The purpose of the study is to perform comparative analysis of cerebral perfusion SPECT parameters found in liquidators of the Chernobyl accident suffering from dyscirculatory encephalopathy (DEP) long after exposure to radiation and to identify indicators for monitoring their physical condition and assess treatment effectiveness.

Materials and methods. We used cerebral single-photon emission computed tomography (SPECT) to examine a group of liquidators of the Chernobyl accident (LCA) and a group of patients who had not been exposed to radiation, all of them suffering from dyscirculatory encephalopathy (DEP). We examined a total of 147 men, including 93 LCAs aged 69.38 (6.42) (the study group) and 54 patients aged 70.70 (7.25) (the comparison group). No differences by age were identified (p = 0.347). The study was performed using General Electric Healthcare Discovery NM/CT 670 Pro. Cerebral scintigraphy was performed using Russian-made Theoxym, 99mTc. Cerebral perfusion imaging was carried out with the help of diacarb (acetazolamide). We compared a total of 22 SPECT parameters.

Results. Arterial inflow time in the frontal and back views in both groups increased after taking diacarb by 8.37% (p = 0.138) and 6.62% (p = 0.213) in LCAs and by 15.38% (p = 0.035) and 13.63% (p = 0.037) in the comparison group. Regional cerebral blood flow (rCBF) in the right and left brain hemispheres of LCAs was below the age norm (p = 0.001 and p < 0.001), as well as below the rCBF in the frontal, temporal, parietal, and occipital lobes of the brain in healthy subjects of comparable age (p < 0.001). Average cerebrovascular reserve (CVR) in both groups was lower than the lower end of the normal range (31–75%). Only some of the patients from the comparison group fell within this range: 2.94% of those examined – in the temporal and occipital lobes of the right hemisphere and 8.82% – in the occipital lobe of the left hemisphere. CVR was lower in LCAs than in the comparison group by 14.19 and 14.08% in the frontal lobes of both hemispheres and by 16.31% in the temporal lobe of the left hemisphere; in the occipital lobes, however, it was higher by 29.07 and 12.06%. We found a negative correlation between rCBF and CVR and LCAs’ age, as well as between CVR and radiation dose (p < 0.05).

Conclusion. SPECT is a promising method of detecting DEP in LCAs and other patients who have been exposed to radiation, as well as of preventing health complications and assessing treatment effectiveness. A decrease in rCBF and CVR in the frontal and frontotemporal areas of the brain may serve as the criterion for DEP detection.

Most of the literature data on eyelid structures are based on the measurements in cadavers or histological samples. Nonetheless, such data can differ from the living tissues with interstitial fluid and filled vessels. In clinical work, specialists sometimes need to be aware of the in vivo parameters of eyelids tissue structures.

Information on live thickness of eyelid structures supports diagnostic process and surgery planning. Nonetheless, the eyelids are affected by age related changes as other facial soft tissues.

Purpose: To compare thickness of normal eyelid structures measured with ultrasound in various age groups.

Methods. This prospective observational study was comprised of intact eyelids of 37 patients with a mean age of 46 ± 13.13 years (aged 27–79 years; 28 women). All subjects were divided into 4 groups with an interval of 10 years from 20 to 60 years and a group of aged above 60 years. Same operator took measurements skin, circular eye muscle, conjunctiva, tarsus and their composition of both eyelids with B-scan ultrasonography.

Results. We established some age-related trends for all parameters, but two of them change the most significantly. The lower eyelid skin thickness in group of 31–40 years old people (1.2 [1.0;1.4] mm) significantly differed from the values in the groups of people aged 41–50 (1.65 [1.45;1.85] mm and 51–60 лет (2.05 [1.73;2.7] мм. Upper eyelid conjunctiva at the level of tarsal plate upper margin also tends to be thicker in people( older 60 years (0.97 [0.8;1.2] mm) than in younger adults, especially at the age of 21–30 (0.49 [0.44;0.55], p = 0.053) and 41-50 y.o. (0.58 [0.50;0.65] mm, p = 0.053).

