Objective: to study the characteristics of the osseous orbit and its apex in health.

Material and methods. The computed tomography scans of 210 individuals (266 orbits) without orbital disease were examined.

Results. The paper presents linear indicators (horizontal input, vertical input, length) of the osseous orbit and its apex in health. It is emphasized that the volume of the osseous orbit and its apex in healthy men and women has statistically significant differences. Individual asymmetry of osseous orbital volumes in health was detected in 80.95% of the men and in 82.85% of the women; asymmetry of orbital fat volume was in 47.61% of the men and in 51.42% of the women.

Conclusion. The asymmetry of the mean normal osseous orbital volumes in the population is only within the margin of statistical error. At the same time the individual asymmetry of osseous orbital volumes in health is as much as 3.0 cm3; that of osseous orbital apical volumes is not greater than 1.0 cm3. The linear and volume characteristics of the osseous orbit and its apex are useful in estimating the degree of clinical symptoms. These should be kept in mind in the differential diagnosis of true and false exophthalmos and these can also play a crucial role in choosing surgical tactics.

Objective: to improve radiodiagnosis of orbital fractures at pre- and postoperative treatment stages, to provide a rationale for detailed evaluation of orbital osseous and soft tissue structures to prevent early postoperative complications.

Material and methods. The I.M. Sechenov First Moscow State   Medical University Clinic examined 52 (100%) patients on days 1–2 after injury. A patient group consisted of 49 (94%) men and 3 (6%) women whose age was 17 to 49 years. Multislice computed tomography (MSCT) was carried out prior to surgery on the day of their admission. Postoperative MSCT was done within 7–10 days after surgical treatment.

Results. Preoperative MSCT could reveal fractures of the inferior and lateral orbital walls in all 52 (100%) patients. Fractures of the medial and superior orbital walls were identified in 8 (15%) and 3 (6%) cases, respectively. In 12 (23%) patients, prolapse of the fat and oculomotor muscles into the respective maxillary sinus was imaged, which gave rise to enophthalmos and an increase in orbital volume. Three (6%) patients were identified as having sequels of   eyeball trauma. Optic nerve abnormality was detected in 11 (21%) patients. Oculomotor muscle injury was encountered in 20 (38%) patients. After surgical treatment, 4 (8%) patients had a persistent inferior orbital wall defect in the posterior portions where the retrobulbar fat prolapsed into the maxillary sinus. Three (6%) out of the 20 (38%) patients with different oculomotor abnormalities had persistent postoperative muscle injuries that were mainly associated with erroneous orbital floor implantation. The number of patients with eyeball disease remained unchanged – 3 (6%). Among 11 (21%) patients with a postoperative pathologically changed tortuous nerve course, the optic nerve attained its correct even course all the way in 5 (10%) cases; it remained pathologically changed as before in 6 (12%) cases.

Conclusion. MSCT is the preoperative technique of choice for examining patients with orbital injuries. After surgery, MSCT in the early postoperative period makes it possible to assess the results of treatment and to reveal possible complications and it is a decisive guide for a doctor in charge when planning resurgery.

Objective: to study the rate, nature, and symptoms of bile flow impairments running without developing suprastenotic dilatation.

Material and methods. A total of 1082 patients undergoing endoscopic retrograde cholangiopancreatography for the differential diagnosis of jaundices were followed up. According to the diameter of the common bile duct, the patients were classified into cholangioectasia and non-cholangioectasia groups. The investigators studied the causes of bile evacuation disorders; the levels of bilirubin, hepatic transferases, and alkaline phosphatase; the duration and periodicity of obstructive jaundice; еxtended compression of suprastenotic dilatation; the occurrence of other symptoms; and the efficiency of additional procedures for the differential diagnosis of hepatic and obstructive jaundices.

Results. There was no suprastenotic dilatation in 11 cases: in noncircular   amorphous internal hepatocholedochal blocks, in cicatrical stenoses of the hepatocholedoch, in excessive metastatic spread into the hepatic portal and parenchyma, extended stenosis of the common bile duct does not lead to intrahepatic cholangiectasia. In 9 cases, instrumental palpation and aspiration biopsy were used to visualize common bile duct stenosis in order to elucidate its nature, degree, and rigidity. Endobiliary stenting was employed for the differential diagnosis of jaundices.

Conclusion. No suprastenotic dilatation was seen in 0.8% of patients with organic bile flow impairment. In these cases, obstacles to bile flow may be suggested by clear-cut variations in the diameter of the hepaticocholedoch and its deformity. The absence of suprastenotic dilatation may be partly explained by excessive metastatic liver involvement and malignant hepatoduodenal ligament infiltration. When suprastenotic dilatation is absent, instrumental palpation and diagnostic and therapeutic stenting may be used for the differential diagnosis of obstructive and hepatic jaundices.

Objective: to develop a radiographic morphometric procedure for estimating the sizes and shapes of intervertebral spaces in the thoracic and lumbar spine and to evaluate the status of intervertebral spaces in women in health in terms of their age and in dystrophic transformations of intervertebral disks.

Material and methods. The data of a radiographic morphometric study of the sizes and forms of intervertebral spaces were analyzed in 127 women of different ages. Lateral thoracic and lumbar spondylograms performed in compliance with a number of requirements were used to estimate the sizes of anterior, middle, and posterior portions of intervertebral spaces (from T4 to L5); the magnitude of dystrophic changes in the intervertebral disks were determined applying  semiquantitative methods.

