The paper presents Consensus Guidelines of Russian Society of Radiology (RSR) and Russian Association of Specialists in Ultrasound Diagnostics in Medicine (RASUDM) «Role of imaging (X-ray, CT and US) in diagnosis of COVID-19 pneumonia» (version 2) of the Russian Society of Radiology and the Russian Association of Specialists in Ultrasound Diagnostics in Medicine.
The guidelines list radiological techniques for lung diseases, which are used in coronavirus COVID-19 infection (chest X-ray, lung computed tomography (CT), and lung ultrasound (US), diagnostic algorithm, and follow-up study. The guidelines propose the models of the work of radiological rooms/departments of a healthcare facility, the procedure for conducting an examination, and recommendations for providing a description and assessing changes in the lung and chest in existing/suspected COVID-19-related pneumonia and present the schemes of X-ray and CT protocols at the initial examination and assessment of the changes.
Chest X-ray has a low sensitivity for detecting initial changes in the first days of the disease and is not recommended for early diagnosis. Mobile radiography is an important tool for diagnosis of lung pathology in the intensive care units.
CT is the most sensitive technique in detecting lung changes characteristic of COVID-19-related pneumonia. It is advisable to use CT for the initial evaluation of thoracic organs in patients with severe and progressive forms of the disease, as well as for the differential diagnosis and follow up.
Lung US in patients with suspected/known COVID-19-related pneumonia is an additional imaging method that does not replace or exclude X-ray and CT. If the correct procedure is followed, correct indications are selected, and trained medical personnel is available, this study is highly sensitive in detecting interstitial changes and consolidations in lung tissue, but only in their subpleural location. The US data do not always allow definite determination of the reasons for the occurrence and/or actual extent of lung tissue changes.
Standard reporting guidelines (CT, X-ray) about the possibility of COVID-19 pneumonia and its severity should be used.
The follow up using CT, X-ray, or US depends on the clinical indications that necessitate dynamic assessment. The recommended frequency of repeat CT and X-ray in patients having no substantial changes in their clinical condition outside the intensive care units is not more than once every 5-7 days. An objective assessment of the time course of changes is possible only when comparing the data of the same type of study.

Objective. To analyze the spectrum and frequency of inner ear anomalies in patients with congenital hearing impairment in Yakutia.
Material and methods. A total of 165 patients with congenital hearing impairment were surveyed. All the patients were examined by an audiologist, an educational audiologist, and a neuropsychiatrist. All the patients underwent X-ray computed tomography (X-ray CT) of temporal bone structures (which was supplemented by magnetic resonance imaging (MRI) in some cases).
Results. Based on modern ideas about inner ear anomalies and their classification, the authors first analyzed the spectrum and frequency of inner ear anomalies in patients with congenital hearing impairment in Yakutia. Inner ear malformations were identified in 16 (9.7%) of the 165 patients with hearing impairment, which corresponds to that in the previously studied samples of deaf people in different countries (from 3% to 35%). Of the inner ear structures, the cochlea and vestibule were more commonly affected. Abnormalities of the internal auditory meatus, semicircular canals, and vestibular aqueduct were less common. In general, the spectrum of anomalies was represented by 7 different malformations. Incomplete partition type II (IP-II) (34.3%) came first in incidence among all the abnormalities. Incomplete partition type III (IP-III) (18.7%) ranked second in incidence. The expansion of the internal auditory meatus (12.5%) and vestibular aqueduct (12.5%) occupied the third place. Inner ear anomalies occurred as concurrences that are difficult to interpret and classify in half (50%) of all the cases.
Conclusion. Analysis of the spectrum and frequency of temporal bone abnormalities in Yakutia suggests that every 10 patients with congenital hearing impairment have one or another inner ear structural malformation (9.7%) and require accurate and timely diagnosis using up-to-date X-ray CT and MRI techniques.