Conclusion. Significant differences in the skin thickness of the lower eyelid were detected in the group of 31–40 years from the values in the groups of 41–50 years (p = 0.03) and 51–60 years (p = 0.05). In persons over 60 years of age, the conjunctiva of the upper eyelid at the level of the upper edge of the TP was significantly thicker than in younger age groups. It was noted that most of the structures of the upper eyelid (skin, conjunctiva, TP, conjunctiva-TP complex, orbicularis oculi muscle and the total thickness of the eyelid at the level of TP) in all age groups are much thinner (p <0.05) than the corresponding structures of the lower eyelid. The obtained data can serve as a guide for diagnosis and planning of surgical interventions.

The purpose of the study. Multimodal study of the state of the brachiocephalic arteries, with assessment of blood flow in the extra- and intracranial portions of the carotid arteries and brain perfusion, as well as the structure of the brain in patients with different types of elongation of the carotid arteries (ECA).

Material and methods. The data of examinations of 79 patients (45 men (57.0%, average age – 61.0 ± 10.1 years) and 34 women (43.0%, 65.3 ± 13.6 years), average age 62.8 ± 11.8 years) during the year after ischemic stroke in posterior circulation were analyzed. ECA was verified by multispiral computed tomographic angiography (msCTA) in 44 patients (55.7% of the total number of cases), the control group was selected by gender and age with “case-control” elements and consisted of 35 (44.3%) patients without a mustache. All underwent msCTA of the thoracic aorta and BCA and CT perfusion examination, magnetic resonance imaging of the brain, duplex scanning of BCA and transcranial duplex scanning, transthoracic echocardiography, transcranial Doppler monitoring with microembolodetection.

Results. We have registered intergroup differences, which can be divided into structural and functional. The former include: higher aortic arch location in patients with DCA: Th_II – 6.3% vs. 0%, Th_III – 43% vs. 0%; Th_IV – 28.1% vs. 62.9%* and Th_V 21.9% vs. 37.1% (p < 0.0005); lower values of cervical spine height (114.70 ± 11.03 mm, vs. 120.46 ± 9.75 mm, p = 0.022), greater absolute length of the ICA (on the right – 101.32 ± 14.59 mm vs. 85.06 ± 12.07 mm, p < 0.0005; on the left – 100.00 ± 14.03 mm vs. 84.66 ± 12.63 mm, p < 0.0005). The presence of ECA was associated (p < 0.05) with a higher frequency of vertebral artery elongation. The severity of small vessel disease during MRI in individuals with ECA was slightly higher (not at the trend level, p = 0.076). Functional differences consisted in the registration of lower (p = 0.019) values of the end diastolic velocity in M1 of the middle cerebral arteries. The values of some perfusion indices in the blood supply of elongation arteries were lower than in persons without ECA. There were no cases of registration of microembolic signals in the ECA patients examined by us.

Conclusion. In the individuals with ECA we examined, a complex of anatomical and hemodynamic features was determined, which, both individually and collectively, cannot lead to a decrease in the level of blood flow or be a source of arterio-arterial embolism in the carotid system, regardless of the configuration of the ICA.

Aim. Analysis of the structural and systole-diastolic characteristics of the left chambers of the heart in children with obstructive hypertrophic cardiomyopathy.

Materials and methods. A comprehensive retrospective comparative echocardiographic study of children with obstructive HCM aged 1–17 years (n = 52) and a control group (n = 1060) of healthy children of the same age was performed.

Results. The main indicators of the structural and systole-diastolic properties of the left chambers of the heart in children of two groups were analyzed. In addition, in patients with HCM, the correlation between parameters of systolic and diastolic function of the left ventricle and the thickness of the interventricular septum was assessed. Most of the indicators characterizing the systolic properties of the LV had no correlation with an increase in the thickness of the IVS. Diastolic parameters – the rate of myocardial relaxation during the rapid filling phase, determined by tissue Doppler mode (e), and LV filling pressure – statistically significantly correlated with an increase in IVS thickness.

Conclusions. Echocardiography in children with obstructive HCM remains the gold standard for diagnosis, allowing a comprehensive assessment of the main structural characteristics of the heart chambers.

