Background. Diagnosis of hypersensitivity pneumonitis (HP) using high-resolution computed tomography (HRCT) is not an easy task. The most difficult aspects of the disease include differential diagnosis of its fibrotic (fHP) and non-fibrotic (nfHP) phenotypes, as well as their differentiation from usual interstitial pneumonia (UIP) in idiopathic pulmonary fibrosis. The determination of fibrous changes at an early stage of development can significantly accelerate the beginning of antifibrotic therapy and improve the prognosis.

Objective: to identify key HRCT signs for reliable differentiation of fHP and nfHP, to carry out differential diagnostics between fHP and UIP.

Material and methods. The data of 73 patients with morphologically verified HP, in whom HRCT had been performed, were retrospectively analysed. In 21 patients, nfHP was determined, and in 52 patients fHP was identified. The comparison group consisted of 24 patients with a typical radiological UIP pattern. The analysis of the changes detected during HRCT was carried out by qualitative and semi-quantitative methods. The significance of qualitative differences in a sign manifestation was assessed by Fisher’s exact test, semi-quantitative differences were evaluated using Mann–Whitney test.

Results. The results of the study allow to assume, that the presence and degree of manifestation of certain HRCT signs significantly differ between the selected groups of patients in qualitative and/or semi-quantitative terms. In cases of НP, the distribution of changes was mostly uniform and diffuse, with no clear predominance in certain lobes. In UIP, diffuse craniocaudal distribution took place, and in the axial plane, the changes were mainly subpleural in nature.

Conclusion. Based on the results of the study, it can be assumed that fHP significantly differs from nfHP in such features as the presence and degree of manifestation of ground glass and honeycombing symptoms, reticular changes and traction bronchiectases. When comparing the fHP and UIP groups, the distinctive signs of fHP were centrilobular nodules, mosaic pattern, as well as diffuse axial sign distribution.

Objective: to compare radiological features of pulmonary nontuberculous mycobacterioses (NTM) caused by fast- or slow-growing mycobacteria.

Material and methods. Radiological features of the disease were studied in 110 patients with newly diagnosed NTM. The patients were divided into two groups: 70 (63.6%) patients with slow-growing NTM and 40 (36.3%) with fast-growing NTM. The diagnosis was based on patient’s complaints, specified case history, radiological studies, clinical laboratory studies, sputum smear studies, bronchoalveolar lavage studies, different types of bronchial biopsies, and video-assisted thoracoscopic surgery resection samples. According to the results of high-resolution computed tomography (HRCT), a comparative analysis of the degree of involvement in the pathological process of such anatomical formations as parenchyma and stroma, vessels, bronchi, pleura and intrathoracic lymph nodes was carried out.

Results. The analysis of HRCT studies showed that fast-growing NTM is not characterized by gross deformation of bronchopulmonary structures. There is a more pronounced infiltrative phase with the involvement of vessels, pleura and bronchial lesions of smaller generations, the formation of broncho-bronchiolectasias and symptoms of bronchiolitis, faster clinical and radiological involution under dynamic observation. Slow-growing NTM is characterized by a more severe deformation of bronchopulmonary structures with the formation of different-sized bronchiectasis, bronchogenic cavities, a more torpid course of the inflammatory process.

Conclusion. Despite the similarities of clinical and radiological patterns of NTM, we established some distinguished features for slow-growing and fast-growing types.

Objective: to compare intra- and inter-operator reproducibility of thoracic aorta (ThAo) morphometric parameters, calculated by multislice computed tomography (MSCT) and magnetic resonance imaging (MRI).

Material and methods. The prospective study included 20 patients with ascending aorta (AAo) dilatation (≥45 mm). All patients underwent MSCT- and MRI-angiography in electrocardiogram-gated mode. Mean diameter (Dmean) and cross-sectional area (CSA) were measured at different ThAo levels in the systole and diastole along the inner contour of the vessel. All measurements were performed by two radiologists. Each of them took measurements twice at an interval of at least 1 month. The reproducibility of repeated measurements was studied using intraclass correlation coefficient.

