Medical Visualization (E-Journal) / Медицинская визуализация
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Результаты хирургического лечения больных неспецифическим аортоартериитом с поражением ветвей дуги аорты по данным дуплексного сканирования
Full text linkОценка портального кровотока у больных циррозом печени до и после внутрипеченочного введения криопреципитата
Full text linkAim: to study the influence of intraparenchymal cryoprecipitate injection on portal blood flow in cirrhotic liver with the use of Duplex portal vein ultrasound scanning. Material and methods: 40 patients with liver cirrhosis were measured the splenoportal index and congestion index in portal system before and after the cryoprecipitate injection. 8 patients had liver cirrhosis class A by Child-Pugh scoring system, class B was registerd in 13 patients and class C in 19. The cryoprecipitated was injected transcuta-neously under the US control, 1-2 ml into each segment. 13 patients had cirrhosis of the combined (viral and toxic) ethiology, the rest 27 had alcoholic cirrhosis. Men were 28 (70%), women - 12 (30%). Patients aged 25-60 years. Results: statistically significant changes of portal blood flow indexes were registered after 6 months after the stimulation in 92% of patients. The congestion index, wich correlates with the varices bleedeng, returned to normal in all patients within 6 months. The decreased values of splenoportal index was registered in 77.5% of patients. Therefore, the method leads to normalisation of portal blood flow and decreases the risk of variceal bleeding in patients with long-lasting liver cirrhosis. No statistically significant differences were registered after a year after cryoprecipitate injection in comparison with the 6 months data. Conclusion: intraparenchymal cryoprecipitate injection decreases portal hypertension in 92% patients with liver cirrhosis within 6 months. Patients with decompensated liver cirrhosis (Child-Pugh class C) require the repeated cryo-precipitate administration after 6 months
Ультразвуковая диагностика двусторонних разрывов сухожилия четырехглавой мышцы бедра у пациентов с хронической болезнью почек, получающих лечение диализом
Full text linkPurpose: to assess the incidence of quadriceps tendon ruptures in patients with end-stage kidney disease treated with dialysis, to establish ultrasound characteristics in the setting of this complication and to analyze correlation between established deviations and calcium phosphate metabolism disorder. Materials and methods. We performed clinical, laboratory and ultrasound examination of 175 patients aged 17 to 73 years with end-stage kidney disease on dialysis. Duration of dialysis averaged 60 months (0.5 to 230 months). Results. During the observation period there were three cases of quadriceps tendon ruptures. Average age of patients with ruptures was 40 years; average duration of dialysis was 76.7 months. We analyzed correlation between this observed complication and calcium phosphate metabolism disorder. We also established ultrasound characteristics of quadriceps tendon ruptures of different duration. The most common site of tendon rupture was close to its insertion to the patella, which in some cases was accompanied by the superior pole avulsion. Another found characteristic was quadriceps calcification. Conclusion. Ultrasound is an inexpensive and informative tool for diagnosis of spontaneous quadriceps tendon ruptures. Our data confirms leading role of the high level of the parathyroid hormone and hyperphosphatemia in development of the spontaneous tendon ruptures in dialysis patients
История кафедры лучевой диагностики института последипломного образования Красноярского государственного медицинского университета им. В.Ф. Войно-Ясенецкого
Full text linkДиагностика фемороацетабулярного импинджмент-синдрома: роль магнитно-резонансной томографии
Full text linkThe aim of the study was to determine the role of MRI in diagnostics of femoroacetabular impingement syndrome of the hip. Materials and Methods. MRI-scanning results were analyzed for 142 persons (63 (44.4%) males, 79 (55,6%) females; mean age 34 ± 3.2 y.o.), 122 (85.9%) of them had complaints of pain sensation located in the hip joint. All the patients were divided into two groups: an experimental group (n = 122 (85.9%; 62 (50.8%) males, 60 (49.8%) females; mean age 33 ± 5.7 y.o) and a control group (n = 20 (14.1%); 15 (75.0%) males, 5 (25.0%) females; mean age 30 ± 3.8 y.o.). The enrollment criteria for the control group were: absence of complaints of pain sensation located in the hip joint, under sixty years of age. The age limit was provided the high risk of involutional changes in the hip within the patients of this age. In all patients MRI examination were done by high-field MR-scanners associated to designed protocol. While interpreting the results values of neck-shaft angle, lateral center edge angle, Tonnis angle and alpha angle were determined. Results. Different types of femoroacetabular impingement syndrome were determined in 35 (28.7%) patients. In all patients pathologic parameters were observed: abnormal (39 degrees) lateral center edge angle (n = 17; 48.6%), abnormal (55 degrees) alpha angle (n = 17; 48.6%) were determined. Conclusion. MRI allowed to determine abnormality of configuration of the femoral bone and acetabulum, to characterize the pathological conditions of the labrum and subchondral bone. The main symptoms of femoroacetabular impingement syndrome are pathologic configuration of the femoral head and acetabulum. The degeneration and tear of the labrum could be observed in the early stage of disease
