The presented article analyzes the data obtained as a result of the applied imaging methods of the study of 38 patients admitted to the surgical department of the Surgut Regional Clinical Hospital with suspicion of acute pancreatitis. The main criterion for inclusion in the study was the period from the onset of the initial symptoms of the disease, which did not exceed three days. In the hospital, all patients underwent perfusion computed tomography (PCT) in the first 3 days and subsequently, in accordance with national recommendations, multislice computed tomography (MSCT) with bolus intravenous contrast enhancement for 3–5 days. In 31,5 % of cases (12 out of 38 patients), a violation of the perfusion characteristics of the pancreatic parenchyma corresponding to ischemic tissue damage was diagnosed. MSCT with bolus intravenous contrast enhancement confirmed the presence of a formed zone of necrosis of the pancreatic tissue in 21 % of patients. In 10,5 % of cases, progression of ischemic damage to the pancreatic tissue was not revealed by MSCT, which was confirmed by further observation of this group of patients. Based on the study, conclusions were drawn about the ability of perfusion CT to serve as an effective predictor of pancreatic necrosis, which makes it possible to choose the optimal surgical tactics at the early stages of treatment of such patients.

Early diagnosis of respiratory tuberculosis among HIV-infected patients improves the prognosis of recovery and reduces mortality. The emergence of cavities is one of the patterns of the progression of pulmonary tuberculosis. The article analyzes the results of examination of HIV-infected tuberculosis patients with cavities. We estimate the data of anamnesis, the disease clinic and immune status. The retrospective study included patients of the Leningrad region with HIV/TB with early respiratory tuberculosis from 2014 to 2016 (n = 852). We identified a clear relationship between chemoprophylaxis and antiretroviral therapy on developing tuberculosis non-cavity, but no direct relationship was found with widespread or disseminated TB. We also obtained a significantly relationship between the bacterial excretion and the detection of destruction in the lung tissue on the background a pronounced decrease in the immune status (CD4 100 cells/μl or less). There are statistically significant decreases in the frequency of cavities of respiratory tuberculosis and the proportion of etiologically verified cases is in case in the suppression of immunity (CD4 100 cells/μl or less). However, the relationship between early mortality from tuberculosis (during the first year) and pulmonary tuberculosis with cavities was not obtained.

The purpose of the study was to explore the correlation between 11С-methionine (Met) uptake measured by combined positron emission and computed tomography (PET/CT) in newly diagnosed cerebral gliomas and tumor proliferative activity as measured by Ki-67 labeling index (Ki-67 LI).

The results of PET/CT with 11С-methionine (PET-Met) of 236 adult patients with pretreated glial brain tumors were included in retrospective analysis. The final diagnosis of glioma according to WHO classification of CNS tumors (2007) was based on both histology and immunohistochemistry using Ki-67 antibodies. On PET-Met tumor-to normal brain uptake ratio (TBR) was calculated by dividing maximum Met uptake in the tumor (hot spot 10 mm in diameter) to activity concentration in the contralateral cortex. The Spearmen rank correlation test was used to analyze the relationships between TBR and Ki-67 LI.

PET-Met analysis showed that TBR increases with an increase in the aggressiveness of the glial tumor. The differences of TBR values between gliomas grade II vs III and grade III vs IV were significant (p < 0,001). Among grades II-III gliomas Met uptake was significantly higher in oligodendroglial and mixed gliomas than in astrocytomas (p < 0,001), but the differences did not depend on Ki-67 LI.

Correlation analysis demonstrated significant correlation between Ki-67 LI and TBR values (r = 0,49, p < 0,05, Spearman rank test). With analyzing glioma subgroups TBR values correlated with Ki-67 LI in diffuse astrocytomas (r = 0,52, p < 0,05), oligodendrogliomas (r = 0,40, p < 0,05), oligoastrocytomas (r = 0,47, p < 0,05) and in high-grade gliomas (r = 0,45, p < 0,05) but not in low-grade gliomas. Comparison between TBR value and Ki-67 LI in each glioma showed a lack of coincidence in 22 % of cases (high Met uptake but low Ki-67 LI and vice versa). The main reasons for such discrepancies were tumor molecular biology or incorrect biopsy target.

Met uptake in diffuse gliomas correlates with proliferative activity which justifies the use of PET-Met for glioma grading. In case of mismatch between two biomarkers one should rely on the indicator that implies a higher aggressiveness of the glioma.

