ISSN / EISSN : 1607-0763 / 2408-9516
Published by: Vidar, Ltd. (10.24835)
Total articles ≅ 353
Latest articles in this journal
Medical Visualization; https://doi.org/10.24835/1607-0763-1162
Research objective: establish the impact of Left Atrium Volume Index (LAVI) on on effectiveness of Thoracoscopic Ablation (TSA) in the Treatment of Atrial Fibrillation (AF) and define the risk factors for manifestation of supraventricular arrhythmias in the long-term follow-up resultsMethods. Prospective cohort study of 121 patients with AF (from 2018 to 2021) who performed TSA. The patients were divided into two groups: patients with increased LAVI (group I), patients with normal LAVI less than 34 ml/m2 (group II).Results. According to echocardiography, the mean LAVI was 45.48 ± 9.3 ml/m2 and 28.59 ± 4.13 ml/m2 in groups I and II, respectively (p = 0.012). The mean value of left ventricular ejection fraction (LVEF) according to Teicholz in group I was 61.62 ± 7.041%, in group II 63.57 ± 6.16% (p = 0.8). Spearman's сorrelation analysis showed the relation-ship between LAVI and LVEF before surgery and in the long-term follow-up period, that is agreed with world literature data about contribution left atrial (LA) to left ventricular (LV) function. According to our study, only LAVI < 34 ml/m2 is a risk factor for arrhythmia after TSA. Effectiveness TSA in I group was 77.8%, that is lower than the II group – 88.9%. 3 months after TSA, 20 (17%) patients were required catheter ablations (CA), mainly in I group.Conclusions. Research results showed that an increase in LAVI significantly reduces the effectiveness of TSA in the long-term period by 11.1% compared with LAVI < 34 ml/m2. That are conform with other data of previously submitted works.
Medical Visualization; https://doi.org/10.24835/1607-0763-1129
The purpose: to determine the influence of various aspects of the MR-enterography technique on the quality of the obtained images.Materials and methods. MR-enterography was performed in 634 patients for verified Crohn's disease and suspected inflammatory and tumor diseases of the small intestine. The following drugs containing polyethylene glycol (PEG) were used as an oral contrast agent in 573 patients, mannitol in 32 patients, pineapple juice in 16 patients, water in 11 patients, milk in 2 patients. Oral administration of 1500 ml of contrast agent was carried out fractional for an hour in 3 stages of 15 minutes with an interval of 10 minutes. Each patient underwent programs: T2-FIESTA mode in three planes, diffusion-weighted images with a slice thickness of 5 mm through 1 mm.Results. There were no significant differences in the severity of filling of the loops of the small and large intestine in patients taking polyethylene glycol (n = 573) and mannitol (n = 32) as an oral agent. Adequate stretching of the loops of the small intestine was achieved in 94% of patients, the expansion of the loops was considered moderate or unsatisfactory in 11 patients (4%), which is associated with poor tolerance of the contrast agent or individual characteristics of peristalsis. After coloprotectomy in 14 patients, the volume of the contrast agent was reduced to 1000 ml and the time of its administration to 30–40 minutes due to the rapid passage. MR-enterography could not be performed in 27 patients due to intolerance to PEG and mannitol drugs, which caused a pronounced gag reflex. In these cases, we resorted to alternative options in the form of water (n = 11) and pineapple juice (n = 16).Conclusions. A qualitative assessment of the condition of the small intestine is possible only with the exact observance of all aspects of the research methodology in the form of: an interval between the last meal and MR-enterography of at least 8 hours, the volume of oral contrast agent (mannitol or PEG) 1200–1500 ml, taken 60 minutes before the study. When performing MR-enterography in patients after coloprotectomy, we recommend reducing the volume of oral contrast agent to 1000 ml and the preparation time for the study to 30–40 minutes.
Medical Visualization; https://doi.org/10.24835/1607-0763-1089
Background. The amount of extracellular myocardial matrix is a non-invasive tool for quantitative assessment of myocardial fibrosis. MRI with late gadolinium-enhancement is considered to be the “Gold standard” of non-invasive practice. Dual Energy computed tomography is a new non-invasive approach for detection of myocardial fibrosis and its prognostic value remains unclear.The purpose of this study was to summarize all available data and to study prognostic value of DECT for the detection of fibrotic changes in myocardium.Methods. We searched MEDLINE, EMBASE, Cochrane, SCOPUS and Web of Science for cohort studies up to October 2021 that reported myocardial extracellular volume fraction quantification using contrast enhanced dual energy CT or/and MRI with delayed enhancement.Results. Eleven studies met eligibility criteria. A systematic analysis demonstrated the difference in extracellular volume fraction in patients with fibrotic and inflammation changes of the myocardium, as well as good comparability between DECT and MRI. The value of extracellular volume fraction in myocardium with fibrotic or inflammatory changes was higher than in healthy tissue, which makes it possible to use the ECV as a non-invasive marker of myocardial fibrosis.
