Background. Early adnexal torsion (AT) is extremely rare. It usually involves a torsion of the ovary together with the tube, which cannot be differentiated by transabdominal ultrasound, so the terms "adnexal torsion" and "ovarian torsion" for children are echographically identical.

Objective. To study the features of echographic representation of ovarian torsion in infant girls.

Materials and Methods. During 2015–2024, adnexal torsion was echographically diagnosed in 6 girls of the first year of life. All patients underwent transabdominal ultrasound in B-mode and color Doppler scanning. All children were operated, and the diagnosis was verified.

Results. The frequency of adnexal torsion in children under 1 year of age was 13.3% of all patients (45) with this pathology. The complaints and clinical picture were nonspecific. In all cases, suspicion of adnexal torsion was expressed only when ultrasound was performed. There was an increase in the volume of the affected ovary by 6.91 ± 0.68 times compared to the contralateral ovary and increased echogenicity of the ovarian parenchyma, against which numerous anechogenic follicles were traced. Vascular pattern in the parenchyma of the affected ovary was detected in 2/6 cases (33.33%), uterine appendages were irreversibly changed. Hyperstimulated ovaries were observed in 4 out of 6 cases. The distribution of follicles in the affected ovary was chaotic, there was no "necklace symptom", there was no marked rounding of the ovarian shape, and the amount of stromal component in the tilted ovary was relatively small. In 5/6 (83.3%) girls, no pelvic cavity effusion was noted.

Conclusion

1. There are no specific anamnestic and clinical data suggestive of adnexal torsion in infants, which determines the importance of ultrasound as virtually the only method of emergency diagnosis of this pathology.
2. The peculiarity of ultrasound in the infant should be the maximum expansion of the area of examination with attempts to visualize the pelvic organs regardless of the degree of bladder filling.
3. The basis of echographic diagnosis of adnexal torsion in infants are structural changes of the appendage in B-mode: increase in linear size of 1.5–2 times, volume of 4–10 times and increased echogenicity of the stroma. Rounding of the shape of the affected ovary is insignificant.
4. A feature of twisted appendage in infants is a large number of follicles in the affected ovary (2/3 of observations). The "necklace" symptom is atypical.
5. The presence of abdominal effusion in adnexal torsion in infants is not characteristic.
6. Preservation of the vascular pattern in the ovary does not exclude adnexal torsion, is infrequent (in 1/3 of cases) and does not guarantee preservation of ovarian viability.

Aim. Тo study the peculiarities of blood supply to the transitional zone of the uterus in patients with chronic nonspecific endometritis (ChE).

Materials and methods. 106 women aged 22–45 years were examined. The main group included 72 patients with morphologically verified chronic endometritis. We distinguished subgroup I (n = 39.37%) of HE with an autoimmune component, subgroup II (n = 33.31%) with HE without an autoimmune component, as well as a control group consisting of 34 patients with a normal result of morphological examination. Transabdominal and transvaginal ultrasound examination (ultrasound) of the uterus and appendages was performed on the 18th–23rd day of the cycle, with the calculation of the parameter proposed by US — the coefficient of vascularization of the transitional zone of the uterus (k).

Outcomes. In the control group, the average k value was 32 ± 2.6%, in the subgroup of patients with an autoimmune component (subgroup I) — 17.0 ± 4.0%, in the subgroup with a nonimmune component (subgroup II) — 23.0 ± 3.4%.

Statistically significant differences in the k value were obtained between subgroup I and all the others, but there were no differences between subgroup II and the control group.

Autoimmune nonspecific HE was predicted when the vascularization coefficient was below 20.9%. In nonimmune nonspecific HE, the resulting model was not statistically significant. Nonimmune nonspecific HE was predicted when the vascularization coefficient was equal to or higher than 18.6%.

Under normal conditions, the resulting model was statistically significant. The norm was predicted when the vascularization coefficient was equal to or higher than 27.6%.

Conclusion. The proposed coefficient of vascularization of the transitional zone of the uterus (k) showed high diagnostic value in patients with nonspecific СhE and it can be recommended for inclusion in the ultrasound examination protocol at the stage of pre-gravidar preparation.

Cervical spinal stenosis is accompanied by dysfunction of the spinal cord, leading to numerous complications and disability of patients. These issues are well known to radiologists, vertebrologists, and neurosurgeons, however, not all of multiple diagnostic problems and issues of surgical treatment can be considered resolved.

Purpose of the study. Justification of the possibilities and necessity of qualitative and quantitative MRI study of the severity of myelopathy in cervical spinal stenosis.

Materials and methods. The results of an MRI examination of 82 patients with cervical spinal stenosis due to degenerative processes were carried out with the use of osteoplastic bilateral laminoplasty technique with simultaneous foraminotomy under neurophysiological control. The examination was conducted before and after the treatment. The study was carried out using standard programs, such as T2 haste localizer, t2_tse_cor_p2, t2_tse_sag_p2, t1_tse_sag_p2.

