ORIGINAL RESEARCH
The aim of the study was to determine the diagnostic capabilities of stereoscopic mammography against non-palpable breast lesions. The study involved 120 patients with different pathologies of the mammary glands in the age group from 30 to 80 years. The study identified the main benefits of a stereoscopic mammography to standard digital mammography in the diagnosis of breast lesion. It is found that the stereoscopic mammography has high sensitivity (86 %), high specificity (84 %) and high prediction accuracy (85 %), for setting conclusion «BC» and «suspicion of breast cancer» (sensitivity 86 %, specificity of 84 % and accuracy 85 %). Using stereoscopic mammography, with high probability, can significantly reduce the incidence of additional surveys, as the breast lesion is visualized immediately to the extent that allows the correct diagnosis and determine the optimum tactics of the patient reference
The study involved 25 patients with established diagnosis of renal lymphoma. There are 5 variants of ultrasound picture: lesions in the kidney parenchyma; diffuse lesion; invasion of tumors in the kidney; invasion of tumors in pelvis and calyx; perinephric masses. These ultrasound pictures are represented in this article. It is noted that renal lymphoma has no specific ultrasound picture and can manifest by various options. Renal lymphoma usually has not expressed clinical presentation. Revealing hypoechoic, homogeneity, hypervascularisation formations, the presence of lesions of other organs and lymph nodes can help in the differential diagnosis of the disease
The aim of the study was to identify and evaluate of the factors affecting the efficiency of magnetic resonance-guided focused ultrasound ablation (FUS) of uterine fibroids. Retrospective analysis of 67 FUS ablations (67 women, 94 fibroids) was performed. We evaluated the characteristics of fibroids (the number of fibroids in uterus, the location in the myometrium and in relation to parts of the uterus, MR-type, standardized signal intensity (SSI) and signal heterogeneity in T2-WI, the maximum diameter, the distance to the skin and to the sacrum during FUS, volume, nonperfused volume (NPV) after treatment), sonication energy and patients age. Standardization of the fibroid signal intensity was performed by using the signal intensity from iliac muscle. Correlation between NPV and quantitative characteristics was calculated. The estimation of influence of the qualitative factors (MR-type, location and number of fibroids) on the NPV values was performed. We evaluated the relation between MR-type of fibroids and SSI. Post treatment NPV ratio was 57,1 ± 22,5 % (n = 94). SSI showed significant correlation with NPV ratio (R = – 0,28, p < 0,01). Significant correlation between NPV ratio and others quantitative characteristics was not detected (p > 0,05). NPV for MR-type 1 fibroids (n = 67) was 63,4 ± 19,7 %, for type 2 (n = 20) – 46,8 ± 19,5 % and for type 3 (n = 7) – 26,4 ± 21 %. Differences between groups was significant (p < 0,05). NPV for intramural and type 2 submucosal fibroids (64,8 ± 20,2 and 61,3 ± 20,1 %) was significantly higher than for type 1 and 2 subserosal fibroids (45,1 ± 20,7 and 49,4 ± 20,1 %) (p < 0,05). Significant difference between NPV ratio for type 1 submucosal fibroids (49,8 ± 37,4 %) and for fibroids in other locations was not identified (p > 0,05). Differences of the NPV ratio depending on the number and location of fibroids (in relation to the parts of the uterus) were not observed (p > 0,05). MR-types of fibroids were characterized by different SSI (p < 0,05). SSI ≤ 1,4 was characteristic only for 1 MR-type fibroids and these SSI values were observed in 56 (83,6 %) of them. Fibroid signal intensity in T2-WI and location in the myometrium significantly affect the NPV ratio and therefore the effectiveness of FUS ablation. Lower fibroid SSI values orrespond to the higher NPV values after FUS. MR-type 1 fibroids are characterized by the highest values of NPV after FUS ablation. The effectiveness of MR-guided FUS of intramural and type 1 submucosal fibroids is higher than subserosal fibroids
CONTINUING MEDICAL EDUCATION
Blunt abdominal trauma up to the present time maintains a high medical and social importance. Diagnosis of this pathology needs to be quick and precise because the time factor may be crucial. The most informative method, which allows to improve the condition of the organs and structures of the abdominal cavity and retroperitoneal space, is multidetector computed tomography. The article presents a clinical case of blunt abdominal trauma, resulting from road accidents. Utilization multidetector computed tomography allowed us to determine the severity of internal injuries and to choose optimal treatment tactics.
Orthopantomography (OPTG) is performed routinely as a diagnostic method for practically any dental disease. However, most dentists don’t attach importance to the fact that this X-ray technique allows to visualize the changes not only of the facial bones of the skull, and also of the soft tissues of the neck, one of which are calcifications of the carotid arteries (CCA). CCA visualization shows the presence of the atherosclerosis of the arteries of the neck in this patient, which in turn is one of the main causes of cerebrovascular accident by ischemic type. All this confirms the fact that the assessment of OPTG as the screening method to identify the CCA is a promising direction, which in the future will might help to reduce the level of cardio- and cerebrovascular complications of atherosclerosis
CLINICAL OBSERVATIONS AND BRIEF REPORTS
Iliopsoas abscess (IPA) is a rare disease in neonates that can cause serious complications. We present a clinical case of bilateral iliopsoas abscess in 19-day neonate. The pathology have been diagnosed with sonography. Thepercutaneous surgical draining of purulent collections was performed, postoperative period was uneventful. The results of the echographic study and the short review of the literatureis present