FMRI RS analysis is an adequate for basic level human brain’s functional activity study in health and pathology. However there is no recognized processing algorithm, convenient for clinic. Objective: allocation of a typical RS networks in healthy people based software FSL and analysis of a number of qualitative and quantitative indicators of potentially promising for comparison with cerebral pathology. Materials and methods. We conducted a pilot RS studies (fMRI 3T) in 12 healthy volunteers according ICA as implemented in FSL software. Based on published data contained in the introduction, differentiated artifact (cerebrospinal fluid, vascular) and typical neural network RS. We analyzed the last in the group taking into account the observations of gender and profile motor hemispheric asymmetry. Particular topography as well as a number of integrated quantitative indicators of RS networks activity was tested: the total volume and intensity of activation as well as power spectrum frequency characteristics of hemodynamic signals (average frequency, dominant frequency peak). Results. Each the subject has been allocated 7-8 network RS, similar to those described in the literature basic “reference networks”. A comparison of the frequency and integrated activity indicators of these networks to the individual characteristics of the subjects showed descriptiveness considered quantitative parameters. A more detailed analysis of DMN network, showed considerable variation in the “volume of network” in healthy people, while the intensity parameter activation small differences of values (ie more stable) in the norm, but is changing dramatically in patients with traumatic brain injury. Relatively low variability in norm is also characterized by the average frequency of the spectrum’s active zone. Conclusion. These data demonstrate the correctness of the used FSL algorithm for fMRI resting state analysis and perspectivity of using some integrated quantitative indicators for fMRI activity assessment of healthy and sick human brain.

Aim: the article is devoted to determine the capabilities of T1-dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in differentiation diagnosis primary and secondary brain tumors. Materials and methods. The analysis was based on data generated from MRI examinations using a T1-DCE protocol of 74 patients with intracerebral tumors: gliomas - 24 (32.4%) cases (glioblastoma - 17, astrocytoma - 5 and oligodendroglioma - 2), meningioma - 23 (31.1%) and metastases - 27 (36.5%) cases (melanoma - 8, breast cancer - 7 and lung cancer - 12). MRI was performed on 3,0-T scanner (Skyra, Siemens AG, Erlangen Germany) and included following sequences: a) routine sequences in axial direction before contrast agent injection (T1-SE, T2-SE, T2-FLAIR, DWI), b) T1-Vibe with two different flip angles and DCE-protocol, c) T1-VIBE in axial direction after contrast injection with 3D-reconstruction. Results. The highest average K^trans and V_e were observed in meningiomas (0.097 ± 0.019 min^-1 and 0.151 ± 0.017), the lowest in gliomas Grade I-II (0.022 ± 0.001 min^-1 and 0.029 ± 0.003). The highest average were in melanoma mts (1.14 ± 0.331 min^-1) and lowest - in breast cancer mts (0.063 ± 0.193 min^-1). Conclusion. DCE MRI - potentially perspective and demanding further studying method allowing to assume possibility of carrying out effective differential diagnostics of various brain tumors by a cumulative assessment of the pharmacokinetic parameters providing valuable information on hemodynamic and proliferative properties of tumor tissue.

Acute herpetic encephalitis is a brain injury caused by herpes simplex virus, usually type 1 (HSV-1), at least of type 2 (HSV-2). Occurs as an acute infectious disease caused by the development of brain tissue necrosis and accompanied by cerebral and focal symptoms of central nervous system. This clinical observation gives an idea of the possibilities of research methods used in herpes encephalitis. Powered by clinical observation of the patient with herpes encephalitis and the results of studies such as computed tomography, magnetic resonance imaging, clinical and laboratory methods. The use of computed tomography and magnetic resonance imaging in the detection of changes of the brain makes it possible suspect in most cases to confirm the diagnosis of encephalitis earlier laboratory and clinical research methods, and promptly appoint antiviral therapy, to trace the dynamics of changes in the course of the therapy, which determines the selection of the appropriate treatment policy and prognosis of the disease.

