Magnetic resonance imaging (MRI) is one of the key tools for confirming the diagnosis of multiple sclerosis (MS). It also enables differential diagnosis, monitoring of treatment effectiveness, and assessment of disease activity using contrast agents. T1-weighted images are traditionally considered the gold standard for detecting contrast enhancement in demyelinating lesions. However, recent hypotheses suggest that post-contrast T2 FLAIR mode may increase the diagnostic yield in identifying active MS lesions. This study evaluates the potential of postcontrast T2 FLAIR imaging in the diagnosis of multiple sclerosis.

Aim. To assess the role of postcontrast T2 FLAIR imaging in detecting demyelinating lesions in the brain in patients with multiple sclerosis.

Materials and Methods. The study included 60 patients with multiple sclerosis aged 20– 59 years. MRI was performed on two scanners: Siemens Magnetom Avanto (1.5 T, n = 30) and Siemens Magnetom Prisma (3.0 T, n = 30). The protocol included standard modes, as well as T1 MPRAGE and T2 FLAIR before and after administration of gadobutrol (0.1 mmol/kg). Contrast enhancement was evaluated using the contrast index (CI) before and after contrast administration, followed by calculation of the signal intensity increase (ΔCI). Lesions were also compared based on the pattern of contrast accumulation in T1 MPRAGE and T2 FLAIR modes. The study further assessed whether visual contrast enhancement in T2 FLAIR could predict enhancement in T1 MPRAGE, and whether ΔCI in T2 FLAIR could be used as a predictive marker.

Results. A total of 132 demyelinating lesions were identified in 60 patients undergoing contrast-enhanced MRI. Of these, 35 lesions (26.5 %) showed enhancement in the T1 MPRAGE mode. Notably, 16.5 % of lesions showed enhancement in T2 FLAIR despite the absence of enhancement in T1 MPRAGE. There was a statistically significant correlation between enhancement in T2 FLAIR and T1 MPRAGE (p < 0.001). CI and ΔCI calculations confirmed intergroup differences. The diagnostic performance of T2 FLAIR visual analysis in predicting T1 MPRAGE enhancement showed a sensitivity of 94.3 %, specificity of 83.5 %, and accuracy of 86.4 %. ROC analysis revealed an AUC of 0.934 (95 % CI: 0.875–0.994), indicating excellent predictive ability of ΔCI in T2 FLAIR for contrast accumulation in T1 MPRAGE.

Conclusion. Incorporating post-contrast T2 FLAIR into standard MRI protocols for MS patients is a valuable diagnostic tool that may provide additional information. Further studies with larger cohorts are warranted to explore the full potential of post-contrast T2 FLAIR imaging in clinical practice.

Objective. To determine the place of T-SLIP and ASL-perfusion in the algorithm of management of patients with liver cirrhosis.

Materials and Methods. 83 patients with liver cirrhosis who were hospitalized in the gastroenterological and infectious departments were observed. All patients underwent abdominal ultrasound with Doppler imaging and transient liver elastography. The abdominal MRI was performed on a Vantage Titan 1.5 T (Toshiba) according to the standard protocol with additional inclusion of non-contrast ASL-perfusion of the liver and non-contrast MR-portography (T-SLIP) of the arterial and venous blood flow. The reference group consisted of 37 healthy individuals. A retrospective analysis group was also selected, which did not undergo ASL-perfusion and T-Slip (n = 15).

Results. Statistically significant differences in perfusion parameters of the hepatic parenchyma were revealed in patients between liver cirrhosis and healthy individuals (p < 0.01). In our study, a hyperperfusion map with liver cirrhosis occurred in 24 (28.9 %) cases. It should be noted that patients with hyperperfusion according to ASL-liver data required correction of medical monitoring, which consisted in increasing the frequency of observation in accordance with clinical recommendations. According to the results of T-SLIP in this patient, according to the severity of the violation of the architectonics of the blood flow, stage F4 of liver fibrosis was divided into categories: F4a (n = 12) — disruption of architectonics in the peripheral parts; F4b (n = 5) — disruption of architectonics in the central parts; F4c (n = 7) — disruption of architectonics in the peripheral and central parts. Based on the data obtained, an algorithm was developed for managing patients with liver cirrhosis with hyperperfusion, indicating the timing of follow up, and the frequency of prescribing antifibrotic therapy.

Conclusion. Quantitative indicators of ASL-perfusion of the liver allow us to suspect liver cirrhosis (p < 0.01). 2. ASL hyperperfusion map is an indication for liver T-SLIP and F4-stage category determination. 3. The inclusion of liver T-SLIP in the MR examination algorithm makes it possible to prescribe antifibrotic therapy on time and recommend monitoring time. 

