Репозиторий Университета

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: Assessing the dynamics of vulnerability of atherosclerotic plaques in patients with angina pectoris on atorvastatin therapy (40 mg for 10-12 months) based on coronary computed tomography angiography (CCTA) data. Materials and methods: The study prospectively enrolled 74 patients with angina pectoris not medicated with statins. All patients underwent CCTA. 30 patients with vulnerability of atherosclerotic plaques were selected for further observation and atorvastatin was administered to them at dose of 40 mg. Repeated tomography scans were recorded 10-12 months later. Images were analyzed by "Vitrea" workstation in a blind manner. Statistical processing was performed on SPSS version 11.5 software (BioStat). Results: Statistically insignificant decrease in: total plaque volume (from 188.64 ± 35.8 to 184.96 ± 34.45 mm3), low-attenuation plaque (from 60.46 ± 12.87 to 57.06 ± 12.34 mm3), degree of stenosis (from 41.6 ± 3.16 to 40.65 ± 3.26%), spotty calcification (from 86.0 to 90%), remodeling index (from 1.25 [1,0;1,4] to 1.1 [1,0;1,4]), napkin-ring sign (from 69.76 to 60%), irregularity of the contour (from 79.1 to 65%). LDL levels decreased from 3.23 ± 0.33 to 2.76 ± 0.27 mmol/L. Statistically significant decrease of total cholesterol was from 5.75 ± 0.45 to 4.42 ± 0.57 mmol/L. The study also revealed statistically significant positive correlation between decrease of LDL levels and total plaque volume decrease (R=0.51, P=0.002), mainly because of lowattenuation components. Conclusion: We review our experience of using CCTA for noninvasive monitoring of vulnerability of atherosclerotic plaques in dynamics and show that atherosclerotic plaques stabilize on long-term atorvastatin treatment.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Purpose. The aim of the study is an increasing frequency of predicting the results of remote shock wave lithotripsy in patients with nephrolithiasis. Matherials and methods. The study involved 127 patients with diagnosed urolithiasis with the presence of a single renal calculus from 10 to 17 mm in size. All patients underwent a complex of laboratory analyses, multispiral computed tomography. The concrement elimination was carried out by extracorporeal shock-wave lithotripsy. Results. In this study, there were no sufficient relationships between the maximum size and average density of stone and the number of extracorporeal lithotripsy sessions in patients with nephrolithiasis. On the contrary, the parameter of the "homogeneity" of the stone, reflecting its structure, showed a strong reliable relationship with the effectiveness of extracorporeal shock-wave lithotripsy, as well as high sensitivity and specificity. Using this indicator, it was possible to increase the percentage of successful procedures from 56,9% to 75,8%. Conclusion. The maximum size and average density of stone have insufficient diagnostic value in predicting the results of shock-wave lithotripsy in patients with single kidney stones 10-17 mm in size. In this case, an indicator of the "homogeneity" can be used to select the optimal method of treatment.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Purpose. The literature data and the results of our own research, which demonstrate the possibilities of using radiological research methods for the analysis of the lungs lesions in deceased patients, are presented. It is shown that the postmortem computed tomography (CT) allows to identify abnormalities of the chest bones, as well as to establish the presence, precise localization and volume of gas and air accumulations, including pneumothorax. The literature data on the comparison of postmortem CT lung characteristics, including the density of their tissue, with data of histological examination of lung preparations and causes of death in adult patients, are presented. It is noted that postmortem magnetic resonance imaging (MRI) is more expedient for the detection of the lungs pathology in dead fetuses and deceased newborns. The possibilities of postmortem MRI for the diagnosis of congenital pneumonia, hemorrhages in the lung tissue, pulmonary edema, hydrothorax, as well as for differential diagnosis of stillbirth and the death of a living newborn are shown. Differential diagnostic signs of pulmonary artery thromboembolism and postmortem blood clots are indicated. The possibilities of postmortem CT and MRI for noninvasive determination of the sizes and weight of the lungs, including for assessment of pulmonary hypoplasia in newborns with congenital diaphragmatic hernia, are described. It is concluded that the postmortem radiological methods of investigation can be used to analyze of the lung lesions and determine the causes of death. The combined use of CT and MRI is recommended for a full analysis. It is emphasized that postmortem radiological examination can not be an alternative to pathological and forensic autopsy. Radiological methods should be used as a supplement to the autopsy, including as a kind of "guide" for a better definition of pathological processes during the autopsy.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Lymphangioleiomyomatosis (LAM) is an orphan disease, which patterns have not been fully studied. The use various methods of diagnosing (computed tomography, HRCT, CT angiography, SPECT, PET-CT) allows to identify and to evaluate the spec-trum of thoracic and extra- thoracic changes in this disease. Purpose. To evaluate the clinical and radiation characteristics of thoracic and extra- thoracic changes in patients with LAM. Materials and methods. The study included 83 patients with morphologically con-firmed LAM. The average age of patients was 42.2 ± 6.3 years (w / m - 83/0). Clinical and X-ray were used in the complex examination of patients: radiography in two projections, com-puted tomography (CT), high-resolution CT (HRCT), and single-photon emission computed tomography (SPECT). If necessary: CT angiography - in 43 patients, PET-CT in 7 patients. Also, patients underwent a complex lung function examination (CLFE) and echocardiog-raphy. All patients were observed in dynamics (observation was 6.1 ± 4.2 years). Results. Analysis of the results of clinical and radiological investigation revealed the following variants of pulmonary manifestations of LAM: the nodular form was verified in 14 patients, diffuse in 65 patients and mixed in 4 patients. The diffuse form was divided ac-cording to the CT scan into 3 groups. The first group - with sporadic small cysts (14 pa-tients). During SPECT in patients of this group, no significant perfusion disorders