Objective. To carry out clinical, radiological,  and pathological comparisons in congenital and acquired cystic lung changes to determine the capabilities of computed tomography (CT) in the detection and differential diagnosis of lung diseases in neonates  and infants.

Material and methods. The authors describe their own clinical cases of 185 neonates  and infants followed up and treated for variant focal lung malformation for 20 years, with their histological verification, the time and algorithm of a postnatal radiological examination, as well as a treatment  option,  and a follow-up  with X-ray and CT monitoring in 83 patients during 6 months to 16 years.

Results. The CT semiotics of different variants of congenital and acquired cystic  lung malformations are presented  and compared with pathomorphological signs. The results of prenatal radiological diagnosis  of lung diseases agreed with the final diagnosis  of  the  type  of  disease  in 42.03%; 50% of  cases  showed changes  in the prenatal diagnosis  established after CT; and this affected the concept  of the patient and modified treatment policy in 36.96% of cases.

Conclusion.  CT is an expert radiation diagnostic technique for lung diseases in neonates  and infants,  which  contributed  to  an accurate differential diagnosis in 94.05% and to the change in the policy and timing of surgical treatment  for focal lung malformations in 51.89%.

Objective. To investigate the  characteristics of lengthening the lower limb in its proximal portion in patients with subjectively short stature and varus deformity.

Material and  methods. Computed  tomography  was  used  to analyze  the  features  of distracted  regeneration  in the  proximal tibia in 65 patients  with subjectively short stature,  limb shortening  and deformity  secondary  to  various  etiologies at  different stages  of leg lengthening.

Results. Regeneration in lengthening  the  leg and eliminating varus deformity was characterized by its anatomical features while maintaining the typical zonal structure.  85% of patients  older than 30 years of age had a characteristic mass over the anterior surface of the low-density regeneration  area that was subsequently manifested by a reduction in the bone diameter, by a marginal defect, or by formation of a cyst. Bone organotypic remodeling after lengthening came to an end 1–3 years later, depending on the etiology of the disease and the magnitude of lengthening.

Conclusion.  The findings showed that bone regeneration  during distraction  in patients  with any etiology of shortening  had a clearly  marked zonal structure  with  bone  portions  and growth areas – a connective tissue  layer. Bone regeneration  during fixation  was  presented  by a trabecular bone  with longitudinally  or obliquely oriented bone trabeculae.  In patients  with subjectively short stature  at the age of over 35 years,  the bone organotypic remodeling period lasted two or three years. The findings should be kept in mind during treatment and rehabilitation.

Objective. To determine  an optimal  method  for preventing regional relapses in patients with locally advanced cutaneous melanoma (CM).

Material and methods. The investigation included 755 patients  with locally advanced  CM who had been treated  at the Medical Radiology  Research  Centre.  Among them, 213 patients had wide excision only for the primary tumor; 242 patients  were additionally  treated  with preventive  lymphadenectomy (pLAE), and 300 patients  underwent  sentinel  lymph node (SLN) biopsy. The groups were matched for the local extent  of a tumor in the TNM  staging  (p = 0.178), which  allowed  a proper comparative analysis  of treatment  results.  The Russian  radiopharmaceutical 99mTc-Technefit  having  necessary lymphotropic  properties  was used  to identify  SLN.  Intraoperative  navigation  was  performed using a Radical handheld gamma probe counter (Amplitude Research  and Technology Center, Russia).

Results. Regional relapses were observed in 20.2% of cases in the primary CM excision group. In the pLAE group, latent regional lymph node metastases were detected in 10.7% of the patients; and 12.0% more of the patients  developed subsequently regional relapses  in the  intact  lymph nodes.  The total  number of latent regional  metastases in this  group was  22.7%; these  were  diagnosed  as a result of pLAE in less than half of the cases  (47.3%). SLN biopsy revealed  subclinical regional metastases in 20.7% of the  patients   and  regional  relapses   were  seen   only  in  3.3%. Overall, SLN biopsy could detect latent lymph node metastases in 86.1% of all cases; these were demonstrated  with clinical relapses  only in 13.9%. The efficiency  of SLN biopsy in preventing regional relapses   was  significantly   higher  than  was  achievable   during pLAE (p =0.001). The five  and seven-year survival  rates  were 61.5 ± 4.3 and 54.3 ± 4.6% in the CM excision group, respectively; 68.8 ± 0.35 and 61.3±3.9%  in the pLAE group; and 84.8 ± 6.5 and 84.8 ± 6.5% in the SLN biopsy group (p = 0.001).

