Aim. To determine the possibilities of high-resolution ultrasound examination of the skin at planning of photodynamic therapy and in the early post-therapeutic period.

Materials and Methods. 128 patients referred for photodynamic therapy (PDT) of basal cell skin cancer of the head and neck region were examined. The PDT was preceded by two diagnostic techniques: fluorescence diagnostics (FD) and high-resolution ultrasonography. The latter was performed before and within 24–72 h after PDT on an expert class device Philips Epic 7 (USA), high-frequency linear transducer eL18-4 using MicroFlow Imaging (MFI) technology.

Results. Horizontal and vertical dimensions and tumor microvascularization were assessed by ultrasound. Depending on thickness and vascularization, all tumors were divided into three groups: with peripheral vascular pattern (Me 1.6 mm), with peripheral and central vascular pattern (Me 2.4 mm), and with no vascular pattern (Me 1.3 mm). Significant statistical differences (p < 0.001) were found that were dependent on tumor thickness. When comparing the horizontal dimensions obtained by ultrasound and fluorescence diagnostic methods, a moderately close direct relationship was found, which was attributed to the difference in techniques. When the primary horizontal dimensions at ultrasonography (extent) increased by 1 mm, an increase in dimensions at FD of 0.413 mm was to be expected. The resulting model explained 15.9 % of the observed size variance in FD. Based on the results of tumor thickness data in ultrasonography and horizontal margins in FD, the parameters of PDT were determined. Evaluation of microvascularization of the pathological focus in the period 24–72 h after PDT predicted the outcome of PDT. The vascular pattern in the tumor was absent in 90.5 % of cases (excluding masses with uninformative vascular pattern at the primary examination), in 7.6 % of cases peripheral vascular pattern was visualized, most likely it was connected with the signs of active inflammation of the surrounding tissues. In 1.9 % of cases intratumoral vascularization remained, which required a repeated PDT session.

Conclusions. Ultrasound skin examination in combination with FD allows to optimize PDT and to estimate the therapeutic effect of the procedure in the early post-therapeutic period.

It is crucial to know the numerical values of diffusion tensor magnetic resonance imaging (DTMRI) parameters in healthy subjects, as well as their correlation with demographic, biometric data and the key parameters of standard MRI, for the purpose of diagnosing pathological changes in brachial plexuses, especially when dealing with non-specific or unclear alterations according to standard magnetic resonance imaging finding.

Aim. Assessing the potential of using diffusion tensor magnetic resonance imaging (DTMRI) to study brachial plexuses, developing an algorithm for data processing and evaluating the distribution of parameter values in normal conditions, as well as exploring whether they correlate with socio-demographic and anthropometric indicators.

Materials and Methods. The study included 50 healthy volunteers without signs of damage to the peripheral nervous system. The diffusion tensor MRI parameters were recorded at a distance of 1–2 cm from the spinal ganglion on both sides using the Siemens workstation with manual setting of the area of interest. Parameters such as fractional anisotropy, mean diffusivity, axial and radial diffusion coefficients were recorded. In addition, the intensity coefficient was measured at the same point using a standard three-dimensional sequence STIR images.

Results. The average values for each assessed parameter were obtained. A statistically significant difference in FA was found between the sides, with the right side being significantly higher than the left. Additionally, a negative correlation was observed between AD and the age of the subjects on both sides. When the subjects were categorized by gender, men exhibited significantly larger nerve diameter, subclavian artery diameter, height, and weight.

Conclusion. The presence of a significant negative correlation between AD on both sides and age may indicate a gradual thinning of nerve fibers as one ages. The differences in measured parameters among subjects of different genders and their dependence on biometric indicators are consistent and should be taken into account when interpreting studies in patients with various pathological conditions. Furthermore, the substantial difference in the functional asymmetry between sides prevents the interpretation of the obtained data using a mixed model and necessitates the examination of numerical parameters for each side separately.

Objective. Evaluation of the possibility of magnetic resonance cholangiopancreatography with the construction of three-dimensional models in children with cystic dilation of the bile ducts.

Materials and methods. 73 children with cystic dilation of the bile ducts were examined: 47 girls (64 %) and 26 boys (36 %). The age of the patients ranged from 5 days of life to 17 years 7 months. All children were examined by ultrasound and MRCP with the construction of 3D-models.

Results. During the MRCP study, 43 children (58.9 %) were found to have fusiform cystic bile ducts and 30 children (41.1 %) had spherical cystic bile ducts. The variability of intrahepatic ducts in children with cystic bile ducts was assessed.