Aim: reduce the percentage of acute post-resection liver failure after major resection. Material and methods. From January 2013 patients who planned removal of more than 3 segments of the liver, in addition use computer liver volumetry used SPECT / CT of the liver with the definition of the scope and location of the pre-emptive functioning liver parenchyma on lobes. Identified two groups of patients. The first group included patients (n = 15) who were treated with up to January 2013 (SPECT/CT of the liver was not used), all patients in the first phase was completed preliminary portal vein embolisation (PVE). The second group included patients (n = 9), which, depending on the data of CT volumetry and the presence of precipitating factors to apply differential treatment when interpreting the data SPECT / CT. Results. In the first group of radical surgery in 9 patients. Acute postoperative hepatic failure occurred in one patient, who was stopped on a background of conservative therapy (Class A). In the second group of patients based on the results of pre FLR volumetry ranged from 25 to 35%. In 5 patients, the amount of functioning liver parenchyma in the FLR was 30% or more, they performed a liver resection: RHHE - 2 ERHHE - 2. In 4 patients the amount of functioning parenchyma in the remaining part was less than 30% of these patients has been applied a two-step method of treatment. Radical surgery in 3 patients: RHHE - 2 ERHHE - 1. Signs of acute post-resection liver failure in this group of patients was not. Conclusion. Patients with borderline FLR application of SPECT/CT allows differentiated liver choose the tactics of treatment and thereby reduce the likelihood of developing post-resection of acute liver failure, reduce postoperative mortality and improve treatment outcomes in this group of patients.

The aim: to improve and implement stomach ultrasound examination in the diagnostic algorithm. Materials and methods. 100 people in the group of healthy individuals without stomach pathology and 100 in the group of patients operated on stomach with the use of noninvasive ultrasound diagnosis technology system were examined. There was an equal number of men and women among those examined (aged approximately 42.8 ± 12.3). The modified technique of trans-abdominal ultrasound stomach examination when the stomach is filled with liquid and its walls are medicamentally relaxed, and the technique of trans-abdominal ultrasound examination of an operated stomach were carried out with the help of scanning devices Aixplorer (Supersonic Imagine, France) and Accuvix V10 and Accuvix V20 (Medison, South Korea) in different modes of 2D-3D ultrasound imaging using curvilinear transducer, mini-curvilinear transducer, sector transducer, linear array transducer with frequency 3.5 to 7.5 MHz. The results were compared with the histomorphologic research data. Results. The major factors in the assessment of unchanged echostructure of gastric wall during gastroechography were the indicators of overall gastric wall thickness and thickness of its individual echo-layers, thickness and integrity of the mucin layer. The average gastric wall thickness normally made up 4.6 ± 0.3 mm (p < 0.001). The average gastric wall thickness of an operated stomach was as follows: on the 5-th day after surgery - 15.7 ± 2.7 mm; on the 10th day - 10.1 ± 1.17 mm; on the15 th day - 8.8 ± 0.6 mm; on the 25 day - 8.25 ± 2.3 mm; on the 30 th day - 7.0 ± 1.0 mm; in 2 months - 5,5 ± 0,5 mm; in 6 months - 5.6 ± 0.3 mm (p < 0.05). The ultrasound criteria of the norm with the assessment of mucin layer microcirculation that we have established provided us with the new data concerning an unchanged stomach echostructure. Dynamic ultrasound examination of an operated stomach at different terms after surgery helped to credibly assess the gastric stump and anastomosis condition to assist in predicting postoperative period course and choice of an effective tactics for further disease management. Conclusion. The results has proved the expediency of trans-abdominal ultrasound stomach examination usage in the system of standard abdominal organs diagnostics techniques.

Objective: to determine the ratio of the linear dimensions of the spleen and measuring the area for the standardization of research protocols and to compare over time. Materials and methods. 500 patients who underwent ultrasound of the spleen were examined. The length, width and area were measured. The mean age was 40.5 ± 7.3 years. Men in the study were 196 (39.2%) women - 304 (60.8%) Results. Direct dependence of increase in the linear sizes and the area of a spleen is revealed. Increasing the length of more than 13 cm always indicative of splenomegaly. However, the length in the range of 10.0 to 13.0 cm can fit both normal size and a significant increase even. In this connection, it is recommended to contentious matters an extra dimension or width or area of the spleen for subsequent monitoring of the dynamics of change. Conclusion. Measurement of the topometric indicators of the spleen is an important prognostic sign. It is recommended to measure as the linear dimensions and area of the largest cross-section for ease of comparison of the data.

