BACKGROUND: The use of telemedicine technologies in the provision of medical care is becoming a widespread phenomenon. The law is designed to regulate emerging social relations in order to prevent negative manifestations and organize their harmonious development. In the field of medicine, it is important to establish legal norms aimed at protecting and safeguarding the rights and legitimate interests of the patient, since fundamental natural human rights — the right to health care and life — are affected. The provision of a wide margin of discretion to those engaged in medical-legal relations may result in a significant violation of the constitutional right of a citizen to health. One of the principal applications of telemedicine technologies is remote consultation with the patient. AIM: The aim of the study was to review the current legal framework regulating remote patient consultations, identify problematic issues, and propose solutions to address these issues. MATERIALS AND METHODS: The materials of the present study are the Federal Law dated November 21, 2011 № 323-FZ “On the Fundamentals of Health Protection of Citizens in the Russian Federation”, Order of the Ministry of Health of the Russian Federation dated November 30, 2017 № 965n, Order of the Ministry of Health of the Russian Federation dated September 14, 2020 N 972n. The research methods are formal-legal, comparative-legal, as well as general scientific methods of cognition. RESULTS: The general legal regulation permits remote consultation with the patient in the absence of a face-to-face preliminary visit to the attending physician (Art. 36.2 of the Federal Law dated November 21, 2011 No. 323-FZ “On the Fundamentals of Health Protection of Citizens in the Russian Federation”). Nevertheless, the physician is constrained in his authority to prescribe treatment, modify previously prescribed therapy, or issue an electronic prescription. The result of such a consultation is a medical report. Should the physician determine that a face-to-face appointment is necessary, the patient may be advised to undergo preliminary examinations (clauses 47 and 48 of the Procedure for the Organization and Provision of Medical Care with the Use of Telemedicine Technologies, approved by Order of the Ministry of Health of the Russian Federation No. 965n dated November 30, 2017). Consequently, there are issues pertaining to the determination of the potential content of the medical report (clause 9 of the aforementioned Order). This affects the scope of liability, as the consulting physician is liable within the limits of the issued medical opinion. Furthermore, these provisions conflict with the requirements to indicate in the medical report reasonable conclusions about the presence (absence) of diseases, the presence of medical indications or medical contraindications for the use of methods of medical examination and (or) treatment, to determine the effectiveness and validity of therapeutic and diagnost
{"title":"Legal regulation of remote consultation in the field of telemedicine","authors":"M. A. Kovalenko","doi":"10.17816/dd626878","DOIUrl":"https://doi.org/10.17816/dd626878","url":null,"abstract":"BACKGROUND: The use of telemedicine technologies in the provision of medical care is becoming a widespread phenomenon. The law is designed to regulate emerging social relations in order to prevent negative manifestations and organize their harmonious development. In the field of medicine, it is important to establish legal norms aimed at protecting and safeguarding the rights and legitimate interests of the patient, since fundamental natural human rights — the right to health care and life — are affected. The provision of a wide margin of discretion to those engaged in medical-legal relations may result in a significant violation of the constitutional right of a citizen to health. One of the principal applications of telemedicine technologies is remote consultation with the patient. \u0000AIM: The aim of the study was to review the current legal framework regulating remote patient consultations, identify problematic issues, and propose solutions to address these issues. \u0000MATERIALS AND METHODS: The materials of the present study are the Federal Law dated November 21, 2011 № 323-FZ “On the Fundamentals of Health Protection of Citizens in the Russian Federation”, Order of the Ministry of Health of the Russian Federation dated November 30, 2017 № 965n, Order of the Ministry of Health of the Russian Federation dated September 14, 2020 N 972n. The research methods are formal-legal, comparative-legal, as well as general scientific methods of cognition. \u0000RESULTS: The general legal regulation permits remote consultation with the patient in the absence of a face-to-face preliminary visit to the attending physician (Art. 36.2 of the Federal Law dated November 21, 2011 No. 323-FZ “On the Fundamentals of Health Protection of Citizens in the Russian Federation”). Nevertheless, the physician is constrained in his authority to prescribe treatment, modify previously prescribed therapy, or issue an electronic prescription. The result of such a consultation is a medical report. Should the physician determine that a face-to-face appointment is necessary, the patient may be advised to undergo preliminary examinations (clauses 47 and 48 of the Procedure for the Organization and Provision of Medical Care with the Use of Telemedicine Technologies, approved by Order of the Ministry of Health of the Russian Federation No. 965n dated November 30, 2017). Consequently, there are issues pertaining to the determination of the potential content of the medical report (clause 9 of the aforementioned Order). This affects the scope of liability, as the consulting physician is liable within the limits of the issued medical opinion. Furthermore, these provisions conflict with the requirements to indicate in the medical report reasonable conclusions about the presence (absence) of diseases, the presence of medical indications or medical contraindications for the use of methods of medical examination and (or) treatment, to determine the effectiveness and validity of therapeutic and diagnost","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":"79 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141681991","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}
V. V. Popov, Yulia A. Stankevich, L. M. Vasilkiv, A. Tulupov
