Objective – to optimize dedicated assessment of carotid arteries in case of occlusive disease with computed angiography (CTA).

Material and methods. During 2015–2016 years 65 patients underwent ultrasound examination and computed tomography examined before carotid surgery.

Results. Aortic arc branching variants were observed in 26% cases. In 51% combined steno-occlusive process in common, internal carotid arteries and subclavian arteries was confirmed. In 29% of cases atherosclerotic plagues were detected in upper parts of common carotid arteries and such data changed surgical strategy. Patients included in study has internal carotid artery (ICA) stenosis more than 50% NASCET. Detailed assessment was used for cervical ICA distal to stenosis. In 62% of patients with carotid subocclusion narrowing in upper segments were detected. In 3 cases ascending pharyngeal artery arose from affected carotid artery and these findings change surgical approach. All patients underwent carotid surgery. Degree of ICA stenosis detected with CTA was conformed. CTA data for carotid plague extension were less informative – intraoperative plague length exceeded CTA results.

Conclusion. CTA is high informative study that allows detailed assessment of occlusive carotid disease for carotid surgery. 

Objective: to evaluate the upper airway (UA) soft tissue structures in patients with obesity, comparable body mass index (BMI), and obstructive sleep apnea syndrome (OSAS) varying in severity, by using magnetic resonance imaging (MRI).

Material and methods. The results of UA soft tissue MRI were analyzed in 20 patients without obesity and OSAS (a control group), in 42 patients with obesity and severe OSAS (a study group), and in 32 patients with obesity and mild OSAS (a comparison group). MRI scans were used to calculate the volumes of the soft palate (SPV), tongue (TV), lateral pharyngeal walls (LPWV) at the level of the retropharyngeal and retroglossal regions (RPR and RGR), soft tissue amounts (STA) at the level of the RPO and RGR, lingual fat inclusions, as well as lingual fat concentrations, and the area of maximum upper airway stenosis (MUAS) at the level of the RPR and RGR.

Results. It was found that in the patients with OSAS, obesity, and comparable BMI, SPV and LPWV at the level of the RPR and RGR, STA at the level of RPR and RGR, and lingual fat inclusions and concentrations were higher in the severe OSAS group than those in the mild OSAS group (p < 0.001). The area of MUAS at the level of RPR and RGR was smaller than that in the mild OSAS group (p < 0.001).

Conclusion. In patients with obesity and OSAS, BMI is not always a clear predictor of the degree of severity due to the uneven accumulation of adipose tissue in the soft tissues surrounding the the upper airway. 

Objective: to analyze the results of focused ultrasound ablation (MRgFUS) of uterine fibroids and to evaluate the factors affecting the long-term results of treatment.

Material and methods. Retrospective analysis of 67 FUS ablations (67 women, 94 fibroids) was performed. The observation period after FUS was up to 36 months. Characteristics of fibroids (standardized signal intensity (SSI) and signal heterogeneity in T2-WI, maximum diameter, volume, nonperfused volume (NPV), coefficients of volume and NPV dynamics (CDV, CDNPV), MR-type) were assessed by MRI. Standardization of the fibroid signal intensity was performed by using the signal intensity from iliac muscle. CDV, CDNPV were calculated as the ratio of fibroids volume and NPV at the time of control MRI to their initial values.

Results. Post treatment NPV ratio was 57.1 ± 22.5%. The maximal significant reduction of fibroids volume and NPV was detected by 12 months after FUS (52.1% and 85.8%). CDV and CDNPV showed significant (p<0.05) correlation with post treatment NPV ratio (r=-0.5 and r=0.37), fibroids volume (r=0.28 and r=0.49) and maximum diameter (r=0.26 and r=0.49). Fibroids with NPV ≥50% and volume <150 cm3 were characterized by the highest rate of volume reduction. Fibroids with NPV≥75% and volume >100 cm3 were characterized by the lowest rate of NPV reduction. The maximal reduction of volume during the observation period was detected in fibroids with NPV≥75% and volume <100 cm3, the minimal – in fibroids with NPV<25% and volume >150 cm3.

Conclusion. The dynamics of fibroids volume and NPV after MRgFUS depends on initial values of these characteristics. 

The paper describes a rare proven case of pulmonary zygomycosis as a complication of supersevere idiopathic acquired aplastic anemia in an 11-year-old child. The authors give the results, interpret computer tomography, radiographic, clinical, and laboratory data, and discuss the causes and clinical presentations of invasive zygomycosis and methods for its timely diagnosis. The case is of interest due to the atypical course and outcomes of the disease.

The paper provides information on the safety, diagnostic efficiency, and bioequivalence of using gadobutrol in neonates and babies compared to older children and adult patients. In infants aged less than 2 years, including full-term newborns, the pharmacokinetic profile of gadobutrol is similar to that in older children and adults. Gadobutrol given at a standard dose of 0.1 mmol/kg body weight has a favorable safety profile and is well tolerated by children of any age and by adults. There is evidence that the use of gadobutrol may be extrapolated to infants younger than 2 years of age, including full-term neonates, for the effective diagnosis of blood-brain barrier disorders, pathological changes in the cardiovascular system, and focal diseases of the internal organs of the whole body.

Owing to the setting up of new nuclear medicine centers, not only choiceless treatment, such as radioactive iodine therapy, but also an indispensable technique in examination, such as 18-fluorodeoxyglucose positron emission tomography/computed tomography (18FDG PET/CT), has become available to many patients with differentiated thyroid cancer (DTC). The purpose of this review was to analyze numerous studies of new trends in and current recommendations for the use of PET/CT for DTC. Elevated thyroglobulin (TG) levels and negative 131I whole-body scintigraphy data remain a main indication for these techniques. However, PET/CT is also able to change treatment and diagnostic tactics in patients with iodine-sensitive tumors. The minimum TG level, at which it is clinically appropriate to perform PET/CT, has not so far been determined. Whether there is the need for PET/CT during thyroid-stimulating hormone stimulation remains to be solved.

Urinary fistulas complicating treatment of pelvic tumors are the clinical diagnostic problem that needs research and decision. The top-priority radiological method for diagnostic urinary fistulas is computed tomography. About application magnetic resonance imaging (MRI) is less well knows. The possibilities MRI to diagnostic of urinary fistulas are illustrated in the article; we discuss the limitation of method requiring additional use of other radiological methods. A literature search on the topic of research was carried out on the databases PubMed and eLIBRARY.