Acute surgical pathology in patients with HIV infection is much more severe due to immunodeficiency, opportunistic infections and neoplastic processes, which significantly complicates not only the choice of treatment tactics for these patients, but also the initial diagnosis. In our article, we examined the features of primary radiation diagnosis of acute surgical pathology against the background of previously undiagnosed non-Hodgkin's lymphoma and demonstrate our own clinical experience. In the presented clinical cases, acute surgical pathology occurred as a result of the progression of non-Hodgkin's lymphomas, as well as the addition of an opportunistic infection, as a result, this not only leveled the overall clinical picture, led to repeated relaparotomy, but also ended in death 

Aim. To determine the informativeness of native high resolution MRI of the shoulder joint with use Recon DL option in the diagnostics of various variants of hidden soft tissues injuries of the biceps tendon pulley structures.

Materials and methods. A study of 39 patients suffering from degenerative and traumatic injuries of the biceps tendon pulley structures was conducted. All patients underwent MRI of the shoulder joint (Signa Artist 1.5 T) with thin slices (2.0 mm) and a 288 × 384 matrix, in three planes — axial, oblique coronal and sagittal. The informativeness of the MRI method for various variants of injuries the of the biceps tendon pulley structures were calculated.

Results. The cases of medial subluxation of the long head biceps tendon at the level of its pulley were revealed in 67.6 % of cases, 20.6 % intra-articular dislocation of the long head biceps tendon and 5,9 % of cases of extra-articular dislocation of the long head biceps tendon. Two cases (5.9 %) of minor medial subluxation of the long head biceps tendon were not revealed by MRI. There was not a single case of superior glenohumeral ligament rupture detected on native MRI. The sensitivity and specificity indices of the MRI method are: for medial subluxation biceps tendon the sensitivity is 92.0 %, specificity is 77.8 %, for intra-articular dislocation biceps tendon the sensitivity and specificity are 100.0 %, for extra-articular dislocation of the biceps tendon the sensitivity and specificity are 100.0 %.

In 84.0 % of cases, a slight medial displacement of the long head biceps tendon was noted, in 16.0 % of cases — moderate medial displacement of the biceps tendon.

Degenerative changes in the long head biceps tendon were diagnosed in 100,0 %, degeneration of the subscapularis tendon in 67.6 %, rupture of the subscapularis tendon in 26.5 % of cases. In 5.9 % of cases degeneration of the subscapularis tendon was not recognized on MRI.

Conclusions. The method of native MRI with use Recon DL option has very high information content only in the cases of obvious medial subluxations and dislocations of the long head biceps tendon pulley, but does not always allow for the reliable detection of more subtle hidden and minor injuries of the ligaments accompanying the biceps tendon pulley. 

Objective. To evaluate the possibility of using the «SyGrid» digital image processing program for mammography (software grid) instead of the traditional movable grid.

Materials and methods. On the basis of the mammograph Mammo-4MT-Plus (JSC «MTL», Moscow), the «SyGrid» software grid was compared with a standard movable grid. At the laboratory stage, CDMAM and CIRS 010D phantoms were used. At the clinical stage, doses were compared in samples of 1063 studies with a physical grid and 1132 studies with a software grid. To compare the image quality, 200 random studies from each sample were independently blindly evaluated by three radiologists.

Results. At equal doses, the quality metrics calculated with CDMAM and CIRS 010D phantoms with a software grid were no lower than with a physical grid. Radiologists, on average, rated the quality of images with a software grid significantly higher than with a physical one. The average dose in the sample with a software grid was 22 % lower than in the sample with a physical grid.

Conclusion. The «SyGrid» software grid can be used instead of a movable physical grid for mammography.

Aim. Analysis of domestic and international literature to evaluate the capabilities of multidetector computed tomography (MDCT) in assessing major vascular involvement of the hepatobiliary region in perihilar cholangiocarcinoma (PHC).

Materials and Methods. The literature review included the most cited scientific publications available in open-access databases.

Results. The reviewed studies address the use of various CT criteria and corresponding terminology for evaluating the relationship between PHC and the major vessels of the hepatobiliary region.

Conclusion. MDCT with intravenous contrast remains the method of choice for preoperative assessment of PHC resectability. Despite the use of vascular involvement criteria similar to those applied in pancreatic cancer, considerable variability persists in their interpretation and diagnostic accuracy. Evaluation of major hepatic vessel involvement remains a challenging task, emphasizing the need for further clarification of terminology and standardization of descriptive criteria.