Pub Date : 2022-07-08DOI: 10.20862/0042-4676-2022-103-1-3-55-61
N. Savrasova, Y. Melnichenko, S. Kabak, A. Perminov
Hyperpneumatization of the paranasal sinuses is a rare condition. Hypersinus, pneumosinus dilatans, and pneumocele are the three types of excessive pneumatization according to the traditional classification proposed by Urken et al. (1987). If in the first case, no treatment is required, but the latter two may be accompanied by aesthetic and/or functional disorders or may result in pressure effects on adjacent anatomical objects, therefore they require surgical correction. Maxillary sinus pneumocele is described in few publications. The presented case demonstrates typical clinical and radiographic signs of the maxillary sinus pneumocele, as well as hypersinus on the contralateral side. Cone beam computed tomography scans in combination with anamnestic and clinical data provide key information for the diagnosis of maxillary sinus pneumocele, as well as for differential diagnosis with other variants of their excessive pneumatization.
{"title":"Maxillary Sinus Pneumocele","authors":"N. Savrasova, Y. Melnichenko, S. Kabak, A. Perminov","doi":"10.20862/0042-4676-2022-103-1-3-55-61","DOIUrl":"https://doi.org/10.20862/0042-4676-2022-103-1-3-55-61","url":null,"abstract":" Hyperpneumatization of the paranasal sinuses is a rare condition. Hypersinus, pneumosinus dilatans, and pneumocele are the three types of excessive pneumatization according to the traditional classification proposed by Urken et al. (1987). If in the first case, no treatment is required, but the latter two may be accompanied by aesthetic and/or functional disorders or may result in pressure effects on adjacent anatomical objects, therefore they require surgical correction. Maxillary sinus pneumocele is described in few publications. The presented case demonstrates typical clinical and radiographic signs of the maxillary sinus pneumocele, as well as hypersinus on the contralateral side. Cone beam computed tomography scans in combination with anamnestic and clinical data provide key information for the diagnosis of maxillary sinus pneumocele, as well as for differential diagnosis with other variants of their excessive pneumatization.","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":"47734183","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 : 2022-07-07DOI: 10.20862/0042-4676-2022-103-1-3-15-29
V. E. Prokina, А. А. Ansheles, A. Tarasov, A. Ametov, V. Sergienko
Objective: to estimate the possibilities and determine the diagnostic value of scintigraphy and single-photon emission computed tomography combined with computed tomography (SPECT/CT) in the assessment of the functional state of parathyroids in comparison with laboratory data in patients with secondary hyperparathyroidism (SHPT). Material and methods. The study consistently included 64 patients with the established diagnosis of SHPT due to the acquired vitamin D deficiency or with terminal chronic kidney disease (CKD), with the presence of ultrasound data and laboratory tests of calcium-phosphoric exchange indicators. Neck and mediastum nuclear study with 99mTc-methoxy-isobutyl-isonitrile (MIBI) was performed in the planar two-phase scintigraphy mode according to the standard protocol with an estimation of parathyroid visualization intensity, as well as in SPECT/CT performed 1 hour after MIBI injection. Results. In the group of patients with CKD as a cause of SHPT (n = 14), the most pronounced increase of parathyroid hormone (PTH) level (210.8 ± 103.0 vs. 107.0 ± 40.2 pg/ml in patients with vitamin D deficiency (n = 50, p < 0.001)) and phosphorus (mean 1.39 ± 0.51 mmol/l), as well as excess of normal levels of alkaline phosphatase (407.7 ± 338.1 units/l) were noted. In patients with vitamin D deficiency, impaired parathyroids according to SPECT/CT data was visualized in 8 % of cases, and in patients with CKD in 14.3 %. No significant differences in the mean levels of vitamin D in patients with (n = 46) and without (n = 4) modified parathyroids according to scintigraphy were detected: 26.06 ± 13.19 vs. 25.82 ± 18.80 ng/ml, respectively (p = 0.97). Differences in PTH and calcium levels were not observed: 91.3 ± 39.2 vs. 89.2 ± 29.5 pg/ml (p = 0.90), 2.53 ± 0.21 vs. 2.58 ± 0,15 mmol/l (p = 0.64), respectively. Conclusion. The neck SPECT/CT is a key method of topical imaging of impaired parathyroids in preoperative preparation of patients with SHPT caused by CKD. The method may have a diagnostic value in treatment-resistant patients with vitamin D deficiency and upper-normal PTH and calcium levels in terms of detection of the nodular form of parathyroid hyperplasia. The implementation of SPECT/CT after 1 hour after MIBI injection increases the sensitivity of the study.
