Pub Date : 2022-10-26DOI: 10.20862/0042-4676-2022-103-4-6-52-57
D. K. Yudin, S. А. Gette
Background. The existing variety of approaches to the treatment of temporomandibular joint (TMJ) dysfunction corresponds to the variety of methods for its diagnosing. The absence of a universal technique of updating a particular diagnostic method data makes it impossible to evaluate the effectiveness of treatment.Objective: to evaluate the universality of magnetic resonance imaging (MRI) in the diagnosis and determination of tactics for the treatment of TMJ pathologies.Material and methods. One hundred patients of different age groups and genders with and without TMJ pathology were divided into groups according to Angle’s classification: Class 1 – 27 persons, Class 2 – 41, Class 3 – 32. The studies were carried out using Green 18 computer tomograph (Vatech, South Korea), Optima MR450W magnetic resonance tomograph (General Electric, USA), Dentograph digital Roshchin axiograph (Prosystom, Russia), SAM 2PX articulator (SAM Praezisionstechnik GmbH, Germany). The RadiAnt Viewer software was used.Results. We conducted a comparative analysis of the indicators of articular structures mutual disposition obtained using various methods of TMJ diagnosis. A technique for estimating TMJ parameters using the analysis of MRI data was proposed. A correlation was revealed between the indications obtained using various diagnostic methods.Conclusion. The developed method of TMJ structures analysis has high accuracy and is applicable in practice.
{"title":"Method of Analysis of the Temporomandibular Joint Parameters According to Magnetic Resonance Imaging","authors":"D. K. Yudin, S. А. Gette","doi":"10.20862/0042-4676-2022-103-4-6-52-57","DOIUrl":"https://doi.org/10.20862/0042-4676-2022-103-4-6-52-57","url":null,"abstract":"Background. The existing variety of approaches to the treatment of temporomandibular joint (TMJ) dysfunction corresponds to the variety of methods for its diagnosing. The absence of a universal technique of updating a particular diagnostic method data makes it impossible to evaluate the effectiveness of treatment.Objective: to evaluate the universality of magnetic resonance imaging (MRI) in the diagnosis and determination of tactics for the treatment of TMJ pathologies.Material and methods. One hundred patients of different age groups and genders with and without TMJ pathology were divided into groups according to Angle’s classification: Class 1 – 27 persons, Class 2 – 41, Class 3 – 32. The studies were carried out using Green 18 computer tomograph (Vatech, South Korea), Optima MR450W magnetic resonance tomograph (General Electric, USA), Dentograph digital Roshchin axiograph (Prosystom, Russia), SAM 2PX articulator (SAM Praezisionstechnik GmbH, Germany). The RadiAnt Viewer software was used.Results. We conducted a comparative analysis of the indicators of articular structures mutual disposition obtained using various methods of TMJ diagnosis. A technique for estimating TMJ parameters using the analysis of MRI data was proposed. A correlation was revealed between the indications obtained using various diagnostic methods.Conclusion. The developed method of TMJ structures analysis has high accuracy and is applicable in practice.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47900524","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 : 2022-10-26DOI: 10.20862/0042-4676-2022-103-4-6-58-70
S. P. Aksenova, N. Nudnov, V. Solodkiy
Background. A wide variety of pulse sequences, the possibility of multiplanar imaging significantly increase the capabilities of magnetic resonance imaging (MRI) in diagnosing diseases of the female reproductive system. At the same time, the lack of a regulated scanning protocol, especially in patients who have undergone anticancer treatment, requires standardization of the technique and the search for an optimal set of pulse sequences that allows to visualize the vagina throughout its entire length and to perform differential diagnosis between continued tumor growth and post-radiation changes while maintaining an adequate examination time.Objective: to determine the optimal set of MRI pulse sequences for pelvic organs examination in patients with vaginal tumors and to form an original research protocol based on diagnostic information content.Material and methods. The study included 141 patients with vaginal tumors. A comparative analysis of four MRI protocols was carried out, built according to the principle “from simple to complex” (from native to multiparametric MRI).Results. A significant difference was obtained between all information content indicators of Protocol 4 compared to Protocol 1 (sensitivity p = 0.00006, specificity p = 0.00443, AUC p = 0.00000). Data analysis also showed a significant difference between sensitivity and AUC for Protocols 2 and 4 (p = 0.00150 and p = 0.00087, respectively), and Protocols 3 and 4 (p = 0.01333 and p = 0.01333, respectively).Conclusion. Significant increase in the information content of Protocol 4 compared to other protocols (sensitivity up to 93%, specificity up to 94%, accuracy up to 93%) indicates the expediency of the priority use of multiparametric MRI in the primary diagnosis of vaginal tumor lesions.