Medical Visualization; https://doi.org/10.24835/1607-0763-1168
Aim of the study: to evaluate the possibilities of differential diagnosis of cystic metastases of pancreatic cancer in the lungs and pulmonary Langerhans cell histiocytosis (PLCH)Materials and methods. Multiple cysts were visualized in the patient's lungs, which had thin and thick walls. We visualized in the patient's lung several small nodes with random distribution. These changes were located mainly in the upper and middle sections of the lungs, with the presence of several cysts and nodes near the costal-diaphragmatic angles. The differential diagnosis is formed from metastatic lung disease and pulmonary Langerhans cell histiocytosis. Morphological verification of changes in the lungs confirmed metastatic lung disease.Conclusion. A careful assessment of the thickness of the walls of cysts and the type of location of nodes in the patient's lungs made it possible to diagnose metastatic lung disease according to CT scans.
Medical Visualization; https://doi.org/10.24835/1607-0763-1112
Background. Giant coronary artery aneurysms are extremely rare findings. According to foreign authors, their prevalence as a result of autopsy ranged from 0.02 to 0.2%. Most often, they do not have specific symptoms and are detected after the development of complications, such as acute coronary syndrome, myocardial infarction. The risk of sudden complications causes an unfavorable prognosis of the disease and requires immediate surgical correction.Aim: to demonstrate the effectiveness of radiology methods in assessing coronary anatomy and the possibility of visualization before planning surgery.Materials and methods. The patient was referred to the Federal State Budgetary Institution “FCCVS” of the Ministry of Health of Russia (Penza) for additional examination and surgical treatment. Before surgery, to clarify the features of the macromorphology of the aneurysm, selective coronary angiography and CT coronary angiography were performed.Results. Before surgery, according to CT coronary angiography, a partially thrombosed fusiform aneurysm was detected in the anterior descending artery with a maximum size of 7.0 x 3.5 cm, adjacent to the pulmonary artery trunk and left atrial appendage.Conclusion. In modern conditions, the methods of radiology are successfully used to clarify the localization of aneurysms and individual topographic and anatomical features of the coronary arteries.
Medical Visualization; https://doi.org/10.24835/1607-0763-1107
Aim. To form for viewers an actual vision of the issue of septic pulmonary embolism in the terminological, morphological and clinical aspects, as well as presentation of the methodic of medical imaging of such patients, to systematize and illustrate the main and rare CT signs of septic embolism.Materials and methods. We analyze the data of national and foreign scientific papers for 2001-2021 on the platforms PubMed, Elibrary, etc., as well as earlier "classic" publications on sepsis, infectious endocarditis and septic pulmonary embolism. Also presents own experience of practice with such patients in multidisciplinary hospitals and typical cases, taking into account more than 5 years of experience on this topic in radiology departments in cooperation with related specialists (cardiologists, therapists, purulent surgeons, morphologists).Results. 52 of the most relevant scientific papers were selected from 162 available articles. Based on the results, a review was compiled on the peculiarities of terminology, epidemiology, etiology, clinical presentations, as well as methods for diagnosis of septic pulmonary embolism, CT signs of verified cases during primary scanning, as well as follow-up images, which is extremely important in differential diagnosis. The part with the pathological anatomy of septic embolism makes it possible to better understand CT signs and the difference between this process from ordinary pneumonia.Conclusion. Due to the fact that septic embolism is a secondary process, the correct and quick interpretation of the CT images initiates the search for the primary purulent source of embolism in the body, and follow-up CT-scans (especially in infectious endocarditis) allows you to assess the effectiveness of therapy.
