Magnetic resonance imaging (MRI) nowadays is the main diagnostic tool in multiple sclerosis (MS). The article is aimed at reviewing basic signal changes, location and morphology of pathologic lesions in the brain in multiple sclerosis, the role of contrast agents in its diagnostics and monitoring. Among conventional MRI techniques T2-weighted and T2FLAIR-weighted images are the most sensitive for focal damage detection, contrast-enhanced T1-weighted images are still irreplaceable for "active" lesions visualization. Dissemination in space and time is necessary for confirming the diagnosis and forms the basis of McDonald criteria revision of 2005 and 2010. New or enlarged MS lesions on T2 and T2FLAIR images are important for disease activity evaluation together with contrast enhancing T1 lesions. MS lesions detection in the spinal cord is of great importance as it's seen in the majority of patients. MRI also let us identify atypical MS forms like Shilder's diffuse periaxial encephalitis, Balo's concentric sclerosis, Marburg disease and pseudotumorous MS, which are characterized by special neuroimaging signs and thus could be differentiated from classic multiple sclerosis and other central nervous system pathology.

The aim of the study was to determine the diagnostic efficacy of computed tomography (CT) in detecting of regional lymph nodes metastases in gastric cancer patients. Materials and methods. Work is based on the comparison of clinical and pathologic features in 69 gastric cancer patients (42 (61%) men, 27 (39%) women, ranging in age from 24 to 79 years). All of the patients underwent preoperative multidetector computed tomography (MDCT). Parameters of lymph nodes evaluated were presence or absence of nodes in the regional areas, their number, size and shape. Statistical analyses were performed with SPSS statistical software version 13.0. The qualitative data were evaluated with Pearson х² test; the diagnostic values of lymph node shape for delectability of lymph node metastasis were evaluated by Receiver Operating Characteristic (ROC) analysis. Results. The frequency of lymph node metastasis was associated significantly with their number (three or more) (х² = 8.395; p = 0.004), size (up to 10 mm or more than 10 mm) (х² = 8.448; Р=0,002), and node shape (the ratio of long and short diameters <1.5 site) (х² = 9.996; Р = 0.001). Sensitivity of computed tomography in the assessment of metastatic lymph nodes were 86.4%, specificity - 89.4%, accuracy - 88.4%, positive predictive value - 79.2%, and its negative predictive value - 93.3%. Conclusion. The use of CT criteria and regional lymph node assessment scheme improves the preoperative evaluation and allows the radiologist to examine successively every possible zone of regional lymph nodes localization. Combination of factors such as: the location of lymph nodes, three or more nodes, and enlargement 10 mm or more, their rounded shape was the optimal diagnostic criterion for lymph node metastasis in patients with gastric cancer.

The aim was to analyze CT-perfusion of adenocarcinoma and pancreatic parenchyma outside the tumor. Material and methods. We examined 12 patients with histologically verificated pancreatic adenocarcinoma and 25 patients that hasn’t any pathology of pancreas. Perfusion CT was performed at 320-slice CT. Perfusion parameters were calculated with maximum slope method. Results. There were no significant differences found between perfusion characteristics of pancreatic head, body and tail. Also, we didn’t found significant differences in perfusion of visually not altered pancreatic parenchyma between patients with tumor and patients without any pathology of the pancreas. Perfusion of tumor was significantly lower than perfusion of visually not altered pancreas (64 ± 32 vs 115 ± 34 ml/100 ml/min; p < 0.05). Accordingly to perfusion changes tumor can be divided into three parts: superficial zone of decreased blood flow not correlating with the distance from tumor border, zone where we can see gradual centripetal decreasing of blood flow and central zone of the most altered perfusion without centripetal decreasing of blood flow. Conclusion. With PCT we can get additional characteristics of tumor which can be helpful in understanding of tumor pathogenesis.

Purpose: to compare the accuracy of preoperative detection of insulinomas between Volume Dynamic CT- tomography, percutaneous sonography, endoscopic sonography, none contrast MDCT, conventional angiography and selective arterial-stimulated blood sampling. Materials and methods. The study included 45 patients with typical clinical symptoms and the presence of Whipple's triad. All 45 patients underwent percutaneous and endoscopic sonography, non -contrast MDCT, dynamic volume computed tomography, selective angiography with arterial stimulation with calcium with simultaneous venous sampling (ASVS). Results. lintraoperatively in 45 patients it was found 66 insulinomas. During preoperative volume dynamic computed tomography was found 61 (92.42%). The degree of contrast enhancement of insulinoma in all contrast phases of the study was significantly higher than contrast enhancement of normal pancreatic parenchyma. Delectability of insulinoma in the arterial contrast phase was significantly higher compared with portal contrast phase. This kind of research has revealed early accumulation of contrast medium in small formations (up to 10 mm) of the pancreas, which allowed localize insulinomas in 92.4% of cases. The highest sensitivity of detection of insulinoma in less than 10 mm was observed with VDCT (92.4%) and ASVS (87.9%). The highest sensitivity of insulinomas detection from 10 to 20 mm was with VDCT (95.8% ), equal sensitivity was in ASVS and endoscopic sonography (83.3%) , slightly lower sensitivity showed angiography (79.2%) compared with a statistically significantly (P<0.05) less sensitive transcutaneous sonography and non-contrast MDCT . In the diagnosis of tumors larger than 20 mm are equally sensitivity (93.8%) were using VDCT, endoscopic sonography, ASVS, was less sensitivity in angiography (87,5%). Conclusion. Volume dynamic computed tomography is highly sensitive in the topical diagnosis of insulinoma, as it allows visualizing the pancreas in all contrast enhancement phases in 4D mode.

