The diagnostics are based on the principle of obtaining informative and high-quality images with minimal radiation exposure using radiation diagnostic methods: traditional radiography, multislice and cone-beam computed tomography.

When conducting X-ray examinations, the main factors in reducing the risk of radiation exposure are the use of highly sensitive digital diagnostic image receivers, minimal exposure time, and a minimum number of images per examination. A lower current value and high anode voltage values, a minimum focal spot size, the placement of the tube as far as possible from the patient and the image receiver as close to the patient as possible, collimation of the radiation beam, and preference for a low radiation dose rate mode are also factors in reducing the risk of radiation exposure.

Imaging of the craniovertebral region using cone beam computed tomography offers the opportunity to evaluate the bone structure of the region in detail, with an equal or less effective dose to the patient.

The condition of increased cardiac output is a state in which, in response to various pathological causes, there is a pathological activation of the renin-angiotensin-aldosterone and sympathetic-adrenal systems, which overall creates a multifaceted, increased load on the heart, ultimately leading to heart failure. The cause of this condition may be arteriovenous pathological shunts, among which arteriovenous dural fistulas in glomus tumors (intracranial paragangliomas) occupy a special place. An arteriovenous fistula is a direct connection between an artery and a vein bypassing the capillary bed, creating a massive shunt from the high-pressure system to the low-pressure system, triggering a pathophysiological chain. In addition, activation of the renin-angiotensin-aldosterone and sympathetic-adrenal systems and direct myocardial damage can be caused by elevated levels of catecholamines in the blood in cases of adrenal paraganglioma (pheochromocytoma) and neuroblastoma. The condition of increased cardiac output is more often described in the literature using examples of clinical cases in adults, with significantly less literature data available in pediatric practice.

Von Hippel-Lindau syndrome (VHL) is a rare autosomal-dominant inherited cancer syndrome with different phenotypes caused by variants in the VHL gene.

Hemangioblastoma (HAB) is a benign tumor of the central nervous system and may appear as a component of VHL disease.

HAB is one of the most common manifestations and a leading cause of morbidity and mortality in patients with BGL, but can also occur as a sporadic form. This tumor often has a cystic component and is multiple in nature. Mainly located subtentorially. MRI is the gold standard for diagnosis; computed tomography and perfusion techniques can also be used to make the correct diagnosis. The definitive treatment for these lesions is surgical resection, followed by SRS if necessary. Stereotactic irradiation is the method of choice for hemangioblastomas, especially with early detection of relatively small lesions, including those with multiple lesions. Radiosurgery is carried out with a high degree of efficiency with low toxicity, which is especially important for patients with minimally severe symptoms and in pediatric patients and also is recommended to patients with limited surgical alternatives (i.e., severe medical comorbidities, surgically unresectable tumors). SRS offered a satisfactory 5-year tumor control of HHB to VHL patients.

The article describes a family case of hemangioblastoma, traced over several generations, provides an algorithm for the management of patients with VHL syndrome with recommendations for the required scope of their diagnosis, observation and discussion of approaches to their treatment.

Careful collection of family history, genetic and follow up examination carried out systematically and correctly, monitoring of patients with VHL will allow timely establishment of the correct diagnosis and more widespread use of the stereotactic irradiation method.

Objective. Quantitative assessment of changes in brain myelin content after the first course of chemotherapy

Materials and Methods. T1 and T2 maps as well as myelin water fraction (MWF) and macromolecular proton fraction (MPF) maps, reflecting myelin content, were acquired in 6 patients (mean age — 13.7 ± 2.4 years) before and after the first course of chemotherapy. The study was carried out using on 3T MRI scanner. Statistical data processing was carried out using the GraphPad Prism.

Results. MPF and T2 values showed an increase in the thalamus and white matter of the occipital lobes of the brain, while MWF values showed an increase in the cerebellum and a decline in the white matter of the frontal lobes. Significant changes were not found for T1 values.

Discussion. According to MWF the structures of the brain which are primarily affected by treatment with toxic drugs — the white matter of the frontal lobes and the cerebellum, were revealed. MWF values decreasing in the white matter of the frontal lobes may indicate the process of demyelination in this area, while increased MWF values in the cerebellum could be caused either by remyelination processes or by incomplete cleansing of myelin residues accumulation by macrophages at the site of degeneration.

 Conclusion. The results obtained demonstrated high potential of MWF values serve as early changes biomarker of neurotoxicity after the chemotherapy treatment. Along with this, the MPF index, which is more sensitive to cerebral edema, may be a predictor of demyelination.

The purpose of work was to determine CECT characteristics of primary juvenile angiofibroma of the nasopharynx and skull base (JNA), as well as determination of the paths of spread for the tumor, search for those of them, which are statistically significantly associated with surgical blood loss of subsequent treatment and search for ways to model possible blood loss on their basis.

Materials and methods. The data of 60 patients aged from 8 to 17 years were analyzed retrospectively. All patients were boys. The median age was 14 years. The median duration of the disease at the time of surgery was 7 months. The correlation between each of 45 evaluation criteria and intraoperative blood loss was determined for patients in the study group.

Results. CT characteristics of JNA were established. The factors, detected by CECT, statistically significantly influencing intraoperative blood loss in angiofibroma treatment were established. A method for modeling intraoperative blood loss based on imaging data was presented.

Conclusion. CT with contrast enhancement allows determining of characteristic radiological signs of JNA as well as its characteristics influencing blood loss during surgical treatment. Based on CT data it is possible to model blood loss potential during the JNA treatment.

Hemolytic — uremic syndrome (HUS) is one of the most severe conditions in pediatric practice. Acute kidney failure (AKF), which is a component of HUS, requires the earliest diagnosis and emergency medical care. Most of the young patients suffer from diarrhea-associated (D+) HUS, so ultrasound marks of kidney injury very important for young patients with severe hemocolitis. In this article we present the observation of preclinical diagnostics AKF the child 2 years and 11 month old with hemocolitis, when HUS’s marks (such as structure’s changes of the renal parenchyma and critical changes of renal hemodynamics) were detected before clinical manifestation AKF. This observation is illustrated with echograms and accompanied by a brief review of the literature.