disease.

 

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15.   Pelliccia F., Pasceri V., Evangelista A. et al. Diagnostic accuracy of 320-row computed tomography as compared with invasive coronary angiography in unselected. consecutive patients with suspected coronary artery disease. Int. J. Cardiovasc. Imaging. 2013;29(2):443-452.

16.   Obaid D.R., Calvert PA., Gopalan D. et al. Dualenergy computed tomography imaging to determine atherosclerotic plaque composition: a prospective study with tissue validation. J Cardiovasc Comput Tomogr. 2014; 8(3):230-237. [PubMed: 24939072]

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18.   Stehli J., Clerc O.F., Fuchs T.A. et al. Impact of monochromatic coronary computed tomography angiography from single-source dual-energy CT oncoronary stenosis quantification. J Cardiovasc Comput Tomogr. 2016;10(2):135-140.

19.   DanadI., Hartaigh B., Min J.K. Dual-energy computed tomography for detection of coronary artery disease. Expert Rev Cardiovasc Ther. 2015;13(12):1345- 1356.

20.   Petranovic M., Soni A., Bezzera H. et al. Assessment of nonstenotic coronary lesions by 64-slice multidetector computed tomography in comparison to intravascular ultrasound: evaluation of nonculprit coronary lesions. J Cardiovasc. Comput. Tomogr. 2009;3(1):24-31.

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22.   Wu Y, Zheng M., Zhao H. et al. Low-concentration contrast material for dual-source computed tomography coronary angiography by a combination of iterative reconstruction and low-tube-voltage technique: feasibility study. Zhonghua YiXueZaZhi. 2014;94(29):2260-2263.

 

 

Abstract:

Anatomical variants of abdominal and retroperitoneal veins are characterized by a great diversity Mostly anomalies are asymptomatic, in some cases they may have clinical manifestations. Information about features of the venous anatomy is necessary when planning surgical operations and interventional procedures in the abdomen and retroperitoneum

Aim: was to increase efficacy of diagnostics of abdomen and retroperitoneal veins' anomalies by evaluating clinical significance of observed changes of veins and analysis of incidence of venous anomalies at MSCT of the abdomen.

Materials and methods: 440 patients with different diseases of the abdomen and retroperitoneum underwent MSCT Anomalies of the inferior vena cava (IVC) and its tributaries were classified by Huntington G.S. and C.F.W. McLure. As the normal anatomy of the portal vein (PV) was taken a «classic» variant of the division into two branches. Normal type of hepatic veins (HV) anatomy meant the presence of three venous trunks independently flowing into the IVC Results: venous malformations were detected in 67% cases, combined with each other in many cases. Most common were aberrations of renal veins (43%), followed by variants of HV (31%), PV (18%) and IVC (1,6%).

Conclusion: our results show the necessity of detailed assessment of venous anatomy during abdominal MSCT for selecting the optimal treatment strategy, planning and the success of surgery.

 

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