Pub Date : 2023-11-14DOI: 10.20862/0042-4676-2023-104-3-182-191
R. B. Amansakhedov, L. I. Dmitrieva, T. G. Smirnova, A. A. Veshkin, A. E. Ergeshov
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.
{"title":"Radiological Features of Changes in the Lungs Caused by Fast- or Slow-Growing Nontuberculous Mycobacteria","authors":"R. B. Amansakhedov, L. I. Dmitrieva, T. G. Smirnova, A. A. Veshkin, A. E. Ergeshov","doi":"10.20862/0042-4676-2023-104-3-182-191","DOIUrl":"https://doi.org/10.20862/0042-4676-2023-104-3-182-191","url":null,"abstract":"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.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":"117 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134957604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-14DOI: 10.20862/0042-4676-2023-104-3-222-238
S. P. Aksenova, N. V. Nudnov, A. V. Slanskaya, V. A. Solodkiy
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.
{"title":"To Help the Practitioner: Imaging of Ovarian Masses According to the O-RADS MRI Ovarian Malignancy Categorical Risk Scale","authors":"S. P. Aksenova, N. V. Nudnov, A. V. Slanskaya, V. A. Solodkiy","doi":"10.20862/0042-4676-2023-104-3-222-238","DOIUrl":"https://doi.org/10.20862/0042-4676-2023-104-3-222-238","url":null,"abstract":"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.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":"101 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134957620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-14DOI: 10.20862/0042-4676-2023-104-3-168-181
I. E. Tuyrin, D. A. Kuleshov, M. V. Samsonova, A. L. Chernyaev, E. V. Kusraeva, N. V. Trushenko, S. Yu. Chikina, S. N. Avdeev
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.
{"title":"Differential Diagnosis of Fibrotic Hypersensitivity Pneumonitis with Its Non-Fibrotic Phenotype and Usual Interstitial Pneumonia During High-Resolution Computed Tomography","authors":"I. E. Tuyrin, D. A. Kuleshov, M. V. Samsonova, A. L. Chernyaev, E. V. Kusraeva, N. V. Trushenko, S. Yu. Chikina, S. N. Avdeev","doi":"10.20862/0042-4676-2023-104-3-168-181","DOIUrl":"https://doi.org/10.20862/0042-4676-2023-104-3-168-181","url":null,"abstract":"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.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":"102 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134957753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-14DOI: 10.20862/0042-4676-2023-104-3-192-207
Yu. V. Varlamova, V. V. Saushkin, N. I. Ryumshina, D. S. Panfilov, B. N. Kozlov, S. I. Sazonova
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) cm 2 ; MSCT: 11.4 (10.3–13.3) cm 2 ; p = 0.009), AAo CSA(MRI: 17.6 (14.6–20.8) cm 2 ; MSCT: 19.6 (16.7–21.5) cm 2 ; 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) cm 2 ; MSCT: 19.7 (15.3–21.8) cm 2 ; 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) cm 2 ; MSCT: 7.4 (5.9–7.8) cm 2 ; p = 0.007), as well as CSA at the left atrium level (MRI: 4.9 (4.2–5.0) cm 2 ; MSCT: 5.1 (4.67–5.5) cm 2 ; 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