Results. The focus of myelopathy was detected by MRI in 74.4 % of cases, which confirmed the severity of the pathology. 28 out of 60 patients with myelopathy displayed a clearly defined «snakeeyes» sign, also knows as «owl-eyes» or «fried-eggs» appearance. In some patients, one zone was identified in the form of a rounded focus of increased signal intensity on the axial section.

The average value of the signal intensity coefficient in patients before treatment was 1.89 ± 0.31, after treatment — 1.63 ± 0.21. Significant differences in MRI before and after treatment occurred in 45 % of patients.

Conclusion. The results of the work showed that quantitative assessment of the signal intensity from the spinal cord in stenosis can be used to assess the severity of myelopathy and compare data before and after treatment. In order to identify the source of the most intense signal more accurately and increase the overall measurement accuracy, it is advisable to carry out color mapping of images.

Mycobacterioses are caused by a large number of conditionally pathogenic mycobacteria that are widespread in the environment. The incidence of diseases caused by nontuberculosis mycobacteria (NTMB) is steadily increasing due to an increase in the number of immunoscompromised patients.

The aim of the study was to analyze controversial issues encountered in the differential diagnosis of tuberculosis and non-tuberculosis mycobacterial infection.

Materials and methods. The study was performed on a 64–slice GE REVOLUTION EVO computed tomograph.

Discussion. Based on the anamnesis and the results of a microbiological study, the attending physician eventually diagnosed a non-tuberculosis mycobacterial infection and prescribed appropriate treatment.

Conclusion. Despite the fact that in most cases the radiological and clinical picture of non-tuberculosis mycobacteriosis is nonspecific, there are clinical and radiological syndromes highly specific for non-tuberculosis mycobacteriosis.

Objective. To demonstrate the diagnostic algorithm and tactics of a surgical management of patients with pulmonary arteriovenous malformations.

Materials and Methods. Based on a patient`s clinical data analysis, further examination tactic was chosen: in the pre and postoperative periods multispiral computed tomography (MSCT) angiopulmonography (on a Canon Aquillion Prime, Japan) was performed before and after intravenous administration of a iodine-containing contrast agent (Ultravist, 370 mg/ ml) at the rate of 1 ml/kg. Brain magnetic resonance tomography was performed on a Signa Voyager, General Electric, China, 1,5 Tl in the pulse sequences T1, T2, T2 FLAIR, DWI, SWAN in three mutually perpendicular planes with a slice thickness of 1-5 mm to examine the neurological complications. Interventional angiopulmonography was implemented by using General Electric Innova IGS530, France, angiographic system before and after endovascular occluder ("AMPLATZER Vascular PLUG 4", USA) and spirals ("2D-Helical-35" 9 mm in diameter and 2,7 mm long (4 spirals) and "Complex–Helical-18" 11 mm in diameter and 17 mm long, USA) placement. A literature review in Russian and English languages for the last 5 years was searched using CyberLeninka, PubMed Central, Elibrary data bases, by keywords: pulmonary arteriovenous malformation, MSCT angiopulmonography, endovascular treatment. The prospective longitudinal study was conducted in compliance with the principles of ethics in accordance with the Helsinki Declaration, and informed voluntary consent was obtained from the patient.

Results. According to clinical and instrumental data, the tactics of combined endovascular treatment of a vascular malformation with subsequent postoperative control was collectively chosen. During the curation, an increase in saturation parameters, general wellbeing improvement, decrease in pulmonary pressure parameters, and diminution in the size of the right heart's parts were achieved.

Conclusion. Arteriovenous malformations (AVMs) are rare vascular abnormalities that represent a pathological communication between the arterial and venous bed. The fistulous link leads to an abnormal discharge of blood, bypassing the physiological capillary channel. Radiation and interventional visualization methods play the most important diagnostic, and the latest — therapeutic role in management of patients and are able to establish indications for surgical intervention, prevent the occurrence of life-threating complications: abscesses, paradoxical embolism and heart attacks, progressive respiratory and heart failure.

Aim. Demonstrate the features of magnetic resonance diagnostics of tenosynovial giant cell tumor.

Materials and Methods. Using magnetic resonance imaging, we identified patients with tenosynovial giant cell tumor of the knee joint, describing the diagnostic features and clinical course of diffuse and local forms of the tumor.

Results. Specific MRI patterns of tenosynovial giant cell tumor are hemosiderin deposits, villous and nodular growths of the synovium of the knee joint, joint effusion and bone erosion.

Conclusion. Тenosynovial giant cell tumor is a rare mesenchymal neoplasm arising from the synovium of joints and tendon sheaths, disabling young able-bodied people. Magnetic resonance imaging, being the “gold” standard for radiological diagnostics, helps to identify specific patterns.