Objective. To study and analyze the significance of the degree and possibility of surgical resection of a brainstem tumor in children and adolescents on the results of treatment in relation to various prognostic factors.

Material and methods. This investigation enrolled 102 children with a brainstem tumor. A morphological study was not performed because of the location of the tumor and the inability to perform a surgical intervention. The patients’ mean age was 7.1 ± 3.4 years. The results of the study were assessed in terms of overall cumulative survival rates.

Results. Primary chemoradiotherapy was performed in 52 of the 102 patients; 50 children underwent repeat chemoradiotherapy. In the entire group, 89 (87%) patients received no surgical treatment;  while subtotal resection or ventriculoperitoneal bypass surgery (VBS) could be done in 13 (13%) children; the median follow-up of the entire group was 19.2 weeks. In the study groups, the statistical  differences in overall survival rates were significant (Log-Rank p = 0.044).

Conclusion. Regardless of primary or repeat  radiotherapy  and  chemotherapy, surgical intervention, including VBS in children and adolescents, significantly affects overall survival rates.

Objective. To optimize diagnosis of various variants of morphologically verified extrinsic allergic alveolitis (EAA), by determining the most significant clinical and radiological indicators of its development.

Material and methods.  Examinations were made in 82 patients  with morphologically confirmed EAA, including 10 people with acute EAA, 38 with subacute EAA, 26 with chronic EAA, and 8 with recurrent EAA. Their medical history data were studied; physical examination, clinical blood, pulmonary function (PF), and lung diffusing capacity tests, and high-resolution  computed tomography (HRCT) of the chest were performed. Transbronchial and/or  video-assisted thoracoscopic lung biopsies were used for morphological studies.

Results. Four disease course variants were identified. Disease duration, adherence to a specific antigenic effect, and the clinical, radiological, and morphological patterns of the disease were determined for its each variant.

Conclusions. 1. Acute EAA is characterized by an abrupt onset and rapid (no more than 3 months) development with a preponderance of intoxication syndrome (Cumulative Index (CI), 2.1 ± 0.2 scores); subacute EAA is characterized by a slower (8.5–10 months) development with a predominance of respiratory symptoms (CI, 2.5 ± 0.1 scores), the steady progression of which is observed in chronic EAA (CI, 2.9 ± 0.2 scores). Recurrent EAA  in  previously cured  patients  is  accompanied  by both  syndromes simultaneously  (CI, 2.7 ± 0.3). 2. The characteristic feature of acute EAA on HRCT of the chest is the extent of ground-glass opacity in both lungs (more than 3 segments) and perivascular infiltrates; that of subacute EAA is microfocal dissemination; that of chronic EAA is macrofocal changes in the presence of interlobular septal thickening, as well all the development of cystic changes in the subpleural zones. In recurrent EAA, all the listed symptoms may appear. 3. Enlarged intrathoracic lymph nodes are most common in subacute EAA in 45.9% of cases and less common in acute and chronic EAA in 20 and 23.8% of cases, respectively. In all disease variants, lymph node hypertrophy affects the bifurcation and paratracheal groups and less often the bronchopulmonary and tracheobronchial groups; the sizes vary from 11 to 20 mm with means of 13.0 ± 1.2 mm.

Objective.  To estimate the informative value of computed tomography (CT) in the planning of inferior vena cava (IVC) resection in patients with alveococcosis of the liver on the basis of the extent of contact of parasitic masses with its wall around the circumference.

Material and methods. CT studies and surgery protocols were retrospectively analyzed in patients with liver alveococcosis in the period between 2014 and 2017.

Results. The CT-measured extent of contact of parasitic masses along the circumference of IVC was compared with the intraoperative pattern for its involvement and with resection volume data. CT findings show that circular resection was not required in contact of parasitic mass with the IVC wall  over a 90° stretch; the resection could be performed in 29, 86, and 100% of patients in contact over 180, 270, 360° stretches, respectively.

Conclusion. CT can assess whether there may be IVC invasion when planning a surgical intervention.  The threshold value of the extent of contact of parasitic masses with IVC, as evidenced by CT, is 180°, at which the possibility of circular resection and vein prosthesis should be considered.

Objective. To assess accuracy in calculating the values of end-diastolic and end-systolic volumes (EDV and ESV), ejection fraction (EF), and left ventricular (LV) mass, which are obtained according to ECG-synchronized myocardial perfusion scintigraphy (ECG-MPS) on a CZT  camera versus those of cardiac multislice computed tomography (MSCT).

Material and methods. Thirty-four patients (mean age, 62 ± 5 years) with suspected coronary heart disease or its previously established diagnosis were examined. All the patients underwent MSCT coronary angiography and myocardial perfusion scintigraphy with ^99mTc-methyxy-isobutyl-isonitrile. For a comparative analysis, the investigators used the EDV, ESV, FV and LV mass values determined by ECG-MPS at rest and cardiac MSCT. The studies were conducted on a 64-slice SPECT/CT hybrid scanner (Discovery 570c, GE Healthcare, USA).

Results. The analysis of the results obtained by both methods revealed statistically significant differences in the values of EDV (MSCT: 168 (145–210) ml; ECG-MPS: 112 (94–141) ml; p < 0.05), ESV (MSCT: 72 (49–83) ml; ECG-MPS: 44 (32–66)  ml; p < 0.05), and LV  mass (MSCT:  123 (107–143)  g; ECG-MPS: 140 (124–168)  g; p < 0.05).  There were no significant differences in LV EF  (MSCT:  64 (54–69)%; ECG-MPS: 61 (50–66)%; p > 0.05).  There was a statistically  significant correlation between the values of EDV,  ESV,  and LV  mass (r = 0.81; r = 0.78; r = 0.82, respectively, p < 0.05) and a mean correlation of LV EF  (r = 0.66; p < 0.05). The Bland–Altman analysis showed that the values of EDV, ESV, and LV mass had statistically significant differences. The consistency limits for the indicators were as follows: EDV, 9–105 ml; ESV, 9–55 ml; LV  mass, 51.6–20.7  g. There was a measurement consistency only for EF  (consent  limits, 16.9–18.4%; p < 0.05). Linear regression equations were calculated, which allow determination  of exact values for the volume indices and LV mass according ECG-MPS data.

Conclusion. The scintigraphic method versus MSCT yields significantly smaller volumes (EDV and ESV) and higher LV mass. The  ECG-MPS values for EDV, ESV, EF, and LV mass have a statistically significant strong correlation with MSCT findings. At the same time, a good consistency of measurements was found only for LV EF.

PET/MRI is a new hybrid imaging technique that involves all achievements of modern magnetic resonance imaging (MRI) and positron emission tomography (PET). PET/MRI has advantages over other imaging methods and will most likely soon become the gold standard for visualization in some areas of radiodiagnosis. This clinical case demonstrates  the  first application  of PET/MRI  in Russia in a patient  with multiple endocrine neoplasia type 1. PET/MRI has yielded more accurate data than PET/CT and SPECT/CT.

Atrial fibrillation is the most common type of cardiac arrhythmia. Identification of an etiological factor for the occurrence and maintenance of atrial fibrillation is of paramount clinical importance and is a necessary condition for successful treatment.

The paper describes a clinical case of myocarditis diagnosed in a patient with atrial fibrillation resistant to drug therapy. Additionally, the patient underwent single-photon emission computed tomography/computed tomography with ^99mTc-pyrophosphate to diagnose a myocardial inflammatory process, followed by comparison of results and histological findings.