Objective. To validate MR-criteria used for diagnosis of trigeminal neuralgia (TN).
Material and methods. Study population consisted of 133 patients: with trigeminal neuralgia (86, surgically (56) and clinically (30) verified; 55 ± 11 years) and control group (47; 51 ± 16 years). The data were obtained using the FIESTA sequence (slice thickness 0.5 mm) on 3T and 1.5T (Discovery 750w and Optima 450w, General Electric).
Results. The diameters of the adjacent vessels on the symptomatic side were significantly bigger than the diameters on the asymptomatic side in patients with neuralgia (medians 1.2 and 1 mm, p<0.001). The shortest distances between nerves and vessels on the symptomatic side were significantly smaller than the distances on the asymptomatic side (medians 0 and 1.6 mm, p<0.001). The distances between points of closest neurovascular contact and pons on the symptomatic side were significantly smaller in comparison with the controls (medians 2.7 and 5.3 mm, p<0.001); the distances between the symptomatic and asymptomatic side were not statistically different (medians 2.7 and 3.9 mm, p=0.09) in this parameter. The lengths of closest neurovascular contact was bigger in patient with TN (medians 3 and 0 mm, p<0.05), as well as in comparison with the asymptomatic side (medians 3 and 0 mm, p<0.0001).
Conclusion. Noninvasive MR-measurements of the posterior cranial fossa vessels show the differences between the symptomatic and asymptomatic side in the patients with TN as well as healthy individuals. This result may be used as a predictor of TN.

Objective. To identify the anatomical variants of nasal bones and pyriform apertures in view of normal configuration of external nose and different types of aesthetic nasal deformities, to estimate its possible relations.
Material and methods. We performed a retrospective analysis of multi-slice computed tomography (MSCT) data of 2737 patients with the image processing (multiplanar and 3D-volume rendering). The sample comprised 121 patients with aesthetic nasal deformities (rhinokyphosis – nasal hump, long nose, combined deformity like a hidden hump, short nose, wide nose) and 37 individuals with normal European nasal configuration.
Results. The most frequent variants of pyriform apertures are drop, heart and pear types. The most common variants of nasal bones in all groups were II, V, VI types according to Lang and Baumeister. Every kind of deformities was described with their characteristic features of pyriform apertures and nasal bones.
Conclusion. Statistically proved correlation between the facts of deformities and variants of pyriform apertures and nasal bones was obtained. The preoperative study of variable anatomy must be always performed for improving functional and aesthetic results of rhinoplasty.

Objective. To compare cardiac ¹²³I-MIBG and ⁹⁹m Tc-MIBI single-photon emission computed tomography (SPECT) data in patients with primary pulmonary hypertension (PPH).

Material and methods. The study included 22 patients with confirmed diagnosis of PPH, with clinical status assessment, Holter ECG monitoring and rest cardiac ultrasound (US) data. All patients, as well as a group of healthy volunteers (n=20) underwent myocardial perfusion SPECT with ^99mTc-MIBI at rest and after treadmill exercise test, and myocardial neurotropic SPECT with ¹²³I-MIBG, performed in 15 min (early phase) and 4 hours (delayed phase) after MIBG administration. LV perfusion abnormalities were evaluated using standard SSS and SDS parameters, RV was assessed visually, RV/LV and IVS/LW uptake ratios were calculated. Global sympathetic activity (SA) was assessed with delayed heart/mediastinum ratio (H/M_d ) and MIBG Washout Rate in 4 hours (WR). Regional SA abnormalities were assessed using early Summed MIBG Score (SMS_e). MIBG RV/LV and LV IVS/LW uptake ratios were calculated. All parameters were compared with normal database (n=20).

