Background. Biliary complications, such as choledochojejunal anastomotic strictures and bilomas, remain among the most common (10–30 %) and serious problems in the postoperative period for liver recipients, significantly affecting graft survival and the outcome of transplantation in general. Timely diagnosis is a key factor for successful treatment; however, there is currently no unified protocol for radiological monitoring of patients.

Objective. To assess the diagnostic and prognostic value of a developed standardized protocol for dynamic MSCT/MRI monitoring for the detection and management of biliary complications in patients after liver transplantation.

Materials and methods. A single-center retrospective cross-sectional study of 67 patients who underwent liver transplantation was conducted. All patients underwent MSCT and MRI/MRCP according to a standardized protocol in the preoperative period and dynamically in the postoperative period (on days 3–7, at 1 and 3 months). Patients were divided into groups: those with developed biliary complications (n = 18) and those without (n = 49).

Results. A standardized protocol for dynamic MSCT/MRI monitoring in the early and late postoperative periods improves the diagnosis of biliary complications after liver transplantation. Early detection of biliary complications enables timely application of minimally invasive treatment methods, leading to successful management in over 64 % of cases and significantly reducing the overall incidence of persistent biliary complications from 44.8 % to 26.9 % (p = 0.026, OR = 2.25; 95 % CI 1.09–4.63). Further studies are needed to validate this method.

Conclusion

1. The etiology of the underlying liver disease is a significant predictor of the risk of developing biliary complications after transplantation. The highest risk is associated with Wilson – Konovalov disease (11,1 % vs 0,0 %, р = 0,017, OR = 4,13; 95 % CI 2,66–6,41) and primary sclerosing cholangitis (16,6 % vs 2,1 %, р = 0,023, OR = 9,86; 95 %CI 1,02–102,42).

2. The standardized protocol of dynamic MSCT/MRI monitoring in the early and late postoperative periods allows for improved diagnosis of biliary complications (anastomosis stenosis, biloma) af­ter liver transplantation. Early detection of biliary complications enables the timely application of minimally invasive treatment methods, resulting in successful resolution in more than 64 % of cases and significantly reducing the overall frequency of persistent biliary complications from 44.8 % to 26.9 %, OR = 2,25; 95 % CI 1,09–4,63). 

Study objective. Quantitative magnetic resonance T2* relaxometry is a promising method for assessing changes in the fetal brain associated with hypoxic conditions, which remain invisible with structural MRI and ultrasound. To obtain reproducible quantitative data, as well as to adjust scanning parameters and develop T2* mapping methods, it is necessary to create a test object with reference characteristics close to the values of the fetal brain. The aim of the study is to create a test object (phantom) for model experiments to adapt the T2* relaxometry method to in utero neuroresearch.

Materials and Methods. A comparative study was conducted of materials potentially suitable for imitating the T2* time relaxation (TR) of the fetal brain. The phantom construction was created using fused deposition modeling 3D printing technology. The resulting phantom was examined on a 3 T scanner, and scanned three times over the course of a month on a 1.5 T scanner to determine the stability of its characteristics and the reproducibility of the results. The study protocol included multiecho GRE sequences, acquiring 16 echo-images (n (TE) = 16) and single-shot multi-echo GRE EPI sequences, acquiring 5 echo-images (n (TE) = 5) of a single slice, with T2* calculations, with and without accounting for macroscopic magnetic field inhomogeneities, respectively.

Results. T2*-TR analysis of the test materials revealed that agarose gels at concentrations of 0.4 and 0.7% demonstrate T2* values close to those of the fetal brain: at n (TE) = 16, taking into account macroscopic inhomogeneities of the magnetic field, the calculated T2*-TR at 1.5 / 3 T were: 266 (4.4) / 246 (4,7) ms for the 0.4 % sample and 161 (3.5) / 163 (5) ms for the 0.7 % sample. A series of repeated experiments demonstrated high stability of the phantom's T2*-TR values for one month after its preparing (coefficient of variation 2.85 and 0.36 %, respectively).

Conclusion. An original phantom for fetal T2*-relaxometry has been created, applicable in the scientific and clinical practice of quantitative MRI. 

Background. Late fetal growth restriction (FGR) is the second leading cause of perinatal mortality, with underdiagnosis rates reaching 30–40 % due to challenges in differentiating it from constitutionally small-for-gestational-age (SGA) fetuses. Fetal chronic hypoxia triggers a compensatory brain-sparing effect, yet the exhaustion of this mechanism leads to structural cerebral decompensation. Developing objective MR-morphometric criteria is essential to accurately differentiate pathological smallness and assess the severity of brain impairment.

Objective. To evaluate the diagnostic value of fetal brain MR-volumetry in differentiating late FGR from SGA, and to determine the impact of blood flow centralization on the severity of brain structural impairment.

Methods. This prospective study included 147 pregnant women categorized into control (AGA, n = 71), SGA (n = 38), and late FGR (n = 38) groups based on the Delphi consensus criteria (2016). Fetal MRI was performed at 1.5 T. Supratentorial and cerebellar volumetry was conducted via manual segmentation (Cavalieri principle) using ITK-SNAP software. Statistical evaluation and ROC analysis were performed using JASP and MedCalc.