目的:通过与实验室资料的比较，探讨闪烁成像和单光子发射计算机断层扫描联合计算机断层扫描(SPECT/CT)评估继发性甲状旁腺功能亢进(SHPT)患者甲状旁腺功能状态的可能性，并确定其诊断价值。材料和方法。该研究一致纳入了64例因获得性维生素D缺乏或终末期慢性肾病(CKD)而确诊为SHPT的患者，并提供了超声数据和钙磷交换指标的实验室检测。使用99mtc -甲氧基-异丁基-异腈(MIBI)在平面两相闪烁模式下进行颈部和纵隔核研究，根据标准方案估计甲状旁腺显像强度，并在MIBI注射1小时后进行SPECT/CT检查。结果。在CKD引起SHPT的患者组(n = 14)中，甲状旁腺激素(PTH)水平(210.8±103.0 vs. 107.0±40.2 pg/ml，维生素D缺乏症患者(n = 50, p < 0.001))和磷(平均1.39±0.51 mmol/l)升高最为明显，碱性磷酸酶(407.7±338.1单位/l)高于正常水平。在维生素D缺乏症患者中，SPECT/CT数据显示8%的患者甲状旁腺受损，CKD患者中这一比例为14.3%。经显像检查，有修饰甲状旁腺的患者(n = 46)和没有修饰甲状旁腺的患者(n = 4)维生素D的平均水平无显著差异:分别为26.06±13.19 ng/ml和25.82±18.80 ng/ml (p = 0.97)。PTH和钙水平无差异:分别为91.3±39.2 vs 89.2±29.5 pg/ml (p = 0.90)， 2.53±0.21 vs 2.58±0.15 mmol/l (p = 0.64)。结论。颈部SPECT/CT是CKD致SHPT患者术前准备中甲状旁腺损伤局部显像的关键方法。该方法在检测结节状甲状旁腺增生方面可能对维生素D缺乏症和PTH和钙水平高于正常水平的治疗抵抗患者具有诊断价值。在MIBI注射后1小时进行SPECT/CT检查增加了研究的敏感性。
{"title":"The Role of Scintigraphy and Hybrid Single-Photon Emission Tomography in Comparison with Laboratory Data in a Comprehensive Examination of Patients with Secondary Hyperparathyroidism","authors":"V. E. Prokina, А. А. Ansheles, A. Tarasov, A. Ametov, V. Sergienko","doi":"10.20862/0042-4676-2022-103-1-3-15-29","DOIUrl":"https://doi.org/10.20862/0042-4676-2022-103-1-3-15-29","url":null,"abstract":" Objective: to estimate the possibilities and determine the diagnostic value of scintigraphy and single-photon emission computed tomography combined with computed tomography (SPECT/CT) in the assessment of the functional state of parathyroids in comparison with laboratory data in patients with secondary hyperparathyroidism (SHPT). Material and methods. The study consistently included 64 patients with the established diagnosis of SHPT due to the acquired vitamin D deficiency or with terminal chronic kidney disease (CKD), with the presence of ultrasound data and laboratory tests of calcium-phosphoric exchange indicators. Neck and mediastum nuclear study with 99mTc-methoxy-isobutyl-isonitrile (MIBI) was performed in the planar two-phase scintigraphy mode according to the standard protocol with an estimation of parathyroid visualization intensity, as well as in SPECT/CT performed 1 hour after MIBI injection. Results. In the group of patients with CKD as a cause of SHPT (n = 14), the most pronounced increase of parathyroid hormone (PTH) level (210.8 ± 103.0 vs. 107.0 ± 40.2 pg/ml in patients with vitamin D deficiency (n = 50, p < 0.001)) and phosphorus (mean 1.39 ± 0.51 mmol/l), as well as excess of normal levels of alkaline phosphatase (407.7 ± 338.1 units/l) were noted. In patients with vitamin D deficiency, impaired parathyroids according to SPECT/CT data was visualized in 8 % of cases, and in patients with CKD in 14.3 %. No significant differences in the mean levels of vitamin D in patients with (n = 46) and without (n = 4) modified parathyroids according to scintigraphy were detected: 26.06 ± 13.19 vs. 25.82 ± 18.80 ng/ml, respectively (p = 0.97). Differences in PTH and calcium levels were not observed: 91.3 ± 39.2 vs. 89.2 ± 29.5 pg/ml (p = 0.90), 2.53 ± 0.21 vs. 2.58 ± 0,15 mmol/l (p = 0.64), respectively. Conclusion. The neck SPECT/CT is a key method of topical imaging of impaired parathyroids in preoperative preparation of patients with SHPT caused by CKD. The method may have a diagnostic value in treatment-resistant patients with vitamin D deficiency and upper-normal PTH and calcium levels in terms of detection of the nodular form of parathyroid hyperplasia. The implementation of SPECT/CT after 1 hour after MIBI injection increases the sensitivity of the study.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44707877","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 : 2022-07-07DOI: 10.20862/0042-4676-2022-103-1-3-6-14
I. V. Sutyagin, Sergey А. Nizhechik, Roman V. Stepanov, P. V. Netsvetov, Alexander V. Burtsev
Objective: determining the neglected ankle fractures clinical stages based on the analysis of computed tomograms (CT) at various time from the injury and radiological findings in different types of ankle injury. Material and methods. An open randomized multicenter study included 48 patients with Weber type B and C ankle fractures (15 males, 33 females) aged from 27 to 68 years old (mean age 45 years old). The result of the CT analysis for each patient was the ratio of bone density on the damaged side to the bone density of the intact ankle. Next, the correlation was defined between the attitude and time from injury (in days) as well as diastasis (in millimeters) and age (in years). Results. Mean bone density in the period up to 15 days was 403.25 ± 63.74 HU, in the period between 15 and 32 days – 359.85 ± 71.34 HU, in the period more than 32 days – 271.91 ± 73.34 HU. Local bone density is inversely proportional to the time from injury (correlation coefficient –0.678) and the fracture gap (correlation coefficient –0.396). There was no significant dependence of local bone density on the patient’s age (correlation coefficient –0.177). Local bone density significantly (p = 0.05) decreased in the period of more than 14 days from the injury and was 80% and less from intact bone density in the period of more than 32 days from the injury (p = 0.0004). Signs of fracture healing appeared, in average, on the 28 th day after the injury with the fracture gap less than 1 mm. Conclusion. From the point of view of preoperative planning, neglected ankle fractures bone density critical points are 14 th and 32 nd days after injury.
