Objective: to study the basic characteristics of changes revealed by MRI in patients with syringomyelia associated  with Chiari malformations type I before and after surgery.

Materials and methods. MRI was performed in 70 patients with syringomyelia before and after surgery in period from 2015 to 2016.

Results. There was almost complete regression of syringomyelia cavity in 11 (16%) patients. The reduction in size of syringomyelia cavity was in 50 (71%) patients. Size of syringomyelia cavity has not changed in 9 (13%) patients.

Conclusions. The use of modern MRI Protocol allows to evaluate the long-term consequences of surgical treatment in patients with Chiari malformation associated with syringomyelia and to evaluate further the prognosis of this disease.

Левое предсердие (ЛП) обеспечивает наполнение левого желудочка (ЛЖ), исполняя роль резервуара, кондуита, а также насосную функцию в разные фазы сердечного цикла. Размер ЛП напрямую зависит от диастолической дисфункции ЛЖ и отражает степень ее выраженности. Диастолическая дисфункция развивается на фоне ряда сердечно-сосудистых заболеваний. Таким образом, увеличение объема ЛП может являться индикатором различных кардиологических патологий.

Цель исследования: определить степень изменения волюметрических показателей ЛП, измеренных по данным мультиспиральной компьютерной томографии (МСКТ), у пациентов с ишемической болезнью сердца (ИБС), артериальной гипертензией (АГ) и фибрилляцией предсердий (ФП), а также оценить возможную роль измерения объема ЛП для диагностики сердечно-сосудистых заболеваний и прогнозирования их течения.

Материал и методы. 67 пациентам (средний возраст 61 год, 66% – мужчины, 34% – женщины) было проведено МСКТ-исследование сердца с ретроспективной синхронизацией по ЭКГ на компьютерном томографе Philips Ingenuity 64 core. Данные МСКТ использованы для построения 3D-модели ЛП с дальнейшим подсчетом его объема. Проведена корреляция между объемом ЛП и имеющимися клиническими данными о наличии сердечно-сосудистых патологий.

Результаты. У пациентов без сердечно-сосудистых патологий объем ЛП составил 92 ± 15 мл. В группе пациентов с подтвержденной ИБС отмечалось увеличения объема ЛП до 96,1 ± 17 мл (p = 0,535). В группе пациентов с изолированной ФП отмечалось увеличение объема на 30% – до 118 ± 31 мл (p = 0,03) по сравнению с двумя предыдущими. В группах, где у пациентов наблюдалась ФП в сочетании с другими сердечно-сосудистыми заболеваниями, отмечалась тенденция к большему увеличению объема по сравнению с группой пациентов с изолированной ФП.

Заключение. Объем ЛП и индексированный объем ЛП являются достоверными индикаторами наличия сердечно-сосудистых заболеваний. Резкое увеличение объема (на 30%) отмечается в группе пациентов с изолированной ФП по сравнению с группами пациентов без заболеваний и с ИБС. При сочетании ФП с ИБС и АГ отмечалась тенденция к прогрессирующему увеличению объема ЛП. С учетом полученных данных увеличение объема ЛП может быть маркером субклинического течения сердечно-сосудистых заболеваний, а также служить для прогнозирования риска возникновения ФП у пациентов, которым выполняют КТ-исследование сердца, грудной клетки, коронарных артерий с ЭКГ-синхронизацией по поводу других состояний. Кроме того, объем ЛП может быть использован как диагностический фактор прогрессии сердечно-сосудистого заболевания при динамическом наблюдении пациентов.

The aim: to show the possibilities of the method of magnetic resonance imaging (MRI) in the detection and characterization of hypertrophic cardiomyopathy (HCM). Identify the relationship between the presence of foci of fibrosis in the myocardium of the left ventricle (LV) and the occurrence of arrhythmia.

Materials and methods. The study involved 31 patients with HCM and obstruction of the LV outflow tract, who subsequently underwent Morrose's myoseptectomy. In order to detect abnormalities of rhythm, all patients underwent daily Holter monitoring. The presence and nature of the accumulation of contrast medium was assessed by the MRI method in the early and delayed phases of contrasting.

Results. The use of MRI with contrast enhancement made it possible to identify areas of delayed contrast in the hypertrophied walls of the LV - fibrotic changes in the myocardium. The centers of fibrosis were revealed in 14 (45.2%) patients. In 5 patients (16.1%), there were no cardiac rhythm disturbances in the presence of changes in the myocardium. Multivariate regression analysis of risk factors showed the relationship between the presence of foci of fibrosis in the myocardium of the LV and the occurrence of arrhythmia (p = 0.021). The presence of violation zones of local contractility (p = 0.327) and the thickness of the hypertrophic wall (p = 0.146) have no significant effect on cardiac rhythm disturbance.

Conclusions. The presence of foci of delayed contrast (fibrosis) in the wall of the left ventricle, detected by MRI, increases the chance of arrhythmia in patients with HCM in 12.9 times. MRI with contrast enhancement should be included in the algorithm for diagnosis of HCM, including for evaluating the onset of structural changes in the myocardium.

