Background. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an acknowledged efficient and safe method of treatment of advanced stages of Parkinson’s disease. The traditional way of intraoperative target verification is a combination of microelectrode recording (MER) and intraoperative macrostimulation. The appearance of high-field tomographs, new sequences, and methods of computer processing of the obtained images raises the question whether it’s necessary to use intraoperative verification of the target.
Objective. The aim of the study was to analyze the comparability of 3T MRI data and microelectrode registration data in determining the boundaries of the subthalamic nucleus in patients with Parkinson's disease.
Material and methods. 20 patients who have been undergone 3T MRI for preoperative planning for STN-DBS were included in the study. We determined the upper and lower boundaries of 40 subthalamic nuclei in high-resolution T2 and SWAN modes and compared these data with the data obtained during surgery using the MER.
Results. The discrepancy between the MED and 3T MRI data when determining the upper STN border was 1.2 mm in SWAN mode and 1 mm in high-resolution T2 mode. The lower border of the subthalamic nucleus could be determined with an accuracy of 0.85 in SWAN mode and 0.75 mm in T2 mode. The groups didn’t have significant differences (Wilcoxon sign-rank test, p > 0.05).
Conclusion. 3T MRI in high-resolution T2 and SWAN modes demonstrated high comparability with microelectrode data in determining the upper boundary, lower boundary and middle of the subthalamic nucleus, which makes it possible to use it as a method for direct STN imaging.

Aim of the study. To evaluate the influence of modern MRI imaging, CT- and MRI fusion in STB planning on effectiveness of morphological verification and risks of intraoperative complications.
Materials and methods. The most common indications for brain tumor biopsy is definitive diagnosis of the intracranial lesion and differentiation of the neoplastic and non-neoplastic pathology. During 2019 170 patients (95 men and 75 femmes) 7–69 years old underwent stereotactic biopsy an Integra LifeSciences Corporation Cosman–Roberts–Wells® (CRW®) system. In 80 cases, we used CT and MRI fusion by NeuroSight program to select the target point, entry point and trajectory of the brain biopsy. In 90 cases we use only CT images for stereotactic brain biopsy planning.
Results. Among 80 patients with use of combined CT-MRI fusion only one case was not histologically verified. In 90 patients with use of only CT-imaging for STB 3 cases were histologically not verified. There were no hemorrhagic complications among 80 patients in CT-MRI fusion group. In 3 cases intracranial hematomas were identified that required surgical treatment after STB with use of CT-imaging for STB panning.
Conclusion. The use of modern MRI and PET-CT imaging for STB planning increases its informativity and reduces the probability of hemorrhagic complications. Stereotactic biopsies remain a safe and reliable method for obtaining histological material. The use of modern imaging methods in biopsy planning increases their accuracy and reduces possible complications.

Objective. To analyze recent studies related to the use of computed tomography in traumatic brain injury in young children.
Results. Traumatic brain injury (TBI) is one of the most common causes of death and disability in children. Pediatric TBI has a number of characteristics different of adults. This is due to age-related anatomical and physiological differences depending on patient's physical condition and on problems with his/her neurological assessment. Young children demonstrate specific pathological reactions to TBI with clear concomitant neurological manifestations. The authors present an important information on current aspects of CT application for all types of isolated blunt TBI in children aged from birth to 3 years with consideration of age-appropriate characteristics and emergency condition. Although TBI mechanisms are similar in young children and adults, visual manifestations of head injury in children have their own specific features due to the developing brain and cranial vault. Radiologist's primary role is to identify and characterize the type and severity of head injury so as to assist the correct management of the patient. Using the information obtained from CT examination and knowing TBI mechanisms in infants and young children, a radiologist can play a key role both in diagnostics and in selection of effective care, thus improving clinical outcomes.
Conclusion. Head CT with multifaceted and 3D reconstructions has now replaced X-ray examination of the skull in suspected TBI and has become the most important diagnostic technique in patients with TBI at emergency settings. Radiographs do not provide with additional diagnostic information and may be excluded from the examination, if CT with 3D reconstruction are planned to perform or has already been performed.

The article presents the experience of using the TIRADS classification (2020) in multiparametric ultrasound examination of the thyroid gland of 60 patients with subsequent morphological verification by fine needle aspiration biopsy. The article support the problems and difficulties that may arise in the ultrasound diagnostics doctor during the stratification of nodules and possible ways to solve this problems.

The classification of tumors of the lung, pleura, thymus and heart was published by the World Health Organization (WHO) in 2015. It presents a completely different approach to adenocarcinoma compared to the 2004 WHO classification.
Adenocarcinoma is the most common histological type of lung cancer.
The interdisciplinary classification is based on consensus among oncologists, thoracic surgeons, pulmonologists, pathologists, molecular biologists, radiologists, radiologists and identifies a wide range of adenocarcinoma types and subtypes with varying prognosis and treatment. They are accompanied by a variety of manifestations and features on computed tomography, which usually correlate with histopathological findings, highlighting one of the key roles of the radiologist in the diagnosis and treatment of such patients.
The aim of the work is to familiarize radiologists with the WHO 2015 classification, terminology and computed tomographic diagnostic criteria for various types of lung adenocarcinoma.