{"title":"Local Bone Dencity in Neglected Ankle Fractures","authors":"I. V. Sutyagin, Sergey А. Nizhechik, Roman V. Stepanov, P. V. Netsvetov, Alexander V. Burtsev","doi":"10.20862/0042-4676-2022-103-1-3-6-14","DOIUrl":"https://doi.org/10.20862/0042-4676-2022-103-1-3-6-14","url":null,"abstract":" Objective: determining the neglected ankle fractures clinical stages based on the analysis of computed tomograms (CT) at various time from the injury and radiological findings in different types of ankle injury. Material and methods. An open randomized multicenter study included 48 patients with Weber type B and C ankle fractures (15 males, 33 females) aged from 27 to 68 years old (mean age 45 years old). The result of the CT analysis for each patient was the ratio of bone density on the damaged side to the bone density of the intact ankle. Next, the correlation was defined between the attitude and time from injury (in days) as well as diastasis (in millimeters) and age (in years). Results. Mean bone density in the period up to 15 days was 403.25 ± 63.74 HU, in the period between 15 and 32 days – 359.85 ± 71.34 HU, in the period more than 32 days – 271.91 ± 73.34 HU. Local bone density is inversely proportional to the time from injury (correlation coefficient –0.678) and the fracture gap (correlation coefficient –0.396). There was no significant dependence of local bone density on the patient’s age (correlation coefficient –0.177). Local bone density significantly (p = 0.05) decreased in the period of more than 14 days from the injury and was 80% and less from intact bone density in the period of more than 32 days from the injury (p = 0.0004). Signs of fracture healing appeared, in average, on the 28 th day after the injury with the fracture gap less than 1 mm. Conclusion. From the point of view of preoperative planning, neglected ankle fractures bone density critical points are 14 th and 32 nd days after injury.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49012754","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 : 2022-02-04DOI: 10.20862/0042-4676-2021-102-6-390-398
O. A. Staroseltseva, N. Nudnov, M. Radutnaya, Е. L. Bondar’, А. N. Vorobyev, D. V. Levin, А. А. Yakovlev, Е. V. Pron’kina
The timely diagnosis of postoperative consequences through identification of intracranial foreign bodies enables prevention of complications and improvement in quality of life. The paper considers two clinical cases after surgical interventions to remove subdural and intracerebral hematomas of different ages. Computed tomography (CT) was performed on a 64-slice Somatom Perspective apparatus (Siemens, Germany) applying a reformative slice thickness of less than 0.6 mm. Magnetic resonance imaging (MRI) was carried out using a Magnetom Essenza 1.5 T system (Siemens, Germany). When wording the CT and MRT findings, it was suggested that each of the patients had an intracranial foreign body in the presence of postoperative changes. The CT and MRI findings were fully correlated with intraoperative data on the location, number, shape, and size of foreign bodies. The neuroimaging techniques are highly informative in identifying intracranial foreign bodies and are especially important for chronically critically ill patients because of the lack of productive contact with them due to speech problems and cognitive impairment. They assist in making a correct diagnosis and playing a leading role in neurosurgical practice, allowing the detection of an abnormality, the optimal planning of patient management tactics, and the prevention of possible complications.
{"title":"Intracranial Iatrogenic Foreign Bodies: Features of Neuroimaging","authors":"O. A. Staroseltseva, N. Nudnov, M. Radutnaya, Е. L. Bondar’, А. N. Vorobyev, D. V. Levin, А. А. Yakovlev, Е. V. Pron’kina","doi":"10.20862/0042-4676-2021-102-6-390-398","DOIUrl":"https://doi.org/10.20862/0042-4676-2021-102-6-390-398","url":null,"abstract":"The timely diagnosis of postoperative consequences through identification of intracranial foreign bodies enables prevention of complications and improvement in quality of life. The paper considers two clinical cases after surgical interventions to remove subdural and intracerebral hematomas of different ages. Computed tomography (CT) was performed on a 64-slice Somatom Perspective apparatus (Siemens, Germany) applying a reformative slice thickness of less than 0.6 mm. Magnetic resonance imaging (MRI) was carried out using a Magnetom Essenza 1.5 T system (Siemens, Germany). When wording the CT and MRT findings, it was suggested that each of the patients had an intracranial foreign body in the presence of postoperative changes. The CT and MRI findings were fully correlated with intraoperative data on the location, number, shape, and size of foreign bodies. The neuroimaging techniques are highly informative in identifying intracranial foreign bodies and are especially important for chronically critically ill patients because of the lack of productive contact with them due to speech problems and cognitive impairment. They assist in making a correct diagnosis and playing a leading role in neurosurgical practice, allowing the detection of an abnormality, the optimal planning of patient management tactics, and the prevention of possible complications.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45517991","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 : 2022-02-04DOI: 10.20862/0042-4676-2021-102-6-383-389
М. V. Malakhova, Е. А. Prokhorova, А. S. Kulichkin, К. R. Bril’, Е. Y. Van, А. N. Dzeranova, Т. N. Galyan, V. V. Khovrin, E. Charchyan
Prosthetic infection is the most common complication after aortic replacement with a synthetic vascular prosthesis or a valved conduit (VC); in this case, aortic valve (AV) rupture occurs in 0.1-1.3% of patients. The cause of valve rupture is not only infective endocarditis; ascending aortic aneurysm and obvious calcification of the native AV are also known risk factors. The paper describes a clinical case of a 49-year-old patient examined and treated in Petrovsky Russian Scientific Center of Surgery. Eighteen years after primary surgical intervention for aortic stenosis, AV reprosthesis and ascending aorta VC replacement were performed according to the Bentall - De Bono procedure modified by Kouchoukos. In 2021, computed tomographic aortography has revealed that in the presence of infective endocarditis, there is aortic prosthetic rupture to form a paraprosthetic fistula and a pseudoaneurysm cavity. The results of instrumental studies are comparable with intraoperative data. The clinical case is of interest due to the rare occurrence of complications and to the significant role of multislice computed tomography during examination and postoperative monitoring.