BACKGROUND: Non-contrast magnetic resonance perfusion can identify areas of cerebral perfusion changes in patients with multiple sclerosis, even in the absence of focal lesions [1]. This technique offers several advantages, including non-invasiveness [2] and a short data collection time, which allows for repeated examinations and dynamic monitoring without contrast loading on the patient. The use of contrast-free magnetic resonance perfusion in patients with multiple sclerosis may prove to be a valuable diagnostic, management, and evaluation tool for the disease course. Nevertheless, the quantitative assessment of perfusion in multiple sclerosis remains a relatively understudied area in clinical practice [3]. The application of the developed algorithm for postprocessing of non-contrast MR perfusion data allows for the assessment of specific areas of interest and the estimation of absolute perfusion values in milliliters per 100 grams per minute. AIM: The study aims to develop an algorithm and investigate cerebral perfusion changes by non-contrast magnetic resonance perfusion in patients with multiple sclerosis compared with controls. MATERIALS AND METHODS: The study population comprises patients with multiple sclerosis (n=15) and a control group (n=15). The methodology employed in this study is magnetic resonance imaging on a 3.0T Philips Ingenia machine, using the basic study protocol (T1- and T2-weighted images, FLAIR, DIR, and CE_T1) and supplemented with pseudo-continuous arterial spin labeling (pCASL). The statistical analysis employed nonparametric methods. RESULTS: The quantitative processing of non-contrast perfusion data presents significant challenges. To address this, an algorithm was developed, which incorporates the use of the following software: Radiant, MatLAB, FSL (BASIL), MriCroGL, PyCharm. The perfusion in a group of conditionally healthy volunteers, without consideration of liquor-containing spaces and cerebral vessels, was isolated and co-registered with the atlas of T1-weighted images. The average perfusion was found to be 52.8±1.32 mL/(100 g×min), which is consistent with the findings of leading studies worldwide and reflects the efficacy and quality of the algorithm [4, 5]. Furthermore, within the context of the study, values for the demyelination focus [9.7 ± 5.4 mL/(100 g×min)] and for the visually intact white matter of the cerebral hemispheres [46.1 ± 1.7 mL/(100 g×min)] were obtained in the group of patients with multiple sclerosis. Moreover, a diffuse decrease in perfusion indices in visually intact regions of the cerebral hemispheres relative to the control group was revealed. This finding is also widely reported in the scientific literature [6]. CONCLUSIONS: The application of the developed algorithm for the analysis of pseudo-continuous arterial spin labeling in patients with multiple sclerosis allows for the assessment of perfusion in both the focus of demyelination and in the visually intact white matter of t
{"title":"Non-contrast quantitative study of brain perfusion changes in multiple sclerosis","authors":"V. V. Popov, Yulia A. Stankevich, L. M. Vasilkiv, A. Tulupov","doi":"10.17816/dd625953","DOIUrl":"https://doi.org/10.17816/dd625953","url":null,"abstract":"BACKGROUND: Non-contrast magnetic resonance perfusion can identify areas of cerebral perfusion changes in patients with multiple sclerosis, even in the absence of focal lesions [1]. This technique offers several advantages, including non-invasiveness [2] and a short data collection time, which allows for repeated examinations and dynamic monitoring without contrast loading on the patient. The use of contrast-free magnetic resonance perfusion in patients with multiple sclerosis may prove to be a valuable diagnostic, management, and evaluation tool for the disease course. Nevertheless, the quantitative assessment of perfusion in multiple sclerosis remains a relatively understudied area in clinical practice [3]. The application of the developed algorithm for postprocessing of non-contrast MR perfusion data allows for the assessment of specific areas of interest and the estimation of absolute perfusion values in milliliters per 100 grams per minute. \u0000AIM: The study aims to develop an algorithm and investigate cerebral perfusion changes by non-contrast magnetic resonance perfusion in patients with multiple sclerosis compared with controls. \u0000MATERIALS AND METHODS: The study population comprises patients with multiple sclerosis (n=15) and a control group (n=15). The methodology employed in this study is magnetic resonance imaging on a 3.0T Philips Ingenia machine, using the basic study protocol (T1- and T2-weighted images, FLAIR, DIR, and CE_T1) and supplemented with pseudo-continuous arterial spin labeling (pCASL). The statistical analysis employed nonparametric methods. \u0000RESULTS: The quantitative processing of non-contrast perfusion data presents significant challenges. To address this, an algorithm was developed, which incorporates the use of the following software: Radiant, MatLAB, FSL (BASIL), MriCroGL, PyCharm. The perfusion in a group of conditionally healthy volunteers, without consideration of liquor-containing spaces and cerebral vessels, was isolated and co-registered with the atlas of T1-weighted images. The average perfusion was found to be 52.8±1.32 mL/(100 g×min), which is consistent with the findings of leading studies worldwide and reflects the efficacy and quality of the algorithm [4, 5]. Furthermore, within the context of the study, values for the demyelination focus [9.7 ± 5.4 mL/(100 g×min)] and for the visually intact white matter of the cerebral hemispheres [46.1 ± 1.7 mL/(100 g×min)] were obtained in the group of patients with multiple sclerosis. Moreover, a diffuse decrease in perfusion indices in visually intact regions of the cerebral hemispheres relative to the control group was revealed. This finding is also widely reported in the scientific literature [6]. \u0000CONCLUSIONS: The application of the developed algorithm for the analysis of pseudo-continuous arterial spin labeling in patients with multiple sclerosis allows for the assessment of perfusion in both the focus of demyelination and in the visually intact white matter of t","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":"140 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141681821","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}
BACKGROUND: Viral pneumonia represents a significant and potentially life-threatening complication of coronavirus infection. It can result in a range of adverse outcomes, including pulmonary embolism. However, the prevalence of pulmonary embolism in these patients remains poorly understood. Multispiral computed tomographic angiography offers a valuable tool for studying the unique characteristics of radiation diagnostics in this disease and identifying specific signs of this complication. AIM: The aim of this study is to improve the diagnosis of pulmonary embolism in patients with SARS-CoV-2 virus-induced pneumonia using multispiral computed tomographic angiography. MATERIALS AND METHODS: A retrospective review of medical records and multispiral computed tomographic angiography data from 200 patients with viral pneumonia (COVID-19) who were treated between May 25, 2021, and October 15, 2021, for suspected pulmonary embolism based on laboratory findings was conducted. RESULTS: Of the total number of patients (58.5% female, 41.5% male), the majority were aged between 60 and 69 years. Pulmonary embolism was confirmed in 42 patients, which constituted 21% of the total number. This group included 36% males and 62% females. When the localization of thromboemboli was assessed, it was found that 64.3% of cases had a peripheral localization, 24% of cases had thromboemboli at the level of lobular branches, 7.1% of cases had thromboemboli in the main arteries and pulmonary trunk, and 4.6% of cases had thromboemboli in the pulmonary trunk. In the assessment of pulmonary perfusion disorders, the majority of patients exhibited a degree of severity classified as I (78.6%), with a smaller proportion classified as III or IV (11.9% and 9.5%, respectively). A statistical analysis of the incidence of pulmonary embolism in patients with varying degrees of pneumonia severity revealed that in over half of the cases, the condition was confirmed in patients with minimal pulmonary parenchyma lesions. Specifically, 22 (52.4%) patients exhibited this pattern. The second part accounted for 16.6% of cases with critical severity of pneumonia, 16.7% with moderate severity, 11.9% with significant severity, and only 2.4% of cases with regression of inflammatory infiltration. Among patients with pulmonary embolism, pneumonia was in the advanced stage in 35.7% of cases, the peak stage in 33.3%, the incomplete stage in 21.4%, the early stage in 7.2%, and the resolution stage in 2.4%. However, when comparing the severity and stage of pneumonia in patients with confirmed and unconfirmed pulmonary embolism, no statistically significant differences between these parameters were found (p 0.05). CONCLUSIONS: Among patients with suspected pulmonary embolism and viral pneumonia, 21% had a confirmed diagnosis. Of these, 64.3% had a peripheral localization of thromboemboli, 78.6% had grade I impairment of pulmonary perfusion, and most cases were in the advanced (35.7%) and peak (33.3%) st