Gallstone small bowel obstruction is a rare complication of gallstone disease, characterized by the migration of stones from the gallbladder into the lumen of the small intestine, followed by occlusion of its lumen. Cholelithiasis diagnostics of small bowel obstruction based only clinical symptoms is difficult, therefore, it is necessary to use the data from instrumental methods to establish an accurate diagnosis. The method of choice of diagnostics is computed tomography, allowing to determine the cause of intestinal obstruction and its level; the state of the gallbladder; as well as the dimensions, number and location of gallstones. This present clinical observation demonstrates the possibility of the integrated clinical and instrumental examination of 83 years old women for the diagnosis of intestinal obstruction caused by the occlusion of the intestinal lumen gallstones.

Mucocele of the appendix is a rare pathological condition which is characterized as the lumen expansion in the appendix caused by abnormal accumulation of mucus content. Mucocele of the appendix can be found on average 0.2-0.7% of all appendectomies and in 8% of all tumors of the appendix according to different sources. Mucocele is most commonly occur in women, in mean age of 55 years. Nonspecific symptoms, possibility of developing serious complications (pseudomyxoma peritoneum, and so on.), possibility of malignant genesis, requires an accurate preoperative diagnosis of this pathological condition. Conclusion. The mean dADC(lesion-liver), and rADC(lesion/liver) are more useful in the differential diagnosis of focal liver lesions.

The aim: to identify opportunities of multislice computed tomography (MDCT) and cone beam computed tomography (CBCT) in the diagnosis and monitoring of surgical treatment with the use of bone grafts and implants of non-biological origin. Materials and methods. The study is based on the analysis of clinical and radiological survey of 112 patients with injuries and post-traumatic deformations of the walls of the orbit at the stage of preoperative planning and postoperative monitoring, using MDCT and CBCT Results. Informativity of CBCT on the diagnostic step below MDCT in the study of soft tissues of the midface. In the study of osteo-traumatic changes in the information content is identical to that zone. Possibilities MDCT and CBCT in the control of surgical treatment using bone grafts and implants of non-biological origin: The characteristic CT signs of implants and grafts used in the plastic bottom wall of the orbit, at the same CBCT and MDCT Established repeatability sizes of the orbits and positions of the eyeballs, regardless of the method of CT. Conclusion. The data obtained allow to recommend the cone-beam computed tomography for the diagnosis and monitoring of post-operative plastic defects and deformations of the walls of the orbits in the absence of the need to assess the state of the soft tissues or the possibility of the MDCT

Aim: to study stigmatization of connective tissue dysplasia and androgenic profiles as potential markers associated with temporomandibular joint disorders, compared with magnetic resonance tomography imaging of the temporomandibular joint in patients with different clinical variants of its dysfunction. Materials and methods. 40 patients with distal occlusion 35 women (87.5%) and 5 men (12.5%) and dysfunction of the temporomandibular joint (from mild to severe). The clinical examination included: evaluation of connective tissue dysplastic stigmatization; Magnetic resonance tomography on Vantage Atlas-X 1.5 T, hormones concentrations estimation by Enzyme immunoassay: testosterone-estradiol binding globulin, total and free testosterone, estradiol, free androgen index. All patients were devided into two groups according to the Scale of severness of temporomandibular “joint dysfunction syndrome”: the 1-st mild group (0-6 score) included 18 patients (45,0%) with less than 3 displastic stigmatization; the 2nd severe group (1012 scores) - 22 patients with 6 and more dysplastic stigmatization. Results. In the first group of mildly symptomatic patients without complaints in 56.6% cases a combination of up to 2, in 44.4% - up to three clinical manifestations, the temporomandibular joint dysfunction was found. Signs of intra violations in each fourth case reflected changes, characteristic of early stages of osteoarthritis. The combination frequency of over 3 clinical manifestations in patients of the second group (100%), combined with magnetic resonance imaging of soft tissue and bone changes in intra-changes with the hallmark of chronic synovitis - the presence of a pathological effusion in 45.5% of cases. The detected significant increase in androgens in patients of the second group correlated with the severity of the studied disease and the degree of morphological changes. Conclusion. The extent of anatomical and functional changes in the joint correlates with increasing frequency of detection, bilateral localization and involvement into the process of other joint elements (bone, soft tissue, muscular system), as well as phenotypic burdened stigma DST and hyperandrogenism in patients with distal occlusion.