{"title":"Diagnosis and Successful Surgical Treatment of Ascending Aorta Valved Conduit Rupture","authors":"М. V. Malakhova, Е. А. Prokhorova, А. S. Kulichkin, К. R. Bril’, Е. Y. Van, А. N. Dzeranova, Т. N. Galyan, V. V. Khovrin, E. Charchyan","doi":"10.20862/0042-4676-2021-102-6-383-389","DOIUrl":"https://doi.org/10.20862/0042-4676-2021-102-6-383-389","url":null,"abstract":"Prosthetic infection is the most common complication after aortic replacement with a synthetic vascular prosthesis or a valved conduit (VC); in this case, aortic valve (AV) rupture occurs in 0.1-1.3% of patients. The cause of valve rupture is not only infective endocarditis; ascending aortic aneurysm and obvious calcification of the native AV are also known risk factors. The paper describes a clinical case of a 49-year-old patient examined and treated in Petrovsky Russian Scientific Center of Surgery. Eighteen years after primary surgical intervention for aortic stenosis, AV reprosthesis and ascending aorta VC replacement were performed according to the Bentall - De Bono procedure modified by Kouchoukos. In 2021, computed tomographic aortography has revealed that in the presence of infective endocarditis, there is aortic prosthetic rupture to form a paraprosthetic fistula and a pseudoaneurysm cavity. The results of instrumental studies are comparable with intraoperative data. The clinical case is of interest due to the rare occurrence of complications and to the significant role of multislice computed tomography during examination and postoperative monitoring.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43725741","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 : 2022-02-03DOI: 10.20862/0042-4676-2021-102-6-377-382
P. Nikitin, N. Nudnov, I. Znamenskiy, R. Azimov, A. A. Karpova, E. E. Averin
Objective: to assess the percentage of mesh “titanium silk” implant shrinkage after inguinal hernia repair surgery in the late postoperative period using multi-slice computed tomography (MSCT). Material and methods. The comparative assessment of the long-term results of treatment in 90 patients with inguinal hernias was performed using MSCT. In 36 (40%) patients of Group 1 the titanium implant was used in Lichtenstein hernia repair surgery. In Group 2, 54 (60%) patients were operated by laparoscopic hernia repair surgery. On day 3 and 3 months after surgery every patient underwent MSCT with subsequent determination of the implant square. Results. The percent of mesh “titanium silk” implant shrinkage 3 months after surgery according to MSCT was 4.4% in Lichtenstein hernia repair group, and 8.3% in laparoscopic hernia repair group. According to Kruskal-Wallis test, there were no statistic differences of this indicator between two groups (p = 0,185). Conclusion. The analysis of long-term results of inguinal hernia repair surgery with titanium mesh implants using MSCT showed that implant square significantly decreases 3 months after surgery. There were no significant differences in implants shrinkage regarding the type of surgery. MSCT is an effective method for evaluating the size of mesh titanium implants after hernia repair surgery.
