Aim. To evaluate the diagnostic value of PET with¹⁸F- choline in patients with glial brain tumors. Materials and Methods. The analysis was based on data generated from PET/CT and MRI examinations of 28 patients with intracerebral tumors: glioblastomas - 8 (28.5%) cases, anaplastic astrocytomas - 8 (28.5%) cases, glioma GrII - 7 (25%) cases, benign astrocytoma GrI - 5 (18%) cases. All patients with brain neoplasms underwent a selective brain¹⁸F-choline PET/CT and MRI follow up at minimum two time points: for at least 6 months. All two-stage PET/CT studies were performed with Biographm CT Siemens (multidetector (64) helical CT scanner, 120 kV, 300 mA, slice thickness 1.2 mm; PET acquisitions occurred at 4 bed positions ( 48 lutetium based units each), scan slab- 21.6 cm, at the first stage 5 min / slab, the second 10 min / slab). The first registration was performed immediately after intravenous injection of the radiopharmaceutical (RP) using an automatic RP-injector Intego 2010. Then patient were scanned again with the same protocol 45-55 min after injection. Administered activity was 300 MBq. Images visually and semiquantitatively assessment, with maximum standardized uptake value registration (maxSUV1 - on the first stage and maxSUV2 - on the second), was performed offline on a Syngo Via workstation using Oncology protocol. Results. The highest average maxSUV1 were observed in anaplastic astrocytomas and glioblastomas - 5.07 and 4.89, respectively, but the highest average growth (in %) of maxSUV2 observed in glioblastomas - 15.46%. The lowest maxSUV1 0.76 was registered in low-grade gliomas GrI. Conclusion. PET using different RP, provides unique information on the functional status of tumors for a variety of biological processes.¹⁸F-choline (N,N-dimethyl-N-18F-fluoromethyl-2-hydroxyethylammonium) is a marker of cell membrane lipid metabolism, so it could allow estimating the activity of cell membranes formation. An unaffected brain substance almost does not accumulate¹⁸F-choline. Two-stage PET technique of brain scanning with¹⁸F-choline enabled us to assume the gradate of malignancy of intracranial tumors - which depends on both the level of accumulation of RP in the first stage (maxSUV1) and the degree of uptake increase in the second stage (maxSUV2). Thus, the increment of maxSUV2 may be useful in the evaluation of tumor activity.

Aim. Persitent galactorrhoea-amenorrhoea syndrome is closely dependent on hypothalamic-pituitary disorders, thyroid disorders and possible presence of pituitary adenoma, often use to be a reason for sterility. In patients with arterial hypertension the hyperprolactinaemia can serve as ethiologic component of arterial hypertension. Thus we retrospectively evaluated the relationship of MRI features and clinical presentations in galactorrhoea-amenorrhoea syndrome. Material and methods. The study comprised 1230 persons, separated to two groups. Retrospectively the results of diagnostic MRI studies of hypophysis were analyzed in patients with hyperprolactinaemia (the study group - 1200 (97,6%) patients, 84 (7%) male and 1116 (93%) female. The duration of the follow-up did last for up to 17 years. At cardiovascular examination in 30% of these also the arterial hypertension of studies 2-3 was revealed. The control group included 30 (2.4%) healthy persons, in whom the magnetic resonance tomographic study of the brain was carried out from traumatologic or psychiatric indications and did not revealed any abnormal results. Results. From the results of the MRI studies the patients were assigned to one of the following four groups: the first (n = 869 (72.4%) comprised patients with pituitary adenopathy when crossover dimension of T1-hypointensive inclusions to the pituitary was n below 3 mm; the second (n = 202 (16.9%) included cases of microadenomas as little as four to six mm; the third (n = 59 (4.9%) included cases of pituitary microadenomas in ranges 6 to 10 mm; the fourth (n = 70 (5.8%) comprised macroadenomas of hypophysis with dimension over 11 mm. Recurrent adenomas after surgical treatment were in 13 (19.7%) cases of the group 4. There are presented cases of successful therapeutic treatment of prolactinomas with dimensions bigger than 20 mm. In adenopathies the sufficient periodic factor is one MRI scanning per two years, in adenomas as little as 4-6 mm it is once per 1,5 years; in prolactinomas as large as 6-10 mm and bigger once per year. Conclusion. From the results of long-term follow-up of patients there are, first, an approach supposed to the classification of adenomas (prolactinomas) of the hypophysis basing on anatomic dimensions measured by MR-tomography, and second, an optimal repetition factor has been formulated for repeat MRI studies in patients after surgical and medical therapy of prolactinomas.