目的:比较多层螺旋计算机断层扫描(MSCT)和磁共振成像(MRI)计算的胸主动脉(ThAo)形态计量参数在操作者内部和操作者之间的可重复性。材料和方法。前瞻性研究纳入20例升主动脉(AAo)扩张(≥45 mm)患者。所有患者均在心电图门控模式下进行了MSCT和mri血管造影。测量血管收缩和舒张期不同ThAo水平下的平均直径(Dmean)和横截面积(CSA)。所有测量均由两名放射科医生进行。每组至少间隔1个月测量2次。采用类内相关系数研究重复测量的可重复性。结果。收缩期框架分析显示测量Dmean的方法(MRI: 42.5 (41.0-47.8) mm;MSCT: 37.7 (34.7-40.3) mm;p = 0.003)和CSA在窦管交界处水平(MRI: 14.8 (12.7-17.9) cm 2;MSCT: 11.4 (10.3-13.3) cm 2;p = 0.009)， AAo CSA(MRI: 17.6 (14.6-20.8) cm 2;MSCT: 19.6 (16.7-21.5) cm 2;p = 0.035)和左锁骨下动脉(LSA)近端水平的Dmean (MRI: 31.5 (31.0-34.0) mm;MSCT: 31.7 (27.3-32.9) mm;P = 0.041)。对于舒张框架，测量AAo CSA (MRI: 17.0 (14.5-19.7) cm 2;MSCT: 19.7 (15.3-21.8) cm 2;p = 0.025)， Dmean (MRI: 30.5 (29.3-32.8) mm;MSCT: 29.8 (27.1-31.3) mm;p = 0.05)和LSA近端的CSA (MRI: 7.5 (6.9-7.9) cm 2;MSCT: 7.4 (5.9-7.8) cm 2;p = 0.007)，以及左心房水平的CSA (MRI: 4.9 (4.2-5.0) cm 2;MSCT: 5.1 (4.67-5.5) cm 2;P = 0.042)。对于msct血管造影，在所有ThAo水平上获得了良好的操作者内部和操作者之间的测量再现性。对于mri血管造影，在确定主动脉弓和降主动脉水平的Dmean和CSA时，操作者内部和操作者之间存在很强的差异。结论。主动脉横截面积在MSCT和mri血管造影之间显示出最好的操作者内部和操作者之间的重复性和可比性
{"title":"Comparative Reproducibility Analysis of Thoracic Aorta Morphometric Parameters According to Computed Tomography and Magnetic Resonance Angiography","authors":"Yu. V. Varlamova, V. V. Saushkin, N. I. Ryumshina, D. S. Panfilov, B. N. Kozlov, S. I. Sazonova","doi":"10.20862/0042-4676-2023-104-3-192-207","DOIUrl":"https://doi.org/10.20862/0042-4676-2023-104-3-192-207","url":null,"abstract":"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) cm 2 ; MSCT: 11.4 (10.3–13.3) cm 2 ; p = 0.009), AAo CSA(MRI: 17.6 (14.6–20.8) cm 2 ; MSCT: 19.6 (16.7–21.5) cm 2 ; 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) cm 2 ; MSCT: 19.7 (15.3–21.8) cm 2 ; 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) cm 2 ; MSCT: 7.4 (5.9–7.8) cm 2 ; p = 0.007), as well as CSA at the left atrium level (MRI: 4.9 (4.2–5.0) cm 2 ; MSCT: 5.1 (4.67–5.5) cm 2 ; 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","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":"116 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134957469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-14DOI: 10.20862/0042-4676-2023-104-3-208-221
S. P. Shevkina, S. I. Zhestovskaya, V. V. Vyazmin, N. Yu. Shumilina
Objective: evaluation of the results of single-photon emission computed tomography (SPECT) with technetium-99m-methoxyisobutylisonitrile (99m Tc-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 99m Tc-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 99m Tc-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 99m Tc-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.