{"title":"Multi-Slice Computed Tomography in Assessing Mesh Titanium Implant Shrinkage After Prosthetic Inguinal Hernioplasty","authors":"P. Nikitin, N. Nudnov, I. Znamenskiy, R. Azimov, A. A. Karpova, E. E. Averin","doi":"10.20862/0042-4676-2021-102-6-377-382","DOIUrl":"https://doi.org/10.20862/0042-4676-2021-102-6-377-382","url":null,"abstract":"Objective: to assess the percentage of mesh “titanium silk” implant shrinkage after inguinal hernia repair surgery in the late postoperative period using multi-slice computed tomography (MSCT). Material and methods. The comparative assessment of the long-term results of treatment in 90 patients with inguinal hernias was performed using MSCT. In 36 (40%) patients of Group 1 the titanium implant was used in Lichtenstein hernia repair surgery. In Group 2, 54 (60%) patients were operated by laparoscopic hernia repair surgery. On day 3 and 3 months after surgery every patient underwent MSCT with subsequent determination of the implant square. Results. The percent of mesh “titanium silk” implant shrinkage 3 months after surgery according to MSCT was 4.4% in Lichtenstein hernia repair group, and 8.3% in laparoscopic hernia repair group. According to Kruskal-Wallis test, there were no statistic differences of this indicator between two groups (p = 0,185). Conclusion. The analysis of long-term results of inguinal hernia repair surgery with titanium mesh implants using MSCT showed that implant square significantly decreases 3 months after surgery. There were no significant differences in implants shrinkage regarding the type of surgery. MSCT is an effective method for evaluating the size of mesh titanium implants after hernia repair surgery.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43328636","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 : 2022-02-03DOI: 10.20862/0042-4676-2021-102-6-369-376
Е. S. Chukhontseva, Т. Morozova, А. Borsukov
Objective: to define the role of transcranial electrical stimulation in the assessment of the microvascular bed by contrast-free magnetic resonance (MR) perfusion imaging in patients with chronic cerebral ischemia. Material and methods. Examinations were made in 37 people aged 65-70 years who were diagnosed with chronic cerebral ischemia. The patients were divided into two groups: with and without cognitive impairment (CI). The investigation algorithm involved brain magnetic resonance imaging (MRI) (Toshiba Vantage Titan, 1.5 T), transcranial electrical stimulation (TES) using a TETOS computer hardware diagnostics (Research and Production Firm “BIOSS”) and repeated brain MRI in the arterial spin labelling (ASL) perfusion mode. ASL perfusion data were used to assess cerebral blood flow in the regions of interest before and after TES. Results. Contrast-free MR perfusion imaging revealed relative hyperperfusion within the cortex of the frontal and parietal lobes concurrent with hypoperfusion of the subcortical nuclei and cerebral white matter in patients with CI, which suggests that enhanced cortical blood flow is ineffective and shunting blood flow forms. TES caused a statistically significant change in cerebral perfusion in the non-CI group of patients with chronic cerebral ischemia. After TES by ASL perfusion imaging, the patients without CI showed a diffuse increase in cerebral blood flow (p = 0.002), whereas the group of apparently healthy volunteers exhibited this increase in blood flow. Conclusion. Cerebral perfusion indices before and after TES in patients of all the examined groups define its role as a complementary tool to assess the compensatory capabilities of the microvascular bed by contrast-free MR perfusion imaging in chronic cerebral ischemia.
{"title":"Experience with Transcranial Electrical Stimulation in the Assessment of the Microvascular Bed by Contrast-Free Magnetic Resonance Perfusion Imaging in Patients with Chronic Cerebral Ischemia","authors":"Е. S. Chukhontseva, Т. Morozova, А. Borsukov","doi":"10.20862/0042-4676-2021-102-6-369-376","DOIUrl":"https://doi.org/10.20862/0042-4676-2021-102-6-369-376","url":null,"abstract":"Objective: to define the role of transcranial electrical stimulation in the assessment of the microvascular bed by contrast-free magnetic resonance (MR) perfusion imaging in patients with chronic cerebral ischemia. Material and methods. Examinations were made in 37 people aged 65-70 years who were diagnosed with chronic cerebral ischemia. The patients were divided into two groups: with and without cognitive impairment (CI). The investigation algorithm involved brain magnetic resonance imaging (MRI) (Toshiba Vantage Titan, 1.5 T), transcranial electrical stimulation (TES) using a TETOS computer hardware diagnostics (Research and Production Firm “BIOSS”) and repeated brain MRI in the arterial spin labelling (ASL) perfusion mode. ASL perfusion data were used to assess cerebral blood flow in the regions of interest before and after TES. Results. Contrast-free MR perfusion imaging revealed relative hyperperfusion within the cortex of the frontal and parietal lobes concurrent with hypoperfusion of the subcortical nuclei and cerebral white matter in patients with CI, which suggests that enhanced cortical blood flow is ineffective and shunting blood flow forms. TES caused a statistically significant change in cerebral perfusion in the non-CI group of patients with chronic cerebral ischemia. After TES by ASL perfusion imaging, the patients without CI showed a diffuse increase in cerebral blood flow (p = 0.002), whereas the group of apparently healthy volunteers exhibited this increase in blood flow. Conclusion. Cerebral perfusion indices before and after TES in patients of all the examined groups define its role as a complementary tool to assess the compensatory capabilities of the microvascular bed by contrast-free MR perfusion imaging in chronic cerebral ischemia.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42946474","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 : 2022-02-03DOI: 10.20862/0042-4676-2021-102-6-349-358
N. Griva, P. Gavrilov, I. A. Nikitina, L. Kiryukhina, A. Narkevich, E. Sokolovich
Objective: to characterize the relationship between the subtype and volume of pulmonary emphysema on the indicators of lung ventilation and gas exchange functions. Material and methods. The data of radiation and functional studies were analyzed in 50 patients. The inclusion criteria were chronic obstructive pulmonary disease and emphysema, which had been diagnosed by computed tomography (CT) and confirmed by two radiologists; comprehensive pulmonary function studies, including spirometry and body plethysmography, were performed; diffusion capacity was measured using a single-breath method, involving inhalation of carbon monoxide, and a breath hold. Patients with primary pulmonary emphysema, any history of pulmonary surgery, and emphysema concurrent with other lung X-ray syndromes (consolidation, cavity) were excluded. CT was performed with a 1-mm thick slice and standard scanning parameters on Toshiba tomographs (Japan). Pulmonary function was tested using a MasterScreen Body Diffusion expert diagnostic unit (VIASYS Healthcare, Germany) in accordance with the criteria for correct pulmonary functional tests proposed by a joint group of experts from the American Thoracic Society and the European Respiratory Society. Volumetric analysis of emphysema was performed using the Lung Volume Analysis software package (Toshiba, Japan). In the study, there was a predominance of male patients (n = 42 (84%)), mainly in the 61-70 age group. Results. The isolated type of emphysema was rare: centrilobular and paraseptal emphysemas were seen in 3 (6%) and 2 (4%) patients, respectively. The mixed type of emphysema was detected in 90% of cases; 33 (66%) patients having a predominant centrilobular component constituted a large proportion. It was determined that as the volume of emphysema increased, the patency of the airways worsened, the static pulmonary volumes increased, the lungs were hyperinflated, pulmonary gas exchange worsened, the bronchial resistance slightly increased during calm breathing. No statistically significant results were found from the point of view of correlations between the volume of emphysema and other parameters of pulmonary function. Conclusion. An increase in the volume of emphysema deteriorates pulmonary function; the greatest contribution to the overall picture is made by the patients with a mixed type of emphysema with a predominance of the centrilobular component.
