Aim. We have evaluated the abilities of new original paramagnetic contrast agent Mn-DCTA (0,5M solution of Manganese (II) complex with trans-1,2-diaminocyclohexane-N,N,N',N'-tetraacetate, registered trade mark Cyclomang) for contrast-enhanced imaging of brain tumors in dogs. Material and methods. Twelve animals were included, all with brain tumors reveald during out-patient veterinary examinations. In ten of twelve the diagnosis was verified later by pathomorphologic study. The cerebral MRI has been carred out as set of axial, sagittal and coronal slices as thin as three to five mm, covering all the volume of brain. The scanning parameters in T1-weighted spin-ech mode were as follows : TR = 400-500 ms, TE = 15-20 ms, the dose of injected paramagnetic was standardised as 1 mM per 10 Kg of body weight. For quantitative analysis the index of enhancement was calculated as ratio : IE = (Intensity of T1-w MRI Post Mn-DCTA , (Intensity of T1-w MRI Pre Mn-DCTA Results. In all cases the sure enhancement with clear visualization of cerebral tumor was obtained due to highly intensive uptake of Mn-DCTA to the tumor tissue. When evaluated quantitatively the uptake of Mn-DCTA to the tumor gave the index of enhancement in T1-weighted spin-echo mode as high as IE = 1,72 ± 0,18 for the central parts of tumor and IE = 2,08 ± 0,23 for the peripheral ones. Intravenous injection of Mn-DCTA to dogs with cerebral tumors did not induce anydetectable pathologic or even physiologic effects. Conclusion. Mn-DCTA provides highly available methodologically simple imaging of cerebral tumors and can be thought out as promising paramagnetic agent for clinical magnetic resonance imaging.

Purpose: presentation of CT anatomy of regional lymph nodes in gastric cancer Materials and methods. The work is based on the literature data and the results of MDCT 91 patients with gastric cancer. The study was performed with a multidetector row CT scanners (Somatom Emotion 6 and Somatom Sensation Open; Siemens, Germany). Results. On the basis of the Japanese classification of gastric carcinoma we grouped the regional lymph nodes sites into 10 areas that could be easily visualized by CT: lymph nodes of diaphragmatic esophageal hiatus, lesser curvature, cardial, hepatoduodenal, celiac trunk, splenic, greater curvature, mesocolon, peripancreatic and para-aortic. Conclusion. This pictorial review can be used as a handbook to learn the nomenclature and location of the regional lymph nodes for the gastric cancer detected with CT imaging. Knowledge of the CT anatomy of regional lymph nodes allows radiologists to improve the accuracy of the diagnostic conclusions and assess the degree of lymphatic spread of tumor.

The purpose: submit a feature of modern diagnostics cholangiocarcinoma. The main provisions. The article describes the classification, incidence, risk factors for cholangiocarcinoma. Considered diagnostic capabilities of techniques of transabdominal, endoscopic and intraductal ultrasound and CT MRI, PET and cholangiography in the detection of extrahepatic and intrahepatic cholangiocarcinoma, locoregional tumor spread. The expansion of the bile duct on ultrasound tomograms-an important feature for the early diagnosis of cancer of the bile duct and the reason for a larger survey using other informative methods. Ultrasound examination - the method of choice for interventional procedures such as percutaneous transhepatic cholangiography and drainage of abscesses peribiliary. The development of new methods of investigation bile duct led to the use of ultrasound during endoscopy-endoscopic ultrasound and during cholangiopancreatogra-phy-transpapillary intraductal ultrasonography. Conclusion. Most authors believe that the diagnostic methods for bile duct carcinoma without jaundice include ultrasound, MRCP, EUS, ERCP and intraductal ultrasound. Diagnostic methods for carcinoma of the bile duct with jaundice: ultrasound, CT or MRI, puncture under the control of EUS, ERCP. PET successfully identifies intrahepatic cholangiocarcinoma, but has a poor performance in detecting informative extrahepatic cholangiocarcinoma. Its role is to identify distant metastases and assessment of treatment efficacy.