{"title":"Diagnosis of pulmonary embolism in patients with viral pneumonia using multislice spiral computed tomographic angiography","authors":"Ekaterina P. Kalinina, I. B. Belova","doi":"10.17816/dd626886","DOIUrl":"https://doi.org/10.17816/dd626886","url":null,"abstract":"BACKGROUND: Viral pneumonia represents a significant and potentially life-threatening complication of coronavirus infection. It can result in a range of adverse outcomes, including pulmonary embolism. However, the prevalence of pulmonary embolism in these patients remains poorly understood. Multispiral computed tomographic angiography offers a valuable tool for studying the unique characteristics of radiation diagnostics in this disease and identifying specific signs of this complication. \u0000AIM: The aim of this study is to improve the diagnosis of pulmonary embolism in patients with SARS-CoV-2 virus-induced pneumonia using multispiral computed tomographic angiography. \u0000MATERIALS AND METHODS: A retrospective review of medical records and multispiral computed tomographic angiography data from 200 patients with viral pneumonia (COVID-19) who were treated between May 25, 2021, and October 15, 2021, for suspected pulmonary embolism based on laboratory findings was conducted. \u0000RESULTS: Of the total number of patients (58.5% female, 41.5% male), the majority were aged between 60 and 69 years. Pulmonary embolism was confirmed in 42 patients, which constituted 21% of the total number. This group included 36% males and 62% females. When the localization of thromboemboli was assessed, it was found that 64.3% of cases had a peripheral localization, 24% of cases had thromboemboli at the level of lobular branches, 7.1% of cases had thromboemboli in the main arteries and pulmonary trunk, and 4.6% of cases had thromboemboli in the pulmonary trunk. In the assessment of pulmonary perfusion disorders, the majority of patients exhibited a degree of severity classified as I (78.6%), with a smaller proportion classified as III or IV (11.9% and 9.5%, respectively). A statistical analysis of the incidence of pulmonary embolism in patients with varying degrees of pneumonia severity revealed that in over half of the cases, the condition was confirmed in patients with minimal pulmonary parenchyma lesions. Specifically, 22 (52.4%) patients exhibited this pattern. The second part accounted for 16.6% of cases with critical severity of pneumonia, 16.7% with moderate severity, 11.9% with significant severity, and only 2.4% of cases with regression of inflammatory infiltration. Among patients with pulmonary embolism, pneumonia was in the advanced stage in 35.7% of cases, the peak stage in 33.3%, the incomplete stage in 21.4%, the early stage in 7.2%, and the resolution stage in 2.4%. However, when comparing the severity and stage of pneumonia in patients with confirmed and unconfirmed pulmonary embolism, no statistically significant differences between these parameters were found (p 0.05). \u0000CONCLUSIONS: Among patients with suspected pulmonary embolism and viral pneumonia, 21% had a confirmed diagnosis. Of these, 64.3% had a peripheral localization of thromboemboli, 78.6% had grade I impairment of pulmonary perfusion, and most cases were in the advanced (35.7%) and peak (33.3%) st","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":" 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680675","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}
Zoya V. Karaseva, A. S. Ametov, Victoria G. Saltykova, E. Pashkova, Larisa V. Kuznetsova, Ksenia G. Yudina
BACKGROUND: Diabetic polyneuropathy remains a significant and urgent problem in the context of diabetes mellitus, affecting more than a quarter of patients with type 2 diabetes mellitus. Currently, the method of peripheral nerve examination using ultrasound is gaining worldwide popularity. In the Russian Federation, however, it remains widely used only in some medical institutions. The ultrasound method employs the indicator “nerve cross-sectional area” to diagnose this complication, exhibiting a high degree of sensitivity (93%) in comparison to magnetic resonance imaging data (67%). Foreign and Russian studies [3, 4] confirm the observed increase in the cross-sectional area of the nerve in patients with diabetes mellitus. AIM: The study aimed to assess the diagnostic value of the ultrasound method of peripheral nerve examination in the detection of diabetic polyneuropathy in patients with type 2 diabetes mellitus. MATERIALS AND METHODS: The Philips Epiq 7 ultrasonic diagnostic device (USA) with a linear transducer, operating at a frequency of 4–18 MHz, was used. The comparison group consisted of 30 volunteers. The main group comprised 25 patients with type 2 diabetes mellitus and confirmed diabetic polyneuropathy, as determined by electroneuromyography and physical examination methods. The median cross-sectional area of the sciatic and common peroneal nerves in patients with type 2 diabetes mellitus and healthy volunteers was calculated. The criterion for a difference in area values was calculated using the Mann-Whitney test. RESULTS: The cross-sectional area thresholds were determined based on the 95th percentile of a cohort of healthy volunteers. In patients with type 2 diabetes mellitus, the following median nerve cross-sectional area values were found: for the sciatic nerve, 0.579 cm2 (at the gluteal crease) and 0.553 cm2 (2 cm proximal to the bifurcation); for the common peroneal nerve, 0.11 cm2 (1 cm distal to the bifurcation of the sciatic nerve) and 0.08 cm2 (at the level of the head of the fibula). In healthy volunteers, the values were as follows: for the sciatic nerve, 0.46 cm2 (at the gluteal crease) and 0.37 cm2 (2 cm proximal to the bifurcation); for the common peroneal nerve, 0.08 cm2 (1 cm distal to the bifurcation of the sciatic nerve) and 0.06 cm2 (at the level of the head of the fibula). A significant difference was found between the control and target groups using the Mann-Whitney test (p 0.01). CONCLUSIONS: In patients with type 2 diabetes mellitus and diabetic polyneuropathy, a significant increase in the cross-sectional area of the nerves of the lower extremities (sciatic and peroneal nerves) was revealed, which allows for the use of ultrasound as an additional method for the instrumental diagnosis of diabetic polyneuropathy. However, due to the small sample size, further study is required to confirm these findings.