Objective. The comparison of protocols of computed tomography (CT) angiography of the aorta and their modification in conditions of radiation and iodine load reducing on the patient.
Methods. In 95 patients (57 men, 38 women, mean age 61.4 ± 15.6 years) CT angiography of the aorta was performed using two- and three-zone scanning protocols with the voltage value on the X-ray tube (80 and 100kV) depending on the anthropometric measure namely body mass index (BMI). We compared dose length product parameters (DLP), effective dose (E), time and duration of scanning, as well as counting the amount of injected contrast agent (CM) between groups examined using a two-zone and three-zone protocols at an X-ray tube voltage of 80 and 100kV.
Results. Analysis of the data obtained showed that the DLP and E values were statistically significantly lower with the CT angiography of the aorta protocol, which consisted of three scanning zones (at 80kV p = 0.008; at 100kV p < 0.001). At the same time, there was no significant difference in the length of the study area in groups with the same voltage on the X-ray tube (p = 0.55), in the group with a three-zone protocol, the scanning time was significantly lower (p < 0.001) and amounted to 9.4 ± 0.5 sec/10.24 ± 0.9 sec (80/100kV), which made it possible to significantly reduce radiation exposure up to 40% and the amount of injected contrast agent by 20%.
Conclusions. The use of a three-zone CT-angiography of the aorta protocol with individual selection of voltage of the X-ray tube is justified and allows a significant reduction of radiation and iodine exposure compared to twozone scanning while maintaining the high images quality.

Purpose. 1. To compare the ultrasound indices of time in comparison (AT), cardiac catheterization evaluating severity (AT/ET) with the indices of direct cardiac catheterization and assess the prognostic ability in the assessment of severity of AS in patients with Normal flow High Gradient 2. To determine the threshold values for the indicators of AT and AT/ET in predicting severe AS.
Materials and methods. This is prospective single center study. We evaluated results of treatment of 75 patients with mean age 72 ± 6 years that were planned for aortic valve replacement due to aortic stenosis. Inclusion criteria: isolated aortic valve stenosis with ultrasound characteristics of severe AS. Before transcatheter aortic valve implantation, all patients underwent cardiac catheterization with the measurement of parameters necessary to assess the severity of AS.
Results. Linear regression analysis showed a statistically significant correlation between AT and AT/ET (p < 0.05). The ROC-analysis has showed the highest predictive ability in assessing the severity of aortic stenosis for the AT / ET index (AUC – 87%, p < 0.001), slightly lower predictive power for the AT parameter (AUC – 80%, p < 0.001). The sensitivity and specificity of the AT / ET indicator in determining severe AS was 84% and 79%, respectively. For the AT indicator, the sensitivity was 82% and the specificity was 46%. The threshold values for AT and AT / ET were 105 ms and 0.35, respectively.
Conclusions. 1. AT and AT / ET have a strong correlation with catheterization data and a high predictive ability of severe aortic stenosis in patients with Normal Flow High Gradient patients. 2. Threshold values for AT and AT /ET, that predict a high probability of AS, were 105ms and 0.35ms respectively. The study showed, echocardiographic indicators AT and AT ET have a strong correlation with catheterization data and a high predictive ability of severe aortic stenosis in patients with Normal Flow High Gradient patients. Threshold values for AT and AT ET, that predict a high probability of AS, were 105 ms and 0.35 ms respectively.

Relevance. The level of cerebral perfusion in patients with multifocal atherosclerosis depends not only on the restriction of blood flow through the carotid arteries, but also on the degree of myocardial changes. Goal of investigation. Determine the presence of a relationship between the indices of regional cerebral blood flow according to SPECT data and echocardiographic parameters of cardiac activity and analyze the mechanism of their relationship.
Material and methods. We examined 22 patients (18 men and 4 women aged 64 ± 6.5 years) with signs of chronic heart failure and multifocal atherosclerosis with the involvement of carotid and coronary arteries, who underwent simultaneous surgery. All patients underwent echocardiographic examination of the heart and SPECT of the brain.
Results. Moderate direct correlations were revealed between the indices of regional cerebral blood flow (CBF) and ejection fraction (p = 0.009307), SV/EDV (p = 0.012431); moderate inverse correlations between the indices of CBF and SV (p = 0.002913), EDV (p = 0.031737), ESV (p = 0.016483), ESV/EDV (p = 0.010645), ESV/SV (p = 0.007255). In the postoperative period, a moderate direct correlation was found between indicators of cognitive status (MMSE) and indicators of cerebral perfusion in the right occipital, parietal and frontal lobes (p = 0.021162, R = 0.511475).
Conclusion. The echocardiographic parameters we studied in patients with chronic heart failure correlate with indicators of regional cerebral blood flow, and this relationship is more pronounced not in the ejection fraction, but is traced between the parameters of the end diastolic volume, end systolic volume and their ratio according to the principle of the golden ratio. The data obtained on the perfusion of the brain by the SPECT method are associated with indicators of cardiac activity and reflect the severity of chronic heart failure.