Results. The intervertebral space width of the lower segment was more than that of the upper one. The differences in the width of intervertebral spaces of the neighboring segments in the lower portions of the vertebral column were greater than those in its upper portions. The intervertebral spaces (T4-T12) were biconvex in shape and those in the upper lumbar segments were posterior wedgeshaped. There was no noticeable narrowing of the intervertebral spaces with age. The age group of 70 years or older showed a significant moderate increase in the height of intervertebral spaces in the middle and lower thoracic vertebral segments. In varying degrees of dystrophic intervertebral disc changes, their most pronounced manifestations were found to be accompanied by a decrease in the width of intervertebral spaces in the lower half of the vertebral column in conjunction with their normal shape being impaired.

Conclusion. The sizes and shape of intervertebral spaces show a number of regularities associated with the position of a segment in the vertebral column. In the bulk of the thoracic spine, the vertebral spaces are biconvex in shape and those in the transient thoracolumbar area and in the lumbar segment were posterior wedgeshaped. The age-related changes in the sizes and shape of intervertebral spaces are associated with their slight dilatation at the age of 70 years or older, without their normal shape being impaired. When dystrophic intervertebral disk changes develop, there is a moderate narrowing of intervertebral spaces in the lower half of the vertebral column in conjunction with a wedgelike alteration in their shape.

Objective: to estimate the capabilities of magnetic resonance imaging (MRI) in revealing bladder tumor in relation to its sizes and location and in diagnosing concomitant urodynamic disorders.

Material and methods. A total of 93 patients (78 men and 15 women; mean age, 62.1±12.2 years) with bladder cancer were examined. еxaminations were made using 1.5 T MRI according to an extended protocol with a mandatory inclusion of diffusion weighted images; dynamic contrast-enhanced MRI was carried out in 86 patients.

Results. There were single nodules in 48.7% of the patients and multiple bladder wall lesions in 51.3%. Bladder wall injury involving the  functional area of Lieutaud’s triangle was revealed in 67.5% of the patients. Single and multiple tumors in Lieutaud’ triangle were observed in 58.9 and 80.5% of cases. Ureteral orifice involvement led to secondary ureterectasia in 68.2%.

Conclusion. As the number of tumors detected in the bladder increases, the risk of tumors in Lieutaud’s triangle injury rises. The involvement of the triangle into the pathological process is accompanied by impaired urodynamics as ureterectasia in every four cases (26.8%; p < 0.008). It is shown that dynamic contrast-enhanced MRI must necessarily be  performed to better visualize a tumor and to determine its relationships to the underlying wall and basic structures of the bladder.

Objective: to estimate the capabilities of magnetic resonance imaging (MRI) in revealing and estimating the extent of secondary vaginal involvement.

Material and methods. Thirty patients with secondary vaginal tumor involvement underwent contrast-enhanced MRI. Examinations were made using a 1.5 T MRI. The protocol encompassed T2- and T1-weighted, diffusion-weighted, and dynamic contrastenhanced MRIs. To smooth out vaginal wall rigosity, the examination was made using an intracavitary MR-compatible applicator.

Results. Vaginal metastatic involvement was detected in 30 patients with sustained malignancies at various sites. The largest group consisted of 16 (53.3%) patients with uterine corpus metastases. Secondary vaginal involvement was observed in 11 36.7%) patients with cervix uteri cancer, in 2 (6.7%) patients with progressive ovarian cancer, and in 1 (3.3%) patients with rectal cancer. With a significant tumor volume giving rise to thickening of the vaginal wall or its impaired slice differentiation, the portion of an inhomogeneously increased MR signal portion during T2-weighted MRI, which intensively accumulated the paramagnetic in an arterial and venous phase of dynamic contrast-enhanced MRI, was detected. There were no T2-weighted images of a hypointense muscular layer and paravaginal fat streaks during an invasive process. In our investigation, vaginal metastatic tumors which were enclosed by the mucous membrane and evident as shallow erosion, as shown by the data of clinical and   рistological examinations, had no specific MRI signs in any of the pulse patterns, which is likely to be associated with the resolution of this technique.

Conclusion. The proposed protocol of comprehensive magnetic resonance imaging makes it possible to clearly localize a tumor process into the vagina and to determine the volume and pattern of involvement in most patients, including whose who have a history of antitumor treatment.

Early detection of drug-induced pulmonary parenchymal injuries is often hampered by nonspecific clinical and X-ray manifestations. The diagnosis is usually based on a history of drug use, clinical and X-ray presentation, and exclusion of other causes of lung tissue injury.
Chemical preparations most commonly cause pathological pulmonary changes. Overall, about 10% of all patients receiving chemotherapy develop pathological changes in the lung parenchyma. The main chemical preparations causing lung injury are bleomycin, methotrexate, carmustine, busulfan, and cyclophosphamide.

Out of all examination techniques, computed tomography is most sensitive in determining the presence, specific features, and trends in the development of drug-induced pulmonary parenchymal
disease.
The paper gives the data available in the literature and 2 clinical observations of  pulmonary parenchymal disease induced by bleomycin and methotrexate.