Breast cancer occupies a leading position in cancer morbidity and mortality. Accurate staging of the disease increases the chances of a high relapse-free survival. 18F-FDG PET/CT is considered the «gold standard» for diagnosing metastatic lesions in a number of cancers, including breast cancer. Diffusion-weighted imaging (DWI) is a specific pulse sequence that allows differentiation of the malignant process. The place of whole body DWI in the diagnostic algorithm for breast cancer is not defined. The aim of the work was to evaluate the possibilities of whole body DWI in comparison with 18F-FDG PET/CT and whole body CT for the local and distant spread of breast cancer. A comparison was made of diagnostic indicators, including sensitivity, specificity, positive and negative predictive value, accuracy. A whole body MRI with DWI demonstrated an advantage in diagnosing metastatic lesions of the liver and skeleton. The use of exclusively whole body MRI with DWI for staging and restaging of breast cancer is not justified due to the low specificity of detection of metastases of regional and distant lymph nodes. A whole body MRI with DWI may be recommended as a clarifying method after performing 18F-FDG PET/CT or whole body CT.

Diseases of the temporomandibular joint in recent years are increasingly common in the population. Magnetic resonance imaging (MRI) in the position of open and closed mouth is a routine examination of these patients. The article presents a study of a group of orthopedic patients using an additional dynamic protocol, which allows to evaluate both morphology and the sequence of movements in the joint. Variants of the position of the intraarticular disk and its form in patients with various stages of dysfunction are considered, and the indisputable importance of pseudo-dynamic MRI and real-time studies for patients with intraarticular meniscus adhesion and hypermobility of articular condyle of the mandible are given.

The 92 patients in the aged group of 25 to 84 (mean 56 years) diagnosed with an ovarian tumor (OT) have been prospectively examined. All patients were undergone a routine MRI and have been obtained DWI (b value = 50, 800 and 1000 mm2/s) with the construction of the map of the apparent diffusion coefficient (ADC). A statistically reliable significant difference of the intensity signal of solid tissue of OT on DWI at value b = 1000 and T2-WI between patients with benign ovarian tumors (BOT) and malignant ovarian tumor (MOT) (p < 0,001) as well as by ADC (p = 0,009) was revealed. Statistically significant difference of intensity signal on T2WI and on DWI with ADC of solid and cystic components of OT between the primary MOT and metastatic ovarian were not detected. The average value of ADC of the solid tissue of MOT was 0,6 × 10-3 mm2/s, whereas of BOT consisted of 0,3 × 10-3 mm2/s. According to the ROC analysis the average value of ADC 0,35 × 10-3 mm2/s can serve as a threshold for the differential diagnosis of BOT and MOT with the sensitivity 95 %, specificity 60 %, with the positive predictive value 90 % and negative predictive value 75 %: with ADC below this value is more likely BOT, at exceeding of the trigger value is MOT. Thus, the analysis of the solid component of OT with using conventional MRI with DWI/ADC maps is most informative in the differential diagnosis of the BOT and MOT. MOT was characterized the higher signal intensity on DWI, T2WI and also higher ADC values than for BOT. Additionally, MOT had bilateral lesion, irregular shape, larger size, cystic-solid structure, irregular septs and ascites.

It is important to confirm the accuracy and reproducibility of densitometric studies of the assessment of mineral density, therefore, as part of the introduction of asynchronous quantitative computed tomography (QCT) on the basis of several Moscow medical organizations, it is necessary to evaluate its effectiveness, including the study of accuracy and reproducibility. To perform these works, anthropomorphic phantoms are used. In this work, the phantom developed by the authors is used. Assessment of accuracy indicators was carried out in three medical organizations, the results were calculated relative error, coefficient of variation. High reproducibility of the results of evaluation of bone mineral density by the asynchronous QCT method (0,06-0,86 %) was demonstrated. It was shown that the simulation of subcutaneous fat leads to an underestimation of the results of QCT. When using the optimal reconstruction filter, the relative error was in the range from -3,9 to 4,3 %.

Calcification of the coronary arteries is a quite common characteristic finding at chest CT, especially in elderly and smoking patients . The standardised method of evaluation of coronary artery calcification is a calcium score. Coronary calcium, quantified on ECG-gated CT examinations, is the strong predictor of cardiovascular events in the asymptomatic population. A zero calcium score stands alone as perhaps the most powerful «negative risk factor» for near-term development of a coronary event, particularly in patients with an intermediate-risk. According to international guidelines, the calcium score should be used in patients with intermediate risk or low risk with a cardiovascular family history. On the other hand, most of these patients may be candidates for lung cancer screening chest CTs, especially old patients and heavy smokers. The possibility of using standard and low-dose protocols of chest CTs in determining the calcium score is quite promising.

