The aim: to study the accuracy of various radiographic tomographic techniques in the evaluation of the volume of the root canal. Materials and methods. Test objects (phantoms) containing various groups of teeth, allowing to carry out X-ray examination in the same position were studied. The research methods: multislice computed tomography, cone-beam computed tomography, cone-beam computed tomography with high resolution and microcomputer tomography. Results. The index values exceeding microcomputer tomography ranged from 2 to 16 times dominating over other radiological tomographic techniques at a comparative assessment of methods of research. Comparison methodology was not significantly different from each other in the accuracy of the determination of volume. Conclusion. The excess was greatest for CBCT, then the excess should compare with MSCT, the smallest excess proved to CBCT-HR.

Questions of ultrasound diagnostics of parathyroid glands hyperplasia in patients with chronic kidney disease are analyzed in this literature review. Pathogenesis of secondary hyperparathyroidism and specific parathyroid gland changes with this pathology are discussed. Information on strengths and weaknesses of sonography in comparison with other methods of visualization are summarized. Diagnostic potential of ultrasound examination of parathyroid glands utilizing gray scale and Doppler ultrasound is described including assessment of morphological variants of hyperplasia.

Diagnosis and surgical treatment of esophageal diseases, which are one of the most difficult fields in the abdominal surgery, are of great practical interest for many medical specialties. Despite the development of clinical and diagnostic gastroenterology in recent years, esophagology wasn’t almost affected. This review of literature describes modern methods of radiologic diagnosis of surgically significant stenoses of the esophagus. The article focuses on X-ray and predominantly MDCT signs, which allow to differentiate stenoses of the esophagus of different etiologies. The main attention is paid to such the most common stenosis as postburn, peptic esophageal strictures and esophageal cancer.

Purpose. The aim was to investigate the role of positron-emission and computed tomography (PET/CT) with¹⁸F-FDG in the diagnosis and staging of patients with indolent non-Hodgkin’s lymphoma, to compare PET/CT findings with the results of computed tomography (CT) and proliferative activity of tumor cells. Material and methods. 49 consecutive patients with untreated indolent non-Hodgkin’s lymphoma were evaluated in our study. Conventional staging methods including CT as well as PET/CT with¹⁸F-FDG were performed for investigating lymph node and extranodal manifestation of the disease. Results. The sensitivities, specificities and diagnostic accuracies in diagnosis for lymphomatous involvement of nodal regions were 75.7%, 98.4% and 86.8% for PET/CT and 51%, 98.4% and 74.4% for CT The accuracy in detecting extranodal manifestation for PET/CT was 84.6% compared to 71.8% for CT. Disease staging by PET/CT and conventional diagnostic methods was identical in 75.5% of patients, 24.5% showed discordant results. PET/CT correctly resulted in a higher stage than CT in more than 18% (n = 9) of the patients. No significant difference was found between the SUV_max of the various types of indolent lymphoma (p = 0,065). The correlation of SUV_max and Ki-67 index was not statistically significant (r = 0,1, p = 0,7). Conclusion. PET/cT provides significantly more accurate information compared to CT for diagnosis and staging of patients with indolent non-Hodgkin’s lymphoma.

We have presented data from the literature on computed-tomographic characteristics of hepatocellular cancer Was carried out a critical analysis of the criteria for the differential diagnosis of the system LI-RADS and performance of locoregional treatment system mRECIST It is shown that the efficiency of detection and verification of hepatocellular cancer depends primarily on the dimensions of formation and the state of the liver tissue. In the basis of changes in computer-tomographic semiotics of hepatocellular cancer at different phases of the scan are features of its blood supply.

Portal venous system aneurysms - is the term used for the description of aneurysms of portal vein, mesenterica superior and inferior veins, splenic vein and confluence of splenic and mesenterica superior veins. Portal venous system aneurysms consider as rather rare nosological form with various pathogenesis, clinical manifestations or lack of those. Their prevalence varies according to literature depending on the used diagnostics methods (0.6-4.3 for 1000 patients). Since 1953 to today in the analysis of the PubMed, Scopus and eLibrary databases about 480 cases of portal venous system aneurysms are revealed. Aneurysms are localized in extra hepatic part of portal vein most often. They can be isolated and be combined with other pathology. The accompanying pathology are cirrhosis and portal hypertension more often. The clinical picture can be absent or have nonspecific symptoms. Ultrasonography is a preferable method at primary inspection by the patient with suspicion on existence of portal venous system aneurysms. At some disputable or difficult cases, and also in the presence of complications and associated diseases of hepatopancreatobiliary area, performance of MSCT and/or MRI is expedient. Waiting tactics of treatment is the main in the absence of clinic and complications, and also at the small sizes of aneurysm. Dynamic ultrasonography is an effective method of supervision over a condition of aneurysm. Symptomatic aneurysm of portal venous system and progressive rapid growth of aneurysm are indications for surgery. The most widespread complications are thrombosis of a cavity of aneurysm and a gap.