Purpose: to study the ultrasound features of iatrogenic injuries of bile ducts in different terms of postoperative period and to identify the typical variations of the echographic image. Materials and methods. 46 patients who suffered from iatrogenic injury in different terms of cholecystectomy have been examined and treated. Iatrogenic injury of bile ducts was revealed among 12 (26%) patients during the operation, within 7 days - among 15 (33%) patients, within a month - among 8 (17%) patients, and cicatricial stricture of bile ducts in late postoperative period was revealed among 11 (24%) patients within the terms from a month to 16 years. The injuries of bile ducts were the following: ducts crossing took place among 10 (22%) patients, excision - among 14 (31%) patients, peripheral injury - among 7 (15%) patients, thermal injury - among 2 (4%) and it was not possible to identify the nature of the injuries among 13 (28%) patients. The patients were examined by means of the standard methods of sonography of abdominal cavity organs and the scanner settings. Results. In the course of the ultrasound examination 23 patients have been diagnosed to have an iatrogenic injury of bile ducts in the postoperative period, 16 patients have been revealed to have postoperative cicatricial stricture of bile ducts. In relation to a "fresh" iatrogenic injury an expansion of bile ducts has been observed in 61% of cases, changes in the opening of bile ducts - in 74% of cases, free fluid and limited liquid accumulations - in 65% and 52% of cases correspondingly. The increase of echogenicity of the ligamentous apparatus and cellular tissue structures of subhepatic recess has been revealed in 83% of cases during the ultrasound examination. Within a "fresh" iatrogenic injury three most frequent variations of echographic image have been marked out. Ultrasound features of postoperative cicatricial strictures of bile ducts have been summarized. Conclusion. Due to the accomplished research the ultrasound symptom complex within an iatrogenic injury in different terms after the surgery has been studied. On the basis of the analysis of the ultrasound features combination it was possible to reveal the most typical echographic images which are specific for iatrogenic injuries of bile ducts in early terms of postoperative period. The ultrasound examination, in conjunction with other radiological methods, has allowed to choose the optimum minimally invasive surgical tactics, to carry out transcutaneous maneuvers under the ultrasound visual control as a preparatory stage in the treatment of iatrogenic injuries of bile ducts.

Aim: to study the influence of intraparenchymal cryoprecipitate injection on portal blood flow in cirrhotic liver with the use of Duplex portal vein ultrasound scanning. Material and methods: 40 patients with liver cirrhosis were measured the splenoportal index and congestion index in portal system before and after the cryoprecipitate injection. 8 patients had liver cirrhosis class A by Child-Pugh scoring system, class B was registerd in 13 patients and class C in 19. The cryoprecipitated was injected transcuta-neously under the US control, 1-2 ml into each segment. 13 patients had cirrhosis of the combined (viral and toxic) ethiology, the rest 27 had alcoholic cirrhosis. Men were 28 (70%), women - 12 (30%). Patients aged 25-60 years. Results: statistically significant changes of portal blood flow indexes were registered after 6 months after the stimulation in 92% of patients. The congestion index, wich correlates with the varices bleedeng, returned to normal in all patients within 6 months. The decreased values of splenoportal index was registered in 77.5% of patients. Therefore, the method leads to normalisation of portal blood flow and decreases the risk of variceal bleeding in patients with long-lasting liver cirrhosis. No statistically significant differences were registered after a year after cryoprecipitate injection in comparison with the 6 months data. Conclusion: intraparenchymal cryoprecipitate injection decreases portal hypertension in 92% patients with liver cirrhosis within 6 months. Patients with decompensated liver cirrhosis (Child-Pugh class C) require the repeated cryo-precipitate administration after 6 months.

Now, probably, there is no person who would not know about existence of colon cancer. Considerable works on volumes are devoted to a problem of diagnostics of this disease. It would seem that difficulties at a diagnostic stage should not arise. Nevertheless, it is frequent at the atypical erased clinical picture, or at cancer demonstration already from its complications, differential diagnostics is carried out between various diseases of the abdominal cavity and pelvis, while colon cancer often afterthought. Despite the presence of a large arsenal of modern diagnostic methods is not always possible to get answers to questions and clearly resolve doubts: cancer or not cancer. In this report two cases of complicated colon cancer are presented, which led to a long delay in the correct diagnosis. The diagnostic methods of colon cancer are considered, visualization features of complicated forms and main elements of their differential diagnosis on computed tomography are described.