{"title":"Experience in Using Breast Single-Photon Emission Computed Tomography with <sup>99m</sup>Tc-MIBI","authors":"S. P. Shevkina, S. I. Zhestovskaya, V. V. Vyazmin, N. Yu. Shumilina","doi":"10.20862/0042-4676-2023-104-3-208-221","DOIUrl":"https://doi.org/10.20862/0042-4676-2023-104-3-208-221","url":null,"abstract":"Objective: evaluation of the results of single-photon emission computed tomography (SPECT) with technetium-99m-methoxyisobutylisonitrile (99m Tc-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 99m Tc-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 99m Tc-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 99m Tc-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.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":"100 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134957624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-07DOI: 10.20862/0042-4676-2023-104-2-124-137
R. Bashirov, L. Samoilenko, S. A. Ryzhkin, K. Vartanyan, D. A. Gimaletdinova, A. Yusupova, D. Abdulganieva, L. Ziganshina, E. S. Zamanova, E. V. Puzakin, A. Malov, B. Sharafutdinov
Objective: to evaluate the possibilities of dynamic scintigraphy for the diagnosis of esophageal dysmotility (ED) and gastroesophageal reflux (GER) in patients with systemic sclerosis (SS).Material and methods. The study group included 77 patients with established SS of different disease duration (from several months to 30 years) who underwent Technephyt 99mTc dynamic esophageal scintigraphy using two-stage protocol. During the first stage, the esophageal transport function was evaluated; during the second stage, the presence and severity of GER were assessed. Scans were analyzed using visual assessment, quantitative estimation of time/activity curves, and a proposed three-point scale for evaluating ED and GER severity. The control group consisted of 19 practically healthy individuals who underwent a routine examination to exclude digestive system and gastrointestinal tract diseases, the algorithm of which included dynamic scintigraphy.Results. ED was found in 74 of 77 patients (96%). According to three-point scale, severe ED (3 points) was registrated in 41 (55%) patients, moderate ED (2 points) in 15 (21%), and mild ED in 18 (24%). GER was diagnosed in 35 of 77 cases (45%): mild GER in 13 (37%), moderate GER (2 points) in 22 (63%), and none of the patients was found to have severe GER (3 points). A significant relationship between the presence of GER and the severity of ED was not obtained, but a direct correlation was established between ED and GER severity.Conclusion. Most SS patients demonstrated ED of varying severity associated with mild and moderate GER in nearly 45% of the cases. The study results confirm the practical significance of dynamic scintigraphy for assessing the esophageal transport function and GER in SS patients.
{"title":"Radionuclide Diagnosis of Esophageal Dysmotility and Gastroesophageal Reflux in Patients with Systemic Sclerosis","authors":"R. Bashirov, L. Samoilenko, S. A. Ryzhkin, K. Vartanyan, D. A. Gimaletdinova, A. Yusupova, D. Abdulganieva, L. Ziganshina, E. S. Zamanova, E. V. Puzakin, A. Malov, B. Sharafutdinov","doi":"10.20862/0042-4676-2023-104-2-124-137","DOIUrl":"https://doi.org/10.20862/0042-4676-2023-104-2-124-137","url":null,"abstract":"Objective: to evaluate the possibilities of dynamic scintigraphy for the diagnosis of esophageal dysmotility (ED) and gastroesophageal reflux (GER) in patients with systemic sclerosis (SS).Material and methods. The study group included 77 patients with established SS of different disease duration (from several months to 30 years) who underwent Technephyt 99mTc dynamic esophageal scintigraphy using two-stage protocol. During the first stage, the esophageal transport function was evaluated; during the second stage, the presence and severity of GER were assessed. Scans were analyzed using visual assessment, quantitative estimation of time/activity curves, and a proposed three-point scale for evaluating ED and GER severity. The control group consisted of 19 practically healthy individuals who underwent a routine examination to exclude digestive system and gastrointestinal tract diseases, the algorithm of which included dynamic scintigraphy.Results. ED was found in 74 of 77 patients (96%). According to three-point scale, severe ED (3 points) was registrated in 41 (55%) patients, moderate ED (2 points) in 15 (21%), and mild ED in 18 (24%). GER was diagnosed in 35 of 77 cases (45%): mild GER in 13 (37%), moderate GER (2 points) in 22 (63%), and none of the patients was found to have severe GER (3 points). A significant relationship between the presence of GER and the severity of ED was not obtained, but a direct correlation was established between ED and GER severity.Conclusion. Most SS patients demonstrated ED of varying severity associated with mild and moderate GER in nearly 45% of the cases. The study results confirm the practical significance of dynamic scintigraphy for assessing the esophageal transport function and GER in SS patients.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47460682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-07DOI: 10.20862/0042-4676-2023-104-2-151-162
V. Solodkiy, A. Kaprin, N. V. Nudnov, N. V. Kharchenko, O. Khodorovich, G. Zapirov, T. Sherstneva, Sh. M. Dibirova, L. Kanakhina
The relevance of implementing artificial intelligence (AI) technologies in the diagnosis of breast cancer (BC) is associated with a continuing high increase in BC incidence among women and its leading position in the structure of cancer incidence. Theoretically, using AI technologies is possible both at the stage of screening and in clarifying BC diagnosis. The article provides a brief overview of AI systems used in clinical practice and discusses their prospects in BC diagnosis. Advances in machine learning can be effective to improve the accuracy of mammography screening by reducing missed cancer cases and false positives.