{"title":"Diagnosis of diabetic polyneuropathy in type 2 diabetes mellitus: focus on changes in peripheral nerves according to ultrasonic research method","authors":"Zoya V. Karaseva, A. S. Ametov, Victoria G. Saltykova, E. Pashkova, Larisa V. Kuznetsova, Ksenia G. Yudina","doi":"10.17816/dd626159","DOIUrl":"https://doi.org/10.17816/dd626159","url":null,"abstract":"BACKGROUND: Diabetic polyneuropathy remains a significant and urgent problem in the context of diabetes mellitus, affecting more than a quarter of patients with type 2 diabetes mellitus. \u0000Currently, the method of peripheral nerve examination using ultrasound is gaining worldwide popularity. In the Russian Federation, however, it remains widely used only in some medical institutions. \u0000The ultrasound method employs the indicator “nerve cross-sectional area” to diagnose this complication, exhibiting a high degree of sensitivity (93%) in comparison to magnetic resonance imaging data (67%). Foreign and Russian studies [3, 4] confirm the observed increase in the cross-sectional area of the nerve in patients with diabetes mellitus. \u0000AIM: The study aimed to assess the diagnostic value of the ultrasound method of peripheral nerve examination in the detection of diabetic polyneuropathy in patients with type 2 diabetes mellitus. \u0000MATERIALS AND METHODS: The Philips Epiq 7 ultrasonic diagnostic device (USA) with a linear transducer, operating at a frequency of 4–18 MHz, was used. The comparison group consisted of 30 volunteers. The main group comprised 25 patients with type 2 diabetes mellitus and confirmed diabetic polyneuropathy, as determined by electroneuromyography and physical examination methods. \u0000The median cross-sectional area of the sciatic and common peroneal nerves in patients with type 2 diabetes mellitus and healthy volunteers was calculated. The criterion for a difference in area values was calculated using the Mann-Whitney test. \u0000RESULTS: The cross-sectional area thresholds were determined based on the 95th percentile of a cohort of healthy volunteers. \u0000In patients with type 2 diabetes mellitus, the following median nerve cross-sectional area values were found: for the sciatic nerve, 0.579 cm2 (at the gluteal crease) and 0.553 cm2 (2 cm proximal to the bifurcation); for the common peroneal nerve, 0.11 cm2 (1 cm distal to the bifurcation of the sciatic nerve) and 0.08 cm2 (at the level of the head of the fibula). In healthy volunteers, the values were as follows: for the sciatic nerve, 0.46 cm2 (at the gluteal crease) and 0.37 cm2 (2 cm proximal to the bifurcation); for the common peroneal nerve, 0.08 cm2 (1 cm distal to the bifurcation of the sciatic nerve) and 0.06 cm2 (at the level of the head of the fibula). \u0000A significant difference was found between the control and target groups using the Mann-Whitney test (p 0.01). \u0000CONCLUSIONS: In patients with type 2 diabetes mellitus and diabetic polyneuropathy, a significant increase in the cross-sectional area of the nerves of the lower extremities (sciatic and peroneal nerves) was revealed, which allows for the use of ultrasound as an additional method for the instrumental diagnosis of diabetic polyneuropathy. However, due to the small sample size, further study is required to confirm these findings.","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680961","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}
Mikhail S. Maltsev, A. A. Trukhin, A. V. Manaev, M. V. Reinberg
BACKGROUND: The management of differentiated thyroid cancer includes single-photon emission tomography combined with X-ray computed tomography after radioiodine therapy. Despite a good response to surgery and radioiodine therapy, recurrence is noted in some cases, leading to an unfavorable prognosis in 8% of cases [1]. A preliminary analysis of the distribution of I-131 in residual thyroid tissues and foci of metastasis allows for the estimation of the probability of differentiated cancer recurrence. Currently, there is no method that is simultaneously effective and easy to perform for predicting the recurrence of differentiated thyroid cancer. AIM: The aim of the study was to develop a technique for extracting and computing textural features of the I-131 accumulation region using a single-photon emission tomography system corresponding to differentiated thyroid cancer tissue. MATERIALS AND METHODS: A retrospective analysis of single-photon emission tomography combined with X-ray computed tomography of the neck and thorax of 23 patients was conducted. Regions of interest, including foci of I-131 accumulation in the primary tumor bed, regional and distant metastases, were delineated in Xeleris 4DR software. The obtained mask with the original image was processed in a program written with the help of the Matlab package, which localizes the foci. The textural features of foci are calculated based on the obtained spatial adjacency matrix. This matrix shows how often pixels with certain gray scale brightness values occur in an image. Therefore, the features based on the spatial adjacency matrix reflect the frequency distribution of different pixel neighborhoods in a given context. RESULTS: An algorithm for constructing three-dimensional matrices of a radiation source surrounded by tissue of differentiated thyroid cancer was developed. The textural features of three-dimensional matrices were investigated. It was demonstrated that there are tendencies for differences in texture features corresponding to the ordering of pixel values and image contrast. The values of the obtained features obey the lognormal distribution. CONCLUSIONS: An algorithm for extracting textural features of I-131 accumulation foci allows post-therapy single-photon emission tomography images combined with X-ray computed tomography to be analyzed for the likelihood of recurrence of differentiated thyroid cancer.
背景：分化型甲状腺癌的治疗包括放射碘治疗后的单光子发射断层扫描和 X 射线计算机断层扫描。尽管手术和放射性碘治疗反应良好，但仍有一些病例出现复发，导致8%的病例预后不良[1]。对残留甲状腺组织和转移灶中的I-131分布进行初步分析，可以估计分化癌复发的概率。目前，预测分化型甲状腺癌复发还没有一种既有效又简便的方法。目的：本研究旨在开发一种技术，利用单光子发射断层成像系统提取和计算分化型甲状腺癌组织相应的 I-131 累积区的纹理特征。材料与方法：研究人员对 23 名患者的颈部和胸部单光子发射断层扫描结合 X 射线计算机断层扫描进行了回顾性分析。在 Xeleris 4DR 软件中划定了感兴趣的区域，包括原发肿瘤床、区域和远处转移灶的 I-131 聚集灶。利用 Matlab 软件包编写的程序对获得的掩膜和原始图像进行处理，从而确定病灶的位置。病灶的纹理特征是根据获得的空间邻接矩阵计算出来的。该矩阵显示了具有特定灰度亮度值的像素在图像中出现的频率。因此，基于空间邻接矩阵的特征反映了不同像素邻域在给定上下文中的频率分布。结果：开发出了一种构建分化型甲状腺癌组织周围辐射源三维矩阵的算法。研究了三维矩阵的纹理特征。结果表明，与像素值排序和图像对比度相对应的纹理特征存在差异趋势。获得的特征值服从对数正态分布。结论通过一种提取 I-131 积聚灶纹理特征的算法，可以结合 X 射线计算机断层扫描对治疗后的单光子发射断层扫描图像进行分析，以确定分化型甲状腺癌复发的可能性。
{"title":"Emission textural features I-131 of differentiated thyroid cancer tissue","authors":"Mikhail S. Maltsev, A. A. Trukhin, A. V. Manaev, M. V. Reinberg","doi":"10.17816/dd626496","DOIUrl":"https://doi.org/10.17816/dd626496","url":null,"abstract":"BACKGROUND: The management of differentiated thyroid cancer includes single-photon emission tomography combined with X-ray computed tomography after radioiodine therapy. Despite a good response to surgery and radioiodine therapy, recurrence is noted in some cases, leading to an unfavorable prognosis in 8% of cases [1]. A preliminary analysis of the distribution of I-131 in residual thyroid tissues and foci of metastasis allows for the estimation of the probability of differentiated cancer recurrence. Currently, there is no method that is simultaneously effective and easy to perform for predicting the recurrence of differentiated thyroid cancer. \u0000AIM: The aim of the study was to develop a technique for extracting and computing textural features of the I-131 accumulation region using a single-photon emission tomography system corresponding to differentiated thyroid cancer tissue. \u0000MATERIALS AND METHODS: A retrospective analysis of single-photon emission tomography combined with X-ray computed tomography of the neck and thorax of 23 patients was conducted. Regions of interest, including foci of I-131 accumulation in the primary tumor bed, regional and distant metastases, were delineated in Xeleris 4DR software. The obtained mask with the original image was processed in a program written with the help of the Matlab package, which localizes the foci. The textural features of foci are calculated based on the obtained spatial adjacency matrix. This matrix shows how often pixels with certain gray scale brightness values occur in an image. Therefore, the features based on the spatial adjacency matrix reflect the frequency distribution of different pixel neighborhoods in a given context. \u0000RESULTS: An algorithm for constructing three-dimensional matrices of a radiation source surrounded by tissue of differentiated thyroid cancer was developed. The textural features of three-dimensional matrices were investigated. It was demonstrated that there are tendencies for differences in texture features corresponding to the ordering of pixel values and image contrast. The values of the obtained features obey the lognormal distribution. \u0000CONCLUSIONS: An algorithm for extracting textural features of I-131 accumulation foci allows post-therapy single-photon emission tomography images combined with X-ray computed tomography to be analyzed for the likelihood of recurrence of differentiated thyroid cancer.","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680685","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}
BACKGROUND: Anthropomorphic vascular test objects are an important tool for improving computed tomography angiography studies, as they allow avoiding the impact of radiation exposure on the patient. The presented work is a continuation of the research in the field of development and implementation of the system of pulse blood flow simulation of vessels for computed tomography angiography studies. Based on the results of successful validation of the experimental test bench using simplified test objects [1], the work on creation of anthropomorphic test objects of the abdominal aorta imitating normal and aneurysmatically dilated vessels was initiated and carried out. AIM: Creation of anthropomorphic test objects of the abdominal aorta from materials that simultaneously mimic the biomechanical and X-ray properties of the real vessel. MATERIALS AND METHODS: Publicly available computed tomography data of patients were selected to create anthropomorphic test objects [2]. 3D Slicer software was used to segment studies containing normal and aneurysmatically dilated abdominal aortic lumen. The models obtained during segmentation were processed using Autodesk Meshmixer computer-aided design system. Model preparation for printing was performed using Polygon X computer-aided design system. The models were printed from water-soluble plastic using Picaso X PRO 3D printer. The resulting model was used as the basis for creating a test object using the smearing method. In order to ensure uniform thickness of the vessel wall, a structure, which is a rotating frame with adjustable speed, was developed. A combination of silicone matrix and reinforcing threads was used as a tissueimitating material with the required X-ray and biomechanical properties [3]. RESULTS: Anthropomorphic test objects were made for cases of normal and aneurysmatically dilated abdominal aortic lumen in 1:3 and 1:1 scale. A technological process of material application was developed, which made it possible to obtain a uniform layer of material over the entire volume of the model. CONCLUSION: The results are intended for the development of computed tomography angiographyusing anthropomorphic test objects that allow taking into account the individual characteristics of the patient. Further development of the project involves testing of the obtained test objects within the framework of computed tomography angiography research using a device simulating pulse blood flow.