{"title":"Search for Optimal MRI Protocol for the Diagnosis of Vaginal Tumor","authors":"S. P. Aksenova, N. Nudnov, V. Solodkiy","doi":"10.20862/0042-4676-2022-103-4-6-58-70","DOIUrl":"https://doi.org/10.20862/0042-4676-2022-103-4-6-58-70","url":null,"abstract":"Background. A wide variety of pulse sequences, the possibility of multiplanar imaging significantly increase the capabilities of magnetic resonance imaging (MRI) in diagnosing diseases of the female reproductive system. At the same time, the lack of a regulated scanning protocol, especially in patients who have undergone anticancer treatment, requires standardization of the technique and the search for an optimal set of pulse sequences that allows to visualize the vagina throughout its entire length and to perform differential diagnosis between continued tumor growth and post-radiation changes while maintaining an adequate examination time.Objective: to determine the optimal set of MRI pulse sequences for pelvic organs examination in patients with vaginal tumors and to form an original research protocol based on diagnostic information content.Material and methods. The study included 141 patients with vaginal tumors. A comparative analysis of four MRI protocols was carried out, built according to the principle “from simple to complex” (from native to multiparametric MRI).Results. A significant difference was obtained between all information content indicators of Protocol 4 compared to Protocol 1 (sensitivity p = 0.00006, specificity p = 0.00443, AUC p = 0.00000). Data analysis also showed a significant difference between sensitivity and AUC for Protocols 2 and 4 (p = 0.00150 and p = 0.00087, respectively), and Protocols 3 and 4 (p = 0.01333 and p = 0.01333, respectively).Conclusion. Significant increase in the information content of Protocol 4 compared to other protocols (sensitivity up to 93%, specificity up to 94%, accuracy up to 93%) indicates the expediency of the priority use of multiparametric MRI in the primary diagnosis of vaginal tumor lesions.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42706846","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 : 2022-10-25DOI: 10.20862/0042-4676-2022-103-4-6-6-17
F. Lozbenev, T. Morozova
Objective: to evaluate the current possibilities of diffusion-weighted imaging (DWI) in liver magnetic resonance imaging (MRI) for the diagnosis of alcoholic liver disease (ALD).Material and methods. The examined patients were at the inpatient and outpatient stages of observation in the gastroenterology department on the basis of the Clinical Hospital No. 1 (Smolensk) and received treatment for diffuse liver diseases of alcoholic etiology. The study included 128 patients: 76 (59%) males and 52 (41%) females, mean age 42.3 ± 4.7 years. Patients were monitored from 2019 to 2022. All of them underwent abdominal organs ultrasound with liver clinical elastography and liver MRI with DWI; in 34 cases liver multi-slice computed tomography was performed.Results. When comparing the results of a qualitative assessment of liver DWI MRI with the CAGE (Cut, Annoyed, Guilty, Eye-opener) test data and the results of patients and relatives survey about the use of alcoholic beverages, a high correlation was established between the diffusion restriction in the liver during MRI and impaired withdrawal regimen (r = 0.901). The diagnostic and prognostic significance of the developed criteria for liver DWI MRI in patients with ALD at admission was assessed: for qualitative assessment AUROC 0.827 (95% CI 0.792–0.873), for quantitative assessment AUROC 0.949 (95% CI 0.912–0.981); in dynamic observation: for qualitative assessment AUROC 0.958 (95% CI 0.925–0.984), for quantitative assessment AUROC 0.947 (95% CI 0.947–0.981).Conclusion. The obtained quantitative indicators of liver DWI MRI make it possible to predict the clinical form of ALD: apparent diffusion coefficient for steatosis is 2.66 ± 0.9 × 10–3 mm2/s, for steatohepatitis – 2.14 ± 0.5 × 10–3 mm2/s, for hepatitis – 1.75 ± 0.6 × 10–3 mm2/s, for cirrhosis – 1.15 ± 0.6 × 10–3 mm2/s (AUROC 0.948; 95% CI 0.922–0.983). Qualitative parameters of liver DWI MRI (there is/is not a diffusion restriction) predict violations of the withdrawal regimen in patients with ALD in all its clinical forms (AUROC 0.931; 95% CI 0.822–0.979).
