Objective: to study the capabilities of a hybrid single-photon emission computed tomography/computed tomography (SPECT/CT) system during myocardial perfusion imaging study, to evaluate the impact of absorption correction (AC), and to reveal factors influencing the contribution of AC to the diagnostic result of the study.

Material and methods. The study included 167 patients who underwent myocardial perfusion SPECT with and without CT AC. Differences between AC and non-AC studies were visually analyzed; the results of the analysis were used to form groups of visual differences. The supposed factors influencing the contribution of AC were studied, by assigning visual differences to a particular group.

Results. The possible variants of the impact of AC were described in the baseline scintigrams. AC made a significant contribution in 68% of cases. With AC, the perfusion defects visible during non-AC study recovered in 80% of these cases. The factors predicting substantial differences between the AC and non-AC studies included weight, end diastolic volume, male sex, patients with small focal perfusion defects and transient ischemia, and inadequate injected activity. Factors, such as body mass index, large perfusion defects, CT subsystem and orbit settings, and time from the injection of a radiotracer to the initiation of a study, had no substantial impact on the contribution of AC. During AC studies, SRS and transient ischemic dilatation were significantly higher than during non-AC studies, requiring a shift of standard criteria. There were some methodical features of interpretation of myocardial perfusion SPECT using CT correction.

Conclusion. Myocardial SPECT with AC enhances the diagnostic value of the technique, simplifies the interpretation of myocardial perfusion SPECT, and reduces the number of falsepositive and questionable results.

Objective: to determine the incidence of fenestrations from multislice spiral computed tomography angiography (CTA) series and to establish the possible association of fenestrations with aneurysms and other vascular diseases of the brain.

Material and methods. Four hundred and eighty-six persons who had undergone brachiocephalic artery (BA) CTA for different clinical indications were selected for retrospective analysis. Postprocessor data processing was made to detect extra- and intracranial artery fenestrations. Saccular and fusiform cerebral aneurysms, arteriovenous malformations (AVMs), and venous angiomas were detected in addition to fenestrations. When aneurysms were concurrent with fenestrations, their locations were compared.

Results. Among the 486 patients, fenestrations were revealed in 50 (10.3%) cases, of which there were 46 (9.5%) intracranial artery fenestrations and 4 (0.8%) vertebral artery (VA) ones in the extracranial segments. Aneurysms of different locations were found in 163 (33.5%) patients. Venous angiomas of different locations were seen in 9 (1.9%) persons; AVMs were observed in 21 (4.3%) patients. Fifty-four multiple fenestrations were identified. The bulk of fenestrations were located in the area of the anterior communicating artery (ACA) in 28 (51.9%) patients. Aneurysms were found in 11 (22%) patients with fenestrations. Aneurysms were detected in 152 (34.9%) of 436 patients without fenestrations. The incidence of aneurysms was not statistically different in patients with and without fenestrations (p > 0.05); moreover, aneurysms were somewhat more common in patients without fenestrated vessels. Aneurysm located in the area of fenestration was in only one (9.1%) patient. In other cases aneurysms were located in the vessels having no fenestrations. Aneurysms were relatively frequently encountered in 5 (45.5%) patients with BA fenestration. There was no statistical difference in the incidence of AVMs in the fenestration and non-fenestration groups. Venous angiomas significantly more frequently occurred in patients with fenestrations (p < 0.05).

Conclusion. CTA findings showed fenestrations 10.3% of patients. Fenestrations were located most frequently in the area of ACA and less frequently in the area of BA and middle cerebral artery. Those of other locations, concomitant and extracranial ones, were very rare. According to our data, there was no direct relationship of fenestrations to arterial aneurysms and AMVs. When fenestrations were in the area of BA, the incidence of aneurysms increased up to 45.5%. Venous angiomas occurred more commonly in patients with fenestrations.

Objective: to explore the capabilities of single-photon emission computed tomography (SPECT) in combination with x-ray computed tomography (SPECT/CT) in the study of the anatomy and drainage function of lacrimal passages.

