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Journal of radiology and nuclear medicine

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No 4 (2015)
View or download the full issue PDF (Russian)
https://doi.org/10.20862/0042-4676-2015-0-4

5-11 8895
Abstract

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).

 

12-17 724
Abstract

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.

 

18-28 5301
Abstract

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.

 

29-34 1013
Abstract

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

46-53 1456
Abstract
Pulmonary hypertension is a menacing complication of a number of diseases, which is responsible for high mortality rates and considerably poorer quality of life in a patient. The timely detection for pulmonary hypertension allows timely initiation of treatment, thus improvement in prognosis in the patient. Chest X-ray is the most commonly used  radiographic technique for various causes. Physicians’ awareness about the radiographic manifestations of pulmonary hypertension may contribute to the earlier detection of this severe disease. Owing to the natural contrast of reflected structures, a chest X-ray film gives a unique opportunity to assess pulmonary circulation vessels, to reveal the signs of
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

54-61 1608
Abstract
Storage diseases (thesaurismoses, storage reticuloses) are the common name of a large group of hyperplastic non-leukemic diseases characterized by congenital or acquired metabolic disturbances and abnormal accumulation of metabolic products in blood and/or cells of different organs and by hyperplasia of mononuclear phagocyte elements in the liver, spleen, bone marrow, lymph nodes, and other organs, which makes the diseases systemic. Among the imaging techniques for diffuse liver diseases, ultrasonography and X-ray computed tomography are most commonly used for their diagnosis and follow-up. Magnetic resonance imaging (MRI) has the highest sensitivity and specificity in diagnosing liver diseases. The paper considers the current MRI procedures that are used to diagnose storage diseases and to quantify found changes. For Gaucher’s disease, the potentials of novel techniques, such as MR spectroscopy, diffusion-weighted imaging (DWI), and chemical shift imaging (Dickson’s method) for the estimation of revealed changes, are described. For hemochromatosis, the contribution of T2 WI to the quantification of iron overload in the liver parenchyma is depicted, which is an alternative invasive procedure in its determination.
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

35-39 724
Abstract
The paper presents a clinical case of jejunal duplication, a rare anomaly of the gastrointestinal tract. It describes an algorithm for hospital diagnostic and therapeutic measures. The capacities of radiodiagnostic studies, such as ultrasonography and magnetic resonance imaging, applied to this clinical case, are analyzed. The paper is supplemented by a concise review of the literature. An update suggests that there are diagnostic difficulties in this anomaly, even when a complete set of radiation techniques is applied and trained specialists participate.
40-44 596
Abstract
Based on the analysis of the data available in the literature and own clinical observations, the authors consider the diagnostic value of the little known scintigraphic phantom kidney
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.


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