Functional MRI has now become one of the main methods of brain activity imaging. This is the only technique that allows you to analyze brain activity by studying the activation of the local blood flow of the cerebral cortex at rest or in response to any stimulus. Currently, fMRI is not widely used in routine clinical practice, although it has been successfully used in leading neurological and neurosurgical clinics, as well as in scientific research studies for brain activity evaluation. Main goal of using fMRI in clinical practice is preoperative mapping of the brain functions before neurosurgical interventions; however, there are other promising areas of fMRI. This review paper describes the technical aspects of the various fMRI techniques and discusses the possibilities of fMRI in different neurological diseases.

The aim of this study was to evaluate delayed enhancement as the tool for differentiation between metastatic brain lesions and neurotoxoplasmosis.

Materials and methods. 38 patients with multiple brain lesions with mass-effect and ring-type of contrast enhancement based on CT/MRI have been enrolled in the study. All cases were associated with metastatic brain lesions or toxoplasmosis. For every patient we performed contrast enhanced brain MRI and achieved axial T1WI immediately after contrast injection, in 15, 30 and 45 min. Acquired images were evaluated for the presence of contrast accumulation at delayed images in the central part of the lesions. Overall, we analyzed data for 153 lesions with 64 toxoplasmosis lesions and 89 metastatic.

Results. Among 153 lesions with ring-type contrast enhancement central contrast enhancement at delayed images was determined for 83 lesions. Among 89 metastatic lesions 81 demonstrated delayed central enhancement. Among 64 neurotoxoplasmosis lesions only 2 demonstrated delayed central enhancement. The sensitivity of the sign was 88%, specificity 95%.

Conclusions. The presence of central contrast enhancement at delayed images significantly increases the probability of metastatic nature of the lesions (specificity 95%). Consequently that sign might be effectively used for the differential between the metastases and neurotoxoplasmosis.

The transthoracic echocardiography made by multifrequency probes with support of the mode of the second harmonic imaging, is a competitive method for visualization of the main coronary arteries and allows to estimate coronary blood flow with high quality. Of course, the method has considerable restrictions, most important of which is the low spatial resolution of a method, due to small acoustic window. Because of this the transthoracic visualization of coronary arteries perhaps will not become the leading method of anatomic reconstruction of separately taken coronary artery and especially all coronary arteries system. However uniqueness and indisputable advantage of this method is an opportunity to noninvasively estimate a coronary blood flow both once, and in dynamics.

Situs viscerus inversus totalis – a complete reverse arrangement of the internal organs – is a rarely occurring congenital anomaly of development. Situs inversus with dextrocardia is more common. Congenital heart disease is observed with situs inversus with dextrocardia in 3–5% of cases, usually with transposition of large vessels. Сlinical сase of the patient P., 28 years old, with infective endocarditis of the aortic valve and atrial septal defect and situs viscerus inversus totalis also are presented. This case demonstrates the high importance of radiation methods in the diagnosis of complete transposition of organs as a congenital anomaly of development, as well as concomitant pathological conditions at the stages of surgical correction of these conditions.

Routine diagnostic methods have limitations in terms of predicting the ventilation function of the lungs before and after surgery. It was decided to investigate the possibilities of dual-energy CT (DECT) using xenon in assessment of lung ventilation function.

Objective: to master the methods of examination of patients with pulmonary pathology, evaluate the possibility of justifying the volume of operative intervention and prediction of postoperative lung function based on the hybrid images.

Materials and methods. For the study, 12 patients with different pulmonary pathologies were selected (COPD – 5, lung cancer – 4, bronchiectasis – 3). Results. It was found that the use of DECT with xenon reflects the functional state of lung tissue.

Conclusions. DECT with xenon have potential for planning surgical intervention and introducing the method into modern protocols of preoperative preparation.

Purpose: to determine accuracy of applying the new quantitative assessment methodology for liquid in the pleural cavity.

Materials and methods. The research encompassed 296 patients who underwent surgeries at Federal Center of Cardiovascular Surgery (Penza, Russia) with assisted blood circulation from 2015 to 2017. All the patients had ultrasonic examinations of the pleural cavities that identified the full volume of the liquid component in the pleural cavity, shaped elliptically, with further calculation of the volume with the disk test EDV (Dmax × Lmax × 3.42) – 6.44. The research data was processed with the demo software SPSS Statistics (Statistical Package for the Social Sciences). In order to compare the two methods of assessing the pleural effusionvolume resulting from the pleural puncture, we applied the Bland-Altman comparison method and Pearson correlation coefficient. A difference and a mean difference (M difference) were calculated for each pair of measurements; a standard difference deviation (SD difference) was specified with further verification of the assumption that M difference differed from 0. For this purpose, the sampling mean was compared with the speculative general mean, as tested with Student’s t – distribution.

