Objective. To develop a method for investigating the perculiarities of the structure of the nasolacrimal duct orifice according to the data of multislice computed tomography (MSCT).

Material and methods. The structure of the nasolacrimal duct orifice was investigated in 96 cases in 65 people, including healthy volunteers (n=29), patients with dacryostenosis (n=45), and those with unilateral dacryocystitis (n=22). The type of the nasolacrimal duct orifice was identified using the developed procedure on the basis of the data of contrast-enhanced MSCT of the lacrimal passages. For verification, the investigators used retrograde probing of the nasolacrimal duct in all cases.

Results. There were four possible types of the structure of the nasolacrimal duct orifice. Five cases showed discordance between the type of nasolacrimal duct office and the MSCT type identified by retrograde probing. The accuracy of the developed procedure to identify the type of the nasolacrimal duct orifice was 94.8%.

Conclusion. The developed methodology based on CT is noninvasive, can reliably identify the type of the structure of the nasolacrimal duct orifice, and may be included in the algorithm for examination of patients with lacrimation disorders.

Objective. To determine a correlation of myocardial deformation with myocardial T1-relaxation time during extracellular volume (ECV) fraction mapping and the degree of focal fibrosis in each left ventricular (LV) segment in patients with hypertrophic cardiomyopathy (HCM).

Material and methods. A diagnostic test was carried out in 30 patients diagnosed with HCM and in a control group of 10 patients without LV pathology. Cardiac magnetic resonance imaging was performed on a 3.0 T Philips Achieva TX MRI scanner (Philips, Best, the Netherlands) in accordance of the specialized protocol using a 32-channel cardiac coil with heart rate synchronization and the use of gadolinium-based contrast agents at a dose of 0.3 ml/kg. LV T1 mapping was done using the Modified Look-Locker Inversion Recovery (MOLLI) sequences. Postprocessing was performed on Philips and CVI42 workstations. When the data were processed, T1-relaxation time was estimated before and after contrast enhancement.

Results. In all cases, myocardial thickness, extent of myocardial fibrosis, myocardial T1-relaxation time parameters, and ECV could be estimated according to the American Heart Association 16-segment coronary artery model. Before injection of contrast agent, the average LV T1 relaxation time in patients with HCM was 1317±94 msec which was significantly higher than that in the control group (1093±23.7 msec). ECV in the control group was lower (24.8±1.9%) than that in the HCM group (29.8±4.5%). In the univariable group, each index was related to myocardial deformation indicators (radial (Err-FT) and circular (Ecc-FT)) at the segment level. There was a moderate positive correlation between LV thickness and Ecc-FT (r=0.52; p<0.0001), a moderate negative correlation between Err-FT and LV hypertrophy (r=–0.5; p<0.0001), and between Err-FT and myocardial T1relaxation time prior to contrast enhancement (r=–0.5; p<0.0001).

Conclusion. Myocardial T1 time relaxation mapping before contrast enhancement has detected that ECV in patients with HCM is much higher than in those with the intact myocardium. LV deformation in patients with HCM correlates with changes in myocardial T1 time and the magnitude of myocardial hypertrophy and to a lesser extent with focal LV fibrosis. 

Objective.To estimate the clinical significance of compression syndromes accidentally detected by multislice computed tomography (MSCT) of the abdominal cavity and retroperitoneal space.

Material and methods. Intravenous bolus contrast-enhanced MSCT study was performed in 645 patients with different diseases of the abdominal cavity and retroperitoneal space. The information obtained after analysis of diagnostic images was compared with clinical symptoms and, in some cases, with intraoperative data.

Results. MSCT study identified prerequisites for the occurrence of compression syndromes in 71 (11%) patients of the study group, of whom 11 (15%) patients were noted to have relevant clinical manifestations. Surgical treatment was performed in 3 cases; medical treatment proved to be effective in the remaining 8 cases.

Conclusion. Compression syndromes were diagnosed in 11 (1.7%) of the 645 patients examined by MSCT for different diseases of the abdominal cavity and retroperitoneal space. Their timely and adequate diagnosis could rule out other diseases with similar clinical manifestations and define optimal tactics. 

Objective. To comparatively analyze the diagnostic capabilities of magnetic resonance imaging (MRI) of the spine and pelvic bones with the results of 18F-FDG positron emission computed tomography (PET/CT) and single-photon emission computed tomography (SPECT/CT) in the detection of skeletal metastases in patients with peripheral non-small cell lung cancer (PNSCLC) in order to elaborate optimal approaches to using radiation and nuclear diagnostic techniques.

