Objective: to study changes in the cross sectional optic nerve diameter (OND), by using multislice computed tomography (MSCT), in patients with mild traumatic brain injury  (TBI), as well as those with severe (including mixed) TBI before and  after craniotomy; to assess whether this technique can be integrated with a whole-body MSCT protocol in severe mixed TBI (MTBI).

Material and methods. OND was retrospectively studied in two  selected groups of patients with injuries (a total of 51 patients):  Group 1 (n = 40) included 2 subgroups (n = 20 in each) with mild  TBI or severe MTBI; Group 2 (n = 11) comprised 2 subgroups with  severe TBI who had undergone decompressive (n = 6) or  osteoplastic (n = 5) craniotomy with subsequent OND measurement  after 12–18 hours. 

Results. Primary brain MSCT showed that the average OND was  6.12±1,01 mm in severe MTBI and 4.4±0.19 mm in mild TBI (Student’s t = 5.707). After decompressive craniotomy, there  was a decrease in OND from 6.26±0.27 to 5.38±0.22 mm (Student’s t = 2.486).

Conclusion. Among the patients with severe MTBI, the OND at  primary MSCT is significantly greater than that in patients with mild  TBI, which may be due to elevated intracranial pressure, as shown  by the literature data. There is a statistically significant decrease in  OND after decompressive craniotomy and removal of the brain  compressive factor. Whole-body MSCT revealed no technical  obstacles to the application of an OND measurement technique.

Objective: to enhance the efficiency of diagnosis and treatment of  carotid paragangliomas, by introducing of a multidisciplinary approach into clinical practice.

Material and methods. A total of 15 cases of paragangliomas have been followed up for 10 years. The age of the patients was 18 to 58  years (mean age 38±12 years). Primary multiple sites of chemodectomas were noted in 2 cases. Bilateral involvement was observed in one case. In the other, two unilateral vascular  tumors successively developed with an interval of almost 6 years. A  set of studies was conducted, which embraced ultrasound duplex  scanning (USDS) of the neck vessels, computed tomography (CT), and selective carotid angiography (SCAG) in various  combinations. The investigators made a successive examination of  the symmetrical areas of the face and neck and polypositional  scanning of the zone of interest and studied quantitative parameters, including linear blood flow velocity (LBFV) and  volumetric blood flow velocity. Native and contrast-enhanced X-ray  CT and magnetic resonance imaging (MRI) were carried out. SCAG  was performed as digital subtraction angiography.

Results. USDS can confirm the hypervascular nature of the tumor  and its close relationship with the carotid artery branches and  measure blood flow velocity (LBFVmean, 0.46 m/sec). X-ray CT and  MRI examinations in combination with vessel contrasting make it  possible to accurately determine the localization and topography of  the tumor, its association with the carotid artery system and to type  afferent vessels. SCAG is a highly informative technique that can  identify the afferent vessels of the tumor and its relationship with  the great vessels and, if technically possible, perform selective  microembolization of the afferent tumor vessels, which will further facilitate surgical treatment, reducing the risk of intraoperative bleeding.

Conclusion. The multidisciplinary approach to diagnosing carotid  paragangliomas in the maxillofacial area and neck makes it possible  to determine the type, size, and velocity characteristics, to verify the  diagnosis, and to work out optimal treatment policy. Among the  non-invasive techniques, CT angiography and MR angiography are  most valuable for final diagnosis. Selective angiography of the  branches of the external carotid arteries remains the gold standard  and is the final and most important stage of the study, which make it possible to detail angioarchitectonics, to determine afferent vessels,  and to plan further treatment, including endovascular embolization.  The diagnosis of carotid paragangliomas requires a multidisciplinary  approach with the equal attraction of endovascular diagnosis and  treatment specialists, maxillofacial surgeons, angiologists,  ultrasound and radiology diagnosticians, and pathologists both at the  stages of diagnosis and subsequent treatment. This problem can be effectively solved in a multidisciplinary hospital that has skilled  staff with sufficient clinical experience in diagnosing vascular masses and is equipped with modern equipment, which allows  optimization of further treatment.

Objective. Discussion of the X-ray data in patients with epithelial tumors of the lacrimal gland.

Material and methods. We examined CT scans of 20 patients with  lacrimal gland epithelial tumors (20 orbits). Pleomorphic adenoma  was diagnosed in 9 patients, pleomorphic adenocarcinoma was  diagnosed in 11 patients. The computed tomogtaphy was performed  according to the standard method with obtaining axial and frontal  slices. The slicethickness was 1.0 mm, sliceinterval – 1.0 mm.