The aim of the work was to highlight the role of computed tomography as the leading method for assessing the response of tumor treatment. Material and methods. The study is based on the literature data and the results of MSCT examinations of 63 patients (colon cancer - 49 (77,8%), gastric cancer - 14 (22,2%) before and after preoperative chemoradiotherapy. Results. Analysis of the literature and our own experience has allowed describing in detail the role of the computed tomography in the assessment of response to therapy of malignant tumors of different localization. Historical development of various CT-measurement techniques of tumor based on CT criteria for their evaluation was described; the specific approaches to CT evaluation of tumor response to therapy were highlighted in the paper. Conclusions. CT is the leading method for studying tumor response to treatment. Modern methods of diagnostic imaging are a powerful tool for studying the cancer response to treatment. The potential of these methods is great, but their capabilities require further comprehensive study. Methodology to obtain a multimodal image requires the further development as well.

Stress echocardiography has an important role in clinical practice for the early diagnosis and risk evaluation in patients with coronary artery disease (CAD). Conventional isometric stress echocardiography with hand-held dynamometer is not routinely used in patients with CAD because of a low sensitivity in diagnosis of coronary artery stenosis. In the study there was modified stress test using maximal isometric exercise (maximal isometric dominant hand grip force of expander during 3 minutes) combined with emotional component (the investigator inspired patient to maximal effort during the stress) and assessed its diagnostic value for detection of CAD. Purpose. To compare the diagnostic value of traditional method of isometric stress echocardiography and proposed combined maximal isometric handgrip and emotional stress echocardiography (MIHESE) in the diagnosis of CAD. Materials and methods. 138 men scheduled for stress echocardiography (mean age 54.8 ± 0.8 years) were examined. 108 patients underwent combined MIHESE, while 30 patients of group II had conventional isometric stress echocardiography. The diagnosis of CAD was verified with coronary angiography performed in all patients after stress test. Results. Echocardiography test was performed in all patients and no complications were detected. For detection of CAD conventional isometric stress echocardiography demonstrated sensitivity 62.5% and specificity 64.3% compared to sensitivity 87.5% and specificity 94.4% in the group of combined MIHESE. Conclusion. The proposed combined method of maximal isometric handgrip and emotional stress echocardiography showed a high diagnostic value in detection of ischemia and may be used as a novel approach for detection of CAD in clinical practice.

Presents a clinical case of successful diagnosis and surgical treatment of rare complications constrictive pericarditis, thrombosis of the left and right atria. The optimal treatment strategy in thrombosis of the cavities of the heart has not been finally determined and depends on accurate diagnosis of the nature of the thrombus, comorbidities and risk assessment of thromboembolism. Course of conservative therapy, including indirect anticoagulants, in the dynamics of the first stage was conducted based on the data of echocardiography and multislice spiral CT with bolus contrast enhancement (MSCT) A. The subtotal pericardectomy with full normalization of hemodynamics was made then. Two-step treatment strategy allowed us to avoid surgery under extracorporeal circulation in patients with severe circulatory failure and severe concomitant diseases.

Objective. To evaluate the role of integrated use of standard X-ray methods and computed tomography in evaluation of severity of joint destruction in patients with hemophilia. Material and methods. The work is based on an analysis of results of examination and treatment of 87 patients with hemophilic arthropathy of large joints. They treated in specialized department of replacement orthosurgery and polytrauma JSC “RNTSNMP”, with an average age of 42.5 ± 10.3 years, which hemophilia A found in laboratory studies. They are disabled II-III group since childhood. X-rays of the joints before surgery arthroplasty performed, computed tomography was performed on device “Siemens”. Indications for hospitalization wasviolation of large joints: all affected joints 113-104 knee and 9 hip joints. Results and discussion. We used the clinicoradiological classification EZ Novikova (1967) when using standard X-ray to assess severity of joint destruction in patients with hemophilia. It found according to X-ray of the 104 examinated knee in 26% revealed no pathology, I X-ray stage set to 5.8%, II stage - in 6.7%, 37.5% - X-ray revealed signs of arthrosis stage III, in 24% - IV stage. X-ray picture in all 9 patients with complaints of pain in the hip joint is consistent with stage III-IV osteoarthritis, with significant violation of joint function. In recent years, X-ray computed tomography (CT) received widely using to assess bone changes at joint pathology , but literature don’t have enough information about CT descriptions to clarify the stage of progression with hemophilic arthropathy, there is no clear description of CT semiotics at different stages of hemophilic arthritis. After X-ray computed tomography examination is studied 104 knee: 26% of joints that did not have X-ray evidence of osteoarthritis - on CT scans revealed changes corresponding to stages I and II. All these joints defined CT signs of osteoporosis in the form of local areas of bone vacuum, whereas these are not visible in X-ray. It shows, that X-raydoes not give positive result in Istage of disease. At CT of 104 knee joints: from 26% of the joints which didn't have an arthrosis X-ray signs on roentgenograms for CT I and II stages of arthrosis, in all joints - CT-symptoms of osteoporosis in the form of local sites of discharge of a bone tissue whereas on roentgenograms regionarny osteoporosis was noted in 50,6% are revealed. CT, unlike X-rays, has high sensitivity characteristics in diagnosis of hemophilic arthropathy (91.8% and 72.7%), whereas specificity of X-ray is higher CT specificity (86.4% and 71.3%). These two studies are not expected each other, but complemented. The combination of X-ray + CT increases sensitivity to 96.7%, the ratio of TM and DS at the same time is optimal (3:2). Conclusion. Our method of semiquantitative evaluation of hemophilic osteoarthritis’s progression by standard X-ray. computed tomography data supplemented with detailed X-ray tomographic semiotics various stages of hemophilic arthropathy, with diagnostic sensitivity of 96.7% can serve as practical guidelines for physician radiologists, hematologists, orthopedic traumatologist. Timely establishment of changes in joints with hemophilia promotes appointment of adequate therapy, which can affect prognosis of disease evolution and reveals indications for total joint replacement.