{"title":"Modern Possibilities of Liver Diffusion-Weighted Magnetic Resonance Images in the Diagnosis of Alcoholic Liver Disease","authors":"F. Lozbenev, T. Morozova","doi":"10.20862/0042-4676-2022-103-4-6-6-17","DOIUrl":"https://doi.org/10.20862/0042-4676-2022-103-4-6-6-17","url":null,"abstract":"Objective: to evaluate the current possibilities of diffusion-weighted imaging (DWI) in liver magnetic resonance imaging (MRI) for the diagnosis of alcoholic liver disease (ALD).Material and methods. The examined patients were at the inpatient and outpatient stages of observation in the gastroenterology department on the basis of the Clinical Hospital No. 1 (Smolensk) and received treatment for diffuse liver diseases of alcoholic etiology. The study included 128 patients: 76 (59%) males and 52 (41%) females, mean age 42.3 ± 4.7 years. Patients were monitored from 2019 to 2022. All of them underwent abdominal organs ultrasound with liver clinical elastography and liver MRI with DWI; in 34 cases liver multi-slice computed tomography was performed.Results. When comparing the results of a qualitative assessment of liver DWI MRI with the CAGE (Cut, Annoyed, Guilty, Eye-opener) test data and the results of patients and relatives survey about the use of alcoholic beverages, a high correlation was established between the diffusion restriction in the liver during MRI and impaired withdrawal regimen (r = 0.901). The diagnostic and prognostic significance of the developed criteria for liver DWI MRI in patients with ALD at admission was assessed: for qualitative assessment AUROC 0.827 (95% CI 0.792–0.873), for quantitative assessment AUROC 0.949 (95% CI 0.912–0.981); in dynamic observation: for qualitative assessment AUROC 0.958 (95% CI 0.925–0.984), for quantitative assessment AUROC 0.947 (95% CI 0.947–0.981).Conclusion. The obtained quantitative indicators of liver DWI MRI make it possible to predict the clinical form of ALD: apparent diffusion coefficient for steatosis is 2.66 ± 0.9 × 10–3 mm2/s, for steatohepatitis – 2.14 ± 0.5 × 10–3 mm2/s, for hepatitis – 1.75 ± 0.6 × 10–3 mm2/s, for cirrhosis – 1.15 ± 0.6 × 10–3 mm2/s (AUROC 0.948; 95% CI 0.922–0.983). Qualitative parameters of liver DWI MRI (there is/is not a diffusion restriction) predict violations of the withdrawal regimen in patients with ALD in all its clinical forms (AUROC 0.931; 95% CI 0.822–0.979).","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47415220","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 : 2022-07-09DOI: 10.20862/0042-4676-2022-103-1-3-77-82
M. Sorokina, A. N. Redkin, E. Y. Ustinova, O. V. Manukovskaya
Skin melanoma is potentially the most dangerous form among all tumor skin lesions. According to statistics, melanoma accounts for about 90% of deaths. The cause of high mortality of patients is early metastasis. At the same time, melanoma metastases can be localized in almost all organs and tissues. In addition to local and regional metastasis to the skin, subcutaneous tissue and lymph nodes, metastatic melanoma of distant organs is not uncommon, and this dramatically worsens the prognosis of the disease. High-quality instrumental diagnostics at various stages of patient management (from primary diagnosis to treatment control) allow to reduce mortality and increase the overall survival of patients. Positron emission tomography in combination with computed tomography (PET/CT) has been used in the last decade as a dominant imaging method for initial staging, control of treatment and detection of progression or recurrence of various types of cancer, including melanoma. It is of great practical importance for predicting survival outcomes, assessing the risk of disease progression, as well as the effectiveness of radiation and systemic therapy. It is PET/CT that allows to simultaneously evaluate the condition of all organs and tissues with minimal radiation load being more sensitive and specific imaging method in comparison with ultrasound, CT and magnetic resonance imaging. PET/CT with 18F-fluorodeoxyglucose is the most effective method for early detection of asymptomatic melanoma recurrence. In addition to accurate setting the tumor process stage, this method is crucial to ensure adequate and effective treatment, which in turn will increase the life expectancy of this category of patients in the near future.