背景：拟人化血管测试对象是改进计算机断层扫描血管成像研究的重要工具，因为它们可以避免辐射对病人的影响。本文介绍的工作是计算机断层扫描血管成像研究中血管脉冲血流模拟系统开发和实施领域研究的继续。在使用简化测试对象成功验证实验测试台的结果[1]的基础上，开始并实施了仿造正常血管和动脉瘤扩张血管的腹主动脉拟人测试对象的创建工作。目的：用能同时模拟真实血管的生物力学和 X 射线特性的材料制作腹主动脉拟人化测试物体。材料和方法：选择公开的患者计算机断层扫描数据来创建拟人测试对象[2]。使用 3D Slicer 软件对包含正常和动脉瘤扩张腹主动脉管腔的研究进行分割。分割过程中获得的模型使用 Autodesk Meshmixer 计算机辅助设计系统进行处理。打印模型的准备工作使用 Polygon X 计算机辅助设计系统进行。使用 Picaso X PRO 三维打印机用水溶性塑料打印模型。生成的模型被用作使用涂抹法创建测试对象的基础。为了确保血管壁的厚度均匀一致，我们开发了一种结构，即一个速度可调的旋转框架。硅酮基质和加强线的组合被用作组织模拟材料，具有所需的 X 射线和生物力学特性[3]。结果：以 1:3 和 1:1 的比例为正常和动脉瘤扩张的腹主动脉管腔制作了拟人化的测试对象。开发了一种材料应用技术流程，从而可以在模型的整个体积上获得均匀的材料层。结论：该成果旨在利用拟人化测试对象开发计算机断层扫描血管成像技术，从而考虑到病人的个体特征。该项目的进一步发展包括在计算机断层扫描血管成像研究框架内使用模拟脉搏血流的设备对获得的测试对象进行测试。
{"title":"Anthropomorphic abdominal aortic phantoms for computed tomography angiography","authors":"Anastasia V. Guseva, M. Kodenko","doi":"10.17816/dd626820","DOIUrl":"https://doi.org/10.17816/dd626820","url":null,"abstract":"BACKGROUND: Anthropomorphic vascular test objects are an important tool for improving computed tomography angiography studies, as they allow avoiding the impact of radiation exposure on the patient. The presented work is a continuation of the research in the field of development and implementation of the system of pulse blood flow simulation of vessels for computed tomography angiography studies. Based on the results of successful validation of the experimental test bench using simplified test objects [1], the work on creation of anthropomorphic test objects of the abdominal aorta imitating normal and aneurysmatically dilated vessels was initiated and carried out. \u0000AIM: Creation of anthropomorphic test objects of the abdominal aorta from materials that simultaneously mimic the biomechanical and X-ray properties of the real vessel. \u0000MATERIALS AND METHODS: Publicly available computed tomography data of patients were selected to create anthropomorphic test objects [2]. 3D Slicer software was used to segment studies containing normal and aneurysmatically dilated abdominal aortic lumen. The models obtained during segmentation were processed using Autodesk Meshmixer computer-aided design system. Model preparation for printing was performed using Polygon X computer-aided design system. The models were printed from water-soluble plastic using Picaso X PRO 3D printer. The resulting model was used as the basis for creating a test object using the smearing method. In order to ensure uniform thickness of the vessel wall, a structure, which is a rotating frame with adjustable speed, was developed. A combination of silicone matrix and reinforcing threads was used as a tissueimitating material with the required X-ray and biomechanical properties [3]. \u0000RESULTS: Anthropomorphic test objects were made for cases of normal and aneurysmatically dilated abdominal aortic lumen in 1:3 and 1:1 scale. A technological process of material application was developed, which made it possible to obtain a uniform layer of material over the entire volume of the model. \u0000CONCLUSION: The results are intended for the development of computed tomography angiographyusing anthropomorphic test objects that allow taking into account the individual characteristics of the patient. Further development of the project involves testing of the obtained test objects within the framework of computed tomography angiography research using a device simulating pulse blood flow.","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":"128 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141682558","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}
Alexander A. Fedortsov, I. Moshurov, O. V. Manukovskaya, S. M. Povarkov
BACKGROUND: The teaching of surgical skills is a complex and time-consuming process. From the time when surgery became the primary method of curing patients of diseases to the present day, the transfer of knowledge through direct participation in surgical interventions remains relevant. However, technically complex interventions, as well as those that carry a high risk of error, cannot always be allowed to be performed as a learning process. In such cases, the term “live surgery” becomes particularly relevant, as it refers to a demonstration surgery conducted in real time and broadcast on screens in a lecture-dialogue format [1]. This format is particularly valuable in the training of oncologists, whose patients initially face a number of intra- and postoperative surgical risks. AIM: The aim of this study is to demonstrate the efficacy of live surgery as an effective tool for teaching surgical skills to physicians. MATERIALS AND METHODS: A descriptive synthesis of the literature data was conducted to justify the need to implement live surgery in the process of training physician specialists. In the course of writing the paper, studies reflecting various aspects of the process of training physicians in surgical skills using telecommunication technologies were analyzed. RESULTS: In all the studies analyzed, the authors agree that the use of telecommunication technologies that facilitate live surgery sessions for the transfer of knowledge regarding operative techniques to specialists has educational value and presents an opportunity to present a list of practical skills necessary for surgical intervention in a visual and step-by-step manner [1–8]. C. T. Huerta et al. posit that live surgery broadcasts have a greater educational effect than similar manipulations presented by video recordings [2]. A significant number of authors engaged in the study of the potential applications of live surgery have sought to ascertain the safety of this procedure for the patient. The majority of these studies have demonstrated that live broadcasts do not result in an increased incidence of intra- and postoperative complications [1, 3–5], yet a few researchers have identified potential risks, which, when properly mitigated, can be effectively managed through the implementation of a set of rules for live surgery [6, 7]. Furthermore, it is important to obtain the patient’s consent to live surgical treatment prior to the event [7]. CONCLUSIONS: To summarize the above, live surgery can be considered an effective method for training medical specialists in surgical skills. Its use should become regular and technically practiced. At the same time, in order to avoid any potential harm to the patient's health, it is necessary to adhere to the clear rules of live surgery, having previously obtained the patient's informed consent to participate in this event.