Purpose. Assessment the feasibility of using high-resolution linear ultrasonic transducers and diagnostic value of sonoelastography in the study of benign lesions of skin and subcutaneous tissue. Materials and methods. A total of 50 patients range 28-80 years with benign skin and subcutaneous lesions were evaluated using B-mode ultrasonography, pulsed wave Doppler, color Doppler, power Doppler and semiquantitative sonoelastography. Results. Developed a method, evaluated the ultrasonic and sonoelastographic criteria of non-invasive differential diagnosis common in outpatient volume benign skin and subcutaneous disorders. The presence of hyperechoic entry echo with acoustic shadow is statistically significant sign of the differential diagnosis between keratomas and nevi. Using a distinct strain ratio for the most rigid zone of the benign lesion statistically significant allows to differentiate nevi and dermatofibroma. Conclusion. High resolution ultrasound transducers using frequencies in the range 12-17 MHz enables detailed imaging of benign lesions of skin and subcutaneous tissue. Sonoelastography is inexpensive and promising technique to improve the differential diagnosis of cutaneous and subcutaneous benign lesions.

Relevance of the topic. Over the last decade in the world, new data periodicals devoted to the comparative characteristics of widely used in practical work and scientific purposes radiopaque agents. The purpose of this work. Since loversol in essence became the first Russian radiopaque agent is of interest to evaluate the information about it available in the scientific sites. Materials and methods. In the well-known search system PubMed by keyword “ioversol” and “optiray” was searched scientific publications from 2007 to the present, in which there was extensive information about the use of this contrast media with multislice computed tomography and angiography. In this paper we analyze both abstracts and articles themselves (in the available sources). Total 26 publications that analyze different aspects of the application and features loversol was studied. Information combined in groups. The Results. Adverse events, contrast media induced nephropathy, the impact of CM on the blood and its components, the comparison of different concentrations of Cm, a decrease of volume CM for MDCT examinations, pre-filled syringes, invasive intra-arterial procedures - in all these areas there are publications which shows high reliability of Ioversol. Conclusion. Ioversol refers to a group of CM, which have perfectly profile of reliability in laboratory tests and clinical examinations. This is a high-quality and a reliable X-ray CM and it should be in the arsenal of diagnostic radiology department and CT rooms.

Objective: to explore the possibility of quality control in the processes of radiation diagnosis of emergency conditions. Materials and methods. For definition of requirements of the main consumers of services, questioning of 3125 patients, 334 doctors-clinical physicians and 32 experts of insurance companies was carried out. Results. According to the results of the survey analysis needs of consumers of radiation diagnosis (patients, insurance companies, clinicians). In accordance with the requirements of customers, developed quality indicators of radiation diagnosis and their critical values: - discrepancy between diagnoses when cross-checking - 0.06%; - the divergence of diagnoses with external control - 0.01%; - the cost of the established diagnosis - 4286 rubles; - timing of diagnosis - 3 days; - waiting time assigned study - 20 min / 1 day; - the radiation dose to the patient and diagnosis - 4.6 mSv; - the complication rate for diagnostic procedures - 0.0004%; - the frequency of the use of high-tech methods - 60%; - repeated diagnostic procedures - 0.02%; - standby time study - 15 minutes. Examine the reasons for marriage and mechanisms to improve the quality of basic processes in radiation diagnosis. When this process is defined as a set of interrelated activities that transform labor contribution to the creation of services (ray studies). Considered as simple processes (manufacturing X-ray) and complex (the study). Develop standardized study protocols for patients with major urgency syndromes: “Acute abdomen”, “renal colic”, “Head injury”, “acute stroke”, “Obstructive jaundice”. Conclusion. The use of a quality management system, including the use of standardized protocols for patients with urgent conditions led to a decrease in the time of examination, cost savings, as well as increased sensitivity and specificity