Objective: to study the capabilities of a procedure for sonotomography (STG) versus that of X-ray mammography (MG) in patients from different age groups who have different radiological types of the breast structure and to estimate the diagnostic   possibilities of the STG and X-ray MG procedures in detecting cancer in patients its the X-ray dense background.

Materail and methods. The investigation enrolled 143 patients aged 38 to 77 years who had undergone STG after primary X-ray MG. Particular emphasis was placed on a methodological approach to optimizing STG in patients from different age groups with a varying radiological type of the breast structure in different physiological periods. The international breast imaging and reporting data system was used to standardize detected breast masses.

Results. Out of the 143 patients, 102 persons, including 16 patients with verified breast cancer (BC), were found to have space-occupying lesions. During the  performed investigation, computed processing of 3D scans at the working station confirmed the entire quadrant-by-quadrant consentaneity of the glandular structure of the breast at STG and X-ray MG. There were a higher proportion of abnormal breast masses with the increased percentage ratio of glandular tissue in the breast. Emphasis was laid on the role of STG as an additional examination technique in patients from all age groups with the radiologically dense breast in order to detect cancer due to a high sensitivity of 100% and a specificity of 96%.

Conclusion. The procedure of STG versus that of X-ray MS showed a high degree of compatibility of opinions as to the type of the breast structure in the patients. Due to the fact that standardprojection STG scans can be compared, during mammography the procedure of STG must hold a firm place in the examination algorithm of the breast in women with its X-ray dense structure.

 

 

Objective: to estimate the possibilities of using and systematizing computed tomographic findings in patients with toxic phosphorus necrosis of the jaw.

Material and methods. The investigation enrolled 87 patients diagnosed as having toxic phosphorus osteonecrosis. Radiation examination consisted of two stages: primary and repeated radiologic examinations in the postoperative period (final examination before hospital discharge). All the patients underwent skull X-ray and multislice computed tomography (MSCT).

Results. Clinical and radiation examination revealed toxic phosphorus osteonecrosis of the maxilla and mandible in 29 (33%) cases. Osteonecrosis affected only the mandible in 40 (46%) cases and only the maxilla in 18 (21%) cases. In all the patients, computed tomography showed main trends in the X-ray semiotics of toxic phosphorus necrosis of the facial skeleton, such as periostitis; osteosclerosis; development a lesion having a “soap-bubble” appearance; nonspecific and inflammatory bone destruction. The bone, being destroyed, was replaced by pus; inflammatory granulations were absent; osteonecrosis occurred. These processes were characterized by the absence of an obvious demarcation zone along the edges of the process. Sequestration commonly occurred to form sinus tracts. The process involved the adjacent bones; there were reactive changes in the accessory sinuses.

Conclusion. MSCT data are of highly informative value in evaluating the status of bone tissue and teeth and in detecting a concomitant abnormality in patients with osteonecrosis of the facial skeleton and may be used to plan surgical treatment for this category of patients.

 

Objective: to develop novel quantitative approaches of myocardial perfusion analysis, to assess clinical usefulness of new parameters of initial myocardial perfusion impairments.

Material and methods. 80 patients selected from our database formed four groups: 20 patients with no cardiac disease suspect, no ischemic heart disease (IHD) risk factors and definitely normal myocardial perfusion (group 1), 40 patients with equivocal perfusion patterns, that are usually described visually as “inhomogeneous”: 20 – with one subtle perfusion defect (group 2), 20 – with multiple ones (group 3), and 20 patients with non-severe but reliable defects, due to post-MI or another nontransmural cardiac event consequence. None of patients had current cardiac symptoms, positive stress-test results and/or single-photon emission computed tomography (SPECT) signs of stress-induced ischemia, so only rest images were analyzed. Perfusion maps were assessed quantitatively with Summed Rest Score (SRS) and Rest Extent (RE). Also new parameters ósev (severity sigma) и óhet  (heterogeneity sigma) were used. They were calculated as mean-square deviations of relative perfusion values (in %) in each of 17 standard segments in reference to maximum of 100% (for ósev) and to arithmetical mean of those values (for óhet). To minimize known artifacts from CTACcorrected and noncorrected images, relative perfusion values for each segment were taken as  maximal numbers of both images.