Medical Visualization; https://doi.org/10.24835/1607-0763-1064
Purpose: systematization of the knowledge about diffusion tensor magnetic resonance tomography; analysis of literature related to current limitations of this method and possibilities of overcoming these limitations.Materials and methods. We have analyzed 74 publications (6 Проанализировано 74 публикации (6 Russian, 68 foreign), published in the time period from 1986 to 2021years. More, than half of these articles were published in the last ten years, 19 studies-in the time period from 2016 to 2021years.[email protected] In this article we represent the physical basis of diffusion weighted techniques of magnetic resonance tomography, principles of obtaining diffusion weighted images and diffusion tensor, cover the specific features of the probabilistic and deterministic approaches of the diffusion tensor MRI data processing, describe methods of evaluation of the diffusion characteristics of tissues in clinical practice. Article provides a thorough introduction to the reasons of existing limitations of diffusion tensor MRI and systematization the main developed approaches of overcoming these limitations, such as multi-tensor model, high angular resolution diffusion imaging, diffusion kurtosis visualization. The article consistently reviews the stages of data processing of diffusion tensor magnetic resonance tomography (preprocessing, processing and post processing). We also describe the special aspects of the main approaches to the quantitative data analysis of diffusion tensor magnetic resonance tomography (such as analysis of the region of interest, analysis of the total data amount, quantitative tractography).Conclusion. Magnetic resonance tractography is a unique technique for noninvasive in vivo visualization of brain white matter tracts and assessment of the structural integrity of their constituent axons. In the meantime this technique, which has found applications in numerous pathologies of central nervous system, has a number of significant limitations, and the main of them are the inability to adequately visualize the crossing fibers and the relatively low reproducibility of the results. Standardization of the data postprocessing algorithms, further upgrading of the magnetic resonance scanners and implementation of the alternative tractography methods have the potential of partially reducing of the current limitations.
Medical Visualization; https://doi.org/10.24835/1607-0763-1099
The aim of the study: to analyze the features of the classification and diagnosis of hydrocephalus in pediatric patients.Results. Hydrocephalus is a common pathology of the CSF system, often occurring in childhood. The central place in the examination of this group of patients is taken by new neuroimaging technologies, in particular, MRI. Pediatric patients have specific features regarding classification of hydrocephalus and MRI studies. This review presents the research protocol and modern classification of hydrocephalus in children.Conclusion. Examination of pediatric patients for hydrocephalus should be based on the estimated etiology. When conducting an MRI study, the protocol must include modern MRI sequences: FIESTA, T2-CUBE, phasecontrast MRI.
Medical Visualization; https://doi.org/10.24835/1607-0763-1124
The purpose of the study. To clarify the possibilities of using radiation research methods in the framework of complex diagnostics of local peritonitis for timely recognition and treatment of intra-abdominal abscesses and infiltrates.Materials and methods. The analysis of the results of a complex radiation examination in 61 patients with local peritonitis of various etiologies who were treated at the N.V. Sklifosovsky Research Institute for Emergency Medicine was carried out. The complex of radiation diagnostics included ultrasound and X-ray examinations, computed tomography (CT). The studies were performed both initially at admission and in dynamics.Results. The diagnostic algorithm for local peritonitis is analyzed, three stages are identified with the determination of the method of choice on each of them. Ultrasound and X-ray examination methods are mainly used at the stage of primary diagnostics and for dynamic control. CT allows you to clarify the type, localization and volume of inflammatory changes, their relationship with the surrounding organs and structures. When analyzing the results of radiation diagnostics, it was determined the need to identify and evaluate the main signs of local peritonitis, both direct: the presence of voluminous formation of inflammatory genesis (infiltrate and/or abscess); and indirect: changes in the source organ of peritonitis; changes in structures adjacent to the infiltrate /abscess; the presence of reactive effusion into the thoracic and abdominal cavities.Conclusion. Comprehensive radiation diagnostics for local peritonitis makes it possible to obtain complete information about the nature of both inflammatory changes in local peritonitis and the causes of them. The obtained data of complex diagnostics help the surgeon to choose a rational treatment strategy for these patients, including minimally invasive. Diagnostic monitoring allows you to evaluate the effectiveness of treatment and carry out timely correction of tactics.
Medical Visualization; https://doi.org/10.24835/1607-0763-1093
Objective. To present a unique clinical case of metastatic lesions of the perirenal space, ureter and bladder in Merkel's carcinoma with the development of transverse myelitis against the background of immuno-oncological therapy.Matherial and methods. The modern states of issue in diagnose and treatment of metastatic Merkel's carcinoma within multidisciplinary approach based on the medical documentation and radiological examinations (CT, MRI) was analysed in this article.Results. The unique clinical case of metastatic Merkel's carcinoma complicated by transverse myelitis during immuno-oncological therapy according to MSCT and MRI examinations report was demonstrated.Conclusion. Radiological examinations such as MSCT, MRI, ultrasound and PET/CT needed for detection, assess the incidence of tumor (metastasis and staging) and treatment efficiency control because of the rare occurrence and insufficient knowledge of Merkel's carcinoma.