were de-tected, while performing CLFE in patients of this group revealed manifestations of bronchial obstruction. The second group - with multiple large cysts (13 patients), during SPECT for the patients of this group was characterized by the presence, mainly in the central parts of lungs focuses of aperfusion, corresponding with anatomical localization of cysts. CLFE re-vealed pronounced manifestations of bronchial obstruction in combination with diffusion disorders. The third group - with multiple small cysts (38 patients) was characterized by the most unfavorable course: during SPECT in patients of this group, pronounced perfusion disorders were noted: extended hypoperfusion zones in both lungs, aperfusion areas in sub-pleural sections from both sides, according to the results of CLFE in this group of patients obstructive violations of breathing mechanics with a sharp deterioration of gas exchange conditions in the lungs (decrease in FEV1, diffusive capacity of the lungs) were revealed. Complications of the disease were determined in the majority of patients (54 patients - 63%): pneumothorax in 52 patients, chylothorax in 16 patients, pulmonary hypertension in 18 patients, pulmonary hemorrhage in 2 patients, lymphostasis in 9 patients. Extrathoracic changes were detected in 52 patients: kidney leiomyoma in 14 patients, uterine fibroids and uterine fibroids in 27 patients, liver in 3 patients, and extraorganic leiomyomas in 16 pa-tients. Conclusions. The use of a comprehensive clinical and radiation survey allows us to identify the signs of LAM in the early stages of the disease, in some cases avoid the use of surgical biopsy associated with a high risk of complications. The selection of various vari- ants of the flow of the diffuse form of LAM on the basis of the CT features of the picture, which correlate with functional disorders, allows the development of differentiated ap-proaches to therapeutic tactics and determining the prognosis of the disease.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: To investigate the prevalence of anatomic and pathologic findings in the maxillary sinus detected through cone-beam computed tomography (CBCT) in the routine of Stomatology. Materials and methods: The sample consisted of 954 CBCT scans from male (n: 330) and female (n: 624) patients aged between 2 and 86 years (mean age: 33 years). CBCT scans were taken from each patient for dental and maxillofacial diagnosis and treatment planning. The iCAT CBCT device and the inherent VisionQ software package (Imaging Science International, Hatfield, PA, USA) were used. X2 test was used to associate the anatomic and pathologic findings with patients' sex and age. Results: In both males and females, the most prevalent anatomic and pathologic findings in the maxillary sinus were, respectively, the sinus septa (21.2%) and thickening of the sinus mucosa (62.3%). Higher prevalence of maxillary sinus findings were detected within patients in the age range from 12 and 18 years (p<0.05). CBCT exams showed a high prevalence of anatomic and pathologic findings in the maxillary sinus that may have a significant clinical relevance. Conclusions: Stomatologists, Maxillofacial Surgeons and Physicians must properly interpret CBCT exams and must be aware of the occurrence of anatomic and pathologic findings prior to procedures that involve the maxillary sinus.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: To analyze and organize the basic techniques to reduce radiation exposure to patients with computed tomography (CT) scan of the head, chest, abdomen and pelvis. Materials and methods: The analysis of publications was carried out on the databases Scopus, Web of Science, MedLine and RINC. Results: The variants of the use of CT of the head, chest, heart, abdominal and pelvic organs in multidisciplinary institutions with different methods of reducing the dose burden on patients have been analyzed. Conclusion: The factors used to reduce the dose for CT can be systematized in three main ways: 1) methods that depend on the attending physician, radiologist and CT staff; 2) parameters of the research protocol; 3) features of CT-devices and software. Considering the factors reducing the radiation dose of patients in support of the need for CT examination, choice of parameters of the CT protocol, CT devices and software allows to significantly reduce the radiation burden on patients (by 10-78%) without compromising the quality of CT images. The development of methods to reduce the dose of irradiation of patients is extremely urgent, especially in screening, multiple CT studies and CT with contrast.

© 2018 Journal of Pathology Informatics. Background: Interest has grown into the use of multidetector computed tomography (CT) and magnetic resonance imaging as an adjunct or alternative to the invasive autopsy. We sought to investigate these possibilities in postmortem CT scan using an innovative virtual autopsy approach. Methods: Twenty-five postmortem cases were scanned with the Philips Brilliance CT-64 and then underwent traditional autopsy. The images were interpreted by two blinded forensic pathologists assisted by a radiologist with the INFOPSY® Digital Autopsy Software System which provides three-dimensional images in Digital Imaging and Communications in Medicine format. Diagnostic validity of virtual autopsy (accuracy rate, sensitivity, specificity, and predictive values) and concordance between the two forensic pathologists (kappa intraobserver coefficients) were determined. Results: The causes of death at traditional autopsies were hemorrhage due to traumatic injuries (n = 8), respiratory failure (5), asphyxia due to drowning (4), asphyxia due to hanging or strangulation (2), heart failure (2), nontraumatic hemorrhage (1), and severe burns (1). In two cases, the cause of death could not be ascertained. In 15/23 (65%) cases, the cause of death diagnosed after virtual autopsy matched the diagnosis reported after traditional autopsy. In 8/23 cases (35%), traditional autopsy was necessary to establish the cause of death. Digital data provided relevant information for inferring both cause and manner of death in nine traumatic cases. The validity of virtual autopsy as a diagnostic tool was higher for traumatic deaths than other causes of death (accuracy 84%, sensitivity 82%, and specificity 86%). The concordance between the two forensic pathologists was almost perfect (>0.80). Conclusions: Our experience supports the use of virtual autopsy in postmortem investigations as an alternative diagnostic practice and does suggest a potential role as a screening test among traumatic deaths.