Results. The values of a number of myocardial SPECT parameters, both perfusion (SSS, RV/LV_MIBI, IVS/LW_MIBI) and neurotropic (H/M_d, WR, SMS_e, IVS/LW_MIBG), were significantly worse in PPH patients compared to the control group (all p<0.05). Perfusion SPECT showed no significant (SDS>4) transient LV ischemia in all patients, but in 77% of cases IVS perfusion was stably impaired, causing overall SSS=7 (6–10), presumably due to IVS compression by dilated RV. MIBI RV/LV ratio was 0.61±0.02, indicating that RV was clearly visible, with inhomogeneous MIBI uptake in all cases, but without reliable perfusion defects. Values of H/M_d were 1.84±0.18, WR: 27±8%, with no reliable correlations with perfusion parameters. Regional SA defects also were located in IVS predominately, causing SMS_e mean value of 8 (6–10) and IVS/LW of 0.69±0.09, both parameters correlated with SSS (r=0.44, p=0.04 and r=-0.48, p=0.02, respectively). All parameters, except RV/LV_MIBG, had reliable correlations with systolic pulmonary artery pressure assessed by cardiac US, especially RV/LV_MIBI(r=0.64, p<0.01), WR (r=0.55, p=0.01) and IVS/LW_MIBG(r=-0.49, p=0.02).

Conclusion. Combination of myocardial neurotropic and perfusion SPECT has a certain diagnostic value in patients with PPH, since MIBG SPECT reflects SA downregulating, and MIBI SPECT reveals specific microcirculatory abnormalities in these patients, both possibly caused by myocardial pressure overload and responsible for angina-like symptoms.

Objective. To assess the importance of natural language processing (NLP) system for quality assurance of the radiological reports.

Material and methods. Multilateral analysis of chest low-dose computed tomography (LDCT) reports based on a commercially available cognitive NLP system was performed. The applicability of artificial intelligence for discrepancy identification in the report body and conclusion (quantitative analysis) and radiologist adherence to the Lung-RADS guidelines (qualitative analysis) was evaluated.

Results. Quantitative analysis: in the 8.3% of cases LDCT reports contained discrepancies between text body and conclusion, i.e., lung nodule described only in body or conclusion. It carries potential risks and should be taken into account when performing a radiological study audit. Qualitative analysis: for the Lung-RADS 3 nodules, the recommended principles of patient management were used in 46%, for Lung-RADS 4A – in 42%, and for Lung-RADS 4B – in 49% of cases.

Conclusion. The consistency of NLP system within the framework of radiological study audit was 95–96%. The system is applicable for the radiological study audit, i.e. large-scale automated analysis of radiological reports and other medical documents.

Pathomorphosis of tuberculosis and other lung diseases that have a similar clinical radiological and morphological picture leads to considerable difficulties and mistakes in the differential diagnosis of pulmonary processes. In particular, there are difficulties in the differential diagnosis of neuroendocrine lung tumors (NET) and pulmonary tuberculosis.

A clinical case of timely diagnosis of a neuroendocrine tumor in a young female patient without clinical symptoms typical for NETs has been described. The main manifestations revealed by chest CT scanning were single focal consolidations. The diagnosis was confirmed by histological studies of surgery samples.

Asthma and obesity prevalence in population have increased over the last years. In the Global Strategy for Asthma Management and Prevention (GINA, 2017) the “asthma-obesity” phenotype is identified, it has certain clinical features, disease course and response to therapy. One of the hypotheses explaining the relationship between asthma and obesity is the systemic inflammation theory. The visceral adipose tissue (VAT) plays a key role in this hypothesis, it produces various adipokines, imbalance of which results in the state of mild inflammation. With that only the body mass index (BMI) is used to diagnose obesity in asthma patients, but BMI doesn’t take into account the amount of VAT in the body.

The clinical case of a patient with asthma in combination with third degree of obesity is presented. Additionally the patient was given a multislice computed tomography to measure the visceral and subcutaneous fat areas, followed by an evaluation of the obtained data and a collation of the parameters with clinical and anthropometric characteristics.

Substantial changes have been recently made in the concept of the diagnosis of idiopathic pulmonary fibrosis. The concept of disease pathogenesis and the pathomorphologic criteria for diagnosing usual interstitial pneumonia have been revised. All idiopathic pulmonary fibrosis treatments that existed prior to 2011 have been found to be ineffective. This article analyzes the currently existing computer tomographic criteria for the diagnosis and differential diagnosis of idiopathic pulmonary fibrosis and considers the common causes of errors and the possibilities of improving the existing X-ray criteria.