背景：外科手术技能的传授是一个复杂而耗时的过程。从外科手术成为治疗病人疾病的主要方法至今，通过直接参与外科手术干预来传授知识仍然具有现实意义。然而，技术复杂的介入手术以及那些出错风险较高的手术不能总是作为学习过程来进行。在这种情况下，"现场手术 "一词就变得尤为重要，因为它指的是以讲座-对话的形式在屏幕上实时播放的示范手术[1]。这种形式对肿瘤医生的培训尤其有价值，因为肿瘤医生的病人最初会面临术中和术后的一些手术风险。目的：本研究旨在证明直播手术作为向医生传授手术技能的有效工具的有效性。材料与方法：我们对文献资料进行了描述性综合，以证明在培训专科医生的过程中实施现场手术的必要性。在撰写论文的过程中，分析了反映利用远程通信技术培训医生手术技能过程的各个方面的研究。结果：在所分析的所有研究中，作者都认为使用远程通信技术促进现场手术课程，向专科医生传授手术技术知识具有教育价值，并提供了一个机会，以直观和循序渐进的方式展示手术干预所需的实用技能列表[1-8]。C. T. Huerta 等人认为，手术直播比通过视频录制的类似操作具有更大的教育效果[2]。许多从事实况手术潜在应用研究的学者试图确定这种手术对病人的安全性。这些研究大多表明，直播不会导致术中和术后并发症的发生率增加[1, 3-5]，但也有少数研究人员发现了潜在的风险，这些风险如果得到适当缓解，可以通过实施一套直播手术的规则得到有效控制[6, 7]。此外，在手术前征得患者对直播手术治疗的同意也很重要[7]。结论：综上所述，真人手术可被视为培训医学专家外科技能的有效方法。这种方法应经常使用，并在技术上加以实践。同时，为了避免对患者的健康造成任何潜在伤害，有必要在事先征得患者的知情同意后，遵守现场手术的明确规则。
{"title":"“Live surgery” as a modern and visual way of training medical specialists","authors":"Alexander A. Fedortsov, I. Moshurov, O. V. Manukovskaya, S. M. Povarkov","doi":"10.17816/dd627090","DOIUrl":"https://doi.org/10.17816/dd627090","url":null,"abstract":"BACKGROUND: The teaching of surgical skills is a complex and time-consuming process. From the time when surgery became the primary method of curing patients of diseases to the present day, the transfer of knowledge through direct participation in surgical interventions remains relevant. However, technically complex interventions, as well as those that carry a high risk of error, cannot always be allowed to be performed as a learning process. In such cases, the term “live surgery” becomes particularly relevant, as it refers to a demonstration surgery conducted in real time and broadcast on screens in a lecture-dialogue format [1]. This format is particularly valuable in the training of oncologists, whose patients initially face a number of intra- and postoperative surgical risks. \u0000AIM: The aim of this study is to demonstrate the efficacy of live surgery as an effective tool for teaching surgical skills to physicians. \u0000MATERIALS AND METHODS: A descriptive synthesis of the literature data was conducted to justify the need to implement live surgery in the process of training physician specialists. In the course of writing the paper, studies reflecting various aspects of the process of training physicians in surgical skills using telecommunication technologies were analyzed. \u0000RESULTS: In all the studies analyzed, the authors agree that the use of telecommunication technologies that facilitate live surgery sessions for the transfer of knowledge regarding operative techniques to specialists has educational value and presents an opportunity to present a list of practical skills necessary for surgical intervention in a visual and step-by-step manner [1–8]. C. T. Huerta et al. posit that live surgery broadcasts have a greater educational effect than similar manipulations presented by video recordings [2]. A significant number of authors engaged in the study of the potential applications of live surgery have sought to ascertain the safety of this procedure for the patient. The majority of these studies have demonstrated that live broadcasts do not result in an increased incidence of intra- and postoperative complications [1, 3–5], yet a few researchers have identified potential risks, which, when properly mitigated, can be effectively managed through the implementation of a set of rules for live surgery [6, 7]. Furthermore, it is important to obtain the patient’s consent to live surgical treatment prior to the event [7]. \u0000CONCLUSIONS: To summarize the above, live surgery can be considered an effective method for training medical specialists in surgical skills. Its use should become regular and technically practiced. At the same time, in order to avoid any potential harm to the patient's health, it is necessary to adhere to the clear rules of live surgery, having previously obtained the patient's informed consent to participate in this event.","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":"85 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141683881","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}
Ekaterina D. Belyakova, Anastasia A. Nasibullina, Julia V. Bulgakova, Olga Vlasova, Veronika V. Grebennikova, O. Omelyanskaya, A. Petraikin, D. Leonov
BACKGROUND: The knee joint is a frequently visualized anatomical region in clinical practice. Accurate interpretation of CT scans necessitates a comprehensive understanding of anatomy and a sound grasp of fundamental technical principles and imaging protocols. To safeguard the patient's well-being, it is of paramount importance to prevent erroneous studies resulting from suboptimal equipment quality, setup issues, and patient positioning. These difficulties can be circumvented by the use of phantoms to pre-adjust the equipment and the provision of training to medical staff in scanning techniques. AIM: The aim of the study was to develop a technique for creating an anthropomorphic medical phantom of the knee joint that would accurately reflect the X-ray density of the corresponding human tissues, thus enabling the use of computed tomography studies. MATERIALS AND METHODS: The knee joint phantom comprises a series of models representing the femur, tibia, fibula, patella, collateral ligaments, lateral and medial menisci, tendon of the quadriceps femoris muscle, anterior and posterior cruciate ligaments, and patellar ligament. Ligament models were 3D-printed from resin, bones were cast from silicone, soft tissues were modeled with a homogeneous structure of silicone-like materials and made by casting into silicone molds. The skin was similarly modeled. In the study, the anode voltage range of the CT scanner varied from 80 to 140 kV, and the slice thickness was equal to 1.25 mm. RESULTS: The developed anthropomorphic knee joint phantom demonstrated the X-ray density of the modeled anatomical structures, with ligaments exhibiting a range of 80–120 units on the Hausfield scale, bones exhibiting a range of 320–370 units, and soft tissues and skin exhibiting a range of 20–60 units. The use of additive technologies made it possible to achieve a high degree of similarity between the phantom forms and the knee joint. Further research may be directed towards the creation of a more complex model of bone tissue, comprising a separate cortical layer and spongy substance. CONCLUSIONS: The use of an anthropomorphic knee phantom allows for the acquisition of high-quality CT images without the need for prior scanning of patients.