There is a high general and primary morbidity of rheumatoid arthritis in Russian Federation subjects. Diagnosis of this disease in daily practice is based on the assessment of clinical manifestations, laboratory markers and results of radiological methods of investigation, an X-ray among which is still leading. However, standard radiography allows assessing bone structure modification not in all the cases. Nowadays in the diagnostic algorithm for structural changes estimation of musculoskeletal system the high-tech technique of cone-beam computed tomography is gradually adopting. Purpose: the comparative analysis of standard radiography and cone-beam computed tomography in the hand and wrist joints pathological changes detection in rheumatoid arthritis. Materials and methods. The results of hand and wrist standard radiography and cone-beam computed tomography of 42 patients in rheumatoid arthritis in anamnesis have been analyzed. Results. Cone-beam computed tomography showed a significant advantage in assessment of the hand and wrist joints changes regardless of the disease stage in all the patients from the observation group. Conclusion. Taking into consideration low radiation dose, high spatial resolution with the ability to identify structural remodeling spots in size from 1 mm and relatively low direct cost of the study, cone-beam computed tomography could be considered as the methodology of the first step in diagnosis of the hand and wrist joints changes in patients with rheumatoid arthritis. In addition, this technique could be used in the dynamics, while monitoring the effectiveness of the therapy, replacing gradually standard radiography.

The purpose: to estimate and compare sensitivity and accuracy fine-needle aspiration biopsy (FNA) and corebiopsy (CB) in breast lesion's diagnostics of breast lesions. Material and methods. The results of 1496 biopsies performed to patients for 18 months since 2013 were analyzed. Punctures of lesion were carried out with ultrasound guidance by a syringe of 20 ml (20 gauge needle). A corebiopsy was performed under stereotaxic and ultrasound guidance with used automatic systems (Bard Magnum, 14 gauge needles, 130 mm) and semi-automatic systems for biopsy (Somatex, 14 gauge needles, 100 mm). Ultrasound visualization was carried out on system Hitachi Preirus with use of the linear gauge 10-13 MGz, the stereotaxic guidance biopsy was carried out on digital mammography GE Essential with system for a stereotaxic biopsy. Results. 852 (60%) patients with the benign lesions of breast and 644 (40%) patients with the malignant we survey. Results were estimated depending on the size of lesions. Sensitivity, specificity and accuracy FNA under ultrasound guidance for mass less than 1 sm and from 1 to 2 sm have made accordingly 67% and 86%; 93% and 99%; 85% and 95.5%. PPV - 80% and 98%; PNV - 87% and 95%. At the size of mass more than 2 cm sensitivity and specificity FNA has been 100%. Sensitivity and specificity of core-biopsy under ultrasound guidance for mass less than 1 cm was 94% and 100% accordingly. Under radiological guidance - 97% and 100%. For abnormalities more than 1 cm Core-biopsy was informative in 100% of cases for abnormalities more than 1 cm . Conclusion. Verification of breast mass abnormalities less than 2 sm to spend core-biopsy under ultrasound guidance, and calcifications or architectural distortion under stereotaxic guidance more effectively. Sensitivity FNA in diagnostics of mass more than 2 sm under guidance reaches 100%.

Filyariasis of a mammary gland is very rare and descriptions of radiology diagnosis of this pathology aren't found in the available literature. Intermediate owners (filyariya vectors) are the various bloodsucking insects (mosquitoes, gadflies, midges). Case report of a female-patient from Krasnodar region, who approached for nodule in the breast is presented. At the patient’s history it was revealed that she could be bitten by a mosquito 2 years ago at the rest in the Crimea. Opportunities of the set of radiological methods of diagnostic and low-invasive treatment of the patient with nematode abscess of a mammary gland are shown. Ultrasonography is the noninvasive fast and exact method allowing to suspect nematode genesis of abscess and to confirm by means of the fine-needle aspiration biopsy. The golden standard for the diagnosis of abscesses of nematode genesis of surface localization is fine-needle aspiration biopsy, in which threadlike worms can be extracted from the cavity of the abscess cavity and washing it with an antiseptic solution. At stages of antivermicular treatment of the patient US will allow to control regress of superficial abscesses and a condition of lymphatic system.