In the span of 6 years 350 patients that were clinically and radiologically diagnosed with avascular necrosis of the femoral head, at different stages, were examined. Patients were examined using comprehensive radiation examination including radiography and multispiral computed tomography (MSCT) of the hip joints, with the aim to diagnosis avascular necrosis of the femoral head at an earlier stage. According to the results of the examination, 121 patients were diagnosed with an earlier stage of avascular necrosis of the femoral head, on 99 patients was performed core decompression via drilling, 22 patients underwent a joint preservation procedure with the removal of the necrosis tissue following with a bone-graft using bonesubstituting bioresorbable material.

The aim of the study was to evaluate diagnostic accuracy of stress echocardiography (stress echoCG) with combination of high doze АТР and atrial pacing in diagnosis of late coronary shunts stenosis.

48 men aged from 45 to 64 (48,4 ± 1,6 years), 36 patients undergone mammarocoronary shunting, 12 patients undergone auto venous shunting. Stress echoCG with combination of high doze ATP and atrial pacing suggested shunts lesions in 44 patients, in 8 cases previously intact coronary arteries, approved with coronary angiography. Coronary angiographies reviled no coronary lesions in 24 patients > 70 % shunts restenosis, in 22 coronary stenosis from 50 up to 70 %. Accuracy, sensitivity and specificity of stress- EchoCG with combination of stress-agents in coronary shunts restenosis, as well as stenosis of previously intact coronary arteries were 100 %.

In this work a comparative analysis of the possibilities and efficiency of lower extremities perforator vessels visualization using the methods of Doppler ultrasound (DUS) and computed tomographic angiography (CTA) is carried out. As a result, it is shown that DUS has a number of advantages over CTA, allowing to obtain a clearer image of perforator vessels, to determine the exact location of their anatomical localization.

Ultrasound scanning is one of the main methods of instrumental examination of patients after allogenic transplantation of kidney. The main reasons of dysfunction of the kidney transplant in long posttransplantation term are acute or chronic rejection, as well as acute and chronic nephrotoxicity of calcineurin inhibitors. The study includes an analysis of the medical history of 130 children with end-stage chronic renal failure who underwent 130 allogeneic kidney transplants from a posthumous donor. There were analyzed the results of 231 percutaneous puncture biopsies and ultrasound studies of renal transplants. The analyzed data of morphological studies are divided into 4 groups:

1st group — there are no morphological changes affecting graft function;

2nd group — morphological signs of calcineurin toxicity;

3rd group — borderline damage of the graft;

4th group — acute and chronic graft rejection;

5th group — non-specific tubulointerstitial sclerosis and tubular atrophy.

Indices of resistance and pulsation measured at the level of the renal artery and interlobular arteries tended to decrease in the kidneys with immunological influence and remained stable in other morphological groups. This means that, the higher the degree of hyalinosis of the arteries, the lower the indices of resistance and pulsation indices measured at the level of the common renal artery and interlobular arteries. The revealed tendency of a decrease in the values of the resistance index and the pulsation index at the level of the common renal artery of the interlobular arteries can be considered as one of the initial ultrasound signs that allow to speak of a decrease in the elasticity of the vascular wall. Normal indices of renal hemodynamics do not exclude the presence of pathological processes leading to graft dysfunction.

It is important to consider the nature of the patient’s pathology when carrying out X-ray studies outside the X-ray room, as well as the organizational and methodological aspects of its use outside of specialized conditions. The purpose of the study is to analyze the experience of using a new ward mobile X-ray device in a multidisciplinary hospital. It was found that the autonomy of the new X-ray system can significantly reduce the time of the study. No time is required to connect the device to the network and load the complex during the transition from patient to patient.

Diffusion-tensor magnetic resonance imaging (DT-MRI) allows imaging of most brain pathways, quantifying their integrity and even suggesting a leading mechanism of damage (demyelination or ischemia). However, it is difficult to use this technique without a good knowledge of the anatomy. This article provides an overview of the literature on the structure and function of the main brain pathways.

We present clinical case of a patient who was referred for brain MRI to clarify the cause of a first-time seizure. MRI examination showed cortical and medullary veins ectasia in the left cerebral hemisphere with multiple cerebral microbleeds around the medullary veins. The revealed changes were considered as a manifestation of regional venous hypertension, however, its cause remained unclear. We decided to perform non-contrast 3D-TOF angiography that revealed a dural arteriovenous fistula between the left occipital artery and the sigmoid venous sinus with retrograde drainage into cortical veins (Borden type II, Cognard type IIb). Early diagnosis and treatment of «aggressive» dural arteriovenous fistulas avoids the development of lifethreatening complications (an annual hemorrhage rate of 8,1%).