Objective. 25 consecutive patients underwent cardiac CT between November 2009 and September 2012 to evaluate configuration of chronic total occlusion (CTO) of a coronary artery to assess eligibility of percutaneous recanalization. Material and methods. Between 11/2009 and 06/2014 25 consecutive patients underwent DSCT-CA for evaluation of CTO. Technical success and complication rate of revascularization procedures were documented. For image analysis the datasets of 12 parameters were used to calculate CTO-try score. By calibration to the study cohort the AC-CTO-try and simplified CTO-try score were constructed respectively and compared to J-CTO by the area under the ROC-curve. Results. 88% of CTOs involved the right coronary artery (RCA) with a mean length of 4.6 ± 2.7 cm. 68% (17/25) were stratified as difficult or very difficult CTO-segments by J-CTO. Based on CTO-try an intervention was recommended in 9/25 patients, while revascularization was attempted in 16/25 (64%) patients with a success rate of 56% (n = 9/16). Negative predictive value for revascularization failure was 75%. By using sCTOtry, discrimination between success and failure of the intervention was measured with an AROC = 0.892. Conclusions. DSCT-CA permits visualization of the occluded vessel segment and provides a tool for assessing the probability of revascularization failure based on the CTO-try score. SCTOtry, calibrated to our cohort and expertise, can be used for predicting success of recanalization attempt.

Objective: to study radiographic morphological changes in the bones of the foot in its chronic osteomyelitis and to develop indicators for assessing bone quality.

Material and methods. The results of foot bone multislice computed tomography (MSCT) using 64 detector rows were analyzed in 29 patients with chronic osteomyelitis of the talus, calcaneus, and midfoot bones.

Results. Radiographic changes in the talus and calcaneus in chronic osteomyelitis were characterized by pronounced polymorphism and accompanied by the lower density of the talus and calcaneus and by the lack of their organotypic structure. In a number of cases, the organotypic structure was entirely absent in the calcaneus along with marked anatomical changes (a defect). In these cases, the talus also undergoes considerable changes; however, its density does not decrease to more than 200 HU. Based on an analysis of the findings on the specific features of the architectonics of the talus and calcaneus and their density, the criteria for assessing bone quality, which allow estimation of the magnitude of radiographic morphological changes in the foot bones, were proposed to choose a method for treatment and rehabilitation.

Conclusion. The use of the proposed criteria for assessing bone quality indicated moderate, significant, and serious quality defects in 4, 5, and 20 patients, respectively. The findings should be kept in mind when choosing a method for treatment and rehabilitation measures.

Objective: to evaluate the safety and efficacy of transarterial chemoembolization method (TACE) in the treatment of inoperable patients with uveal melanoma with isolated liver metastases with cured the primary focus.

Material and methods. In N.N. Blokhin RCRC since 2000, 31 patients received treatment with metastatic uveal melanoma in the liver. Among them: men – 13 (42%), women – 18 (58%). The average age of 45.12 ± 13.22 years, range 23–71 years. Time detection of liver metastases after treatment of the primary tumor ranged from 2 to 180 months, median – 23 months. Liver lesion volume to 25% was in 11 patients, to 50% in 13, to 75% in 7 patients. Total 62 TACE intervention was performed. As used embolizing materials: Lipiodol 10 ml in 45 cases, microspheres – in 11 cases (particle sizes ranged from 100 to 500 microns), combinations presented embolizing materials have been used in 6 patients. As the chemotherapy Doxorubicin performed at a dosage of 100 mg, or Gemzar 1–2 g, or Carboplatin 450 mg.

Results. 100% of the TACE was technically successful. Complications related to the technical implementation not observed. Local response was observed in 21 (67.7%) patients with metastatic uveal melanoma. Duration of monitoring of patients after TACE was held from 2 to 60 months. Median follow-up in this case was 10 months. Overall survival in this group of patients was calculated by Kaplan–Meier. 1-year was 51.0 ± 9.5%, 2-year 34.0 ± 15.2%. The median survival – 12.9 months. 20 patients were alive at the time of the study, 11 died from progression.

Conclusion. In this study transarterial chemoembolization in patients with metastatic uveal melanoma in the liver has established itself as an effective and well-tolerated treatment. Objective response or stabilization process in the liver was observed in 68% of patients. A median overall survival was comparable to that provided in the literature.

The paper describes a case of mandibular osteonecrosis in a patient who has received a radiotherapy cycle for tongue cancer. It deals with estimating the capacities of radiodiagnostic techniques to detect local tissue responses manifesting as radionecrosis after radiotherapy. To assess bone changes, clinical and laboratory examinations and comprehensive radiodiagnosis were made, which could validly evaluate the bone structures and soft tissues, determine the degree of injury, and identify complications. X-ray studies established that when evaluating the bone tissue, multislice computed tomography (MSCT) and cone-beam computed tomography (CBCT) were comparable in their diagnostic efficiency; however, MSCT was of greater informative value for the detection of soft tissue changes. CBCT may be successfully used during and after jaw osteonecrosis treatment as a control technique to evaluate its efficiency.

Diverticulosis of distal parts of a small intestine is a rare and difficultly diagnosed disease. This pathology usually is asymptomatic, and the first clinical manifestations oftenly testify the development of complications. The leading seat in the diagnosis of diverticulosis is borrowed with beam investigative techniques: ultrasonography, barium enterography, CT or MRI.

In this article a brief review of clinics and possibilities of instrumental diagnosis of diverticulosis of small intestine is presented and illustrated by clinical case of a patient with large jejunoileal diverticulosis.

Global radiology and nuclear medicine have recently shown a clear trend towards hybrid (combined, superimposed) studies. Unfortunately, the Russian literature virtually lacks both methodological and research works on this topic. The basis for this paper was the guidelines of the North American Society of Nuclear Medicine and Molecular Imaging, the North American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography and the principles as jointly set out by the European Society of Nuclear Medicine, the European Society of Radiology, and the European Association of Nuclear Medicine.

The purpose of the paper is to familiarize readers with some methodical aspects of performing superimposed single-photon emission computed tomography (SPECT) and X-ray computed tomography (CT) of the heart. This publication discusses the main indications for and contraindications to hybrid cardiological studies and gives other data that are useful to select patients for examination. A patient's preparation and prevention measures are described. There is information on major radiotracers and equipment for superimposed studies. There are imaging parameters and information on the correction of gamma-ray quantum absorption according to CT data. The paper concerns the interpretation of the results of identifying coronary artery calcification and those of CT coronarography and myocardial perfusion scintigraphy. It presents the methodical aspects of superimposition of radionuclide and CT images, the possible sources of errors during superimposed SPECT/CT, and recommendations for making a diagnostic conclusion. The issues of radiation load and radiation safety are discussed.

It has been given current information about acute and late adverse reactions arising from the use of gadolinium magnetic resonance contrast agents (GMRCA). The role of thermodynamic and kinetic stability GMRCA in the deposition of gadolinium in tissues, including the brain, the development of pseudohypoglycemia and nephrogenic systemic fibrosis (NSF) is considerated. After analysis of data on mechanisms of deposition of gadolinium in the body's cells and mechanisms of cytotoxicity on the chemical structure of existing GMRCA it is concluded that for reducing the accumulation of gadolinium in cells and the risk of development of NSF is advisable to use stable macrocyclic agents such as gadobutrol.