Introduction. Complications that often arise at different stages of treatment of patients with chronic odontogenic maxillary sinusitis caused by pathological changes in the nasal cavity and paranasal sinuses leading to obstruction of the upper respiratory tract and oppression drainage function. This is not always respected maxillofacial surgeons for treatment planning. Therefore, the aim of this study was to explore the relationship between the presence, nature and severity of pathological changes in the maxillary sinuses with odontogenic maxillary sinusitis and the presence and severity of associated pathological changes in the nasal cavity and paranasal sinuses. Materials and methods. Use of MSCT on 108 patients allowed to achieve accurate visualizing and identification of those pathological changes, which cannot be detected by clinical examination, as well as using traditional x-ray methods. Results. The presence of combined congenital or acquired pathological manifestations contributes to the formation of so-called “vicious circles” or syndromes mutual aggravation. Obstruction of the upper respiratory tract leads to violations of the outflow of mucus and fluid from the maxillary sinus, and the oppression of mucociliary transport. This creates conditions for the development of chronic maxillary sinusitis. In addition, violation of the airway increase the risk of development of complications in early and late postoperative periods. Conclusion. Detection of pathological changes not only in the maxillary sinus, but in the nasal cavity, and other paranasal sinuses is extremely important at the stage of examination and planning of complex treatment.

The Purpose. Create an algorithm of using computed tomographydata in patients with malocclusion, accompanied by the narrowing of the maxilla. Create description CT data protocols. Materials and methods. Were examined 20 patients with malocclusion, accompanied by the narrowing of the maxilla. All CT examinations were performed on Toshiba Aquilion ONE, 320 before treatment and 6 months after rapid maxilla expansion. Description CT protocols of these studies were developed. Results. After rapid maxilla expansion it was found that the maximum expansion of the maxilla was at the level of canines, then at the level of premolars, first molars, second molars. 6 months after distraction the density of bone regenerate in the projection of the median palatal suture was estimated. When the distraction was 1-4 mm regenerate bone density ranged 520-890 HU. When distraction was 4-9 mm density varied 320-614 HU. These indicators gave the opportunity to plan further treatment in this group of patients. Conclusion. Computed tomography is an indispensable study in patients with malocclusion, accompanied by the narrowing of the maxilla, and should be performed in all patients before and after rapid maxilla expansion.

Purpose: development available for widespread use in surgical hospitals and effective method of endovascular diagnostics and treatment of patients with acute severe pancreatitis. Materials and methods. The experimental part of the research made on the 11 non-fixed organocomplexes of the top floor of the abdominal cavity. In the clinical part of the study used the results of examination and treatment of 93 patients with acute pancreatitis. Results. Experimental modeling of regional perfusion of the pancreas showed that for the effective distribution of drugs in the parenchyma of the body, rather the execution of non-selective endovascular catheterization of the celiac trunk. The implementation of multislice spiral computedtomographic celiacography the developed technique allows a more informative to visualize necrosis and hypovascular zone in the parenchyma of the pancreas early severe pancreatitis. Evaluation of the clinical results of regional intra-arterial perfusion of the pancreas showed a significant efficacy in the prevention of septic complications, progression of pancreatic necrosis in patients with aseptic forms of severe pancreatitis. Conclusion. Endovascular catheterization the celiac trunk allows MSCTCG, conduct regional drug perfusion of the pancreas in patients with acute pancreatitis.