Material and methods. Twelve scans were carried out in 6 healthy volunteers and in patients with different lacrimal drainage disorders (dacryostenoses, varying obstructive lacrimal passage, dacryocystitis and post-dacryocystorhinostomy). Sodium pertechnetate (99mTc) solution and a radiocontrast agent were instilled into the conjunctival sac during the study.

Results. SPECT is an objective procedure to study lacrimal drainage function. It cannot provide data on the anatomic structure of lacrimal passages and determine the location of their stenosis or obstruction. SPECT/CT makes it possible to simultaneously obtain information on the anatomic structure of lacrimal passages, to visualize the sites of their pathological changes, and to evaluate the drainage function of lacrimal passages.

Objective: to perfect and estimate the possibilities of using a mini-invasive diagnostic procedure under magnetic resonance (MR) guidance in the complex anatomic situations in cases of pathological small pelvic changes of unknown origin.

Material and methods. Ten small pelvic interventions were made under MR guidance. The indications for bone biopsy under MR guidance were poor visualization of bone changes or their absence during radiography, including computed tomography. Small pelvic organ and soft tissue biopsies were carried out in the situations of complex location of pathological changes adjacent to critical organs, large vascular and neural structures. All interventions were done using a high-field MR scanner. Freehand biopsy was performed in a stepwise fashion under axial and sagittal T2-weighted image control.

Results. Informative histological material was obtained in 100% of cases. No complications were observed.

Conclusions. It became possible to verify the diagnosis based on morphological findings and to timely determine management tactics only by target biopsy under MR guidance in these 10 patients with small pelvic changes of unknown origin.

Objective: to study the diagnostic capabilities of diffusionweighted magnetic resonance imaging (MRI) to evaluate the efficiency of treatment, the presence of progressive or recurrent prostate cancer (PC).

Material and methods. The results of small pelvic MRI in 44 patients who had medical (26 (59.1%) patients) or surgical (18 (40.9%) patients) treatment for PC were analyzed. Examinations were performed on a 1.5-Tesla superconducting MRI scanner with a multichannel phased array surface coil. Diffusion-weighted imaging (DWI) at b values of 1000 s/mm–2 was used in addition to the standard MRI protocol in all the cases. The measurable diffusion coefficient (MDC) was calculated when estimating DWI.

Results. Analysis of the results of DWI MRI has indicated that the criteria for the positive impact of medical treatment are a progressive decrease in the prostate volume, a reduction in a MRI signal of a tumor on isotropic DWI, and an increase in MDC. Progressive PC is suggested by a local increase in the MRI signal of a tumor on isotropic DWI and a low MDC. The study has establishes that after radical prostate vesiculectomy, the pattern of tissue masses at the site of cystourethral anastomosis should be assessed not earlier than 6 months postsurgery.

Conclusion. The performed studies have shown that DWI MRI is an objective technique to assess medical and surgical treatment for PC.

The paper describes clinical cases of concomitant lung and intrathoracic lymph node involvements as evidenced by conventional radiography and computed tomography (CT). It shows difficulties in the differential diagnosis of different nosological entities in pulmonary tuberculosis. The x-ray semiotics of concomitant lung injuries is also depicted.

The paper describes the technical features of a transradial approach; indications and patient selection for this arterial approach; and stepwise patient preparation. It depicts the anatomic variants of the origin of the radial artery, which affect the success of this approach. The suitable instruments for this approach are described. The authors give their results of the performed study comparing different types of approaches.

Computed tomography, 18FDG-PET and the hybrid FDGPET/CT are the most commonly used diagnostic tools for the initial staging and treatment response assessment of malignant lymphomas. MRI techniques such as whole-body MRI and diffusionweighted imaging may become good radiation-free alternatives to FDG-PET/CT. Diffusion-weighted imaging is characterized by high sensitivity for the detection of lesions and allows quantitative assessment of diffusion that may aid in the evaluation of malignant lymphomas. This article will review the value of these emerging MRI techniques for the staging and response assessment of malignant lymphoma.

Professor Era Arsen’evna BERESNEVA: on the occasion of the 85th anniversary of her birth.

Professor Anatoliy Petrovich SAVCHENKO: on the occasion of the 75th anniversary of his birth.