Conclusion.  The investigation of SLN is the most  effective, safe,  and reproducible  technique  for the early detection of subclinical  regional  metastases and for the  prevention  of  regional relapses  in patients  with locally advanced  CM. Reliable  regional control  in turn makes it possible  to hope for the best  long-term treatment results.

Ulcerative lesions  of the upper digestive tract often occur in malignant  obstructive jaundice  due  to  multiple  changes  in the coagulation  system. Emergency percutaneous  arterial embolization is an effective and safe procedure to treat acute massive duodenal bleeding; it is most commonly  performed via the standard transfemoral access, which can lead to complications  in this area.

The paper describes  a clinical case of the double use of a unilateral radial access  for emergency  embolization  of life-threatening duodenal bleeding  in complications  of malignant obstructive jaundice.

The paper gives  the results  of emergency  contrast-enhanced multislice computed tomography (MSCT) (MSCT angiopulmonography)   as  a stage  of  preoperative  preparation  in 4 pregnant women in order to confirm fatal thromboembolism. Thromboembolectomy of  the  pulmonary  artery  branches  were done as clinically indicated in all the women on the day of admission.  The time from hospital  admission  to surgery was less  than 1 hour (mean, 40 minutes). Good angiographic and clinical results were achieved  in all cases. Two women  (50%)  delivered  a baby simultaneously with thrombectomy;  two women (50%) delivered 5 weeks and 9 weeks (mean, 7 weeks) after a cardiac surgical procedure. All the babies had an Apgar score of 7–9.

MSCT angiopulmonoraphy  is a reliable non-invasive examination in patients,  including pregnant women with suspected or verified pulmonary embolism.  Low-dose MSCT-angiopulmonography protocols  and use of dual volume contrast  media injectors can minimize testing  time,  radiation load,  and injected  contrast agent  volume  in order to  obtain  qualitatively  adequate  MSCT data  for the  choice  of further patient  management  tactics, by lowering iatrogenic effects  on the fetus.

Alzheimer's disease (AD) is the most common form of dementia among neurodegenerative diseases. New advanced methods of magnetic resonance imaging, such as functional (fMRI) and diffusiontensor imaging (DT-MRI), can evaluate changes in brain matter of AD at the microstructural and functional levels and can be used in the diagnostics of this pathological process on early stages of cognitive impairment. In this review, a literature search was made in electronic databases and scientific libraries of PubMed, Medscape, Elsiever, Cyberleninka. The review highlighted the merits and demerits of fMRI and DT-MRI, the clinical application of this methods in diagnosis of AD on early stage were also assessed.

This literature review provides information on the main radiation diagnostic methods and approaches for prostate cancer, which are used in current medical practice both by ultrasound (routine transrectal ultrasound (TRUS), sonoelastography, etc.) and most promising diagnostic techniques (multiparametric magnetic resonance imaging (mpMRI), hybrid fluorocholine and GaPSMA positron emission tomography/computed tomography and Ga-PSMA, etc.), the widespread clinical introduction of which has been recently observed. The paper discusses their sensitivity and specificity and the role and relationship in the diagnostic process. It also gives current unified mpMRI reporting and data system version 2 (RADSv.2). The advantages and disadvantages of standard ultrasound-guided biopsy (including its extended variant) are discussed. There are data on the experience with new procedures for prostate biopsy under guidance of up-to-date radiology techniques (mpMRI/TRUS fusion-guided biopsy and MRI-guided prostate biopsy) that are yet to take their place in routine clinical practice.

The paper considers the organizational positions of primary professional accreditation, the issues of objective registration of mastered professional competencies, and the proposed provisions of the concept of roentgenologists’ accreditation.