{"title":"Role and Place of PET/CT in the Assessment of Skin Melanoma Prevalence","authors":"M. Sorokina, A. N. Redkin, E. Y. Ustinova, O. V. Manukovskaya","doi":"10.20862/0042-4676-2022-103-1-3-77-82","DOIUrl":"https://doi.org/10.20862/0042-4676-2022-103-1-3-77-82","url":null,"abstract":" Skin melanoma is potentially the most dangerous form among all tumor skin lesions. According to statistics, melanoma accounts for about 90% of deaths. The cause of high mortality of patients is early metastasis. At the same time, melanoma metastases can be localized in almost all organs and tissues. In addition to local and regional metastasis to the skin, subcutaneous tissue and lymph nodes, metastatic melanoma of distant organs is not uncommon, and this dramatically worsens the prognosis of the disease. High-quality instrumental diagnostics at various stages of patient management (from primary diagnosis to treatment control) allow to reduce mortality and increase the overall survival of patients. Positron emission tomography in combination with computed tomography (PET/CT) has been used in the last decade as a dominant imaging method for initial staging, control of treatment and detection of progression or recurrence of various types of cancer, including melanoma. It is of great practical importance for predicting survival outcomes, assessing the risk of disease progression, as well as the effectiveness of radiation and systemic therapy. It is PET/CT that allows to simultaneously evaluate the condition of all organs and tissues with minimal radiation load being more sensitive and specific imaging method in comparison with ultrasound, CT and magnetic resonance imaging. PET/CT with 18F-fluorodeoxyglucose is the most effective method for early detection of asymptomatic melanoma recurrence. In addition to accurate setting the tumor process stage, this method is crucial to ensure adequate and effective treatment, which in turn will increase the life expectancy of this category of patients in the near future.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43740092","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 : 2022-07-09DOI: 10.20862/0042-4676-2022-103-1-3-83-91
А. P. Ivankov, P. Seliverstov
Subchondral stress insufficiency fracture of the knee is a new type of fracture that occurs in people of the older age group (from 50–55 years old) when exposed to a normal load on weakened bone trabeculae. In Russian sources, there is few information about this type of fracture. This is primarily due to the fact that initially the world and domestic medical communities designated this type of pathology as “spontaneous osteonecrosis of the knee”. In recent years, this term has been revised abroad and replaced by a more suitable one – “subchondral insufficiency fracture”. The etiology of insufficiency fracture is based on many diseases and conditions that lead to bone tissue weakening (osteoporosis, collagenosis, rheumatoid arthritis, post-radiation changes in bones, etc.). The main method for diagnosing this type of fracture is magnetic resonance imaging, since it is able to detect a fracture at any stage (especially at an early one). According to modern concepts, the terms “osteonecrosis” and “subchondral insufficiency fracture” require completely different approaches to the treatment. In the presence of complications, a fracture of insufficiency of the knee joint condyles threatens with subchondral collapse and secondary osteoarthritis, which leads to disability of a patient. Given the relevance of this medical problem, the aim of the review is to show the current state of literature data on the issue.
