Relevance. Cone beam computed tomography (CBCT) is widely used in dentistry and other fields of medicine due to the high image quality and low radiation load. Advanced models of tomographs allow for studies of various anatomical areas, which emphasizes the importance of understanding changes in their physical and technical characteristics for an optimal ratio between image quality and radiation load.

Review. The article analyzes the physical, technical and functional parameters of scanning various modern cone-beam computed tomographs (CBCT), which are available in the public domain — central printing or presented on the official websites of manufacturers. As part of the study, data were collected and analyzed on the physical, technical and functional parameters of 11 cone-beam tomographs from various manufacturers equipped with a tomographic table or having the possibility of retrofitting with a tomographic table for conducting research with the positioning of the object of study in a horizontal position. The data obtained were compared with the parameters of cone-beam tomographs used to study the maxillofacial region.

Conclusions. The design features of the new generation of cone beam tomographs increase the variability of functionality, contributing to the expansion of the range of diagnostic techniques. There is no information in open sources about the distances between the emitter and the detector, as well as the object-detector distance, which makes it impossible to draw conclusions about the mechanical and physical solutions in cone beam tomographs, which significantly affects the quality of the images obtained.

Aim. Demonstrate the possibility of reducing the radiation load on the patient while maintaining high quality mammographic images.

Materials and Methods. Using mammography, we obtained digital images of the breast phantom in various shooting modes, recording the dose load during the study and evaluating the quality of visualization.

Results. The optimal shooting parameters have been determined at which the minimum radiation load is achieved without reducing the image quality.

Conclusion. This study demonstrates the potential to reduce radiation exposure during mammography by optimizing the physical and technical parameters used in the procedure.

Objective. To determine the criteria and diagnostic significance of density maps for acute lung injury (ALI) in patients of the intensive care unit according to computed tomography (CT) of the chest.

Materials and Methods. 93 patients aged 44–85 years were examined in the Clinical Hospital No. 1, Smolensk from 2022 to 2024, men — 52 (55.9 %), women — 41 (44.1 %). Patients were admitted to the intensive care unit, 87 (95.6 %) of them were transferred to the other hospital departments corresponding to the nosological forms of the diseases; 81 (93.1 %) patients remained under follow up period during two years (inpatient and/or outpatient stages of treatment). All patients of the main group underwent CT of the chest, with additional assessment of lung tissue density maps, on a 64-slice GE Revolution EVO computed tomography scan, in the control group – in 19 (45.2 %) cases. Statistical analysis of the results included descriptive statistics, comparison samples of nonparametric criteria.

Results. In our study with a summation quantitative criterion of lung tissue density maps of more than 14 %, we watched damage to all life support systems: kidney damage more often occurs with a density criterion from 14 to 25 %, then goes damage of central nervous system; in case of density criterion more than 26 % — kidneys and liver damage. In the monitoring in the intensive care unit in 57 patients, the summation quantitative criterion of density maps ranged from 14 to 25 %. In the follow up period of the presented group of patients, a high correlation was noted with negative clinical and laboratory dynamics in the form of shortness of breath, cyanosis, tachypnea, a decrease in partial oxygen pressure in arterial blood and the development of ALI (r = 0.978). The summation quantitative criterion of lung tissue density maps made it possible to predict the most likely changes from other life support systems upon admission (AUROC 0.912; CI 0.881–0.919) and follow up period (AUROC 0.902; CI 0.868–0.907).

Conclusions

1. There was a high correlation between negative clinical and laboratory dynamics and the development of ALI with a summation quantitative criterion of lung tissue density maps according to CT from 14 to 25 % (r = 0.978), as well as the progression of ALI at 26 % (r = 0.985).
2. The summation quantitative criterion of lung tissue density maps based on CT allows predicting changes from other life support systems upon admission (AUROC 0.912; CI 0.881–0.919) and follow up period (AUROC 0.902; CI 0.868 – 0.907).
3. The inclusion in the algorithm of management of patients in the intensive care unit of the assessment of lung tissue density maps in CT of the chest helps to reduce mortality and the risk of developing the syndrome of the consequences of intensive therapy.

Aim. Assessment of detectability of pulmonary thromboembolism on radiographs. Identification of masks of pulmonary thromboembolism manifestations mimicking other diseases on radiographs.