Angiomyolipomas are benign lesions which in the majority of cases occur in kidneys. Due to the small size and asymptomatic behavior these findings are mostly incidental. They have a typical CT-appearance, which helps to make a diagnosis easily. However, in some cases, lesions detected which looks different from classical CT appearance. This include differences in structure (abscence/poor fatty component) and difrences in grown pattern (recurrence, metastasis). All this arose substantial difficulties in differential diagnosis and suspicious of malignancy. Method of treatment depends on lesion size. Small size lesions asymptomatic and not accompanied by the risks of complications that causes observation management. Large lesions can cause dangerous complications, requiring a surgical treatment, which may vary depending on a kidney parenchyma involvement.

Purpose: to assess the incidence of quadriceps tendon ruptures in patients with end-stage kidney disease treated with dialysis, to establish ultrasound characteristics in the setting of this complication and to analyze correlation between established deviations and calcium phosphate metabolism disorder. Materials and methods. We performed clinical, laboratory and ultrasound examination of 175 patients aged 17 to 73 years with end-stage kidney disease on dialysis. Duration of dialysis averaged 60 months (0.5 to 230 months). Results. During the observation period there were three cases of quadriceps tendon ruptures. Average age of patients with ruptures was 40 years; average duration of dialysis was 76.7 months. We analyzed correlation between this observed complication and calcium phosphate metabolism disorder. We also established ultrasound characteristics of quadriceps tendon ruptures of different duration. The most common site of tendon rupture was close to its insertion to the patella, which in some cases was accompanied by the superior pole avulsion. Another found characteristic was quadriceps calcification. Conclusion. Ultrasound is an inexpensive and informative tool for diagnosis of spontaneous quadriceps tendon ruptures. Our data confirms leading role of the high level of the parathyroid hormone and hyperphosphatemia in development of the spontaneous tendon ruptures in dialysis patients.

Objective: development of ultrasonic criteria simple and proliferating uterine myoma. Materials and Methods. We examined 73 patients with uterine myoma who underwent surgical treatment. Depending on the histological structure of the tumor (a simple myoma or proliferative myoma, including sarcoma) retrospectively compared the ultrasound findings, including data in the В-mode of the uterus and node, high-speed performance, peripheral resistance index, and vascularization index (VI), flow index (FI), vascularization-flow index (VFI) and arterial perfusion index (API). Results. The comparative analysis shows that the majority of sonographic signs and dopplerographic simple and proliferating myomas, including sarcomas of the nature nodule identical. The exception is the character node vascularization (intratumoral or peripheral vascularization), and perfusion of the uterus. Thus, API less than 0.025 s-1 corresponds to a simple myoma, and higher than this value - proliferating myoma and sarcoma, and the threshold value is 7.0% of VI. Simple myoma always had VI less than the uterus, while proliferating myoma and sarcoma - more. Conclusion. To make a decision about the method of treatment of patients with uterine myoma should take into account the data of blood supply to the uterus and node.