 Results. The analysis of the systolic frame revealed significant differences between the methodsfor measuring Dmean (MRI: 42.5 (41.0–47.8) mm; MSCT: 37.7 (34.7–40.3) mm; p = 0.003) and CSA at the level of the sinotubular junction (MRI: 14.8 (12.7–17.9) cm²; MSCT: 11.4 (10.3–13.3) cm²; p = 0.009), AAo CSA(MRI: 17.6 (14.6–20.8) cm²; MSCT: 19.6 (16.7–21.5) cm²; p = 0.035) and Dmean at the level proximal to left subclavian artery (LSA) (MRI: 31.5 (31.0–34.0) mm; MSCT: 31.7 (27.3–32.9) mm; p = 0.041). For the diastolic frame, significant differences between the methods were observed when measuring AAo CSA (MRI: 17.0 (14.5–19.7) cm²; MSCT: 19.7 (15.3–21.8) cm²; p = 0.025), Dmean (MRI: 30.5 (29.3–32.8) mm; MSCT: 29.8 (27.1–31.3) mm; p = 0.05) and CSA at the level proximal to LSA (MRI: 7.5 (6.9–7.9) cm²; MSCT: 7.4 (5.9–7.8) cm²; p = 0.007), as well as CSA at the left atrium level (MRI: 4.9 (4.2–5.0) cm²; MSCT: 5.1 (4.67–5.5) cm²; p = 0.042). For MSCT-angiography, good intra- and inter-operator reproducibility of measurements at all ThAo levels was obtained. For MRI-angiography, there was a strong intra- and interoperator variability in determining Dmean and CSA at the levels of aortic arch and descending aorta.

Conclusion. Aortic cross-sectional area showed the best intra- and inter-operator reproducibility and comparability of measurements between MSCT- and MRI-angiography

Objective: evaluation of the results of single-photon emission computed tomography (SPECT) with technetium-99m-methoxyisobutylisonitrile ^(99mTc-MIBI⁾ in women with breast masses according to mammography (MMG) and ultrasound (US) examination in comparison with the results of morphology analysis.

Material and methods. SPECT with ^99mTc-MIBI was performed in 11 women aged from 30 to 63 years (median age 40 [33.5; 46.5]) with BI-RADS (Breast Imaging Reporting and Data System) categories 4 or 5 mammary masses according to bilateral MMG and US diagnostics. Two patients underwent repeated SPECT and US to analyze the primary tumor response to neoadjuvant chemotherapy.

Results. With a multimodal approach to the diagnosis of breast tumors, including MMG and US, 11 pathological masses were identified. SPECT made it possible to find an additional mass that had not been previously visualized. All 12 masses were subsequently verified morphologically. With benign changes, hyperfixation of ^99mTc-MIBI was not observed. SPECT allowed to assess the accumulation of the radiopharmaceutical in metastatically affected lymph nodes. However, the most sensitive method for detecting the axillary lymph node lesions is US. According to the results of repeated SPECT in 2 patients, no radiopharmaceutical accumulation was noted in mammary gland masses after two courses of neoadjuvant chemotherapy, but according to the histological examination, the tumor response was different: I and IV degrees of pathomorphosis according to G.A. Lavnikova

Conclusion. The experience of using mammary SPECT with ^99mTc-MIBI confirms an increase in the accuracy of radiologic diagnosis of newly identified breast cancer, expands the possibilities of examination in cases of ambiguous MMG and US data, as well as the contraindications or patient’s refusal from magnetic resonance imaging.

Objective: to study the informativity of the Ovarian-Adnexal Imaging-Reporting-Data System Magnetic Resonance Imaging (O-RADS MRI) in detection of ovarian cancer in the practice of a radiologist.

Material and methods. The study included 271 women who underwent pelvic magnetic resonance imaging (MRI) in the period from August to November, 2021. Two radiologists with 6-year (Researcher 1) and 2-year (Researcher 2) experience retrospectively analyzed MR images, in which all ovarian masses were evaluated according to O-RADS MRI categorical risk scale from 0 to 5. The analysis of true positive, true negative, false positive and false negative rates according to MRI data compared to the reference data (histology or 1-year follow-up) was performed.

Results. O-RADS MRI categorial risk scale had high diagnostic performance for the characterization of adnexal lesions (sensitivity 87.5% and 87.5%, specificity 97.84% and 96.75%, area under curve (AUC) 0.991 and 0.986 for Researchers 1 and 2, respectively), as well as good interreader agreement (Cohen’s kappa coefficient 0,83). Researchers’ mistakes were analyzed, as well as controversial issues of categorial affiliation of ovarian masses that caused false positive and false negative results. Visual aids for ovarian MRI in accordance with O-RADS MRI classification were made for quick orientation in the system to simplify creating the radiology report.

Conclusion. O-RADS MRI categorial risk scale proved to be a reliable working tool for the communication between radiologist and gynecologist-oncologist. However, the question of categorial affiliation of a number of nosological names that are not reflected in O-RADS MRI and require further study continues to be debated.