Inborn specific anomalies in the development of the cardio-vascular system require strong attention from physicians of many specialties, especially during diagnosing process. The results of all available diagnostic methods of patient examination determine the further treatment tactic. This tactic implying an individual approach to a specific pathology. There are some cases of combined defects of both, the arterial as well as the venous systems, which appealing special interest. This article describes case report of such anomalies in the structure of the vascular system. This case shown in the form of congenital inflection of the aortic arch with true coarctation and the persistent left vena cava superior.

Purpose. To assess the possibilities of methods of radiation diagnosis in the recognition and staging of gastric cancer.

Material and methods. The results of inspection of 307 patients with cancer of a stomach at which endoscopic, radiological and computer tomography researches on purpose, both primary diagnosis of gastric cancer, and establishment of a staging of process have been executed have been analyzed from 2014 to 2017.

Results. At a radiological research proximal cancer of a stomach is revealed at 63 (20,5%) patients, a body – at 202 (65.8%) and distally – at 42 (13.7%) patients. In all cases we managed to diagnose precisely stomach cancer, its localization and distribution on stomach walls. MSCT allowed to determine the spread of the tumor beyond the organ. Results of comprehensive examination of patients with cancer of a stomach have allowed to stage the process. The first stage has been established at 40 (13.0%) patients, second – at the 117 (38.2%), third – at the 102 (33.2%), fourth – at 48 (15.6%). Of the 307 patients with gastric cancer, various types of interventions were subsequently performed in 254 (83%), chemotherapy, as an independent type of treatment was performed in 49 (16%), refused any treatment of 4 (1%) patients.

Conclusion. Complex radiation diagnosis is highly informative for the detection and staging of stomach cancer.

New criteria for T, N and M categories and characteristics of the stages of hepatocellular carcinoma and intrahepatic cholangiocarcinoma are presented in the eighth edition of the international TNM classification of malignant tumors in 2017. The differences of this classification from the previous seventh edition of 2009 are noted, due to the receipt of new data on the survival of patients. The main characteristics of the primary tumor remained its size, the number of nodes and the presence of vascular invasion.

The number of available methods for hepatic tumor treatment is steadily increasing. Except traditional surgical resection and systemic chemotherapy there are a lot of effective and increasingly used local methods such as Radiofrequency ablation, cryodestruction, transarterial chemoembolization. Radiologist should be able to assess treatment response and evaluate prognosis. We present review of literature on various systems for hepatic tumor treatment response evaluation. WHO, RECIST 1.0, RECIST 1.1, mRECIST and Choi criteria are thoroughly explained in terms of benefits and drawbacks. Also, texture analysis and diffusion-weighted imaging are discussed.

The article contains an attempt to validate the world and European recommendations on liver elastography 2015–2017 for practical health care. From the position of radiology, the expert summarizes the threshold values of liver fibrosis, the ways of clinical interpretation of elastometry. Evaluation of the dynamics of algorithms in elastometry from the European recommendations 2013 to the provisions of the world and European experts 2015–2017. The feasibility of introducing various types of elastometry into domestic practice is assessed, taking into account the pace of updating of ultrasound equipment and the format of interaction between public and private medicine.

Objective: to visualize the cellular structures entered into the arterial course of a liver, for the purpose of assessment of a possibility of their fixing in liver tissue.

Materials and methods. Introduction of mesenchymal stem autologichny cells, marked by iron oxide nanoparticles was carried out to 10 patients with the diagnosis cirrhosis. Introduction was carried out to the arterial course of a liver.

Results. The mesenchymal autologichny cages entered into the arterial course of a liver, marked iron oxide nanoparticles, are visualized in tissue of a liver of patients by means of a magnetic and resonant tomography.

Conclusion. Mesenchymal autologichny cages, marked iron oxide nanoparticles, it is possible to visualize in a human body by means of a magnetic and resonant tomography. The mesenchymal stem autologichny cells entered into the arterial course of a liver are fixed in liver tissue.

Among parasitic diseases, liver alveococcosis is a particular complication. It is often compared with parasitic liver cancer, due to infiltrative growth, the possibility of metastasis, as well as the high frequency of relapse after surgical treatment. However, the main difference between the course of alveococcosis liver damage is a slow infiltrative growth, which, in combination with large compensatory capacities of the hepatic tissue, often leads to the fact that the clinical manifestations of the disease occur late, even with a significant spread of the pathological process, at the stage of complications. At the same time, complete operative re moval of the tumor remains the only radical treatment for such patients. We present the clinical case of the diagnosis and multistage treatment of the patient E., 57 years old, with the widespread liver alveococcosis involving the inferior vena cava.