Objective. To assess the results of treatment involving radiation in combination with magnetotherapy for painful bone metastases in patients with breast cancer.
Material and methods. The paper presents data from a prospective study of treatment in 163 patients with bone metastases from breast cancer (a control group included 83 patients; a study group consisted of 80 patients). The metastases were more often localized in the vertebrae. Only radiation therapy was used in the control group and was combined with vortex magnetic field magnetotherapy in the study group.
Results. The subjective treatment effect by the presence of pain was more commonly recorded in the study group (100% vs 89.2%; p < 0.05). No significant differences in the treatment effect were found in patients with mild pain. In women with moderate pain, the full treatment effect occurred 1.4 times more frequently in the study group than in the control one; the rate of the partial treatment effect was close in the compared groups, and the patients with no effect were significantly fewer in the study group. In women with severe pain, the full treatment effect was noted in 60.5% and 84.1% in the control and study groups, respectively (p = 0.0163); no effect was recorded in 13.2% in the control group and in 0% in the study group (p = 0.0130); there were 26.6% and 15.9% of cases with a partial effect in the control and study groups, respectively (p = 0.2464). Analysis of the patients’ general status according to the Karnofsky performance scale index showed that the pretreatment index ranged from 50 to 70 points in most patients of the control group. After radiation therapy, the indices improved, rising up to 80 points in one-third of patients. Before the treatment, the index in the study group was the same as in the control one; but after treatment it considerably improved and was even equal to 100 points in 7 patients (3 with mild pain before treatment, 1 with moderate pain, and 3 with severe pain).
Conclusion. To improve the results of treating bone metastases, we recommend that radiation therapy be combined with a vortex magnetic field, which enhances the analgesic effect and improves the general condition of the patient and his/her quality of life.

Objective. To optimize a pelvic and lower abdominal cavity MRI protocol in the diagnosis of chronic pelvic pain (CPP) in women.
Material and methods. A total of 57 reproductive-aged women with complaints of CPP were examined. The first stage of all patients after clinical and laboratory examination for clinical indications was performed ultrasound of the pelvis and abdominal cavity with dopplerometry. In the second stage, all the patients underwent an MRI using the standard Protocol, and then a modified Protocol. The final diagnosis was based on the results of a comprehensive examination, which included a clinical and neurological examination, gynecological examination, pelvic and abdominal ultrasound, radiography of the ileosacral joints and lumbosacral spine, fibrocolonoscopy and laparoscopy with morphological examination of the operating material (according to indications).
Results. Forty-six (81%) patients were found to have gynecological factors for the development of CPP; 16 (28%) had extragenital factors. The examination results were verified by the data of surgical intervention (n = 16 (28%)), hysteroscopy (n = 21 (37%)), and laparoscopy (n = 9 (16%)) with morphological examination of biopsy specimens or surgical material.
Comparing with the standard pelvic MR protocol provided evidence for the high diagnostic value of the modified protocol statistically significantly (p < 0.05): 99.2% sensitivity and 99.6% specificity.
Conclusion. The developed non-contrast 1.5T MRI protocol for the pelvis permits MR images of the pelvis and adjacent anatomical areas to be obtained during one study without increasing time expenditures and upgrading equipment and software. The use of the protocol makes it possible to improve the quality of radiation diagnosis of gynecological and extragenital diseases in CPP and to recommend that the protocol in combination with other clinical and instrumental studies be introduced in clinical practice.

The artery of Percheron originates from the right or left posterior cerebral artery and is one of the options for normal blood supply to the paramedian portions of the thalamus. Stroke in this area has specific MRI changes, the most informative ones in diffusion-weighted imaging mode. With the involvement of the midbrain, its pial surface can display an additional pathognomonic V-shaped sign in 67%. The clinical manifestations are non-specific. In some cases, there is a triad of symptoms, which is distinguished into paramedian thalamic syndrome (vertical gaze palsy, neuropsychological disorders, and depressed level of consciousness up to coma). The symptoms of a midbrain lesion as oculomotor nerve group diseases, contralateral hemiparesis, hemiataxia or hemianesthesia, in combination with a triad, develop a thalamopeduncular or mesencephalon thalamic syndrome. The paper presents a clinical case of a 59-year-old man who was hospitalized with acute unconsciousness, a Glasgow coma scale of 13 scores, and disorientation. A neurological examination revealed vertical gaze palsy and upper limb ataxia. Brain MRI revealed characteristic bithalamic paramedian stroke. After completing the treatment, the patient was discharged showing incomplete clinical recovery.

The paper describes a clinical case of successfully applying a transradial access during mechanical thrombus extraction in a patient in the acutest stage of ischemic stroke with a congenital anatomical feature (the left common carotid artery and brachiocephalic trunk with the common ostium from the aortic arch).
X-ray endovascular interventions were performed in an operating room equipped with a digital angiographic unit including an Axiom Artis dTA flat detector (Siemens Medical System).
Mechanical recanalization for acute occlusion of the M2 segment of the left middle cerebral artery (MCA) was carried out using a right radial access into and catheterization of the left internal carotid artery. A stent retriever was inserted into the occlusion area through a microcatheter and was opened. Double thrombus extraction from the left MCA was made using the stent retriever to restore TICI 2B blood flow. There were no signs of dissection, thrombosis, or distal thromboembolism.