Introduction: Computed tomography is the most common imaging modality used to identify necrotic collectionsin acute pancreatitis. However, using CT alone, it can be difficult to differentiate necrotic residues from the liquid component, which plays an important role in planning the intervention and predicting the outcome.

Objective. To evaluate the advantages and disadvantages, as well as the specifics of the use of CT and MRI in characterizing these complications. To characterize and structure local complications of pancreatic necrosis in the late phase using CT and MRI.

Materials and methods. The data of patients of the Botkin State Clinical Hospital for 2017–2022 with a diagnosis of necrotising pancreatitis, who underwent both CT and MRI after 2 weeks or more from the onset of the disease (2nd or late phase of necrotising pancreatitis), were analyzed. There are 57 people in total (34 men and 23 women), the age range is 18–71 years. CT was performed with intravenous four-phase contrast, images in the pancreatic phase were used for evaluation. MRI was performed using a standard protocol including T2-weighted images or the MRCP protocol.

Results. A total of 102 peripancreatic collectionswere identified, the minimum size for evaluation was 20 mm, one patient could have more than one collection. The data obtained were structured in pairs: one collection corresponded to its images on CT and on MRI. CT showed a sensitivity of 77% with respect to dense material in the structure, while MRI revealed sequestration in all cases, sensitivity of 100%. It was possible to visualize the communication of the main pancreatic duct with accumulation on MRI in 12% of cases, on CT in 4% of cases. The identified collectionswere classified into three types based on their structure.

Conclusions. CT remains the “gold standard” for the diagnosis of acute pancreatitis and necrotising pancreatitis, however, it has limited sensitivity in characterizing the structure of local complications in the late phase of the disease. Due to its greater tissue contrast MRI allows to assess the composition of peripancreatic collections and determine their possible connection with the ductal system. The types of collectionswe have identified based on CT and MRI imaging contribute to a more objective assessment of the picture in order to select the most appropriate method of patient management and the type of possible surgical treatment.

Introduction. Computed tomography is the most common diagnostic method for pathological changes in the abdominal organs in institutions providing routine and emergency medical care. Computed tomography is increasingly becoming a method for assessing the condition of blood vessels, including in patients with portal hypertension, which requires assessment of the condition of the veins of the esophagus and stomach.

The purpose of the study. Determination of the optimal technique for performing computed tomography to study the gastric veins.

Materials and methods. The results of studies of 1562 patients who underwent various computed tomography techniques in medical institutions in Moscow from December 2020 to December 2023 were retrospectively assessed. The research results are archived in the unified radiological information system (RIS) in Moscow.

Results. 1051 patients were examined using the standard multiphase computed tomography technique. The topographic and anatomical characteristics of the gastric veins were determined just in 50.01% of cases due to the collapsed state of the stomach. 78 studies were carried out after taking oral contrast agents, veins were identified in 37.44% of cases. The difficulty of imaging is determined by the presence of hyperdense contrast agent in the gastric lumen. After gastric inflation with air, the results of a study of 52 patients were assessed. Positive visualization of gastric veins was obtained in 45% of patients. 381 patients underwent computed tomography with the stomach filled with water (hydro-CT). Normal veins measuring 1 or more millimeters in diameter were visualized and localized in 60.6–72.5% of patients, which is significantly better compared to the standard research method (p < 0.001).

Conclusion. Assessment of the condition of the gastric veins should be carried out using the hydro-CT technique, which significantly improves the assessment of the topographic and anatomical features of the vessels compared to the standard CT technique.

Breast cancer is the most common cancer among women worldwide. Younger women are more likely than older women to have aggressive molecular subtypes and late-stage disease. Mammography has less sensitivity in detecting breast cancer in women with a dense breast, and 2D ultrasound (2D US) has limitations, such as the specialists high level of skill and experience and the time it takes to perform the examination. Nowadays, there is a new technique – automated volumetric ultrasound scanning of the breast (3D US), which allows you to obtain high-resolution images.

Aim. To perform a comparative analysis of the diagnostic efficacy of 2D US and 3D US among women under 40 years of age with high breast tissue density.