{"title":"Current Radiological Aspects of Subchondral Insufficiency Fracture of the Knee","authors":"А. P. Ivankov, P. Seliverstov","doi":"10.20862/0042-4676-2022-103-1-3-83-91","DOIUrl":"https://doi.org/10.20862/0042-4676-2022-103-1-3-83-91","url":null,"abstract":" Subchondral stress insufficiency fracture of the knee is a new type of fracture that occurs in people of the older age group (from 50–55 years old) when exposed to a normal load on weakened bone trabeculae. In Russian sources, there is few information about this type of fracture. This is primarily due to the fact that initially the world and domestic medical communities designated this type of pathology as “spontaneous osteonecrosis of the knee”. In recent years, this term has been revised abroad and replaced by a more suitable one – “subchondral insufficiency fracture”. The etiology of insufficiency fracture is based on many diseases and conditions that lead to bone tissue weakening (osteoporosis, collagenosis, rheumatoid arthritis, post-radiation changes in bones, etc.). The main method for diagnosing this type of fracture is magnetic resonance imaging, since it is able to detect a fracture at any stage (especially at an early one). According to modern concepts, the terms “osteonecrosis” and “subchondral insufficiency fracture” require completely different approaches to the treatment. In the presence of complications, a fracture of insufficiency of the knee joint condyles threatens with subchondral collapse and secondary osteoarthritis, which leads to disability of a patient. Given the relevance of this medical problem, the aim of the review is to show the current state of literature data on the issue.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48222149","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 : 2022-07-08DOI: 10.20862/0042-4676-2022-103-1-3-62-68
V. Labutin, M. V. Rostovtsev, N. Nudnov, V. М. Nadaraya, M. A. Godzhello, I. Litvinenko, T. А. Nikonorova, V. О. Vorob’eva
The jejunal diverticulosis is rare and accounts for approximately 0.5–1 % of the general population. Diagnosis of the pathology is difficult even in the presence of symptomatic complications (perforation, abscess, peritonitis, sepsis, intestinal obstruction and bleeding), therefore, it is often overlooked or delayed, which requires high awareness and vigilance of physicians. Emergency surgical interventions are performed due to the lack of clear clinical symptoms and reliable radiological data in an average of 25 % of patients with complications of diverticulosis. In the presented case, multislice computed tomography (MSCT) with intravenous contrasting revealed multiple diverticula of the jejunum with reactively altered walls, infiltration of the adjacent cellular tissue and small gas inclusions, indicating diverticulum microperforation. Esophagogastroduodenoscopy (EGD) was performed which confirmed the jejunum bleeding, and was followed by laparotomy which confirmed multiple jejunal diverticula with microperforation and bleeding. Thus, timely MSCT in combination with EGD allowed to avoid complications of jejunal diverticulitis.
{"title":"The Use of Computed Tomography in the Diagnosis of Jejunal Diverticulosis Complicated by Diverticulitis and Intestinal Bleeding","authors":"V. Labutin, M. V. Rostovtsev, N. Nudnov, V. М. Nadaraya, M. A. Godzhello, I. Litvinenko, T. А. Nikonorova, V. О. Vorob’eva","doi":"10.20862/0042-4676-2022-103-1-3-62-68","DOIUrl":"https://doi.org/10.20862/0042-4676-2022-103-1-3-62-68","url":null,"abstract":" The jejunal diverticulosis is rare and accounts for approximately 0.5–1 % of the general population. Diagnosis of the pathology is difficult even in the presence of symptomatic complications (perforation, abscess, peritonitis, sepsis, intestinal obstruction and bleeding), therefore, it is often overlooked or delayed, which requires high awareness and vigilance of physicians. Emergency surgical interventions are performed due to the lack of clear clinical symptoms and reliable radiological data in an average of 25 % of patients with complications of diverticulosis. In the presented case, multislice computed tomography (MSCT) with intravenous contrasting revealed multiple diverticula of the jejunum with reactively altered walls, infiltration of the adjacent cellular tissue and small gas inclusions, indicating diverticulum microperforation. Esophagogastroduodenoscopy (EGD) was performed which confirmed the jejunum bleeding, and was followed by laparotomy which confirmed multiple jejunal diverticula with microperforation and bleeding. Thus, timely MSCT in combination with EGD allowed to avoid complications of jejunal diverticulitis.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45732866","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 : 2022-07-08DOI: 10.20862/0042-4676-2022-103-1-3-30-37