Congenital defects of the mesentery are extremely rare abnormalities, can manifest in different age and be combined with other abnormalities. In this report we present a case of ultrasonic diagnostics the small bowel volvulus in the congenital defect of the mesentery (strangulated transmesenteric hernias) in a child of 5 years old. The child was admitted to the hospital in serious condition with symptoms of intestinal obstruction, confirmed during x-ray examination. Ultrasound was discovered the isolated intestinal loops volvulus and ischemic disorders. Detection of the mesenterial defect was operating finding. The boy was recovery within 14 days after the operation. The publication is supplemented with a short review of the literature.

Objective. To determine the possibilities of differential diagnostics of ovarian tumors revealed at MRI staging of cancer of the corpus uteri. Materials and methods. MRI staging using 1.5 T unit was performed in 131 patients with endometrial cancer 15 patients of this cohort had ovarian lesions and were included in further study with clinical, laboratory and MRI data analysis. Among them, metastatic ovarian lesions (FIGO stage IIIA) were histologically proved in 7 (5.3%) cases, synchronous ovarian carcinoma in 6 (4.6%) cases, synchronous stromal ovarian tumors in 2 (1.5%) patients (including one case of fibrosarcoma). Results. Synchronous and metastatic ovarian cancer showed predominantly cystic-and-solid structure, in contradistinction to solid stromal tumors. In cases of synchronous endometrial and ovarian cancer trends for early manifestation of the disease, larger ovarian lesions size and bilateral involvement were identified. Deep myometrial invasion of endometrial cancer was more specific for cases of metastatic lesions. Ca125 showed statistically significant higher values in cases of metastatic process. Conclusion. Despite of differences in clinical and MRI features of synchronous and metastatic ovarian tumors, histological verification is needed in most of cases for diagnosis.

Aim: the aim of this work is to determine the diagnostic capabilities and optimization techniques of multidetector computed tomographic coronary angiography at a multiplicity stenting of coronary arteries. Material and methods. We examined 40 patients, including 20 patients after performing the multiple stenting procedure. The study was performed on a 320-slice “Aquilion One” Toshiba computed tomographic machine with prospective ECG-gating, an intravenous bolus water-soluble nonionic contrast agent and saline. Results. Isolated stenting of left anterior descending coronary artery (LAD) identified in 13 (65%) cases, stenting of LAD and circumflex coronary artery (LCx) - in 2 (10%) cases, LAD and right coronary artery (RCA) - in 3 (15%) cases, all three major coronary arteries (LAD, LCx and RCA) - in 1 (5%) case. In 18 (90%) cases of violation of the stent patency was not found in 2 (10%) cases revealed occlusion of coronary stents. Conclusion. Analysis of the results of multislice computed tomography coronary angiography showed high diagnostic information concerning the method of assessing stents, including in-stent restenosis. Multidetector computed tomographic coronary angiography with a 320-slice computed tomographic machine and with one volume scan, shows a significant reduction of radiation exposure to the patient.

Aim: to determine the capabilities of upright magnetic resonance imaging (MRI) in studying lumbar spine degenerative disorders. Materials and Methods. 58 patients were taken into the study(39 (67.4%), women, 19 (32.6%) men), aged 49.0 ± 13.7 years, suffering from chronic lumbar pain. The study was conducted using a 0.25 T MRI tomograph (G-Scan, Esaote, Italy) and included two parts. In the supine position T2-weigted images (WI) were performed (coronal, sagittal, axial); T1-WI and a sequence suppressing signal from fat tissue (STIR - short TR inversion recovery) in sagittal plane. Upright position protocols included T2-WI in the coronal, sagittal (slice sickness 4.5 mm, interval 5 mm) and axial planes. Results. In 100% cases sagittal disc dimensions showed to be increased in vertical position, which can be considered as typical disc changes. Excessive answer of these structures to the load with protrusion formation and excess of normal reaction by hernias and protrusions allowed to diagnose instability of interested spinal motion segments in 12.1%. In 100% cases characteristic lumbar spine static changes were revealed, such as the increase of physiological lordosis, pathological kyphosis appearance or tendency to develop it. In 10.2% cases vertebral-motion segments instability was revealed, characterized by augmented degree of vertebrae displacement in vertical position. Intervertebral joints' changes in 29.3% cases were described as articular processes' listhesis and synovial fluid movement inside the joint cavity. In 3 patients during verticalization a formation of absolute stenosis was revealed, as a result of vertebrae listhesis, increased herniation of intervertebral discs and ligamentumflava thickening. In 4 cases the upright examination couldn't be performed because of the appearance in patients of severe low back pain. Conclusion. In 22.3% cases this technique was able to suspect disc and vertebral-motion segments instability, as long as to precise the degree of central canal stenosis, which can all influence the choice of further management. MRI in upright position provided additional information in 91.1% of cases, which appeared to be clinically important in 22.3%.