Methods. A retro-prospective clinical single-center study. From February 2019 to May 2023, 1511 patients under the age of 40 were examined. The patients were divided into two groups. Patients in group A underwent 2D ultrasound, the results of the study were evaluated according to the BI-RADS classification. In addition to 2D ultrasound, the patients who were placed in group B underwent 3D US also with the BI-RADS category. Based on the results of the study, the positive and negative predictive value, sensitivity, specificity and accuracy, as well as the compilation of a predictive model of the method were determined.

Results. The 2D US in group A showed sensitivity of 0.8, specificity 1, balanced accuracy of 0.9, and area under the predictive model curve of 0.947, US in group B 0.89, 0.98, 0.94, and 0.903, respectively, and US of the entire sample of 0.87, 0.99, 0.93, and 0.916, respectively. The 3D US in group B showed a sensitivity of 0.95, specificity of 0.99 and a balanced accuracy of 0.97 and an area under the predictive model curve of 0.968.

Conclusion. The diagnostic efficiency of 3D US of the mammary glands in patients under 40 years of age is comparable in terms of specificity and is better in terms of accuracy, sensitivity and a better prognostic model of the method compared to US examination in 2D mode. The 3D US method has advantages in comparison with 2D US examination, namely reproducibility, operator independence of the method, reduced examination time, obtaining visualization of the entire organ, improved visualization in multicentric and multifocal processes, the possibility of operational planning, the possibility of “double reading” of the results.

Purpose: to study the possibilities of magnetic resonance imaging in characterizing the soft tissues of the face after injection of various types of fillers.

Material and methods. A group of 35 patients with a known cosmetic history was analyzed after combined (15) and non-combined (20) injection injections of fillers into various areas of the face. According to the anamnesis, with combined administration, hyaluronic acid (HA) + Ca hydroxyapatite (CaHA) was used in 10 cases, HA + L­polylactic acid (PLA) in 2 cases, HA + PLA + silicone in 1 case, HA + CaHA + silicone in 1 case, in 1 – HA + silicone. With non-combined administration, 16 patients received HA, 2 received Ca hydroxyapatite, one received L-polylactic acid, and one received polyacrylamide gel (PAGE).

MRI of facial soft tissues was performed at different times after drug administration: HA – from 1 month. up to 4 years, CaHA – from 7 days to 1 year, PLA – from 1 to 8 months, silicone – 10–20 years, PAGE – after 6 months.

The studies were carried out on 1.5 T MRI scanners, using T2-WI, T1-WI, STIR, DWI (b = 1000), T1-FS-WI, 3D-T2-WI sag. The location of the filler was determined, the type of filler was differentiated, and its location in relation to the surrounding structures was assessed.

Results. Areas of the HA preparation were characterized by a hyperintense MR signal on T2-weighted images and Stir, isohypointense on T1-WI. Preparations based on CaHA and PLA were determined by isohypointense on T2, T1-WI, isohyperintense on Stir, iso- and isohyperintense on T1-FS-WI signal. Silicone demonstrated isohypointense signal with a hypointense capsule on T2-WI and Stir isointense on T1-WI; PAGE – isohyperintense on T2-WI and Stir, isohypointense on T1-WI with a hypointense capsule on all PIs.

HA-based fillers were more clearly visualized on Stir and T2-WI. Preparations based on CaHA and PLA had identical signal characteristics on T2-WI, which made differential diagnosis difficult, but in a number of cases the following signal changes were detected on T1-FS-WI: iso- and isohypointense from CaHA, isohyperintense from PLA. The MRI picture varied depending on the timing, technique of administration and dilution of the drug.

Conclusions. MRI allows you to visualize and differentiate the type of filler after injection contouring according to signal characteristics that depend on its chemical composition, timing of administration and mechanisms of biodegradation.

Objective: to evaluate the hemodynamics of the uterus and endometrium after therapy for chronic endometritis in women of reproductive age.

