Objective. To explore the features of cardiac sympathetic activity impairments using neurotropic scintigraphy and singlephoton emission tomography (SPECT) in patients with hypertrophic cardiomyopathy (HCM), including the context of the risk of sudden cardiac death (SCD).

Material and methods. 36 patients with HCM, II–IV NYHA CHF grade, underwent cardiac neurotropic scintigraphy and SPECT with 123I-MIBG. 30 patients also underwent cardiac perfusion SPECT with 99mTc-MIBI, standard quantitative parameters of global and local left ventricular sympathetic activity and perfusion impairments were obtained. After 5 years of follow-up, the analysis of the dependence of the frequency of SCD in patients with HCM on the values of the above parameters was performed.

Results. All parameters of perfusion and neurotropic myocardial SPECT were significantly different in patients with HCM compared with the control group (p<0.001). According to perfusion SPECT data, significant transient ischemia of the myocardium (SDS>4) in the main group was detected in 32% of cases, while it had a diffuse character and had no connection with certain coronary artery regions. The volume of regional innervation defects (SMSe) in HCM patients significantly exceeded the total volume of perfusion defects (SSS, p<0.001). SMSe and SSS parameters had a direct correlation (r=0.52, p=0.002). SMSe was higher in patients with HCM with arrhythmias (p=0.046), and lower in patients with HCM with manifestations of angina and cardialgia (p=0.04). Based on the results of a five-year follow-up, SCD occurred in 8 patients with HCM. SMSe was a predictor of SCD (AUC=0.76, p=0.01), its value >14 predicted the occurrence of SCD with sensitivity of 87.5% and specificity of 57.1%. The risk of five-year mortality from SCD was significantly higher when SMSe >14 (p=0.024).

Conclusion. Neurotropic SPECT in patients with HCM is able to identify a group of patients at high risk of sudden cardiac death.

Objective. To determine the effect of quantitative characteristics on the effectiveness of magnetic resonance imaging guided focused ultrasound (MRIgFUS) ablation of uterine fibroids and evaluate the possibility of their use for patient selection.

Material and methods. Retrospective analysis of 67 FUS ablations (67 women, 94 fibroids) was performed. We evaluated the characteristics of fibroids (standardized signal intensity (SSI) and signal heterogeneity in T2-WI, the maximum diameter, the distance to the skin and to the sacrum during FUS, volume, nonperfused volume (NPV), MR-type), sonication energy and patients age. Standardization of the fibroid signal intensity was performed by using the signal intensity from iliac muscle. Correlation between NPV and quantitative characteristics was calculated. ROC-analysis was performed for determination of the optimal SSI threshold value required to achieve NPV≥50%. We evaluated the relation between MR-type of fibroids, NPV ratio and SSI.

Results. Post treatment NPV ratio was 57.1 ± 22.5%. NPV for 1 type fibroids (n=67) was 63.4 ± 19.7%, for 2 type (n=20) – 46.8 ± ± 19.5% and for 3 type (n=7) – 26.4 ± 21%. Differences between
groups was significant (p<0.05). SSI showed significant correlation with NPV ratio (R=-0.28, p<0.01). Significant correlation between NPV ratio and others quantitative characteristics was not detected. Fibroids with SSI≤1.4 characterized NPV≥50% (sensitivity 72.7%, specificity 71.4%, p<0.01, AUC 0.72). MR-types of fibroids were characterized by different SSI (p<0.05). SSI≤ 1/4 was characteristic only for 1 type fibroids.

Conclusion. SSI can be used as an additional objective criterion for prediction of FUS results and patient selection. Good results of FUS (NPV≥50%) in most cases can be achieved for fibroids with SSI≤1.4.

The paper describes a rare case of a giant calculus (measuring 22×15×12 cm and weighing 3250 g) in the sigmoid colon in a 28- year-old man. Extraorgan extraintestinal tumors of the abdominal cavity were misdiagnosed by endoscopic techniques. The efficient use of radiologic methods and especially multidetector computed tomography with 3D reconstruction allowed one to make an accurate preoperative diagnosis of a coprolith in the sigmoid colon and to perform successful surgery.

Metastatic brain tumors – one of the most actual problems of neurooncology. Currently, whole brain radiotherapy and stereotactic radiosurgery are the main treatment methods of this pathology. The assessment of tumor’s response to irradiation is very important issue in postoperative period. We attempted solve it by using diffusion tensor imaging.

The organizational issues of continuing professional education and the accumulative system of educational credit units as a necessary component of an individual five-year plan for the professional development of medical specialists working in the field of radiology, ultrasound diagnostics, and X-ray endovascular diagnostics and treatment are considered.

The presented literature analysis is focused on the heart microvasculature and finding new ways to perform the method of deep coronary penetration technique. Also, new data reflecting the technique’s efficacy and safety are published on regular basis.

In recent decade, nuclear medicine demonstrates a tendency towards improvement of dosimetry approaches to radionuclide therapy. Historically there were developed several methods for calculating effective therapeutic activity: prescription of standard activities (fixed activities) and personalized assessment of effective activity based on evaluation of individual radiobiokinetics, followed by the mathematical modeling. Accumulated variety of approaches to dosimetric planning of radionuclide therapy demonstrates that an optimal algorithm for calculation has not been developed so far. Developing robust pre-therapeutic dosimetric planning protocol for radionuclide therapy requires consideration of all factors (individual biokinetics, geometry, properties of radionuclide) which are independently and significantly affects target absorbed dose delivery on the one hand, and exposure of other organs and tissues, on another hand.

The article presents the analytical report of the service of radiology in 2016 in comparison with previous years data concerning the staffing and logistics of radiological procedures in medical organizations of state and municipal health sector. Studied data based on quantitative composition and staffing radiologists, nuclear medicine specialists, ultrasonic diagnostics specialists and radiographers, the materials of the Ministry of health of the Russian Federation for 2010–2016. It is shown that the number of specialists in the field of radiological diagnostics is constantly slowly growing, however there is a high percentage of part-time. Increases number of instruments for medical imaging, a growing amount of research being conducted, with the most pronounced of these trends in ultrasound diagnostics, X-ray computed tomography and magnetic resonance imaging. However, a qualitative improvement of the diagnostic process, which is reflected in the low level of contrast enhancement in CT and MRI, a low share of a special tomographic imaging including cardiovascular CT and abdominal MRI. The results of the study indicate the necessity of improvement of personnel policy in the field of the medical imaging.