{"title":"Impact of Emphysema Subtypes and Volume on Lung Ventilation and Gas Exchange Functions as Evidenced by Computed Tomography","authors":"N. Griva, P. Gavrilov, I. A. Nikitina, L. Kiryukhina, A. Narkevich, E. Sokolovich","doi":"10.20862/0042-4676-2021-102-6-349-358","DOIUrl":"https://doi.org/10.20862/0042-4676-2021-102-6-349-358","url":null,"abstract":"Objective: to characterize the relationship between the subtype and volume of pulmonary emphysema on the indicators of lung ventilation and gas exchange functions. Material and methods. The data of radiation and functional studies were analyzed in 50 patients. The inclusion criteria were chronic obstructive pulmonary disease and emphysema, which had been diagnosed by computed tomography (CT) and confirmed by two radiologists; comprehensive pulmonary function studies, including spirometry and body plethysmography, were performed; diffusion capacity was measured using a single-breath method, involving inhalation of carbon monoxide, and a breath hold. Patients with primary pulmonary emphysema, any history of pulmonary surgery, and emphysema concurrent with other lung X-ray syndromes (consolidation, cavity) were excluded. CT was performed with a 1-mm thick slice and standard scanning parameters on Toshiba tomographs (Japan). Pulmonary function was tested using a MasterScreen Body Diffusion expert diagnostic unit (VIASYS Healthcare, Germany) in accordance with the criteria for correct pulmonary functional tests proposed by a joint group of experts from the American Thoracic Society and the European Respiratory Society. Volumetric analysis of emphysema was performed using the Lung Volume Analysis software package (Toshiba, Japan). In the study, there was a predominance of male patients (n = 42 (84%)), mainly in the 61-70 age group. Results. The isolated type of emphysema was rare: centrilobular and paraseptal emphysemas were seen in 3 (6%) and 2 (4%) patients, respectively. The mixed type of emphysema was detected in 90% of cases; 33 (66%) patients having a predominant centrilobular component constituted a large proportion. It was determined that as the volume of emphysema increased, the patency of the airways worsened, the static pulmonary volumes increased, the lungs were hyperinflated, pulmonary gas exchange worsened, the bronchial resistance slightly increased during calm breathing. No statistically significant results were found from the point of view of correlations between the volume of emphysema and other parameters of pulmonary function. Conclusion. An increase in the volume of emphysema deteriorates pulmonary function; the greatest contribution to the overall picture is made by the patients with a mixed type of emphysema with a predominance of the centrilobular component.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45273624","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 : 2022-02-03DOI: 10.20862/0042-4676-2021-102-6-359-368
G. Stashuk, Y. Moysyuk, D. Smirnova, O. Sumtsova
Objective: to determine whether liver computed tomography (CT) perfusion imaging can assess hemodynamics in patients with fibrosis and cirrhosis as a result of chronic viral hepatitis C (CVHC). Subjects and methods. The prospective study conducted at the Department of Radiation Diagnosis, M.F. Vladimirsky Moscow Regional Research and Clinical Institute, enrolled 61 patients with liver fibrosis and cirrhosis as a result of CVHC, of whom 26 patients had received antiviral therapy (AVT) and achieved a sustained virological response (SVR) at 24 weeks after the end of treatment. All the patients underwent liver CT perfusion imaging on a 256-slice Philips ICT computed tomography scanner (Netherlands). The parameters of arterial, portal, general perfusion and hepatic perfusion index were measured in each patient in his/her liver segments III, VII, and VIII, by calculating the slope of a curve. Results. The values of perfusion parameters in patients who had undergone AVT and attained SVR and who had received no specific treatment were compared with those in the fibrosis, compensated, subcompensated, and decompensated liver cirrhosis groups. In the liver fibrosis group, the patients who had achieved SVR after AVT had higher portal and total perfusion values than those who had received no specific treatment (p = 0.001 and p = 0.002; respectively). In the same group, the liver perfusion index was higher in the patients who had not undergone AVT than in the treated patients (p = 0.028). The values of total perfusion were statistically significantly higher in patients with compensated liver cirrhosis who had attained SVR after AVT than in the untreated patients (p = 0.008). In the decompensated liver cirrhosis group, portal perfusion after specific treatment was higher than in the non-AVT group (p = 0.012). The subcompensated liver cirrhosis group showed no statistically significant differences when comparing the values of liver perfusion parameters depending on the availability of treatment. Conclusion. Liver CT perfusion imaging cannot give an idea of how the hemodynamics of liver tissue changes in the presence of fibrosis and cirrhosis in patients with CVHC after AVT.