Results. While determining potential connection between the findings of liquidquantity ultrasonic measurement and the actual volume after pleural cavity puncture, the equation of linear regression found a strong linear connection between them with R2 equal to 0.85 p < 0.001). Comparison of the liquid volume by the Bland-Altman method did not find difference in the liquid volume either: all the measurements are within 2SD difference of those parameters, which proves congruity of those methods. When the sampling mean was compared with the speculative general mean, as tested with Student’s t – distribution, no reliable differences (p = 0.52) were identified.

Conclusion. Development of this methodology proves to be justified by the fact that there are often cases in the postsurgery cardiosurgical and thoracic practice when the pleural effusion volume should be measured quickly and rather accurately and assessed in dynamics.

Pancreatic cancer has a poor prognosis, often because most pancreatic neoplasms are found to be unresectable at diagnosis. Early staging of the tumor process can change the tactics of treatment and affect the survival of patients. The purpose of this review is to provide an overview of pancreatic cancer and the role of modern imaging in its diagnosis with an emphasis on PET/CT with a various radiopharmaceuticals.

Compression stenosis of the celiac trunk (CSCT) is a syndrome based on the celiac trunk stenosis of varying degree, sometimes in combination with that of the superior mesenteric artery, caused by the compression of this vessel by the medial arched ligament of the diaphragm, as well as its internal legs and the neurofibrotic tissue of the celiac plexus. CSCT can cause chronic ischemia of the abdominal organs and chronic pain syndrome. The branches of the celiac trunk, supplying the stomach, liver, pancreas to the blood, are connected with the mesenteric arteries of the intestine in a common circle, therefore, with a lack of blood flow along one of the branches, the entire digestive tract suffers . The main clinical manifestation of CSCT is abdominal pain, observed in 97–100% patients. Angiography is the most invasive and, at the same time, the most informative method currently available to assess the extent and degree of the celiac trunk narrowing and to determine indications for surgical treatment. Ultrasound is a harmless, painless and at the same time informative diagnostic method for CSCT. A modern ultrasound technique is ultrasound with the use of echocontrast. Multi-detector CT angiography with multiplanar and 3D reconstruction is the optimal method of X-ray diagnostics of CSCT. MR angiography is successfully used both for preoperative preparation in patients with compression of the celiac trunk, and in the postoperative period. The methods of surgical treatment for abdominal ischemia are divided into palliative, decompressional and reconstructive. Modern diagnostic methods allow non-invasive methods to diagnose CSES in combination with clinical manifestations. The laparoscopic method is optimal for celiac trunk decompression, but the choice of the surgical treatment method should be considered individually.

Urothelial carcinoma is a malignant tumor that develops from the cells of the urothelium mucosa and can be detected both in the upper parts of the urinary tract (renal and pelvic system and ureter) and in the lower parts (bladder and urethra). Urothelial cancer of the upper urinary tract (UCUUT) is quite rare and accounts for 5–10% of all cases of urothelial cancer. UCUUT remains completely unexplored, having to date two equal theories of origin. Despite the modern radiology and endoscopic equipment, in view of the meager and sufficiently generalized  clinical manifestations (similar to other diseases), especially at the initial stages of the disease, it is necessary to constantly improve diagnostic methods for detecting the disease as early as possible. Already today, thanks to new technologies for diagnosis and treatment, it is possible to identify the disease at different stages and extend life to patients with UCUUT. The article presents data on morphology, clinic, diagnostics and modern methods of treatment of this pathology.

Purpose: assessment of complex radiation diagnosis in the recognition and staging of rectal cancer.

Material and methods. From 2016 for 2017 are examined 66 patients with rectum cancer. X-ray methods (irrigoscopy), MSCT and (or) MRI in combination with intravenous contrast enhancement were used as radiation methods.

Results. Rectal cancer was detected in 66 patients. In the study, the upper ampullar part of the rectum was affected in 14 (21%) patients, the upper-middle-ampullar part in 2 (3%), the middle ampullar one in 26 (39%), the middle- lowera mpullar one in 3 (5%), the lower ampullary in 21 (32%). Results of inspection have allowed not only to establish defeat process, but also to specify his stage in compliance with TNM system. Stage I of the disease was established in 2 (3%) patients, stage II in 22 (33%), stage III in 25 (38%) and stage IV in 17 (26%). Subsequently, 39 (59%) patients were operated on.