 It was found that in children with choledochal cyst and the presence of APBS, the risk of developing pancreatitis is 5.13 times higher than in children with normal duct fusion, the results are statistically significant (p < 0.05). It was shown that computer 3D processing improves the efficiency of the method in diagnosing cystic dilation of the bile ducts in children, allowing to overcome the limitations in the form of projection superposition of anatomical structures. Thus, statistically significant differences were obtained in the construction of 3D models compared to the analysis of only MRCP images in relation to the assessment of the variability of the fusion of intrahepatic ducts (χ² = 34, p < 0.001), variants of the cystic duct return (χ² = 46, p < 0.001), when analyzing the type of abnormal pancreatobiliary anastomosis (χ² = 46, p < 0.001).

Conclusion. MRCP allows non-invasively, without radiation exposure and intravenous contrast, to obtain a complete picture of the topography of the extrahepatic bile and pancreatic ducts, which allows planning the course of surgical intervention and avoiding damage to important anatomical structures.

Supplementing the standard MRCP study with the construction of 3D models improves the effectiveness of the method in diagnosing cystic dilation of the bile ducts in children, allowing to overcome limitations in the form of projection layering of anatomical structures, which allows to reduce or completely eliminate intraoperative studies.

Extra-intestinal manifestations in the form of diseases of the musculoskeletal system are often found in Crohn's disease, including sacroiliitis. Early changes in the sacroiliac joints often do not cause clinical symptoms and can only be determined by magnetic resonance imaging.

Objective. Demonstration of the possibilities of magnetic resonance enterography in the diagnosis of sacroiliitis.

Materials and Methods. A clinical case of asymptomatic sacroiliitis in a young patient with severe Crohn's disease is presented. Magnetic resonance enterography and magnetic resonance imaging of sacroiliac joints were performed on a GE tomograph (Optima 450w), with a magnetic field strength of 1,5 Tesla.

Results. During the interpretation of the results, data for active inflammation in the intestine were not revealed, however, unexpressed edema of the bone marrow in the adjacent sacroiliac joints was suspected. The patient was additionally examined on an MRI of the sacroiliac joints, during which the presence of edema was confirmed. At the same time, the patient had no complaints of joint pain.

Conclusion. Sacroiliitis is often found in patients with Crohn's disease and in most cases begins asymptomatically. Primary changes in the sacroiliac joints are more often visualized only according to magnetic resonance imaging. Based on this, the use of magnetic resonance enterography, used in such patients, may also be useful for visualizing inflammatory changes in sacroiliac joints.

Objective. To demonstrate the importance and necessity of ultrasound diagnostics in case of traumatic injury of the upper extremities of various types on the example of a clinical case of detection of volumetric formation of soft tissues of the right upper limb of a false aneurysm and arteriovenous fistula of the brachial artery during ultrasound scanning.

Materials and Methods. Information about the patient's medical history, protocols, laboratory and radiation examination methods.

Results. In a victim with a combined gunshot wound to the chest, abdomen, limbs, and a closed craniocerebral injury in the lower third of the right shoulder, a volumetric pulsating formation measuring 10 × 8 × 8 cm was visually determined, during ultrasound scanning of soft tissues and main vessels of the right limb, defects in the walls of the brachial and radial arteries were revealed with the formation of a pulsating hematoma in the soft tissues of the right shoulder and forearms, defects in the walls of the brachial artery and vein at the level of the lower third of the right shoulder with the formation of an arteriovenous junction between them. The presence of an arteriovenous fistula and pseudoaneurysm were also confirmed during CT angiography. Due to the timely and high–quality radiation diagnosis, the patient underwent successful surgical treatment — resection of the brachial artery aneurysm of the right upper limb, separation of the arteriovenous fistula.

Conclusion. Ultrasound scanning of soft tissues and main vessels of the extremities in case of their traumatic damage, unlike other methods of radiation diagnostics, allows noninvasively, without radiation load, timely and mobile assessment of the state of blood flow in the affected limb, to identify the presence of hematomas, false aneurysms and arteriovenous fistulas and distinguish them from each other based on the spectral characteristics of blood flow and vascular staining in the mode of color Doppler mapping, which was carried out to a wounded man with damage to the right upper limb, who was suspected of having a soft tissue hematoma at the initial examination, and during an ultrasound scan was diagnosed as a false aneurysm and arteriovenous fistula of the brachial artery.

Objective. Demonstration of the possibilities of diagnostics radiology methods in a hospital in the diagnosis of intestinal tumor with invading the bladder and uterus.

Materials and Methods. A patient with pelvic mass underwent magnetic resonance imaging (MRI) and computed tomography (CT) with contrast enhancement to differentiate diagnosis.

Results. Tumor of the distal ileum with invading the bladder and parauterine fat was revealed according to CT and MRI of the pelvis. Signs of liver metastases were noted according to CT of abdomen cavity with intravenous contrast enhancement

Conclusion. The clinical observation presented the c possibilities of MRI and CT with contrast enhancement, performed according to the standard protocol, to diagnose the intestine tumors. The advantages of CT are shown, which made it possible to evaluate several areas (abdominal and pelvic cavities) in a single study in a minimum time and demonstrated better tolerability of the procedure compared to MRI.