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Journal of radiology and nuclear medicine

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Vol 101, No 3 (2020)
View or download the full issue PDF (Russian)
https://doi.org/10.20862/0042-4676-2020-101-3

ORIGINAL RESEARCH

136-146 990
Abstract

Objective. Atypical breast cysts are often quite a serious problem in noninvasive ultrasound differential diagnosis. To develop a system for automated analysis of grayscale ultrasound images, which on the principles of mathematical processing would make it possible to increase the specificity of diagnosis in this situation.

Material and methods. The authors developed the CystChecker 1.0 software package. To test this system, they used a set of 217 ultrasound images: 107 cystic (including 53 atypical lesions that were hardly differentially diagnosed by standard methods) and 110 solid (both benign and malignant) breast masses. All the masses were verified by cytology and/or histology. Visual assessment was carried out analyzing grayscale ultrasound, color/power Doppler, and elastography images.

Results. Using the system developed by the authors could correctly identify all (n = 107 (100%)) typical cysts, 107 (97.3%) of 110 solid masses, and 50 (94.3%) of 53 atypical cysts. On the contrary, the standard visual assessment provided a possibility of correctly identifying all (n = 107 (100%)) typical cysts, 96 (87.3%) of 110 solid masses, and 32 (60.4%) of 53 atypical cysts (p < 0.05). The corresponding values of the overall specificity of automated and visual assessments were 98 and 87%, respectively.

Conclusion. Using the system developed by the authors for automated analysis provides a higher specificity than the visual assessment of an ultrasound image, which is carried out by a qualified specialist.

147-154 1168
Abstract

Objective. To study the gluteal muscles in patients with scoliosis of various etiologies using multislice computed tomography (MSCT).

Material and methods. MSCT was first used to study the gluteal muscles of 27 patients with idiopathic scoliosis. The patients were examined to study the vertebral column in order to determine a method and tactics for scoliosis treatment. The muscles were additionally examined using workstations and programs for MSCT data processing. In a control group of 18 patients with no clinical manifestations of spinal and hip joint abnormalities or those detected on CT, their gluteal muscles were examined due to their pelvic organ diseases.

Results. Patients younger than 18 years of age who had spinal deformations of not more than 60 degrees had muscle changes as moderate hypotrophy, increased density, especially that of the gluteus medius muscle to 62.01 ± 7.20 HU. In patients over 18 years of age, the muscle density decreased at any magnitude of deformation and was the smaller the older patients were. In patients with spinal deformation greater than 90 degrees, the density of the gluteus maximus muscle on the convex side was significantly different from that on the concave side and was less on the concave side (p <0.05) than in those with a deformation of 60–90 degrees.

Conclusion. The results showed that in patients with scoliosis, the gluteal muscles were affected not only by the magnitude of deformation, but also by age. In patients over 18 years of age, muscle changes with equal magnitudes of deformation were more pronounced and were manifested by hypotrophy, atrophy, and fatty degeneration.

155-162 1130
Abstract

Objective. To determine the magnetic resonance imaging (MRI) morphological features of Baker’s cysts and to assess their correlation with the age of patients.

Material and methods. The investigation was based on the assessment of MRI readings in 37 patients with Baker’s cysts; of them there were 29 (78.4%) women and 8 (21.6%) men. The mean age of the examinees was 60.3 years (25 to 82 years).

Results. The mean dimensions of the cysts were measured. Their length, width, and height were 34 ± 2.1 mm, 5 ± 1.2 mm (range 4–31 mm), and 58 ± 2.9 mm, respectively. Their mean thickness was 0.7 mm. Intracystic chondral bodies were detected in 3 (7.5%) cases. These parameters were shown to be unrelated to age. It was found that all cysts were multi-chamber and an average of 6.8 chambers was detected. There was a weak, inversely proportional, statistically significant relationship between the age of the patients and the number of chambers in the cyst. The younger participants of the investigation exhibited no meniscal damage in an overwhelming case (57.1%); whereas complete and incomplete meniscal tears much more often occurred in older patients with Baker’s cysts (from 29 (78.4%) to 34 (91.9%) people, respectively).

Conclusion. Degenerative bone and cartilage tissue changes in the joint increase with age, regardless of the cyst sizes.

163-169 810
Abstract

Objective. To estimate the detection rate of brain arteriovenous malformations (AVMs) in the Chuvash Republic and their characteristics.

Material and methods. The results of CT angiographies performed at the Unit of Radiation Diagnosis in 2014–2017 were retrospectively analyzed.

Results. Over 4 years, brain AVMs were first detected in 29 patients (5–9 cases per year); of them 59% were men and 41% were women. The peak detectability occurred at the age of 31–40 years. AVMs were more frequently localized in the frontal and temporal regions. The high risk of surgery for AVMs according to the grading scheme by R. Spetzler and N. Martin (1986) occurred in 10% of cases. Besides AVMs, cerebral vascular aneurysms were detected in 14% of patients.

Conclusion. Small AVMs with a low risk of surgery are more common; however, there is a higher risk of hemorrhagic complications. The risk of cerebral hemorrhage is higher when AVMs are fed by the internal carotid arteries and drained into the deep veins. The likelihood of strokes in AVMs is 27% higher in patients with the open circle of Willis.

CASE REPORTS

170-174 1019
Abstract
Multiple primary colon cancer is an urgent medical problem of our time, which is associated with a steady increment in the incidence of the above disease and with the high complexity of its diagnosis. According to the literary sources, the incidence of this form of cancer of the colon has recently amounted to as much as 17% among all multiple primary neoplasms and this organ is a very common site. The paper describes a clinical case confirming the need for a thorough diagnosis of multiple primary colon cancer, by applying radiation techniques to further define treatment policies.
175-182 3184
Abstract
Tracheobronchomegaly is a rare developmental defect in children, which is characterized by the expansion of the trachea and large bronchi, the diagnosis and treatment of which are made more often in adult practice, when the clinical diagnostic picture acquires the obvious features of Mounier-Kuhn syndrome. In this connection, the need arises for the early detection of this pathology in children and its differentiation from other diseases and malformations of the tracheobronchial tree, which mask a recurrent inflammatory process in the lung and upper respiratory tract, and primarily with those, such as cystic fibrosis and primary ciliary dyskinesia.

The paper describes a case of secondary tracheobronchomegaly in a child with obvious clinical manifestations of Mounier-Kuhn syndrome in the presence of bronchiectasis, pulmonary fibrosis, and signs of systemic connective tissue disease. It discusses the possibilities of chest computed tomography in the diagnosis of this defect in children, as well as its causes. The sizes of the trachea and main bronchi in this patient are compared with those in the groups of children of the same age and sex who have cystic fibrosis or diffuse pulmonary fibrosis to identify a more significant role of hereditary connective tissue diseases in the development of secondary tracheobronchomegaly. The authors propose to separate the concepts of tracheobronchomegaly and Mounier-Kuhn syndrome in children and to recognize the threshold for tracheal expansion in these patients having +3SD or more.

REVIEWS

183-192 1610
Abstract
The literature review is devoted to the current radiation methods for studying vertebral hemangiomas. The significance of basic (radiography, computed tomography, and magnetic resonance imaging) and additional (Doppler ultrasound, scintigraphy, and selective angiography) diagnostic techniques is analyzed and their role in determining the indications for surgical treatment is clarified. The priority of computed tomography over other imaging methods for this pathology is established. The use of radiation therapy for vertebral hemangiomas at the present stage of medicine development is highlighted.


ISSN 0042-4676 (Print)
ISSN 2619-0478 (Online)