R. Amansakhedov, L. Dmitrieva, T. Smirnova, A. D. Egorova, A. Ergeshov
Objective: to determine, evaluate, and describe different radiological patterns of microbiologically identified nontuberculous pulmonary mycobacterioses (NTPM) based on multislice computed tomography data. Material and methods. The study included 102 patients with radiological signs of lung disease and different types of NTPM. Slowly growing types of NTPM were detected in 62 (60.8 %) patients, and rapidly growing NTPM – in 40 (39.2 %). The diagnosis was established considering a patient’s complaints, a specified case history, radiological and clinical laboratory data including microscopic studies of sputum from 63 (61.8 %) patients, bronchoalveolar lavage and different types of bronchial biopsies data from 19 (18.6 %) patients, samples of lung video-assisted thoracoscopic surgery from 17 (16.7%) patients, pleural fluid samples from 2 (1.9 %) patients, and oropharyngeal wash samples from 1 (1 %) patient. We used the Somatom Emotion 16 multislice computed tomograph (Siemens) and the high-resolution algorithm (HRCT) with 0.8 mm slice thickness and 1.5 mm slice increment. Results. The HRCT data were highly polymorphic and showed interstitial focal changes, different calibre bronchiectasis, conglomerates or cavities, involvements of vessels or pleural layers. In some patients, changes in the axial interstitium were accompanied by single small focal consolidations located either discretely or in small groups. Peribronchovascular spread of dissemination foci in NTPM was detected by HRCT as irregular infiltration of the axial interstitium (vasculitis type). Changes in the bronchial tree in NTPM were characterized by bronchiolitis symptoms (extensive thickening of bronchial walls, bronchioles) with development of the tree-in-bud sign predominantly in the subpleural lung regions. In some cases, bronchiectatic changes formed conglomerate consolidations of sublobular or lobular extent. Changes of the bronchial tree were detected by HRCT predominantly as signs of deforming bronchitis, cylindrical, varicose, or cystic bronchiectasis, either restricted or spread. Changes might be accompanied by single multi-dimensional cystic bronchiectatic cavities. Conclusion. Typical HRCT signs of NTPM are endobronchial and peribronchovascular spread of foci, development of multi-dimensional conglomerates, deforming bronchitis, bronchiectasis, and presence of single multi-dimensional cystic bronchiectatic cavities.
{"title":"Radiological Semiotics of Different Types of Nontuberculous Pulmonary Mycobacterioses","authors":"R. Amansakhedov, L. Dmitrieva, T. Smirnova, A. D. Egorova, A. Ergeshov","doi":"10.20862/0042-4676-2022-103-1-3-30-37","DOIUrl":"https://doi.org/10.20862/0042-4676-2022-103-1-3-30-37","url":null,"abstract":" Objective: to determine, evaluate, and describe different radiological patterns of microbiologically identified nontuberculous pulmonary mycobacterioses (NTPM) based on multislice computed tomography data. Material and methods. The study included 102 patients with radiological signs of lung disease and different types of NTPM. Slowly growing types of NTPM were detected in 62 (60.8 %) patients, and rapidly growing NTPM – in 40 (39.2 %). The diagnosis was established considering a patient’s complaints, a specified case history, radiological and clinical laboratory data including microscopic studies of sputum from 63 (61.8 %) patients, bronchoalveolar lavage and different types of bronchial biopsies data from 19 (18.6 %) patients, samples of lung video-assisted thoracoscopic surgery from 17 (16.7%) patients, pleural fluid samples from 2 (1.9 %) patients, and oropharyngeal wash samples from 1 (1 %) patient. We used the Somatom Emotion 16 multislice computed tomograph (Siemens) and the high-resolution algorithm (HRCT) with 0.8 mm slice thickness and 1.5 mm slice increment. Results. The HRCT data were highly polymorphic and showed interstitial focal changes, different calibre bronchiectasis, conglomerates or cavities, involvements of vessels or pleural layers. In some patients, changes in the axial interstitium were accompanied by single small focal consolidations located either discretely or in small groups. Peribronchovascular spread of dissemination foci in NTPM was detected by HRCT as irregular infiltration of the axial interstitium (vasculitis type). Changes in the bronchial tree in NTPM were characterized by bronchiolitis