Results. Late FGR was characterized by a significant reduction in supratentorial brain volume (244 vs 294 cm³ in SGA and 334 cm³ in AGA; (p < 0.001) and cerebellar volume (14.5 vs 17.7 and 20.6 cm³; (p < 0.001). The brain-sparing effect (CPR < 5th percentile; (n = 25) was associated with an additional 11.6% decrease in supratentorial volume: 251 [206–270] cm³ vs 284 [246–292] cm³ in the non-centralized subgroup (p = 0.045), with no significant changes in cerebellar volume (p = 0.075). Supratentorial volume demonstrated the highest value in differentiating late FGR from SGA (AUC =  0,738; sensitivity 64.9 %, specificity 69.4 %), outperforming cerebellar volume (AUC = 0.687); the combined model yielded no diagnostic improvement (AUC = 0.733).

Conclusion. Multiparametric MR-morphometry successfully verifies fetal brain structural deficits in late FGR, with supratentorial volume serving as a key criterion for differentiating pathological smallness (AUC = 0.738). Doppler-derived blood flow centralization (CPR < 5th percentile) is associated with an additional 11.6 % reduction in supratentorial volume (p = 0.045), demonstrating the exhaustion of compensatory mechanisms and serving as an MR-marker for the transition from hemodynamic adaptation to structural decompensation. 

Objective. To perform a systematic literature review to evaluate the diagnostic performance of contrast-enhanced spectral mammography (CESM) in women with BI-RADS 3–4A breast lesions and to assess its impact on lesion reclassification, biopsy rates, and management strategy. 

Materials and Methods. A literature search was conducted in PubMed, Web of Science, Scopus, MedVis, and the Russian Science Citation Index for the period 2015 – January 2025, including original clinical studies, systematic reviews, and meta-analyses comparing CESM with digital mammography, ultrasound, and MRI in patients classified as BI-RADS 3–4A.

Results. CESM demonstrated high sensitivity (92.7–100 %) and specificity (67.9–100 %), outperforming digital mammography, and allowed safe downgrading of 20–40 % of probably benign lesions to BI-RADS 2, reducing the number of biopsies by 16–43 % while maintaining a high negative predictive value.

Conclusion. CESM is an effective method for further evaluation of BI-RADS 3–4A lesions and dense breast tissue, reduces unnecessary biopsies and short-interval follow-up, and can be considered a cost-effective alternative to MRI in resource-limited settings. 

Objective. Investigate doppler sonographic capabilities in the assessment of cerebrospinal fluid flow dynamics in infants with central nervous system disorders.

Materials and Methods. The article presents data on physiology of synthesis and circulation of cerebrospinal fluid (CSF), its normal composition, and features in the neonatal period. Since the 1990 the doppler researches of cerebrospinal fluid dynamics has been analyzed. 

 Results. The variants of cerebrospinal fluid flow doppler imaging phenomenon in neonates are presented in color and pulse wave modes, furthermore the types of synchronization of the cerebrospinal fluid flow in various pathological conditions. The publication highlights the magnetic resonance imaging (MRI) results obtained in recent years in the study of cerebrospinal fluid dynamics, as well as experimental data on the use of doppler technologies in assessing fluid flows within catheters, including monitoring the functioning of ventriculoperitoneal shunts. Own doppler observations of studying phenomenon are demonstrated.

Conclusion. The Doppler study of cerebrospinal fluid flows has a certain diagnostic value in neonates with cerebral hemorrhage and inflammation; however, a number of controversial issues remain:

— the low detection rate of phenomenon is unclear in changes of cerebrospinal fluid rheological properties in intracranial hemorrhages and meningitis;

— various patterns of cerebrospinal fluid movement synchronization are not completely soluble;

— experimental data do not completely correspond to clinical experience, which determines the perspectives for further researches. 

Pyogenic liver abscesses remain a complex surgical pathology associated with a high mortality rate. This clinical observation presents a case of recurrent cholangiogenic liver abscess and the computed tomography (CT) results that allowed to form the correct diagnosis and further treatment plan.

Aim. To substantiate the diagnostic value of multislice computed tomography (MSCT) with intravenous bolus and oral contrast in topical verification of the source of infection, assessment of the morphological structure and extent of cholangiogenic liver abscess, detection of complications, and monitoring of drainage effectiveness using a clinical case of recurrent cholangiogenic liver abscess.

Materials and Methods. A 38-year-old female patient with a complicated hepatobiliary history and two hospitalizations within a year for recurrent cholangiogenic liver abscess was analyzed. MSCT with intravenous bolus contrast (arterial, portal, and delayed phases), MSCT with oral contrast (in the right lateral decubitus position), abdominal ultrasound, and dynamic clinical and laboratory examination were performed.

Results. In both cases, CT with intravenous contrast revealed large, multilocular, hypodense liver lesions with septa, gas inclusions, and peripheral ring-shaped enhancement of the walls and septa, as well as persistent biliary hypertension with dilation of the intra- and extrahepatic bile ducts, aerocholia, and abnormal contents in the common bile duct, indicating a cholangiogenic mechanism. The first case was complicated by sepsis, bilateral septic pneumonia, hydrothorax followed by pleural empyema, and the formation of an anterior abdominal wall abscess, which required surgical intervention. CT with oral contrast enabled visualization of duodenobiliary reflux and the ascending route of biliary tree contamination, enabling the identification of the probable mechanism for the persistence and recurrence of the infectious process. Native CT and ultrasound were insufficient for a complete morphological characterization of the lesion and differential diagnosis.

Conclusion. Combined MSCT with intravenous bolus contrast provides a reliable interpretation of pathological changes in the liver parenchyma and bile ducts, identification of abdominal and thoracic complications, monitoring of drainage position and effectiveness, and planning of invasive strategies. Oral contrast in the right lateral decubitus position allows for the identification of biliodigestive reflux and ascending cholangitis as probable causes of abscess recurrence, necessitating a reconsideration of treatment strategies if inflammation persists.