Objective. To evaluate a comprehensive examination of uterine hemodynamics depending on the age and volume of the myomas uterus. Materials and Methods. We examined 71 patients with uterine myoma reproductive or premenopausal period and 73 healthy women. The study, including speed performance, peripheral resistance index, and vascularization index (VI), flow index (FI) and vascularization-flow index (VFI). Results. There was a significant (p < 0.05) increase in the maximum and end-diastolic velocity and decrease in peripheral resistance indexes of uterine arteries in both phases of the menstrual cycle in women older than 35 years, suffering from uterine myomas, compared with the control group. As the volume of the uterus significantly (p < 0.05) rose speed performance, and decreased peripheral resistance indices in uterine arteries. The increase in uterine myoma reduces the VI and VFI, whereas the FI has a stable value. Conclusion. To decide on the tactics of patients with myomas hemodynamic changes should take into account the uterus.

Aim: To evaluate the displacement velocity wall of the abdominal aorta in healthy patients with atherosclerosis and the results of ultrasound, followed by treatment at a workstation Multivox. Materials and Methods. Ultrasound of the abdominal aorta performed 57 patients: a healthy person -15 (26.3%), patients with abdominal aortic atherosclerosis - 42 (73.7%), an aneurysm of the abdominal aorta revealed at 22 (52.4%). Results. Identified objective reduction of speed of displacement of the abdominal wall in patients with aortic atherosclerosis in comparison with a group of healthy individuals, respectively: Vs = 3.5 ± 1.1 mm/s, Vd = 1.5 ± 0.5 mm/s and Vs = 9.7 ± 1.4 mm/s . The dependence of the velocity of displacement of the abdominal aorta wall to its diameter in patients with atherosclerotic lesions of the aorta. The highest rate of displacement detected by the aneurysm diameter of 6.0 cm: Vs = 10.7 ± 2.9 mm/s , Vd = 4.8 ± 1.9 mm/s. The velocity of displacement of the wall of the aneurysm is 2.2 times higher than in intact aorta above the aneurysm. Conclusions. In patients with atherosclerotic lesions of the aortic wall displacement velocity of the abdominal aorta was significantly (p < 0.05) lower than those of healthy individuals. Development of aortic aneurysm formation accompanied a significant difference in the rate of displacement wall extended and expanded sections of the aorta, which is a negative prognostic points and leads to aggravation of pathological deformation.

The aim of the study was to assess the opportunities and improve contrast-enhanced cardiac magnetic resonance imaging in the diagnosis of left ventricular papillary muscles scarring. Materials and methods. Contrast-enhanced cardiac magnetic resonance imaging was performed 68 patients after myocardial infarction. The advanced method uses short signal inversion time (150-180 ms) to increase the contrast of myocardial scar in the papillary muscles. Results. The signs of papillary muscles scarring were identified in 16 patients (23,5%) by advanced method and in 12 patient (17.6%) by standard method. The signs of mitral insufficiency was found only in 9 patients (13.2%) by echocardiography. Conlusion. Found that contrast-enhanced cardiac magnetic resonance imaging allows to visualize morphological changes in a papillary muscles before violation of their function and mitral insufficiency development. Using short signal inversion time (150-180ms) allows increase by 3.5 times the contrast of myocardial scar in the papillary muscles.

The aim of the study was to determine the role of MRI in diagnostics of femoroacetabular impingement syndrome of the hip. Materials and Methods. MRI-scanning results were analyzed for 142 persons (63 (44.4%) males, 79 (55,6%) females; mean age 34 ± 3.2 y.o.), 122 (85.9%) of them had complaints of pain sensation located in the hip joint. All the patients were divided into two groups: an experimental group (n = 122 (85.9%; 62 (50.8%) males, 60 (49.8%) females; mean age 33 ± 5.7 y.o) and a control group (n = 20 (14.1%); 15 (75.0%) males, 5 (25.0%) females; mean age 30 ± 3.8 y.o.). The enrollment criteria for the control group were: absence of complaints of pain sensation located in the hip joint, under sixty years of age. The age limit was provided the high risk of involutional changes in the hip within the patients of this age. In all patients MRI examination were done by high-field MR-scanners associated to designed protocol. While interpreting the results values of neck-shaft angle, lateral center edge angle, Tonnis angle and alpha angle were determined. Results. Different types of femoroacetabular impingement syndrome were determined in 35 (28.7%) patients. In all patients pathologic parameters were observed: abnormal (< degrees) neck-shaft angle (n = 11; 31.5%), abnormal (>39 degrees) lateral center edge angle (n = 17; 48.6%), abnormal (<0 degrees) Tonnis angle (n = 12; 34.3%) and abnormal (>55 degrees) alpha angle (n = 17; 48.6%) were determined. Conclusion. MRI allowed to determine abnormality of configuration of the femoral bone and acetabulum, to characterize the pathological conditions of the labrum and subchondral bone. The main symptoms of femoroacetabular impingement syndrome are pathologic configuration of the femoral head and acetabulum. The degeneration and tear of the labrum could be observed in the early stage of disease.