{"title":"Сontemporary Medical Decision Support Systems Based on Artificial Intelligence for the Analysis of Digital Mammographic Images","authors":"V. Solodkiy, A. Kaprin, N. V. Nudnov, N. V. Kharchenko, O. Khodorovich, G. Zapirov, T. Sherstneva, Sh. M. Dibirova, L. Kanakhina","doi":"10.20862/0042-4676-2023-104-2-151-162","DOIUrl":"https://doi.org/10.20862/0042-4676-2023-104-2-151-162","url":null,"abstract":"The relevance of implementing artificial intelligence (AI) technologies in the diagnosis of breast cancer (BC) is associated with a continuing high increase in BC incidence among women and its leading position in the structure of cancer incidence. Theoretically, using AI technologies is possible both at the stage of screening and in clarifying BC diagnosis. The article provides a brief overview of AI systems used in clinical practice and discusses their prospects in BC diagnosis. Advances in machine learning can be effective to improve the accuracy of mammography screening by reducing missed cancer cases and false positives.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45511973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-07DOI: 10.20862/0042-4676-2023-104-2-138-142
M. M. Dunaikin, C. Kailash, E. D. Kireeva, N. L. Komarova, Y. Likar
Positron emission tomography combined with computed tomography (PET/CT) with 18F-fluoro-deoxyglucose (18F-FDG) plays an important role in the management of cancer patients and is mainly used for primary staging, evaluation of treatment response and detection of disease recurrence. Due to non-specific nature of 18F-FDG uptake, a radiologist must be familiar with both physiological and atypical distribution of radiopharmaceuticals. Inappropriate patient preparation for the study and/or taking certain drugs can lead to abnormal 18F-FDG distribution. Our clinical case demonstrates an atypical uptake of 18F-FDG in white adipose tissue in a child treated with glucocorticoids for a long time.
{"title":"Atypical Uptake of 18FDG in White Adipose Tissue During PET/CT in Children","authors":"M. M. Dunaikin, C. Kailash, E. D. Kireeva, N. L. Komarova, Y. Likar","doi":"10.20862/0042-4676-2023-104-2-138-142","DOIUrl":"https://doi.org/10.20862/0042-4676-2023-104-2-138-142","url":null,"abstract":"Positron emission tomography combined with computed tomography (PET/CT) with 18F-fluoro-deoxyglucose (18F-FDG) plays an important role in the management of cancer patients and is mainly used for primary staging, evaluation of treatment response and detection of disease recurrence. Due to non-specific nature of 18F-FDG uptake, a radiologist must be familiar with both physiological and atypical distribution of radiopharmaceuticals. Inappropriate patient preparation for the study and/or taking certain drugs can lead to abnormal 18F-FDG distribution. Our clinical case demonstrates an atypical uptake of 18F-FDG in white adipose tissue in a child treated with glucocorticoids for a long time.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45691080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-07DOI: 10.20862/0042-4676-2023-104-2-143-150
O. A. Zyuzina
Ladd’s syndrome is a violation of intrauterine intestinal rotation. The midgut remains fixed at one point at the origin of the superior mesenteric artery. As a result, conditions are created for the occurrence of a volvulus around the root of the mesentery and acute strangulation intestinal obstruction develops. Ladd’s syndrome includes three features: a high position of the caecum dome, duodenal hyperfixation, and lack of mesenteric fixation. In newborns, this condition is manifested by acute complete high strangulation intestinal obstruction, up to the development of shock. Examination for suspected Ladd’s syndrome should be comprehensive and include a survey abdominal radiography, abdominal ultrasound, gastric and duodenal radiography with oral contrast, irrigography. The article considers clinical cases of Ladd’s syndrome in newborns at the age of 3 and 5 days of life. Echograms made in B-mode using color Doppler sonography are presented. The high informativeness of ultrasound diagnostics for the detection of this syndrome in newborns with a clinic of bile vomiting is shown. In one of the observed cases, a pathognomonic echographic symptom of midgut volvulus was established (a whirlpool sign). In the second observation, a clearly defined vascular ring was not detected due to 180° torsion, which was subsequently confirmed intraoperatively.