Results. The article presents data on the structure of lacrimal gland  epithelial tumors, considering their volume, dimension and density.  Based on the investigation results, the criteria for the differential diagnosis between pleomorphic adenoma and  adenocarcinoma have been established.

Conclusion. Computed tomography is an essential diagnostic technique for a suspected lacrimal gland tumor.  Pleomorphic adenocarcinoma is characterized by a greater density  and more heterogeneous structure compared to pleomorphic  adenoma. Nearly 3/4 of patients with pleomorphic adenocarcinoma  present changes in their orbital walls. The pleomorphic adenoma  can’t be ruled out in patients with the thinning of the orbital wall.

Objective: to assess whether computed tomography (CT) data can  be used for metal transitional spine fixation in patients with thoracic  and thoracolumbar scoliosis at the stage of surgical intervention planning.

Material and methods. Thirty-nine patients with grades 3 and 4  (according to V.D. Chaklin) or type I–III (according to the  classification proposed by L. Lenke) thoracic and thoracolumbar idiopathic scoliosis were examined. All the patients  underwent a comprehensive radiographic and CT examinations. The  radiomorphometric features of the spine were used to plan surgical interventions.

Results. The protocol was clarified for preoperative scoliosis examination using CT data on cervicothoracic and  thoracolumbar vertebrae. A personalized approach to planning an  operation on the basis of CT examination permits one to eliminate  destabilization of the supporting elements of the corrective system  at the most. Reducing the risk of postoperative losses of correction  contributes to the use of multi-rod constructs.

Conclusion. CT that enables a comprehensive assessment of existing pathology and clarification of the nature of impending surgery should be carried out in patients with thoracic  and thoracolumbar idiopathic scoliosis at the stage of preoperative  planning for metal transitional spine fixation.

Objective: to assess whether multislice computed tomography (MSCT) of the lung can be used to diagnose the early manifestations of heart failure in patients with coronary heart disease (CHD) during minimally invasive surgical interventions.

Material and methods. Lung MSCT was performed in 54 patients
aged 43 to 89 years with CHD before and after interventions. The  identified group included 24 patients who had undergone coronary  stenting, 26 who had cardiac pacemaker implantation, and 4  patients who had conduction pathways ablation. Left ventricular  failure was assessed by hemodynamic disorders in the pulmonary  circulation, by taking into account the use of known pathophysiological data. Successive lung MSCT examinations were performed before and after minimally invasive  surgical interventions, by recording local densitometric changes in  the lung parenchyma.

Results. A procedure was proposed to objectively assess comparable ling MSCT images in the same patient in the special  imaging window. The density of the lung parenchyma reduced by  more than 10 Hounsfield units in 24 patients in the next periods  after surgery, which was regarded as a sign of better left ventricular pumping function. 

Conclusion. The study showed that lung MSCT was highly sensitive  in diagnosing left ventricular dysfunction in patients with CHD with  improved coronary blood flow and normalized heart rate. 

Fossa navicularis magna was detected in multislice spiral computed  tomography in two patients who turned to the medical centers with  pathology of the paranasal sinuses. Its appearance is determined during  the development of the basilar part of the occipital bone and the body of the sphenoid bone in embryogenesis. This fossa has the  appearance of an edge defect on the ventral surface of the clivus in  CBCT scans. Practical radiologist should interpret such a finding as a  congenital anomaly of development, but not as an invasive lesion.

The paper gives data on the importance of osteoporosis, existing  approaches to its diagnosis, the specific features of a dual-energy X- ray absorption procedure to measure bone density, the  determination of main densitometric indicators, such as a T-score  and a Z-score, as well as their interpretation, by predicting the  probability of bone fractures. It shows the need for population-based  studies in Russia to set up a normative bone mineral density  base with regard to age- and gender-related differences and other  factors influencing the bone structure. The concept of a threshold for  intervention is discussed, which determines diagnostic and  therapeutic tactics depending on what risk group a patient belongs  to. It is noted that the surveys conducted among radiologists have  indicated that most specialists are poorly aware of the problem of  osteoporosis, its diagnosis, prevention, and treatment. 

Computed tomography (CT) with bolus contrast enhancement is the  main method of objectifying pancreatic pathology in pancreatic necrosis.  This is due to sufficiently high diagnostic accuracy, good  accessibility of the method, fast scanning time, simple interpretation of  the resulting images. At the present stage, perfusion CT of the  pancreas, threedimensional modeling of digital images, determination of anisotropy of pancreatic tissue allow improving the diagnostic efficiency of CT in patients with acute pancreatitis.