The social and economic importance of the chronic kidney disease at the terminal stage is caused by expensive methods of treatment, number of hemodialysis patients that increases annually and the fact that most of them are of working-age. The most prefered vascular access for hemodialysis is the arteriovenous fistula, however its dysfunction occurs at more than 30 % of cases. Adequate long-term fistula functioning depends on its successful maturation, early diagnostics and elimination of vascular access possible complications. The main diagnostic method of the arteriovenous fistula dysfunction is duplex ultrasound that allows to determine diameters, the walls condition and vessels lumen, access flow, to reveal such complications as stenosis of the inflow artery, anastomosis zone and outflow vein, fistula thrombosis, hand ischemia syndrome. Ultrasound diagnostics of vascular access complications allows to provide its early correction that increases duration of fistula adequate functioning.

Kidney disease was and remains one of the main reasons for performing ultrasonography in children. Despite the rich experience of research in this area, there are still situations where gross bilateral structural changes in the kidneys are extremely difficult to interpret due to the extreme rarity of the pathology. Such cases include, in particular, nephroblastomatosis, 4 confirmed observations of which are presented in this publication. As a differential diagnosis, cases of severe nephrotic syndrome, including congenital syndrome, and rare variants of acute renal damage in the debut of lymphoproliferative diseases, when the kidneys also look dramatically enlarged and unstructured, have been demonstrated. Also one case of undifferentiated renal tissue dysplasia, which is echographically identical to nephroblastomatosis, and 16 observations of multiple foci of regeneration of the renal parenchyma in children with bilateral obstructive uropathies, which currently have no morphological evidence, are shown. The publication contains a review of the literature and is extensively illustrated.

The article presents a case of acute postexercise rhabdomyolysis of rare localization in the upper extremities without acute renal damage that developed in a 19-year-old patient after the transfer of heavy objects (in a position with his arms down). The patient was enough trained, was physically developed and didn`t have manifestations of hereditary or acquired neuromuscular pathology. The disease manifested itself immediately after physical exertion in the form of severe edema, hyperemia and pain in the elbow and shoulder joints and moderate muscle weakness of the upper extremities. On the morning of the next day, a volume reduction and a color change of the excreted urine to dark brown was noted. An increase in the level of serum myoglobin to 7231 ng/ml and creatine phosphokinase (CPK) to 157009 U / L made it possible to establish the diagnosis of rhabdomyolysis with oliguria without increasing azotemia. MRI scan of the upper extremities showed a homogeneous increasing of signal intensity in T2-weighted images and STIR, as well as an increasing of relaxation time, indicated the first type of rhabdomyolysis in the triceps of the shoulders, anterior dentate, supraclavicular, subclavian and deltoid muscles. A dynamic examination revealed a direct, high strength correlation between CPK, myoglobin, ALT, AST of blood serum and relaxation time of muscle tissue. Thus, MRI is a sensitive imaging method even for atypical localization of rhabdomyolysis, the results of which affect further treatment tactics and prognosis of complications, and the use of quantitative MRI techniques allows to control the effectiveness of the therapy.

Presented here is a unique case of myofibroma involving the mandible in a 3-year-old patient. Clinically it mimicked more like an ameloblastoma and didn’t exhibit any of its classical signs of a myofibroma. The diagnosis could be established only after complete excision of the lesion and histopathological examination. There was no recurrence after a follow-up period of 6 months. Myofibroma and myofibromatosis is a well-recognized spindle cell neoplasm that occurs predominantly in infants and young children. Classically these lesions are described in children younger than two years old, with 2/3 present at birth and rarely in adults. In the oral region, most lesions occur in the lip, buccal mucosa, and tongue; however, the lesions arising in the maxilla and mandible are very rare. These lesions are a benign fibroblast and myofibroblast proliferation containing a biphasic presentation of spindle-shaped cells surrounding a central zone of less differentiated cells focally arranged in a hemangiopericytoma like pattern. Controversy exists as to an autosomal dominant or recessive inheritance or to a sporadic occurrence. The rarity of this disease makes it difficult to diagnose for clinicians, radiation diagnosticians and histopathologists. Myofibroma has an aggressive clinical presentation and is often treated aggressively because of an inappropriate diagnosis.