symptoms (extensive thickening of bronchial walls, bronchioles) with development of the tree-in-bud sign predominantly in the subpleural lung regions. In some cases, bronchiectatic changes formed conglomerate consolidations of sublobular or lobular extent. Changes of the bronchial tree were detected by HRCT predominantly as signs of deforming bronchitis, cylindrical, varicose, or cystic bronchiectasis, either restricted or spread. Changes might be accompanied by single multi-dimensional cystic bronchiectatic cavities. Conclusion. Typical HRCT signs of NTPM are endobronchial and peribronchovascular spread of foci, development of multi-dimensional conglomerates, deforming bronchitis, bronchiectasis, and presence of single multi-dimensional cystic bronchiectatic cavities.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47815211","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 : 2022-07-08DOI: 10.20862/0042-4676-2022-103-1-3-50-54
А. А. Semenyukov, E. A. Balanyuk, V. О. Vorob’eva, N. Nudnov
Superior mesenteric artery syndrome, first reported by Karl Freiger von Rokitansky, is a rare disorder associated with the compression of the horizontal part of the duodenum between the mesenteric artery and the abdominal aorta. A rare clinical observation of the development of the superior mesenteric artery syndrome in a 19-year-old patient is presented to raise the awareness of doctors about this syndrome and the need for early diagnosis and treatment to prevent complications.
Karl Freiger von Rokitansky首次报道的肠系膜上动脉综合征是一种罕见的疾病,与肠系膜动脉和腹主动脉之间的十二指肠水平部分受压有关。对一名19岁患者肠系膜上动脉综合征的发展进行了罕见的临床观察,以提高医生对该综合征的认识,以及早期诊断和治疗以预防并发症的必要性。
{"title":"Diagnostic Pitfalls in Patients with Aortomesenteric Duodenal Compression","authors":"А. А. Semenyukov, E. A. Balanyuk, V. О. Vorob’eva, N. Nudnov","doi":"10.20862/0042-4676-2022-103-1-3-50-54","DOIUrl":"https://doi.org/10.20862/0042-4676-2022-103-1-3-50-54","url":null,"abstract":" Superior mesenteric artery syndrome, first reported by Karl Freiger von Rokitansky, is a rare disorder associated with the compression of the horizontal part of the duodenum between the mesenteric artery and the abdominal aorta. A rare clinical observation of the development of the superior mesenteric artery syndrome in a 19-year-old patient is presented to raise the awareness of doctors about this syndrome and the need for early diagnosis and treatment to prevent complications.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48476219","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 : 2022-07-08DOI: 10.20862/0042-4676-2022-103-1-3-38-49
D. Kuleshov, I. Tyurin, М. Samsonova, А. L. Chernyaev
Objective: to determine the high-resolution computed tomography (HRCT) signs and their combinations, suggesting the presence of fibrotic hypersensitivity pneumonitis (FHP). Material and methods. The study included 52 patients with pathologically verified diagnosis of FHP who were examined according to the 2021 consensus criteria. All patients had lung HRCT no more than 4 months prior to lung biopsy. The analysis of the changes revealed during HRCT was carried out by qualitative and semi-quantitative methods. The presence of individual signs, the degree of their severity (as percentage relative to the volume of the entire lung tissue) and the features of distribution in the axial and longitudinal planes were taken into account. To search for significant combinations of HRCT signs, a correlation analysis was carried out. Results. The most common HRCT signs in the examined group of FHP patients were reticular changes (96 %) and ground glass opacity (88 %). Most of the patients had signs that did not correspond to the picture of “typical FHP”, such as ground glass and emphysema. Relatively rare cases were centrilobular lesions (46.2 %) and mosaic attenuation (52 %), which are traditionally part of the “typical FHP” picture. In 22 cases (42.3 %) there were signs of emphysema, the presence of which significantly complicated the interpretation of HRCT data even in the cases of characteristic signs of FHP. Correlations of almost all HRCT signs were weak. The most common combinations of features were ground glass + reticular changes, emphysema + honeycombing, reticular changes + bronchiectasis. The combination of ground glass and reticular changes had a moderate correlation, but it has low specificity. Conclusion. The HRCT picture of changes in the lungs among patients with a morphologically verified diagnosis of FHP has important features. A weak correlation between the signs does not allow to identify their combinations that can help in the early diagnosis of FHP with sufficient reliability.