Materials and Methods. The retrospective analysis included 23 patients with pulmonary embolism proven by computed tomography, who were treated at the SBHI City Hospital No. 26. All patients underwent digital chest radiography in two projections on admission using a Samsung XGEO GC80 digital X-ray machine. Computed tomography was performed on a 128-slice General Electric Revolution EVO tomograph using intravenous bolus contrast with Omnipaque at a concentration of 300 mg iodine/ml. The findings of radiologists were compared with the data of computed tomography; detectability of pulmonary embolism on radiographs, correlation between the embolism massiveness and its manifestations on radiographs were evaluated.

Results. Among the 23 digital radiographs interpreted, pulmonary thromboembolism was suspected in 1 case (detection rate of 4 %). In 8 cases (35 %) no abnormalities were found on radiographs. In three patients (13 %) findings were interpreted as manifestations of peripheral lung cancer, that turned out to be areas of pulmonary infarction on CT. The detection rate of indirect signs of pulmonary thromboembolism (discoid atelectasis, small hydrothorax, infarctions, pulmonary hypertension) was at least twice as high in the CT examination. No correlation between the massiveness of thromboembolism and its manifestations on radiographs has been revealed. The most frequent manifestations of pulmonary thromboembolism on radiographs were discoid atelectasis (35 %), lung infarction (35 %), small hydrothorax (26 %) and high position of the diaphragm on the affected side (22 %). Rare sign was dilatation of the pulmonary artery trunk (9 %).

Conclusion. The detectability of pulmonary thromboembolism on digital radiographs is extremely low. Most often this diagnosis is hidden under the mask of a normal X-ray, tumour lesions or manifestations of cardiac insufficiency (hydrothorax). The lack of direct correlation between thromboembolism massiveness and lesions seen on radiographs requires the radiologist to be more attentive to clinical symptoms (sudden dyspnoea, chest pain, dry cough, etc.) when interpreting radiographs.

Aim. Analysis of literature on the use of computed tomography enterography with intravenous contrast enhancement (CTE) in the assessment of the involvement, activity and severity of the Crohn's disease (CD), and expected resection margins in case surgical treatment is necessary.

Materials and Methods. The largest and the most cited studies, fundamental works and recommendations on the diagnosis and treatment of IBD, published in open access scientific databases, were selected for the literature review.

Results. Epidemiology of Crohn's disease, diagnostic capabilities of CTE and their role in surgery planning for patients with complicated CD are considered.

Conclusions. The complicated epidemiological situation with CD requires early diagnosis, increased effectiveness of treatment, and reduction in disability and mortality in patients with CD. CTE is an effective and widely available method for the diagnosis of CD and continues to develop. Further study of the CTE possibilities, precise selection of patients for surgical treatment and preoperative assessment of the resection volume remains an actual problem.

During today's armed conflicts, there has been a tendency to the increased frequency of injuries to the scrotum, which account for about 10 % of all injuries to the genitourinary system. Inaccurate and untimely diagnosis of damage to this area leads to erroneous treatment tactics, which can subsequently cause persistent pain syndrome, erectile dysfunction, and also lead to an increase in the number of infertile men. The article discusses a clinical case of the use of ultrasound research in the diagnosis of damage to the scrotal organs in a patient with a mine blast wound (MBW).

Objective. Using the example of a clinical case, demonstrate the capabilities of the ultrasound method in visualizing structural changes in the organs of the scrotum during MBW, describe the characteristic ultrasound signs of damage to the scrotum and its organs in this type of injury.

Materials and methods. A clinical case of a victim with a mine blast wound to the scrotum is presented. The patient underwent ultrasound and CT with intravenous contrast. The results of radiological research methods were compared with data obtained during surgery.

Results. An ultrasound examination of the victim revealed ruptures of the tunica albuginea of both testicles (in the left testicle with prominence of testicular tissue into the scrotal cavity), hematomas of both testicles, intravaginal hematomas, foreign bodies of the scrotum and penis. The data obtained from ultrasound were confirmed intraoperatively.

Conclusion. Ultrasound scanning is a reliable method for diagnosing combat wounds of the scrotum, which allows you to accurately visualize such injuries as hematomas of the testicle and surrounding soft tissues, rupture of the tunica albuginea of the testicle, foreign bodies of the scrotum, determine the presence and direction of the wound channel, the degree of vascularization of damaged organs, thereby assess the severity of injuries and outline the correct plan for further treatment of the victim.