The aim. The aim of this study was to estimate possibilities of CT in identification of the lesion in lung parenchyma in patients pulmonary Langerhans’ cell histiocytosis X. Materials and methods. The results of 36 studies of patients with pulmonary histiocytosis X, who underwent a complex functional study of respiratory, CT, and HRCT we analyzed. Results. Restructuring of the lung tissue was common fibrotic changes of all structural units of the lung tissue: fibrosis of the wall of the cysts, pleural fibrosis, especially on paramediastinalsurface. Also revealed peribronchial and perivascular fibrosis, leading to a narrowing of the bronchial lumen and deformation of blood vessels. Another type of lession was the presence of multiple, different-sized cysts. A third option is a progressive transformation of the focus lesions in cysts, merging small cysts into the large ones with formation of paradoxical ventilated cavities. Of the 36 patients, according to the results of complex functional study of respiratory, was distinguished a group of patients with restrictive type of ventilation disorders of 8 (22%) patients, which included 7 men and 1 woman (mean age 24.7 ± 2.35 years). All patients were smokers with a mean duration of smoking 11.8 ± 2.96 years. Conclusion. Conducting a complex morpho-functional examination including complex functional study of respiratory and high resolution computed tomography reveals the worst-case flow of histiocytosis X with restrictive type of lung lesions.

Aim: to determine the opportunities of breast ultrasound with qualitative elastography in the diagnosis of small benign Doppler nonvascular lesions in patients with hypothyroidism. Material and methods. In 2010-2013 the study included 319 women aged 20 to 85 years. Mammography and breast ultrasound (US) with qualitative elastography were performed. Mammography used to reveal breast disorders which are background to small benign Doppler nonvascular lesions. Results. Breast US with qualitative elastography allows to differentiate small benign Doppler nonvascular lesions - cysts with dense content and fibroadenomas from 5 to 10 mm. Sensitivity and specificity of breast US with qualitative elastography in diagnosis of cysts with dense content and fibroadenomas from 5 to 10 mm were 88.4%, 89.5% and 88.1%, 90.5% in patients with hypothyroidism and 98.5%, 97.8% and 98.7%, 98.4% in patients without hypothyroidism, respectively. Differential diagnostics of small benign Doppler nonvascular lesions <4 mm with breast US with qualitative elastography quality is complicated. Sensitivity and specificity of breast Us with qualitative elastography in diagnosis of cysts with dense content and fibroadenomas <4 mm were 86.2%, 68.9% and 85.7%, 66.1% in patients with hypothyroidism and 92.6%, 78.3% and 93.9%, 79.3%, in patients without hypothyroidism respectively. The effectiveness of differential diagnostics of small benign Doppler nonvascular lesions in patients with hypothyroidism is lower than in patients without hypothyroidism. Conclusion. Breast US with qualitative elastography usage is advisable combination for small dopplerographic avascular mass larger than 5 mm, both in patients with and without hypothyroidism. Breast US with qualitative elastography is more effective in patients without hypothyroidism than in patients with hypothyroidism.