Сопоставление информативности МР-перфузии и ПЭТ с [11С]метионином в дифференциации продолженного роста церебральных опухолей и лучевых поражений головного мозга после комбинированного лечения
Full text linkThe aim of the study was to compare T2*-weighted MR-perfusion (pMRI) and positron emission tomography using [11C]methionine (PET-Met) in differentiating recurrent brain tumor (RT) from posttreatment radiation effect (PTRE). Material and methods. PET-Met and pMRIwere performed in 45 patients with previously treated brain tumor A total 57 lesions were analyzed. The rCBV index and [11C] methionine uptake index (UI-Met) were calculated as the ratios of the highest lesion value to the that in the reference region. The diagnostic accuracy of UI-Met and rCBV for correct identification of recurrent tumor (RT) versus PTRE was evaluated by ROC-analysis using subsequent histologic analysis or clinical and radiological follow-up. Results. According to the final diagnosis patientsexhibitedthetwo typesofabnormalities: recurrent tumor (n = 33) and non-progressive lesions (n = 24). The inter-individual agreement between the both techniques was observed in 93% of cases. In 4 patients results were discordant. High [11C]methionine uptake and low rCBV were detected in 2 cases of radiation necrosis. In 2 patients PET-Met was able to distinguish foci of radionecrosis and the viable tumor tissue. Conclusion. T2*-weighted MR-perfusion and PET-Met could be efficiently used for differentiation RT from PTRE. Inter-individual comparison of the both methods showed that PET-Met was more sensitive in imaging recurrent tumor, but perfusion MRI had higher specificity
Виртуальная сонография молочной железы. Опыт клинического применения
Full text linkThe aim: to evaluate the diagnostic effectiveness the automated breast volume scanner (ABVS) ACUSON S2000 (Siemens, Germany). Material and methods: The volume data sets were collected from 97 patients and a database containing 27 women with no detectable lesions in multimodal examination (BI-RADS 1), 18 women with clearly benign lesions (BI-RADS2), and 29 women with known breast cancer (BI-RADS5) was created. An independent examiner evaluated all the ABVS data on a separate workstation without any prior knowledge of the patients’ histories. Results. The diagnostic accuracy for the experimental ABVS was estimated as 88%. The independent examiner detected all breast cancers in the volume data resulting in a calculated sensitivity of 100%. After the ABVS examination, there were a high number of requests for further examination in 66%. Over-diagnosis was estimated 24 %. Conclusion. The specificity was 40%. Given the fact that during the application of ABVS no breast cancer was missed - the ABVS must still be regarded as an experimental technique for breast ultrasound, which definitely needs to undergo further evaluation studies
Современные методы диагностики холангиоцеллюлярного рака
Full text linkThe purpose: submit a feature of modern diagnostics cholangiocarcinoma. The main provisions. The article describes the classification, incidence, risk factors for cholangiocarcinoma. Considered diagnostic capabilities of techniques of transabdominal, endoscopic and intraductal ultrasound and CT MRI, PET and cholangiography in the detection of extrahepatic and intrahepatic cholangiocarcinoma, locoregional tumor spread. The expansion of the bile duct on ultrasound tomograms-an important feature for the early diagnosis of cancer of the bile duct and the reason for a larger survey using other informative methods. Ultrasound examination - the method of choice for interventional procedures such as percutaneous transhepatic cholangiography and drainage of abscesses peribiliary. The development of new methods of investigation bile duct led to the use of ultrasound during endoscopy-endoscopic ultrasound and during cholangiopancreatogra-phy-transpapillary intraductal ultrasonography. Conclusion. Most authors believe that the diagnostic methods for bile duct carcinoma without jaundice include ultrasound, MRCP, EUS, ERCP and intraductal ultrasound. Diagnostic methods for carcinoma of the bile duct with jaundice: ultrasound, CT or MRI, puncture under the control of EUS, ERCP. PET successfully identifies intrahepatic cholangiocarcinoma, but has a poor performance in detecting informative extrahepatic cholangiocarcinoma. Its role is to identify distant metastases and assessment of treatment efficacy