Material and methods. Seventy-one patients with PNSCLC underwent a comprehensive examination of the skeleton regardless of whether they had clinical symptoms of bone lesions. MRI of the spine and pelvic bones, 18F-FDG PET/CT, and SPECT/CT were performed in all the patients with PNSCLC. The investigators analyzed MRI changes in different skeletal parts (cervical, thoracic, lumbar spine, sacrum and pelvic bones) in patients with PNSCLC and compared the findings with the results of a set of radiation and nuclear diagnostic techniques (18F-FDG PET/CT, SPECT/CT). The sensitivity, specificity and diagnostic accuracy of imaging techniques were compared. Clinical cases are presented.

Results. 18F-FDG PET/CT is superior to MRI for the detection of metastatic lesions of the spine and pelvic bones. The sensitivity, specificity, and diagnostic accuracy of MRI for the identification of metastases in the spine and pelvic bones were 95.65, 96.8, and 95.85%, respectively. Those of 18F-FDG PET/CT in the detection of bone metastases were 98.7, 99.9, and 99.6%, respectively.

Conclusion. 18F-FDG PET/CT is indicated for all patients with PNSCLC to rule out skeletal metastases. It is expedient to perform MRI if there are technical problems with 18F-FDG PET/CT for the detection of metastatic lesion of the spine and pelvic bones. 

Objective. To identify the possibility of multiparametrical magnetic resonance imaging (mpMRI) in the diagnosis of clinical recurrence of prostate cancer, with the aim of optimizing salvage radiation therapy (SLT).

Material and methods. In this prospective study, the results of 89 patients with marker relapse (PSA) of prostate cancer (PCa) after radical prostatectomy was examined. mpMRI of the pelvis was performed before the SLT and 6 months later. Separately, in 44 patients, the data of dynamic contrast enhancement (DCE) with different contrast agents (gadobutrol, gadodiamide and gadoversetamide) were analyzed.

Results. According to the model of multiple linear regression, the area of the substrate of clinical recurrence is statistically significantly correlated with the PSA level (R=0.74, p<0.0008), regardless of the all type of DCE administered. The sensitivity of mpMRI in detection of clinical recurrence of PCa was 92%, specificity 81%, accuracy 88%, which was assessed by comparison with PSA level. The use of the hypofractive radiation dose to the area of clinical recurrence of PCa, detected with mpMRI, showed a more progressive drop of the marker (PSA), compared to the standard SLT scheme (McNemarre test, p<0.03). A statistically significant correlations (by the Mann–Whitney criterion with p<0.018) from the signal change in DCE after the injection of contrast agents (different types) and the substrate area.

Conclusion. mpMRI has high sensitivity, specificity and accuracy to detecting the substrate of the clinical recurrence of PCa. The use of DCE for concentration of 1.0 mmol (gadobutrol) significantly increases the reliability of detecting clinical recurrence of PCa, especially when the substrate is found to small and ultrasmall sizes. The application of DCE with the contrast agents at the concentration of 1.0 mmol (gadobutrol) prior to initiation of SLT course, helps to plan the proposed radiation exposure zone, with the aim of providing the necessary for a complete resorption of the recurrent tumor, a high tumor dose of radiation to the clinical recurrence region. 

The review analyzes the data of modern literature on main methods for the diagnosis of spinal cord tumors. It reflects the possibilities of using diffusion-weighted MRI (DW-MRI), by constructing the maps of measured diffusion coefficients (ICD) and calculating the mean value of ICD in this pathology. The investigators have collected data on differential diagnosis and the assessment of the degree of malignancy of certain tumor groups on the basis of DW-MRI data. DW-MRI as compared with the data of standard T1- and T2-weighted images can serve as an additional method to diagnose spinal cord neoplasms of different nature at the preoperative stage for the determination of the volume of subsequent surgery.

The paper presents an update on endovascular methods for closure of the left atrial appendage in order to prevent thromboembolic events in patients with nonvalvular atrial fibrillation. It analyzes the results of occlusion devices as an alternative to longterm anticoagulant therapy from the standpoint of evidencebased medicine, advantages, and features of design and implantation of occlusion devices, such as Watchman, Amplatzer, WaveCrest, and Lariat system. Literature searching was carried out using the databases PubMed and Scopus.