Objective: to develop a differential diagnostic ultrasound criteria multifollicle and polycystic ovaries in girls 15-18 years. Materials and methods. The study involved 394 women 15-18 years old. In 172 patients diagnosed with polycystic ovary syndrome (group 1), 95 - multifollicular ovaries (group 2). The control (group 3) reached 127 people. In each group, the girls are divided by age: 15-16 years and 17-18 years. All patients were performed organometric including uterine volume, thickness and volume of the endometrium, ovary volume, the diameter of maximum of the follicle and corpus luteum diameter. Then the degree of vascularization of ovarian was assessed using vascularization index (VI) was carried out and both uterine artery Doppler measurement with their diameter. Then the degree of vascularization was assessed using ovarian vascularization index (VI) and carried both uterine artery Doppler monitoring their diameter. The indices of maximum systolic velocity (Vmax), end-diastolic velocity (Vmin), mean, averaged over time, blood flow velocity (TAMV), pulse index (PI) and resistance index (IR). The final step was the assessment of hemodynamics calculation arterial perfusion index (PAI) of the uterus. Results. Revealed that the girls 15-18 years continues functional formation of pelvic terms of increased endometrial thickness and volume in the II phase of the cycle in comparison with I phase, the diameter of the corpus luteum and improve perfusion of the uterus and ovaries with increasing age. For multifollicular ovarian characteristic increase in the size of the ovaries, which occurs in some women folliculogenesis and ovulation. For polycystic ovary characterized by deeper violations. The volume of the ovaries has no minimum 9 cm³, maximum - 34.5 cm³ with the average 14.5-17.8 cm³, which increases as the girls. In the ovaries of girls of 15-18 years old are no dominant follicle and, accordingly, the corpus luteum. PCO reduced vascularization, with values vascularization index from 0% to 8.0%. Resistance index of the uterine arteries is high, reaching 1.0 in 38.8% of girls aged 17-18 and 50.7% - among 15-16 year olds. In addition, when PCO marked slowdown in the uterus, and therefore the uterine hypoplasia was present in 15-16-year-olds in 34.8% of patients and in 17-18-year-olds in 22.3%. Also recorded monotonous thicknesses and volume of the endometrium, did not increase in the II phase of the cycle. Conclusion. Teens 15-18 years with suspected polycystic ovaries during ultrasound diagnosis is competent only if the registration is not only the increase of ovarian volume, but also taking into account the functional activity of the ovary, its vascularization, endometrial changes in both phases of the cycle and assess uterine volume. Girls with MFO should be attributed to the risk group for the development of PCOS, especially those who have menstrual irregularities.

The purpose. To evaluate the capabilities of new complex pelvic MRI examination in identification and treatment monitoring of primary and recurrent vaginal tumors. Material and methods. 185 MRI examinations of pelvic with contrast enhancement were done in 112 patients. Complex MRI (Toshiba Vantage Atlas, 1.5 Tl) pelvic examinations (CMRE) with contrast enhancement were evaluated in 58 (51.7%) patients aged 34-79 (mean age 56.5 ± 4.7 years) with vagina neoplastic lesion suspicion, consisted of native scanning T1WI, T2WI, T2fatsat, diffusion-weighted imaging (DWI), dynamic contrast enhanced (DCE) examination with additional endovaginal MR-suitable applicator introduction. T2-weighted sequences in para-axial and para-coronal orientation ware orientated orthogonal and parallel to the vaginal axis. Neoplastic process in vagina was confirmed histologically in all cases. Results. Neoplastic lesions in vagina were found during CMRE in 58 (51.7%) patients, at lower third - in 5 (8.6%) pts. as endometrial and vulvar cancer progression; at middle third - in 11 (18.9%) patients; at upper third - in 42 (72.4%), included 18 (31%) patients with vaginal cuff relapse. It was revealed as a zone with increasing signal inT2-weighted sequence and contrast accumulation in the arterial and venous phases. Differential diagnosis with postradiation fibrosis demanded image fusion of T2-weighted fat-saturation sequence, DWI and DCE with endovaginal MR-suitable applicator, which created conditions for better visualization of vaginal wall structure and tumor localization because of fold smoothing. Tumors in situ and intramucose T1 tumors were not be clearly visualized during complex MRI in any sequences. Conclusion. CMRE increases the accuracy of primary and recurrent vaginal tumors determination and treatment results evaluation, especially after radiotherapy.