Cardiovascular diseases (CVD) are socially significant diseases and one of the main causes of death among women. There are no effective and uniform screening methods to prevent the prevalence and mortality of CVD. Breast artery calcifications may be one of the available tools for CVD risk stratification. The pathogenesis of calcification of the middle vessel wall, known as Mönckeberg's arteriosclerosis, is different from the pathogenesis of coronary atherosclerosis that coronary arteries. However, research data supports a correlation between breast artery calcifications and risk factors for CVD. These factors include coronary atherosclerosis, detected by CT-coronarography.
Purpose. To assess the prevalence of breast arterial calcification and to determine the association with cardiovascular risk factors, coronary artery calcification, atherosclerosis of brachiocephalic arteries and visceral branches of the abdominal aorta.
Material and methods. 21 patients were hospitalized in the cardiology department. The patients underwent digital mammography to detect breast arterial calcifications. All patients also underwent CT coronary angiography with angiography of the abdominal aorta.
Results. The use of the Wilcoxon-Mann-Whitney W-test with an abnormal distribution showed a correlation between the breast arterial calcifications and the calcium index (p = 0.0028), coronary artery stenosis (p = 0.040), calcification of the thoracic aorta wall (p = 0.035) and stenosis of the visceral branches of the abdominal aorta (p = 0.037).
Conclusions. The breast arterial calcifications correlates with a more frequent detection of calcifications in the walls of the coronary arteries and a higher calcium index.

Atypical ductal hyperplasia is a proliferation of monomorphic, evenly placed epithelial cells involving terminalduct lobular units. The term atypical ductal hyperplasia identifies a group of lesions with a combination of specifically defined architectural and cytological features that predict an increased risk of subsequent breast cancer.
Our case described the visualization of breast atypical ductal hyperplasia with architectural distortion seen in a form of “radiance” phenomenon in a patient with burdened obstetric and gynecological anamnesis by a tridimensional breast ultrasound examination on the system Siemens Acuson S2000 with mammalogical device ABVS (Automated Breast Volume Scanner).

The purpose of the study. To find typical computed tomographic signs of pyelosinus reflux with a small amount of extravasation of urine.
Material and methods. Eight observations were analyzed in which there was extravasation of urine into the renal sinus detected by CT.
Results. In six cases, the changes were on the right, in two – on the left side. The cause of acute urinary tract obstruction in four cases were ureteral stones, in two cases there was compression of the ureter from the outside by a pelvic tumor. In two cases, a day after the relief of renal obstruction, the contrasted urine outside the pelvic was not determined. Additional findings were: flection of the ureter in two cases, renal sinus cysts – in four observations. In four observations an unusual “pseudodissection” of the renal pelvis in the excretory phase was revealed, which consisted in the presence of a thin non-contrasting layer "dividing" the contrasted contents of the pelvis into two parts.
Conclusions. 1. Identification of the pattern of “pseudodissection” of the pelvis is practically a pathognomonic computed tomographic symptom of extravasation of urine as a result of pyelosinus reflux and rupture of renal calices. 2. Resolution of ureteral obstruction can lead to complete normalization of the computed tomographic picture during the day. 3. Inflection of the ureter, cysts of the sinus of the kidney, may be provoking factors of extravasation of urine in acute ureteral obstruction, but this requires further study.

Acute pancreatitis is one of the most common acute conditions in abdominal cavity with a broad spectrum of clinical symptoms, which range in severity from mild interstitial inflammation to severe forms with significant regional and systemic complications. Despite overall progress in treatment methods and critical care of the acute pancreatitis, this condition remains to be associated with a high mortality rate. Contrast-enhanced CT has been the golden standard in the diagnosis of the acute pancreatitis for a long time, but despite that there’s still a certain degree of inaccuracy in terminology, pertinent to both the literature and the guidelines, which in turn impacts treatment and prognosis. This work is dedicated to the radiological terminology and classification of the characteristic findings in the acute pancreatitis and necrotizing pancreatitis. Recommendations and indications for use of the CT and MRI has been discussed, as well as their methodology. The provisions of the review are illustrated by CT and MRI images of the most striking and significant changes in the framework of the disease from the authors' archive for greater clarity.
The main goal of this study is to consolidate data found in both foreign and domestic research in order to form a comprehensive understanding of development stages of acute pancreatitis. This is mainly achieved by their radiologic characterization, as well as possible complications.