Material and methods. A prospective cohort study of 158 patients with a verified diagnosis of “chronic endometritis” was conducted before and after complex etiotropic therapy. Ultrasound examination was performed in the 1st phase of the menstrual cycle with measurements of Vmax, Vmin, Vmean, PI, RI, the diameter of the uterine arteries with subsequent calculation of the arterial perfusion index. The degree of vascularization of the uterus and endometrium was assessed using the VI, FI, VFI indicators obtained during 3D angioscanning.

Results. In the hypoplastic morphotype, there is a persistent decrease in the arterial blood supply to the uterus, which is combined with hypovascularization of the endometrium both before and after treatment. In the hyperplastic morphotype, the arterial blood supply is not impaired, but in the endometrium, hypervascularization detected before therapy is reliably reduced due to the disappearance of venous stasis during treatment. In the mixed morphotype, there are no pronounced disturbances in arterial hemodynamics; the blood supply to the endometrium after treatment significantly increases, which indicates the absence of a violation of venous outflow and the restoration of the macrovascular network of the mucous membrane of the uterine cavity.

Conclusion. Pathological blood supply to the uterus and endometrium is associated with the degree of severity of venous outflow disorder and the reparative capacity of the endometrium, which change against the background of complex etiotropic therapy depending on the morphological type, which allows us to judge the therapeutic effect.

Objective: to present modern methods of visualization of gouty tophi.

Materials and methods. A search was made for scientific publications and clinical recommendations in the PubMed and Google Scholar information and analytical systems for 2007-2022, using the following words: diagnosis of gout, X-ray gout, gout ultrasound, gout CT, gout DECT, gout MRI, gout scintigraphy.

Results. 894 articles were analyzed, 42 of which were used to compile the review. Search results - blocks of articles were created, within which the articles were analyzed to study diagnostic features.

Conclusion. Early diagnosis and the choice of the correct tactics for the treatment of gouty tophi remain extremely relevant and require additional attention from diagnostic doctors and clinicians.

Diabetic polyneuropathy (DPN) is a complication of diabetes mellitus (DM) that requires special attention in childhood. The search for new methods for assessing peripheral nerves is an urgent task. Shear wave ultrasound elastography offers additional opportunities for assessing peripheral nerve changes in children with type 1 diabetes.

The purpose of the study is to evaluate the parameters of ultrasound elastography of peripheral nerves in children and adolescents with type 1 diabetes mellitus.

Material and methods. The study included data from 213 children aged 7-18 years. Of these, 159 children were diagnosed with type 1 diabetes mellitus of varying duration and the control group included 54 children.

Ultrasound examination of the peripheral nerves of the lower extremities was performed in all patients using B-mode, shear wave elastography mode.

Results. The data obtained during the study indicate the possible use of ultrasound elastography for dynamic monitoring of the condition of peripheral nerves in patients with type 1 diabetes in childhood and adolescence. Peripheral nerves in this category of patients are characterized by higher values of stiffness parameters in ultrasound elastography.

Brief Summary. Visualization of oligometastatic disease (OMD) is a complex diagnostic task, since it requires determining the exact loco-regional stage of cancer and assessing the condition of the patient's entire body in terms of possible detection of polymetastatic condition in the form of detection of disseminated metastases. Given this circumstance, quite often a combination of visualization methods is required.

Purpose of the study: to analyze the possibilities of modern diagnostic imaging methods for oligo metastatic disease and determine the further directions of their development.

Conclusion. Diagnostic imaging is extremely important in the implementation of standard methods of modern antitumor treatment (assessment of the response to special treatment of solid tumors using computed tomography, magnetic resonance imaging and bone scintigraphy), as well as advanced imaging methods (functional, metabolic and radionuclide targeting) to identify and dynamically monitor patients with oligometastatic disease.

High-quality visualization of the temporomandibular joint (TMJ) allows to choose the most optimal tactics for conservative or surgical treatment. Performing magnetic resonance imaging (MRI) in patients with metal structures in the maxillofacial area is a pressing issue in ensuring quality diagnostics. In the presented clinical case, a methodology of performing diagnostically significant MRI of the TMJ in the presence of metal structures in the region of interest (ROI) was clearly demonstrated and described.