{"title":"Liver CT Perfusion Imaging as a Non-Invasive Method for Assessing Hemodynamics of the Hepatic Parenchyma in Patients with Fibrosis and Cirrhosis as a Result of Chronic Viral Hepatitis C","authors":"G. Stashuk, Y. Moysyuk, D. Smirnova, O. Sumtsova","doi":"10.20862/0042-4676-2021-102-6-359-368","DOIUrl":"https://doi.org/10.20862/0042-4676-2021-102-6-359-368","url":null,"abstract":"Objective: to determine whether liver computed tomography (CT) perfusion imaging can assess hemodynamics in patients with fibrosis and cirrhosis as a result of chronic viral hepatitis C (CVHC). Subjects and methods. The prospective study conducted at the Department of Radiation Diagnosis, M.F. Vladimirsky Moscow Regional Research and Clinical Institute, enrolled 61 patients with liver fibrosis and cirrhosis as a result of CVHC, of whom 26 patients had received antiviral therapy (AVT) and achieved a sustained virological response (SVR) at 24 weeks after the end of treatment. All the patients underwent liver CT perfusion imaging on a 256-slice Philips ICT computed tomography scanner (Netherlands). The parameters of arterial, portal, general perfusion and hepatic perfusion index were measured in each patient in his/her liver segments III, VII, and VIII, by calculating the slope of a curve. Results. The values of perfusion parameters in patients who had undergone AVT and attained SVR and who had received no specific treatment were compared with those in the fibrosis, compensated, subcompensated, and decompensated liver cirrhosis groups. In the liver fibrosis group, the patients who had achieved SVR after AVT had higher portal and total perfusion values than those who had received no specific treatment (p = 0.001 and p = 0.002; respectively). In the same group, the liver perfusion index was higher in the patients who had not undergone AVT than in the treated patients (p = 0.028). The values of total perfusion were statistically significantly higher in patients with compensated liver cirrhosis who had attained SVR after AVT than in the untreated patients (p = 0.008). In the decompensated liver cirrhosis group, portal perfusion after specific treatment was higher than in the non-AVT group (p = 0.012). The subcompensated liver cirrhosis group showed no statistically significant differences when comparing the values of liver perfusion parameters depending on the availability of treatment. Conclusion. Liver CT perfusion imaging cannot give an idea of how the hemodynamics of liver tissue changes in the presence of fibrosis and cirrhosis in patients with CVHC after AVT.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42484499","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 : 2022-02-03DOI: 10.20862/0042-4676-2021-102-6-338-348
V. Solodkiy, Vladimir M. Sotnikov, V. Chkhikvadze, Nikolay V. Nudnov, S. Trotsenko
Objective: to comparatively analyze overall survival (OS) in patients with non-small cell lung cancer (NSCLC) with affected lymph nodes (pN1) of the lung root after surgical and combination treatment with postoperative radiotherapy (PORT). Subjects and methods. OS was studied in 310 patients with grade 2-3 NSCLC. (pT1a-4N1M0): in 101 patients after lobectomy/bilobectomy, pulmonectomy with ipsilateral mediastinal lymphadenectomy and in 209 patients after combination treatment with the similar surgical volume and hypofractionated PORT (a single focal dose (SFD) of 3 Gy; 5 fractions per week, a cumulative focal dose (CFD) of 36-39 Gy (43.2-46.8 Gy-eq)) or classical fractionation (SFD2 Gy, 5 fractions per week, CFD44 Gy). An analysis was carried out in the groups of patients younger and older than 60 years with central or peripheral cancer, squamous cell carcinoma or adenocarcinoma, with different tumor grading according to the T criterion (T1-4). Results. PORT in radically operated patients with NSCLC increased 5- and 10-year OS rates only in central squamous cell lung cancer (56.1% and 39.5% vs.25.4% and 4.3%, p = 0.002). This group receiving combination therapy showed a statistically significant increasing trend in 5-year OS rates for both pT1-2 tumors (57.5% vs. 21.3%, respectively, p = 0.013) and pT3-4 tumors (53.9% versus 26.0%; p = 0.044), so did patients younger than 61 years (65.5% vs.29.4%, p = 0.008) and those over 60 years old (47.5% vs.21.3%, p = 0.047). Patients with peripheral squamous cell carcinoma or lung adenocarcinoma at any site exhibited no statistically significant increase in OS after PORT. In general, the 5- and 10-year OS rates in the compared groups were statistically significantly higher in the PORT group (47.9% and 28.9% vs. 27.1% and 11.4, p = 0.006). None of the analyzed subgroups showed a decrease in OS after PORT. Conclusion. In patients with pN1 NSCLC who had radical surgery via lobectomy/bilobectomy or pulmonectomy with ipsilateral mediastinal lymphadenectomy, PORT can be recommended only for those with central squamous cell carcinoma, regardless of tumor size and age group. In other subgroups of patients with pN1 NSCLC, PORT can only be performed within the scientific protocols. The expediency of PORT after bilateral mediastinal lymph node dissection needs to be investigated.
