Objective: to assess the favorable and unfavorable types of lung tissue fibrotic changes in patients with interstitial lung diseases (ILD) detected by high-resolution computed tomography (HRCT).
Material and methods. The results of examinations were analyzed in 385 patients: 181 with respiratory organ sarcoidosis, 130 with fibrosing alveolitis, 36 with histiocytosis X, and 38 with lymphangioleiomyomatosis. All the patients underwent HRCT; the data were compared with the results of comprehensive functional study of external respiration (CFSER), histological examination (in 70.1%), and the pattern of the disease.
Results. Comparison of the clinical and functional course of ILD with the types of lung tissue fibrotic changes detected by HRCT and morphological examination showed that the favorable types of pulmonary fibrosis included stringy central and peripheral interstitial fibrotic changes and the atelectatic type of fibrosis, the occurrence of which failed to affect the development of obvious perfusion and diffusion disorders and to give rise to respiratory failure. The unfavorable types of pulmonary fibrosis included the peripheral pulmonary interstitial fibrotic changes (acinar fibrosis, honeycomb lung), which led to restrictive changes and perfusion disorders, which were accompanied by significant respiratory failure, decreases in quality of life and survival, as well as fibrotic changes in the walls of long-lasting air-containing cysts and a fibrotic cavity mass that resulted in complications (pulmonary hemorrhage, pneumothorax, and pneumomediastinum).
Objective: to investigate the quantitative X-ray manifestations of gonarthrosis in patients in different age groups.
Material and methods. The results of radiography, computed tomography, and 64-slice multidetector computed tomography (MDCT) were analyzed in 86 patients aged 18 to 70 years with arthrosis deformans of the knee.
Results. Knee radiographic anatomic changes in arthrosis deformans are accompanied by the characteristic rearrangement of the femoral and tibial condyles. Quantitative bone density changes appear as an overall decrease in the bone mineral density of the femoral and tibial condyles in 18–35-year-old patients with arthrosis deformans (p<0.05) and a relative increase in that of medial tibial condyles in patients older than 55/60 years, in those with genu varum in particular.
Conclusion. In the patients with arthrosis deformans, the bone radio morphological changes detected by MDCT have a much wider range of qualitative and quantitative characteristics. The data on condylar bone density are directly related to a treatment choice. Data postprocessing using the current visualization programs of working stations identifies minor bone structural changes that are also of importance in solving the tactical problems of medical and surgical treatments.
Objective: to elaborate the magnetic resonance imaging (MRI) signs of prostate cancer (PC) in accordance with the PIRADS classification during multiparametric MRI (mpMRI).
Material and methods. A total of 89 men aged 20 to 82 years were examined. A control group consisted of 8 (9%) healthy volunteers younger than 30 years of age with no urological history to obtain control images and MRI plots and 20 (22.5%) men aged 26–76 years, whose morphological changes were inflammatory and hyperplastic. The second age-matched group included 61 (68.5%) patients diagnosed with prostate cancer at morphological examination. A set of studies included digital rectal examination, serum prostate-specific antigen, and transrectal ultrasoundguided prostate biopsy. All the patients underwent prostate mpMRI applying a 3.0 T Achieva MRI scanner (Philips, the etherlands).
Results. The patients have been found to have mpMRI signs that were typical of PC; its MRI semiotics according to the PI-RADS classification is presented. Each mpMRI rocedure has been determined to be of importance and informative value in detecting PC.
Conclusion. The comprehensive mpMRI approach to diagnosing PC improves the quality and diagnostic value of prostate MRI.
Objective: to determine the efficiency of single-photon emission computed tomography (SPECT) with 99mTc-HMPAOlabelled leukocytes in diagnosing myocarditis, by comparing scintigraphic and histological data.
Material and methods. The investigation enrolled 35 patients with suspected myocarditis, who were planned to undergo coronaroventriculography or intervention with endomyocardial biopsy. Prior to endomyocardial biopsy, all the patients underwent myocardial scintigraphy using 99mTC-exametazime-labelled leukocytes. The results of myocardial scintigraphic and histological examinations were compared.
Results. Abnormal myocardial 99mTc-HMPAO-labelled leukocyte accumulation was detected in 7 (20%) examinees. Myocarditis was histologically verified in 9 (25.7%) persons. Our findings showed that the sensitivity of 99mTc-HMPAO-labelled leukocyte SPECT in diagnosing myocardial inflammatory changes was 62%; its specificity and diagnostic accuracy were 92% and 85%, respectively.
Conclusion. 99mTc-HMPAO-labelled leukocyte scintigraphy is today one of a few procedures for the primary noninvasive diagnosis of myocardial inflammation. However, in view of its sufficiently low sensitivity and laboriousness and the high cost of consumables, the technique is irrationally used in routine clinical practice.
LЕCTURES
pulmonary hypertension, and to estimate trends in the course of the disease.
The paper details a procedure for analysis and the normal radiographic anatomy of pulmonary circulation vessels, gives the present classification of pulmonary hypertension, and sets forth its X-ray semiotics.
REVIEWS OF LITERATURE
Incorporation of MRI into the examination algorithm for patients with storage
diseases will be able to improve the detection of these rare diseases and to monitor
the efficiency of performed therapy.
CLINICAL NOTE
phenomenon, a vascular pool that is detected at the angiographic stage of 99mТс-DTPA dynamic renal scintigraphy and that mimics a removed or absent kidney. The paper describes two cases of the phantom kidney. In one case, the phantom kidney
detected on the side of nephrectomy manifested a kidney cancer recurrence in the bed of the removed organ; in the other, the kidney-like vascular pool in the patient with left-sided pelvic dystopic kidney was due to the recording of the intestinal vasculature at the site of the expected kidney location. Adherence to a number of methodical conditions for conducting a study, as well as combined single-photon emission computed tomography/
computed tomography examination will be able to avoid interpretation errors and to ensure an adequate further diagnostic algorithm.
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