{"title":"Medical phantom of the knee joint for computed tomography studies","authors":"Ekaterina D. Belyakova, Anastasia A. Nasibullina, Julia V. Bulgakova, Olga Vlasova, Veronika V. Grebennikova, O. Omelyanskaya, A. Petraikin, D. Leonov","doi":"10.17816/dd627089","DOIUrl":"https://doi.org/10.17816/dd627089","url":null,"abstract":"BACKGROUND: The knee joint is a frequently visualized anatomical region in clinical practice. Accurate interpretation of CT scans necessitates a comprehensive understanding of anatomy and a sound grasp of fundamental technical principles and imaging protocols. To safeguard the patient's well-being, it is of paramount importance to prevent erroneous studies resulting from suboptimal equipment quality, setup issues, and patient positioning. These difficulties can be circumvented by the use of phantoms to pre-adjust the equipment and the provision of training to medical staff in scanning techniques. \u0000AIM: The aim of the study was to develop a technique for creating an anthropomorphic medical phantom of the knee joint that would accurately reflect the X-ray density of the corresponding human tissues, thus enabling the use of computed tomography studies. \u0000MATERIALS AND METHODS: The knee joint phantom comprises a series of models representing the femur, tibia, fibula, patella, collateral ligaments, lateral and medial menisci, tendon of the quadriceps femoris muscle, anterior and posterior cruciate ligaments, and patellar ligament. Ligament models were 3D-printed from resin, bones were cast from silicone, soft tissues were modeled with a homogeneous structure of silicone-like materials and made by casting into silicone molds. The skin was similarly modeled. In the study, the anode voltage range of the CT scanner varied from 80 to 140 kV, and the slice thickness was equal to 1.25 mm. \u0000RESULTS: The developed anthropomorphic knee joint phantom demonstrated the X-ray density of the modeled anatomical structures, with ligaments exhibiting a range of 80–120 units on the Hausfield scale, bones exhibiting a range of 320–370 units, and soft tissues and skin exhibiting a range of 20–60 units. The use of additive technologies made it possible to achieve a high degree of similarity between the phantom forms and the knee joint. Further research may be directed towards the creation of a more complex model of bone tissue, comprising a separate cortical layer and spongy substance. \u0000CONCLUSIONS: The use of an anthropomorphic knee phantom allows for the acquisition of high-quality CT images without the need for prior scanning of patients.","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":"48 S234","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141683037","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}
BACKGROUND: In computed tomographic angiography, anthropomorphic specimens made of tissue-mimicking materials are used to improve the diagnosis of pathological changes in arteries. The design of test objects requires the selection of materials with properties that correctly reproduce the biomechanical and radiographic characteristics of the arterial wall. Tissue-mimicking materials used in modern specimens do not always take into account the conditions under which the arterial wall functions in vivo [1]. In addition, the selection of materials is required to simulate pathological processes, such as changes in the thickness of the arterial wall in the area of the aneurysm, simulation of thrombus [2]. The choice of tissue-mimicking materials to create a test specimen has a significant impact on the results of studies conducted with these materials. AIM: The aim of this study is to ascertain the biomechanical and X-ray properties of tissue-mimicking materials for the anthropomorphic modeling of arterial vascular test objects. MATERIALS AND METHODS: A literature analysis was conducted to investigate the potential of tissue-mimicking materials for the creation of arterial vessel test objects. The search query included the following keywords: abdominal aorta, aneurysm, CT-angiography, tissue-mimicking material, test objects, and mechanical properties of the arterial wall. The results of the literature review were used to investigate the biomechanical characteristics of the arterial vessel wall in a healthy state and in aneurysm. The advantages and disadvantages of different types of tissue-mimicking materials were analyzed. In the course of this analysis, the requirements for biomechanical and X-ray properties of tissue-mimicking materials were formulated. A ranked list of tissue-mimicking materials for the creation of anthropomorphic test objects of arterial vessels for studies by computed tomographic angiography was prepared. RESULTS: During the course of the work, the requirements for biomechanical and X-ray properties of tissue-imitating materials for the creation of an arterial vessel test object were formulated. Further development of the topic will entail the expansion of the number of simulated pathologies and the search for universal materials suitable for the creation of multimodal test objects. CONCLUSIONS: The results obtained can be used to improve arterial vascular test objects.
背景：在计算机断层扫描血管造影术中，用组织模拟材料制成的拟人化标本可用于改善动脉病理变化的诊断。设计测试对象需要选择具有能正确再现动脉壁的生物力学和放射学特性的材料。现代标本中使用的组织模拟材料并不总是考虑到动脉壁在体内发挥作用的条件[1]。此外，材料的选择还需要模拟病理过程，如动脉瘤区域动脉壁厚度的变化、血栓的模拟[2]。选择仿组织材料制作测试样本对使用这些材料进行研究的结果有重大影响。目的：本研究旨在确定用于动脉血管测试对象拟人建模的仿组织材料的生物力学和 X 射线特性。材料与方法：为研究仿组织材料在创建动脉血管测试对象方面的潜力，我们进行了文献分析。搜索关键词包括：腹主动脉、动脉瘤、CT 血管造影、组织模拟材料、测试对象和动脉壁的机械性能。文献综述的结果用于研究动脉血管壁在健康状态和动脉瘤状态下的生物力学特性。分析了不同类型组织模拟材料的优缺点。在分析过程中，对组织模拟材料的生物力学和 X 射线特性提出了要求。编制了一份组织仿真材料排名表，用于创建拟人化的动脉血管测试对象，供计算机断层扫描血管造影研究使用。结果：在工作过程中，制定了用于制作动脉血管测试对象的仿组织材料的生物力学和 X 射线特性要求。该课题的进一步发展需要扩大模拟病理的数量，并寻找适合创建多模态测试对象的通用材料。结论：所获得的结果可用于改进动脉血管测试对象。
{"title":"Review of tissue-mimicking materials for anthropomorphic modeling of arterial vessels","authors":"Dariya I. Abyzova, M. Kodenko","doi":"10.17816/dd626907","DOIUrl":"https://doi.org/10.17816/dd626907","url":null,"abstract":"BACKGROUND: In computed tomographic angiography, anthropomorphic specimens made of tissue-mimicking materials are used to improve the diagnosis of pathological changes in arteries. The design of test objects requires the selection of materials with properties that correctly reproduce the biomechanical and radiographic characteristics of the arterial wall. Tissue-mimicking materials used in modern specimens do not always take into account the conditions under which the arterial wall functions in vivo [1]. In addition, the selection of materials is required to simulate pathological processes, such as changes in the thickness of the arterial wall in the area of the aneurysm, simulation of thrombus [2]. The choice of tissue-mimicking materials to create a test specimen has a significant impact on the results of studies conducted with these materials. \u0000AIM: The aim of this study is to ascertain the biomechanical and X-ray properties of tissue-mimicking materials for the anthropomorphic modeling of arterial vascular test objects. \u0000MATERIALS AND METHODS: A literature analysis was conducted to investigate the potential of tissue-mimicking materials for the creation of arterial vessel test objects. The search query included the following keywords: abdominal aorta, aneurysm, CT-angiography, tissue-mimicking material, test objects, and mechanical properties of the arterial wall. The results of the literature review were used to investigate the biomechanical characteristics of the arterial vessel wall in a healthy state and in aneurysm. The advantages and disadvantages of different types of tissue-mimicking materials were analyzed. In the course of this analysis, the requirements for biomechanical and X-ray properties of tissue-mimicking materials were formulated. A ranked list of tissue-mimicking materials for the creation of anthropomorphic test objects of arterial vessels for studies by computed tomographic angiography was prepared. \u0000RESULTS: During the course of the work, the requirements for biomechanical and X-ray properties of tissue-imitating materials for the creation of an arterial vessel test object were formulated. Further development of the topic will entail the expansion of the number of simulated pathologies and the search for universal materials suitable for the creation of multimodal test objects. \u0000CONCLUSIONS: The results obtained can be used to improve arterial vascular test objects.","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680845","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}
