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Radiology - Practice

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No 6 (2021)
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ORIGINAL RESEARCH

9-21 452
Abstract

Granulomatosis with polyangiitis (GPA), formerly known as Wegener’s granulomatosis, and lung damage in coronavirus infection have many common clinical and radiological symptoms. In the context of the COVID-19 pandemic the ability of a radiologist to differentiate a viral lung lesion from a granulomatous one is relevant due to the difficulty of recognizing them. In order to develop differential radiation diagnostics, a comparative analysis of the computer tomographic picture of lung lesions in each disease was carried out and the leading X-ray patterns were determined. 61 patients with lung damage were examined, including 30 with HPA, 30 with COVID-19 and 1 patient with a combination of these diseases. A total of 74 native computer tomography examinations of the chest organs were accomplished using a Toshiba Aquilion 64 multi-slice CT scanner. It was found that the most informative radiological sign of HPA are nodes, nodules and masses in the lungs, which were detected in 22 (73.3 %) patients, including 11 (36.7 %) with a necrotic cavitation. Ground-glass opacity is often found in both diseases, but COVID-19 is more characterized by a rounded (56.7 %) or polygonal shape (20.0 %) of pathological areas and their peripheral location (70.0 %) mainly in the posterior parts of the lungs, and triangular areas (42.1 %) with a central location (42.1 %) are more often found in HPA. The rapid dynamics of changes in the lungs on control CT scans is of great diagnostic value, which indicates the viral nature of the disease.

MEDICAL TECHNOLOGIES

22-30 555
Abstract

Ultrasound examination of the skin was performed on 63 women, using a 10–22 MHz high frequency linear transducer on the scanning surface in B-mode and Color Doppler Imaging (CDI) mode with the scanning depth of 7 mm, as well as a 6–18 MHz transducer in B-mode with the scanning depth of 15 mm. The thickness of the dermis was measured between the epidermis and the subcutaneous adipose tissue in the middle and lower third of the face at standard points. To determine the border between the dermis and hypodermis, we used the subdermal vascular plexus as an additional anatomical landmark, which was well visualized in the CDI mode. Comparison of three or more groups of independent quantitative parameters was carried out using ANOVA (Analysis of Variance) for looking for dependencies in the data obtained by determining the significance of differences in means. The level of significance was presented according to F. Fisher’s criterion. As a result of the analysis of variance, a significance level was 0.15, based on which it was concluded that there is no difference in measuring the thickness of the dermis with 6–18 MHz and 10–22 MHz high frequency transducers. The optimal scanning depth for measuring the skin thickness is 7–15 mm. Evaluation of the skin microcirculation should be carried out in the Doppler mode at a pulse recurrence frequency of less than 1 kHz.

31-42 530
Abstract

Ultrasound examination of the skin was performed on 63 women, using a 10–22 MHz high frequency linear transducer on the scanning surface in B-mode and Color Doppler Imaging (CDI) mode with the scanning depth of 7 mm, as well as a 6–18 MHz transducer in B-mode with the scanning depth of 15 mm. The thickness of the dermis was measured between the epidermis and the subcutaneous adipose tissue in the middle and lower third of the face at standard points. To determine the border between the dermis and hypodermis, we used the subdermal vascular plexus as an additional anatomical landmark, which was well visualized in the CDI mode. Comparison of three or more groups of independent quantitative parameters was carried out using ANOVA (Analysis of Variance) for looking for dependencies in the data obtained by determining the significance of differences in means. The level of significance was presented according to F. Fisher’s criterion. As a result of the analysis of variance, a significance level was 0.15, based on which it was concluded that there is no difference in measuring the thickness of the dermis with 6–18 MHz and 10–22 MHz high frequency transducers. The optimal scanning depth for measuring the skin thickness is 7–15 mm. Evaluation of the skin microcirculation should be carried out in the Doppler mode at a pulse recurrence frequency of less than 1 kHz.

CONTINUING MEDICAL EDUCATION

43-54 594
Abstract

Quantification of emphysema has been a topic of research for many years due to the time-consuming process that it requires and the subjectivity of the visual quantification of emphysema. In recent years there are a lot of studies dedicated to the comparison of automatic analysis data with the results of functional pulmonary tests. The previously used Tiffno index-based system for assessing the severity of chronic obstructive pulmonary disease (COPD) has lost its independent value, so today it is recommended to establish the diagnosis and stage of the disease taking into account the frequency and severity of exacerbations. Thus, there is a need to search for more objective diagnostic criteria, which can become an AI-based emphysema quantification.

CLINICAL OBSERVATIONS AND BRIEF REPORTS

55-66 432
Abstract

The author presents his own clinical case demonstrating the long stage and difficulties in diagnosing a rare tumor of the Ewing’s Family of Sarcomas in a young patient, due to the peculiarity of the course of the disease, manifested by a non-pathognomonic clinical pattern.

67-73 363
Abstract

The article describes a clinical case of high-resolution ultrasound (US) diagnostics of changes in the intensity of blood supply to the dermis of a patient with rosacea at different stages of treatment and early visualization of exacerbation. The presented clinical case demonstrates the possibilities of ultrasound in planning the treatment of rosacea, objective assessment of the results of systemic therapy and laser correction, personalization of the protocol, taking into account the clinical findings and instrumental methods of examination.

74-81 413
Abstract

The study describes a clinical case of preoperative planning of an anterolateral femur perforator flap and a peroneal autograft to eliminate a maxillofacial defect. During preparation for the surgery, an anatomical feature of the structure of both extremities circulatory system was found, which did not allow full use of the donor area tissues for subsequent surgical intervention. This feature was identified by Doppler ultrasound, but the final picture became clear only due to the study by computed tomography angiography.

82-91 688
Abstract

Diagnosis of bone mineral disorders (MCI) is an urgent task in pediatrics. Of particular importance is the timely visualization of destructive changes in bone tissue, leading to significant deformations and impairment of the quality of life of patients. At the moment, there are no unified algorithms for radiological examination of children with chronic kidney disease (CKD), allowing early detection of disorders of mineral and bone metabolism. This clinical example demonstrates the difficulties of diagnosing a brown tumor in a child with primary type I hyperoxaluria. Along with this, the effectiveness of methods of radiation diagnostics in the protocol of dynamic observation of patients with the syndrome of mineral and bone disorders in chronic kidney disease (MCD-CKD) is presented.

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ISSN 2713-0118 (Online)