Results. ósev in groups 1, 2, 3 and 4 was 15.9±2.6, 20.4±2.9, 22.4±3.4 and 26.0±3.9 (all paired p (s)<0.05, except p (group 2–3) = 0.19), óhet – 5.4±0.7, 9.1±1.6, 4.4±0.8, 11.3±2.1 (all paired p (s)<0.05 except p (group 1–3) = 0.11), respectively. Rest Extent in groups 1, 2, 3 and 4 was 4.1±1.7, 5.0±2.0,  4.7±2.3, 6.1±2.0 (all paired p (s)>0.05 except p (group 1–4) = 0.020); SRS – 1.3±0.6, 1.9±1.3, 1.6±1.4, 3.0±0.6 (all paired p (s)>0.05 except p (group 1–4)=0.013).

Conclusion. Parameters ósev and óhet are suitable for quantitative description of myocardial perfusion “inhomogeneity”, they are better than Extent/SRS in delineating normal/equivocal (inhomogeneous)/abnormal perfusion patterns.

 

 

Objective: to propose a safer, simpler, and more exact method for the diagnosis of descending perineum syndrome (DPS).

Material and methods. A total of 194 patients aged 5 days to 15 years were examined and divided into 2 groups: Group 1 consisted of 65 patients without anorectal anomalies (AA); Group 2 comprised 129 patients, including 66 children with functional constipation,
55 with AA and visible fistulas, who were preoperatively examined, and 8 patients with anorectal angle (ARA), who were postoperatively examined. All the patients underwent
irrigoscopy that was different from standard examination in the presence of X-ray CT contrast marker near the anus.
Results and conclusion. DPS is caused by puborectalis muscle dysfunction. A method was proposed to evaluate the status of the puborectalis muscle from the distance between the position of the ARA and the marker near the anus. This not only promotes
an exacter estimate of DPS, but also allows refusal of defecography. The use of a barium enema with the minimum number of X-ray films decreases dose of ionizing radiation hazard and permits the use of this procedure not only in adults, but also in children with chronic constipation, fecal incontinence, and in AA for both pre- and postoperatively assessment of the causes of complications.

Breast cancer is the first most common cancer among women. Its increasingly threatening trends force to search for ways to accelerate the introduction of current technologies for the early diagnosis and prevention of breast malignancies. The paper gives data on the quantity and distribution of diagnostic and minimally invasive mammography equipment by the regions of the Russian Federation, which may lead to the conclusion about the regions’ needs for equipment, trends, and possible prospects in the development of digital radiology in mammology.

The paper sets forth the basic provisions of the accreditation of healthcare workers, the principles of a new approach to continuing postgraduate education, by introducing the storage system of credit units, and the tasks of educational establishments to form self-education motivation and to master novel competences.

The diagnosis and treatment of cancer of the tongue and floor of the mouth is a relevant problem, for 60–80% of patients first seek medical treatment only when they have late stages of the disease. The review analyzes the data available in the Russian and foreign
literature on mainstay techniques for radiodiagnosing cancer of the mouth and floor of the mouth. It highlights the capabilities of computed tomography in diagnosing this pathology, in assessing deepseated anatomic structures of the mouth and floor of the mouth, and in detecting metastatic neck lymph nodes.

Errors occur rather commonly in the differential diagnosis of respiratory diseases accompanied by X-ray lung tissue changes as foci and infiltration. Infiltrative and disseminated pulmonary tuberculosis, lung cancer, and pneumonia constitute a high proportion among the detected concurrent lung diseases. The rate of diagnostic discordance for these lung abnormalities accounts for more than 30%; and the diagnosis period for an infiltrative lung process lasts 2–3 weeks in 20% of cases and above 1–3 months in 80%. In particular, clinicians are faced with great difficulties in diagnosing aspiration pneumonia; this is due to that its X-ray manifestations are not purely specific and they are characterized by the parenchymal (alveolar) infiltration of
lung tissue with a varying extent of lung inflammation.
This paper describes a clinical case of a patient with salivary gland adenocarcinoma
and focal infiltrative lung changes. Diagnostic difficulties have emerged in establishing the genesis of the changes in the lung.