Purpose. The study has covered perfusion computer tomography (CT-perfusion) potential for diagnosis of cerebral metastases and meningiomas based on the capabilities of perfusion computed tomography (CT perfusion) to measure the degree of blood supply to tumors. Materials and methods. 50 patients aged 26 to 75 years were examined. CT perfusion assessed main hemodynamic parameters in the solid portion of the data groups of intracranial tumors. There were 35 (70%) patients with cerebral metastasis of lung cancer (n = 14; 40%) of breast cancer (n = 6; 17.1%), renal carcinomas (n = 5; 14.3%), melanoma (n = 5; 14.3%), colon (n = 3; 8.5%), and stomach cancer (n = 2; 5.7%). In 15 cases, patients had meningiomas, 5 of them had a cancer history, and in these cases the differential diagnosis was between a solitary Results. The highest blood flow was observed in cerebral metastases of kidney cancer and melanoma, which was most likely due to the development of a vascular network. The mean parameters of perfusion have been identified in the solid part of meningiomas and metastasis of lung cancer and breast cancer. No significant difference in perfusion were observed for metastases of lung cancer and breast cancer and meningiomas. The lowest blood flow was detected by the colon and stomach cancer metastasis which could be mainly due to cystic structure with small solid component around the periphery Conclusion. The data on the extent of blood supply intracranial tumors suggested the risk of intraoperative hemorrhage and to plan an operative approach and the volume of surgery. Furthermore, data of CT perfusion about the degree of blood supply in solid cerebral tumors allowed to differentiate some brain tumors.

The goal: to evaluate ultrasound pictureof normal anatomical structures of the eyelids and periorbital area and various pathological changes of this area using high frequency ultrasound examination and color doppler imaging (CDI). Materials and methods. We examined in 42 patients (46 eyes) aged 25 to 66 years: 12 patients (14 eyes) with inflammatory diseases of eyelids and periorbital structures; 16 patients (16 eyes) - with benign and tumor-like diseases; 14 patients (16 eyes) - with malignancies. Ultrasound methods were performed on the Voluson 730 diagnostic system using multifrequent linear probe SP 10-16 MHz. Results. Complex ultrasound examination allowed to differentiate eyelids structure, determine the localization and the size of the lesion. Ultrasound methods including CDI are useful in visualization of vessels and blood flow registration. Conclusion. Complex ultrasound eyelids and periorbital region gives you the opportunity to determine the nature of the pathological process and the precise localization.

Multiple symmetric lipomatosis also known as Madelung's disease is a rare disease of unknown etiology, characterized by a marked increase in non-encapsulated fatty mass in the first place around the neck, upper body and back. Currently, there is only about 300 cases with this pathology. The reason for the emergence and development of multiple symmetric lipomatosis is alcohol, which can act as a cofactor in the development of lipomatosis. Diagnosis is based on history, physical examination of the patient. Choices in diagnostic activities is computed tomography which allows preoperative determine the spread and invasion of fat mass in the surrounding soft tissue.

Popliteal venous aneurysm is a rare disease, which etiology is still unknown. Currently, there are a little more than 200 cases with this pathology. Early diagnosis of this disease is extremely important, because its cause of pulmonary embolism, despite proper anticoagulation. Duplex ultrasonography is the most frequently used diagnostic test for popliteal venous aneurysm. Computed tomography with bolus enhancement or magnetic resonance imaging recommended as additional method. Surgical treatment is the best for such patients. We present a unique case of saccular asymptomatic popliteal venous aneurysm in a 74-year-old woman who had Baker’s cyst and varicose veins of the left lower limb.

The aim. To define the abilities of sonography with additional modalities in the differential diagnosis and characteristics of tumor-like masses for surgical treatment. Methods and materials. 201 patients (126 (62.7%) men and 75 (37.3%) women of age 20-75 years, mean age 39 ± 3.2 years) with tumor-like masses were sonographically examined using “Siemens Sonoline Omnia” and “Hitachi EUB7500” scanners with software for Duplex Scannig and Elastography. Linear multifrequency transducers (5-7.5 MHz) were used. All patients underwent ultrasound-guided needle biopsy followed by histological examination of material. Results. Tumor-like were detected: skin cysts and its appendages were found in 95 (47%) cases, ganglion cysts - in 66 (33%), organizing hematomas - in 39 (19.5%), parasitic cyst - in 1 (0.5%). 97.5% of patients with tumor-like soft tissue masses were operated on an outpatient basis. Conclusion. Sonography is a highly informative method allowing differential diagnosis tumor-like soft tissue masses and to select the type of treatment.