Urothelial cancer ranks 4th in the prevalence of malignant tumors after prostate cancer (or mammary glands), lung and colorectal cancer. Urothelial cancer of the upper urinary tract is quite rare and accounts for 5–10% of all cases of urothelial cancer. The leading clinical symptom of cancer of the renal pelvis and ureter is hematuria. Metastasis of tumors of the upper urinary tract is observed quite often. Metastasis of the tumor can be carried out lymphogenically into the para-aortic and parailiac lymph nodes, hematogenous to the liver, lungs, and bones. In addition, urothelial cancer often spreads through the urinary tract mucosa, mainly in the caudal direction. Currently, multidetector computer urography is considered the gold standard for examining the upper urinary tract, taking the place of excretory urography. This study should be performed under optimal conditions, especially with the inclusion of the excretory phase. It is necessary to perform scanning in a spiral mode (with a step of 1 millimeter) before and after the contrast medium. Clinical case of a patient with urethral carcinoma with implantation metastases in the ureter and in the bladder is presented.

The analysis of the diagnostic informativeness of modern radiodiagnosticis methods in determining metastatic lymph node of pelvic cancer gynecological organs according to domestic and foreign publications. At the present stage methods of obtaining visual images pelvic lymph nodes are radiodiagnostics technologies (radiological, ultrasound, magnetic resonance tomography, scintigraphic). The analysis has shown that the researches devoted to diagnostic informational content of modern methods of radiodiagnosis in a differentiation of nature of damage of pelvic lymph nodes aren't enough. According to the literature, the most rational and perspective method for radiodiagnosis metastatics lymph node is a magnetic resonance imaging due to the high information content and thus specificity. At the same time, the continued relevance of further study of methods of radiodiagnostics in order to find the optimal one for the assessment of pelvic lymph nodes.

A new method of automatic breast volume ultrasonography (ABVS) brings out new possibilities for the evaluation of occult breast cancer, missed on X-ray mammography due to dense breast glandular tissue. This is primarily due to the opportunity to assess the 3D format of whole breast by one scan with evaluation of a typical for malignancy spicularity or retraction phenomenon, high quality digital imaging technologies that enhance the visualization of retroareolar area, opportunity to work with the image on the working station, in the absence of the patient, the possibility of obtaining comparable scans and use them to monitor pathological formations. We present our own clinical case of occult breast cancer in a patient with a dense glandular background, demonstrating the possibilities of automatic volume sonography.

Iodine containing contrast media are used much frequently now-a-days for computed tomography examinations in children. The group of non-ionic monomers occupies a special place among modern contrast agents. Low osmolarity and viscosity, electrical neutrality and the highest iodine content of these contrast materials provide the best diagnostic efficacy with minimum risk of adverse reactions. However, characteristic anatomic and physiological aspects of a growing child’s body require additional attention and care during diagnostic procedures with use of such contrast agents. This article presents concise literature review of recent years highlighting practical aspects of nonionic lowosmolar iodinated contrast material use for computed tomography assisted diagnostic examinations in child population.

Purpose. To develop phantom for flow modeling in magnetic resonance angiography (MRA): relative contrast assessment, accuracy of the linear velocity and volumetric flow, what improve accuracy of diagnostic in cardiac and neurosurgical clinics (quality assessment of blood and cerebrospinal fluid motion). To compare scanners of different manufactures in points of the MRA efficiency using the developed phantom.

Materials and methods. The main part of dynamic phantom consists of a disc filled with agarose gel (for linear and volumetric velocity control) and silicone tubes for fluid flow modelling. MR study was performed at MRI units of two manufactures for comparing quantitative assessments of MRA sequences: 2DTOF, 3DTOF, and at three MRI units of one firm for estimated accuracy calibration curve calculating and linear velocity and volumetric flow determination for PC MRA. Phantom study well correlate with clinical MRA results.

Results. Obtained phantom scanning results in 2DTOF, 3DTOF sequences allow for objective comparing two MRI units of different manufactures. For 2DTOF mode was showed more effective signal enhancement affected by TOF effect for scanner of manufacture 2, then manufacture 1: 8.86 ± 0.88 и 6.07 ± 0.03 corresponding. For 3DTOF was observed rather more inflow relative contrast affected by TOF effect for scanner of manufacture 1: 6.06 ± 0.47 and 3.17 ± 0.83 corresponding. However, for manufacture 1 was showed more significant signal suppression for fat tissue, which improve vasculature visualization. Accuracy linear velocity fluid flow measurement in 2DPC is equal to ±2σ = ±0,4 by five pixels for three scanners of one manufacture. Using developed phantom was modelled MRA effects in 3DPC and Time-SLIP modes.

Conclusions. The developed dynamic phantom can be used for calibration tests in MRA. The case of MRI units of two manufactures were compared quantitative assessments of MRA sequences and analyzed methods of enhancement fluid flow signal.

Kotlyarov P.M., Solodkiy V.A. Magnetic resonance imaging of the lumbar spine after the posterior decompression operations. Palmarium Academic Publishing, Germany, 2016.136 p. ISBN: 978-3-659-72334-6