{"title":"Ladd’s Syndrome in Newborns","authors":"O. A. Zyuzina","doi":"10.20862/0042-4676-2023-104-2-143-150","DOIUrl":"https://doi.org/10.20862/0042-4676-2023-104-2-143-150","url":null,"abstract":"Ladd’s syndrome is a violation of intrauterine intestinal rotation. The midgut remains fixed at one point at the origin of the superior mesenteric artery. As a result, conditions are created for the occurrence of a volvulus around the root of the mesentery and acute strangulation intestinal obstruction develops. Ladd’s syndrome includes three features: a high position of the caecum dome, duodenal hyperfixation, and lack of mesenteric fixation. In newborns, this condition is manifested by acute complete high strangulation intestinal obstruction, up to the development of shock. Examination for suspected Ladd’s syndrome should be comprehensive and include a survey abdominal radiography, abdominal ultrasound, gastric and duodenal radiography with oral contrast, irrigography. The article considers clinical cases of Ladd’s syndrome in newborns at the age of 3 and 5 days of life. Echograms made in B-mode using color Doppler sonography are presented. The high informativeness of ultrasound diagnostics for the detection of this syndrome in newborns with a clinic of bile vomiting is shown. In one of the observed cases, a pathognomonic echographic symptom of midgut volvulus was established (a whirlpool sign). In the second observation, a clearly defined vascular ring was not detected due to 180° torsion, which was subsequently confirmed intraoperatively.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41833037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-05DOI: 10.20862/0042-4676-2023-104-2-115-123
K. R. Bril, A. A. Pronkin, T. N. Galyan, V. V. Khovrin
Background . Vascular stiffness is an important predictor of cardiovascular disease. The vascular wall biomechanical parameters change not only in patients with genetic disorders of the connective tissue. This means that, regardless of etiology, the early detection of a progressive loss of aortic elasticity is of great clinical importance in preventing the development of severe complications. Assessment of aortic biomechanical parameters using magnetic resonance imaging (MRI) is a new level of visualization for aortic diseases allowing to improve surgical tactics and prevent complications. A number of biomechanical parameters determined by aortic MRI demonstrates the process of its wall remodeling, so their analysis will allow to develope an algorithm for the early diagnosis of aneurysms and the threat of acute aortic syndrome. Objective : using aortic MRI data, to evaluate the aortic biomechanical parameters and hemodynamics at pre- and postoperative stages and their impact on the occurrence of complications and relapses in the long-term period. Material and methods . Between 2020 and 2023, in Petrovsky Russian Scientific Center of Surgery, aortic MRI was performed prospectively before and after surgery in 107 patients with diagnoses of ascending aortic aneurysm (55 patients: 48 (87%) males and 7 (13%) females, mean age 79.4±14.91 years) and DeBakey type I and III aortic dissection, chronic stage (52 patients: 44 (85%) males and 8 (15%) females, mean age 54.32±10.41 years). Results . The quantitative data analysis in the postoperative period showed a decrease in the aortic wall elastic properties in the form of extensibility (0.4 [0.34; 0.54] %/mm Hg in the aneurysm group; 0.5 [0.25; 0.55] %/mmHg in the dissection group) and an increase in stiffness in the form of Young’s modulus (0.6 [0.38; 0.68] MPa in the aneurysm group; 0.5 [0.39; 0.83] MPa in the dissection group). Hemodynamic changes in the dissection group after surgery demonstrated a significant increase in values of maximum velocity in the descending aorta (78.6 [66.24; 130.78] cm/sec) and pressure gradient at the celiac trunk level (2.10 [1.76; 6.84] mm Hg). When assessing the pulse wave velocity parameter in both groups, high values were noted with a tendency to increase after surgery (in the aneurysm group, 7.7 [5.7; 20.3] cm/s before surgery versus 8.7 [6.5; 10.65] cm/s after surgery; in the dissection group, 9.7 [6.8; 12.9] versus 12.7 [7.7; 15.7] cm/s, respectively). Conclusion . Monitoring general hemodynamics and blood flow patterns together with an assessment of the aortic wall elasticity will make it possible to identify patients with borderline aortic dilatation. At the same time, studies of the aortic prosthetic segment are of particular interest. The obtained data on hemodynamic changes occuring at the border of the prosthetic and native segments of the operated aorta can confirm and justify the development of a complication in the form of distal stent graft-induced new ent
{"title":"Magnetic Resonance Imaging in the Diagnosis of Aortic Wall Elastic Properties Disorders and Its Hemodynamics","authors":"K. R. Bril, A. A. Pronkin, T. N. Galyan, V. V. Khovrin","doi":"10.20862/0042-4676-2023-104-2-115-123","DOIUrl":"https://doi.org/10.20862/0042-4676-2023-104-2-115-123","url":null,"abstract":"Background . Vascular stiffness is an important predictor of cardiovascular disease. The vascular wall biomechanical parameters change not only in patients with genetic disorders of the connective tissue. This means that, regardless of etiology, the early detection of a progressive loss of aortic elasticity is of great clinical importance in preventing the development of severe complications. Assessment of aortic biomechanical parameters using magnetic resonance imaging (MRI) is a new level of visualization for aortic diseases allowing to improve surgical tactics and prevent complications. A number of biomechanical parameters determined by aortic MRI demonstrates the process of its wall remodeling, so their analysis will allow to develope an algorithm for the early diagnosis of aneurysms and the threat of acute aortic syndrome. Objective : using aortic MRI data, to evaluate the aortic biomechanical parameters and hemodynamics at pre- and postoperative stages and their impact on the occurrence of complications and relapses in the long-term period. Material and methods . Between 2020 and 2023, in Petrovsky Russian Scientific Center of Surgery, aortic MRI was performed prospectively before and after surgery in 107 patients with diagnoses of ascending aortic aneurysm (55 patients: 48 (87%) males and 7 (13%) females, mean age 79.4±14.91 years) and DeBakey type I and III aortic dissection, chronic stage (52 patients: 44 (85%) males and 8 (15%) females, mean age 54.32±10.41 years). Results . The quantitative data analysis in the postoperative period showed a decrease in the aortic wall elastic properties in the form of extensibility (0.4 [0.34; 0.54] %/mm Hg in the aneurysm group; 0.5 [0.25; 0.55] %/mmHg in the dissection group) and an increase in stiffness in the form of Young’s modulus (0.6 [0.38; 0.68] MPa in the aneurysm group; 0.5 [0.39; 0.83] MPa in the dissection group). Hemodynamic changes in the dissection group after surgery demonstrated a significant increase in values of maximum velocity in the descending aorta (78.6 [66.24; 130.78] cm/sec) and pressure gradient at the celiac trunk level (2.10 [1.76; 6.84] mm Hg). When assessing the pulse wave velocity parameter in both groups, high values were noted with a tendency to increase after surgery (in the aneurysm group, 7.7 [5.7; 20.3] cm/s before surgery versus 8.7 [6.5; 10.65] cm/s after surgery; in the dissection group, 9.7 [6.8; 12.9] versus 12.7 [7.7; 15.7] cm/s, respectively). Conclusion . Monitoring general hemodynamics and blood flow patterns together with an assessment of the aortic wall elasticity will make it possible to identify patients with borderline aortic dilatation. At the same time, studies of the aortic prosthetic segment are of particular interest. The obtained data on hemodynamic changes occuring at the border of the prosthetic and native segments of the operated aorta can confirm and justify the development of a complication in the form of distal stent graft-induced new ent","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136082545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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