Aim of the sudy. We did attept to compare directly and quantitatively the local uptake of paramagnetics to myocardium at contrast-enhanced myocardial MRI with results of electrophysiologic study of myocardium, in order to test relationships between myocardial damage and rhythm disorders. Material and methods. The study group comprised nineteen patients with recent transmural myocardial infarc tion. The contrast-enhanced MRI has been carried out in T1-weighted SE mode (by Toshiba Vantage Titan, 1,5Т), with injection of 0,5M contrast paramagnetics ex 2 ml per 10 Kg of BW. Contrast uptake to myocardium has been scored accordingly to classic 17-segment map of the left ventricle. Also topic quantitative study of myocardial electric potential has been carried out using Carto XP system (by Biosense Webster). According to amplitude of electric curve in a specific segment of myocardium the decrease in electric potential was assigned to one of the following degrees: 0 - 1,5 - 8 мВ, area of normal potential; 1 - 0,5-1,5 мВ, transient zone; 2 - 0,05-0,5 мВ, low potential zone; 3 - 0-0,05 мВ, area of “electric scar”, absence of electrical activity.. The Index of transmurality (IT) for the contrast uptake was calculated as ratio of thickness of paramagnetic uptake to overall thickness of myocardium. Results. The IT did depend on the local electric potential of myocardium. In particular in electrically normal segments the IT was 0,072 ± 0,020. In the segment of transient zone the IT was = 0,46 ± 0,046, whereas in low potential area 0,32 ± 0,052. The most prominent damage with IT = 0,66 ± 0,082 was observed in the area of electric scar. The best border vaue of IT that provided separation of electrically normal segments from proarrhythmogenic ones was the IT = 0,27. Pathologic proaarhythmogenic decrease in electric activity was detected with sensitivity = 0,87, specificity = 0,93, and diagnostic accuracy = 0,91. Conclusion. Hencefore we conclude the contrastenhanced MRI of the heart provides additional diagnostic information on arrhythmogenity of specific regions of the left ventricle in patients after acute myocardial infarction.

The aim of the study was to describe the cardiac magnetic resonance imaging artifacts and to develop ways to eliminate or interpret them. Materials and methods. 1,5 T contrast-enhanced cardiac magnetic resonance imaging was performed 156 patients with coronary artery disease. Technique of cardiac MRI included an assessment of left ventricular contractility, visualization of edema and acute myocardial damage, assessment of perfusion and myocardial scarring. Results. Various artifacts during cardiac MRI with contrast enhancement were visualized in almost every patient. The quality of cardiac magnetic resonance imaging depended on heart rate and blood flow in the cavities. In addition there were artifacts from the coronary stents, vascular clips, sternum's cerclage, as well as overlaying other organs and structures. During the study, were frequently observed “hyperintense endocardium” and “dark rim” artifacts which simulated endocardial edema and myocardial perfusion defect. Conclusion. The study found that despite the presence of certain artifacts that can affect the quality of the images and their analysis, there are effective ways to eliminate or reduce them. “Hyperintense endocardium” and “dark rim” artifacts can be distinguished from true pathology.

The aim: to evaluate the diagnostic effectiveness the automated breast volume scanner (ABVS) ACUSON S2000 (Siemens, Germany). Material and methods: The volume data sets were collected from 97 patients and a database containing 27 women with no detectable lesions in multimodal examination (BI-RADS 1), 18 women with clearly benign lesions (BI-RADS2), and 29 women with known breast cancer (BI-RADS5) was created. An independent examiner evaluated all the ABVS data on a separate workstation without any prior knowledge of the patients’ histories. Results. The diagnostic accuracy for the experimental ABVS was estimated as 88%. The independent examiner detected all breast cancers in the volume data resulting in a calculated sensitivity of 100%. After the ABVS examination, there were a high number of requests for further examination in 66%. Over-diagnosis was estimated 24 %. Conclusion. The specificity was 40%. Given the fact that during the application of ABVS no breast cancer was missed - the ABVS must still be regarded as an experimental technique for breast ultrasound, which definitely needs to undergo further evaluation studies.

Aim. To study the opportunities of complex radiological diagnostic of breast silicone gel implant rupture after endoprosthesis replacement of mammary glands. Material and methods. Complex kliniko-radiological examination of 630 women with 1260 implants after a breast augmentation of mammary glands is conducted. Various complications after endoprosthesis replacement of mammary glands were diagnosed at 127 (20.1%) women. Thus, ruptures of silicone implants were diagnosed in 27.6% cases of all complications and developed in terms from 2 to 16 years after endoprosthesis replacement of mammary glands. Intracapsular rupture met in 16.1%s, extracapsular - in 11.4%. Bilateral damage of implants of mammary glands met at 18.9% of patients. Results. Sensitivity of mammography in diagnostics of ruptures of implants of mammary glands made 28.4%, specificity -88.3%, diagnostic accuracy - 70.9%. Sensitivity of sonography in diagnostics of ruptures of implants of mammary glands made 77%, specificity - 91.7%, diagnostic accuracy - 87.4%. Sensitivity of MRI in diagnostics of ruptures of implants of mammary glands made 91,9%, specificity - 97.2%, diagnostic accuracy - 95.7%. Conclusion. The analysis of the obtained data showed that sonography is prime, cheap and highly informative method of diagnostics intra-and extracapsular ruptures of breast silicone implants. It is expedient to apply ultrasonography as the first method of visualization in complex clinico radiological inspection of mammary glands after a breast augmentation of mammary glands. The magnetic resonance Imaging (MRI) is the most informative method in diagnostics of ruptures of breast implants. However, in connection with the high cost of research application of this method is limited. Application of MRI is shown for specification of nature of changes of mammary glands and the implants revealed at sonography.