目的:比较分析非小细胞肺癌(NSCLC)伴肺根淋巴结(pN1)手术与术后放疗联合治疗(PORT)患者的总生存率(OS)。研究对象和方法。在310例2-3级NSCLC患者中研究了OS。(pT1a-4N1M0): 101例肺叶/胆叶切除、肺切除合并同侧纵隔淋巴结切除术后的患者，以及209例手术体积相近、低分割PORT联合治疗后的患者(单局剂量(SFD) 3 Gy;5个分数/周，累积病灶剂量(CFD) 36-39 Gy (43.2-46.8 Gy-eq))或经典分离(SFD2 Gy, 5个分数/周，CFD44 Gy)。对中枢性或外周性肿瘤、鳞状细胞癌或腺癌患者进行分组分析，根据T标准(T1-4)进行不同的肿瘤分级。结果。非小细胞肺癌根治性手术患者的PORT仅在中心性鳞状细胞肺癌患者中增加了5年和10年的OS(56.1%和39.5% vs.25.4%和4.3%，p = 0.002)。该组接受联合治疗的pT1-2肿瘤(57.5% vs. 21.3%， p = 0.013)和pT3-4肿瘤(53.9% vs. 26.0%;P = 0.044)， 61岁以下患者(65.5% vs.29.4%， P = 0.008)和60岁以上患者(47.5% vs.21.3%， P = 0.047)也有同样的情况。外周鳞状细胞癌或肺腺癌患者在任何部位进行PORT后的OS均无统计学意义的增加。总的来说，PORT组5年和10年的OS率高于对照组(47.9%和28.9% vs. 27.1%和11.4,p = 0.006)。所有分析的亚组均未显示PORT后OS降低。结论。pN1 NSCLC患者行根治性手术，包括肺叶切除/胆叶切除或肺切除合并同侧纵隔淋巴结切除术，PORT仅可推荐给中枢性鳞状细胞癌患者，无论肿瘤大小和年龄。在pN1 NSCLC患者的其他亚组中，PORT只能在科学方案下进行。双侧纵隔淋巴结清扫后行PORT术的适宜性有待探讨。
{"title":"Impact of Postoperative Radiotherapy on Overall Survival in Patients with pN1 Non-Small Cell Lung Cancer","authors":"V. Solodkiy, Vladimir M. Sotnikov, V. Chkhikvadze, Nikolay V. Nudnov, S. Trotsenko","doi":"10.20862/0042-4676-2021-102-6-338-348","DOIUrl":"https://doi.org/10.20862/0042-4676-2021-102-6-338-348","url":null,"abstract":"Objective: to comparatively analyze overall survival (OS) in patients with non-small cell lung cancer (NSCLC) with affected lymph nodes (pN1) of the lung root after surgical and combination treatment with postoperative radiotherapy (PORT). Subjects and methods. OS was studied in 310 patients with grade 2-3 NSCLC. (pT1a-4N1M0): in 101 patients after lobectomy/bilobectomy, pulmonectomy with ipsilateral mediastinal lymphadenectomy and in 209 patients after combination treatment with the similar surgical volume and hypofractionated PORT (a single focal dose (SFD) of 3 Gy; 5 fractions per week, a cumulative focal dose (CFD) of 36-39 Gy (43.2-46.8 Gy-eq)) or classical fractionation (SFD2 Gy, 5 fractions per week, CFD44 Gy). An analysis was carried out in the groups of patients younger and older than 60 years with central or peripheral cancer, squamous cell carcinoma or adenocarcinoma, with different tumor grading according to the T criterion (T1-4). Results. PORT in radically operated patients with NSCLC increased 5- and 10-year OS rates only in central squamous cell lung cancer (56.1% and 39.5% vs.25.4% and 4.3%, p = 0.002). This group receiving combination therapy showed a statistically significant increasing trend in 5-year OS rates for both pT1-2 tumors (57.5% vs. 21.3%, respectively, p = 0.013) and pT3-4 tumors (53.9% versus 26.0%; p = 0.044), so did patients younger than 61 years (65.5% vs.29.4%, p = 0.008) and those over 60 years old (47.5% vs.21.3%, p = 0.047). Patients with peripheral squamous cell carcinoma or lung adenocarcinoma at any site exhibited no statistically significant increase in OS after PORT. In general, the 5- and 10-year OS rates in the compared groups were statistically significantly higher in the PORT group (47.9% and 28.9% vs. 27.1% and 11.4, p = 0.006). None of the analyzed subgroups showed a decrease in OS after PORT. Conclusion. In patients with pN1 NSCLC who had radical surgery via lobectomy/bilobectomy or pulmonectomy with ipsilateral mediastinal lymphadenectomy, PORT can be recommended only for those with central squamous cell carcinoma, regardless of tumor size and age group. In other subgroups of patients with pN1 NSCLC, PORT can only be performed within the scientific protocols. The expediency of PORT after bilateral mediastinal lymph node dissection needs to be investigated.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47776929","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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