Objectives. Assessment of changes of cross-sectional area (CSA) on different segments of median nerve at different stages of carpal tunnel syndrome (CTS). Methods and materials. The study included 62 patients divided into two groups. In the basic group examined 48 (77%) patients (dominated by women - 36 (75%)), aged 21-86 years (mean age - 56,7 ± 3,99) with clinical picture of CTS and 85 median nerves were studied. 14 (23%) healthy individuals (dominated by women - 10 (71%)), aged 21-53 years (mean - 35,07 ± 6,22) with 23 median nerves studied served as a control. The degree of neuropathy was established by electrophysiological study (Nicolet Viking Select). According to nerve conduction data the different degree of median nerve injury were established: mild -17 (20%), moderate - 44 (52%), severe - 20 (24%), extreme - 4 (5%). CSA was measured by ultrasonography (10-14 MHz linear-array probe, GE Logiq 9) on antebrachi-um (S1), before the nerve entrance to carpal tunnel (S2), on the level of carpal tunnel (S3) just distal to carpal tunnel (S4), cumulative area of distal median nerve branches (S5). Results. We have found the best correlation between severity of neuropathy and CSA, measured at S2 and S4 on all stages of neuropathy (r +0,69, +0,58; р < 0,05). At stages mild to moderate (with preserved sensory conduction) negative correlation between CSA and sensory nerve conduction velocity on the wrist (r = -0,79; р < 0,05) was found. Conclusion. Increase in CSA of median nerve well correlates with the degree of nerve injury at all stages of CTS. CSA measured at S2 and S4 seems to have better correlation with severity of median nerve neuropathy in CTS in compare with CSA measured on other segments. In patients with preserved sensory conduction increase in CSA accompanied by a decrease in conduction velocity in a segment of the nerve.

The purpose of the research was to improve the quality of diagnosis of congenital anomalies of the musculoskeletal system by the ultrasonic method. The descriptions of the two cases of prenatal diagnosis and postnatal treatment of congenital dislocation of the knee are adduced. Ultrasound studies were performed on the medium and expert classes diagnostic apparatus and confirmed by prenatal magnetic resonance imaging and post-natal study by specialized professionals. Based on the analysis of publications devoted to the diagnosis of congenital dislocation of the knee, the issues of etiology, pathogenesis, prenatal ultrasound diagnosis and differential diagnosis of this anomaly ultrasound were considered. It is shown that prenatal ultrasound diagnosis of congenital dislocation of the knee is possible up to 20 weeks. pregnancy. In the presence of the factors that control the mobility of the fetus it needs a targeted search of fetal abnormalities and syndromic disease.

Purpose was the calculation of fractal dimensions of femoral artery angiogram after digital subtraction angiography (DSA). Material and methods. Fractal dimension of 49 images of femoral arteriogram in 31 patients after DSA was calculated. The fractal dimension was calculated geometrically. The geometric method consists in determining the dependence of the number of square cells of the object under study to its size, ie the scale. Preparation of the angiograph-ic images for fractal dimension calculation and its calculation was performed by means of E-film®, Adobe® Photoshop^® CS2, Adobe^® Illustrator^® CS2, Fractal.exe and Microsoft^® Excel^®. Results. In the article step-by-step sequence of preparing of an angiographic images for calculation its fractal dimension by using available software for IBM PC was developed. The limits of the scale of consideration in the light of the stochastic nature of the fractal structure of angiographic images of the femoral arteries were identified. Conclusion. Fractal dimension allows quantify collateral arteries in DSA images postprocessing.