{"title":"The Importance of High-Resolution Computed Tomography in the Early Diagnosis of Fibrotic Hypersensitivity Pneumonitis","authors":"D. Kuleshov, I. Tyurin, М. Samsonova, А. L. Chernyaev","doi":"10.20862/0042-4676-2022-103-1-3-38-49","DOIUrl":"https://doi.org/10.20862/0042-4676-2022-103-1-3-38-49","url":null,"abstract":" Objective: to determine the high-resolution computed tomography (HRCT) signs and their combinations, suggesting the presence of fibrotic hypersensitivity pneumonitis (FHP). Material and methods. The study included 52 patients with pathologically verified diagnosis of FHP who were examined according to the 2021 consensus criteria. All patients had lung HRCT no more than 4 months prior to lung biopsy. The analysis of the changes revealed during HRCT was carried out by qualitative and semi-quantitative methods. The presence of individual signs, the degree of their severity (as percentage relative to the volume of the entire lung tissue) and the features of distribution in the axial and longitudinal planes were taken into account. To search for significant combinations of HRCT signs, a correlation analysis was carried out. Results. The most common HRCT signs in the examined group of FHP patients were reticular changes (96 %) and ground glass opacity (88 %). Most of the patients had signs that did not correspond to the picture of “typical FHP”, such as ground glass and emphysema. Relatively rare cases were centrilobular lesions (46.2 %) and mosaic attenuation (52 %), which are traditionally part of the “typical FHP” picture. In 22 cases (42.3 %) there were signs of emphysema, the presence of which significantly complicated the interpretation of HRCT data even in the cases of characteristic signs of FHP. Correlations of almost all HRCT signs were weak. The most common combinations of features were ground glass + reticular changes, emphysema + honeycombing, reticular changes + bronchiectasis. The combination of ground glass and reticular changes had a moderate correlation, but it has low specificity. Conclusion. The HRCT picture of changes in the lungs among patients with a morphologically verified diagnosis of FHP has important features. A weak correlation between the signs does not allow to identify their combinations that can help in the early diagnosis of FHP with sufficient reliability.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43611699","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 : 2022-07-08DOI: 10.20862/0042-4676-2022-103-1-3-69-76
T. А. Nikonorova, M. V. Rostovtsev, N. Nudnov, V. М. Nadaraya, M. A. Godzhello, A. S. Daabul, V. B. Boronoev, K. М. Kholmurodova, V. О. Vorob’eva
A rare case of jejunal lipoma complicated by intestinal intussusception in a 71-year-old man is presented. Abdominal computed tomography revealed intestinal intussusception caused by the jejunal wall lipoma, allowed to timely make a diagnosis and perform surgical treatment.
{"title":"CT Diagnostics of Intestinal Obstruction Caused by Invagination Due to the Jejunal Wall Lipoma","authors":"T. А. Nikonorova, M. V. Rostovtsev, N. Nudnov, V. М. Nadaraya, M. A. Godzhello, A. S. Daabul, V. B. Boronoev, K. М. Kholmurodova, V. О. Vorob’eva","doi":"10.20862/0042-4676-2022-103-1-3-69-76","DOIUrl":"https://doi.org/10.20862/0042-4676-2022-103-1-3-69-76","url":null,"abstract":" A rare case of jejunal lipoma complicated by intestinal intussusception in a 71-year-old man is presented. Abdominal computed tomography revealed intestinal intussusception caused by the jejunal wall lipoma, allowed to timely make a diagnosis and perform surgical treatment.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42075863","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}