BACKGROUND: The pituitary gland is an endocrine gland that plays a crucial role in the regulation of metabolism, physical and sexual development. Modern medical imaging techniques allow the study of changes in the hypothalamic-pituitary region in children with low physical development [1–3]. AIM: The aim of the study was to investigate the state of the hypothalamic-pituitary region in children with different forms of nanism using magnetic resonance imaging. MATERIALS AND METHODS: The study included 102 boys and 96 girls with complaints of growth retardation. Magnetic resonance imaging of the brain with targeted studies of the pituitary region of children and adolescents aged 8–15 years was studied. Using a high-field magnetic resonance imager, the brain was scanned in the axial, coronal, and sagittal planes using standard modes and targeted examination of the pituitary region using T1- and T2-weighted pulse sequences with a slice thickness of 2.0 mm. Inclusions in the pituitary gland requiring differential diagnosis betwe en adenoma and Rathke’s cleft cyst were imaged with intravenous contrast. The physical development of the children was evaluated using the AntroPlus computer program. The significance of differences between groups was determined by the confidence interval; differences were considered significant at p 0.05. RESULTS: Analysis of the obtained data shows that 92.0% of children and adolescents with idiopathic stunting have a standard deviation of growth from –2.0 to –3.0. In these children, hypoplasia of the pituitary gland was found in 36.4% of cases, residual structures of Rathke's cleft cyst in 16.5%, and inactive pituitary adenoma in 4.2%. Normal structure of the pituitary gland was found in the remaining children. In the group of patients with growth hormone deficiency, children with standard deviation of growth coefficient from –3.0 to –4.0 are more frequent (52.6% of patients), and 31.4% of boys and girls have growth retardation more than –4 σ. In these children, in addition to hypothalamic-pituitary masses and hypoplasia of the adenohypophysis, magnetic resonance imaging revealed in 26.7% of cases (including 83.4% of boys and 16.6% of girls) an abnormality of pituitary development in the form of a triad: hypoplasia of the adenohypophysis, shortened pituitary pedicle, and ectopia of the neurohypophysis. In the group of patients with growth retardation due to the presence of hereditary syndromes, 32.7% of those studied had a coefficient of standard deviation of growth between –2.0 and –3.0, and 33.4% had a coefficient of standard deviation of growth between –3.0 and –4.0. In children with more severe growth retardation, magnetic resonance signs of empty sella (22.6%) and hypoplasia of the pituitary gland (34.8%) were more frequently visualized. CONCLUSIONS: Magnetic resonance imaging is the primary method for evaluating the pituitary gland [4]. Children with idiopathic stunting exhibit a coefficient of standard deviation of
{"title":"Magnetic resonance imaging in assessing the condition of the pituitary gland in children with growth retardation","authors":"Elena A. Finota","doi":"10.17816/dd626160","DOIUrl":"https://doi.org/10.17816/dd626160","url":null,"abstract":"BACKGROUND: The pituitary gland is an endocrine gland that plays a crucial role in the regulation of metabolism, physical and sexual development. Modern medical imaging techniques allow the study of changes in the hypothalamic-pituitary region in children with low physical development [1–3]. \u0000AIM: The aim of the study was to investigate the state of the hypothalamic-pituitary region in children with different forms of nanism using magnetic resonance imaging. \u0000MATERIALS AND METHODS: The study included 102 boys and 96 girls with complaints of growth retardation. Magnetic resonance imaging of the brain with targeted studies of the pituitary region of children and adolescents aged 8–15 years was studied. Using a high-field magnetic resonance imager, the brain was scanned in the axial, coronal, and sagittal planes using standard modes and targeted examination of the pituitary region using T1- and T2-weighted pulse sequences with a slice thickness of 2.0 mm. Inclusions in the pituitary gland requiring differential diagnosis betwe en adenoma and Rathke’s cleft cyst were imaged with intravenous contrast. The physical development of the children was evaluated using the AntroPlus computer program. The significance of differences between groups was determined by the confidence interval; differences were considered significant at p 0.05. \u0000RESULTS: Analysis of the obtained data shows that 92.0% of children and adolescents with idiopathic stunting have a standard deviation of growth from –2.0 to –3.0. In these children, hypoplasia of the pituitary gland was found in 36.4% of cases, residual structures of Rathke's cleft cyst in 16.5%, and inactive pituitary adenoma in 4.2%. Normal structure of the pituitary gland was found in the remaining children. In the group of patients with growth hormone deficiency, children with standard deviation of growth coefficient from –3.0 to –4.0 are more frequent (52.6% of patients), and 31.4% of boys and girls have growth retardation more than –4 σ. In these children, in addition to hypothalamic-pituitary masses and hypoplasia of the adenohypophysis, magnetic resonance imaging revealed in 26.7% of cases (including 83.4% of boys and 16.6% of girls) an abnormality of pituitary development in the form of a triad: hypoplasia of the adenohypophysis, shortened pituitary pedicle, and ectopia of the neurohypophysis. In the group of patients with growth retardation due to the presence of hereditary syndromes, 32.7% of those studied had a coefficient of standard deviation of growth between –2.0 and –3.0, and 33.4% had a coefficient of standard deviation of growth between –3.0 and –4.0. In children with more severe growth retardation, magnetic resonance signs of empty sella (22.6%) and hypoplasia of the pituitary gland (34.8%) were more frequently visualized. \u0000CONCLUSIONS: Magnetic resonance imaging is the primary method for evaluating the pituitary gland [4]. Children with idiopathic stunting exhibit a coefficient of standard deviation of","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141684044","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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