Background. Treatment of patients with acute kidney injury and chronic kidney disease requires renal replacement therapy, peritoneal dialysis (PD) is one of the methods.

Objective. Study of ultrasound capabilities in visualization of PD complications in children.

Materials and Methods. Over the last 10 years in the Department of Gravitational Blood Surgery and Hemodialysis of St. Vladimir's Hospital in Moscow, about 605 patients with acute kidney injury and chronic kidney disease aged from 1 month to 17 years 11 months receiving PD treatment were observed, half of them had complaints associated with PD and requiring echographic differential diagnosis. Ultrasound was performed on Acuson/Sequoia 512, Voluson E-8, Voluson E-10, Acuson NX3.

Results. The variants of peritoneal catheter (PC) visualization in normal and obstructed conditions were studied: omentum fragments, fat suspensions of the colon and uterine appendages fragments (fimbriae) were visualized as irregularly shaped echogenic inclusions inside the catheter. Dialysis peritonitis in the debut of the disease at ultrasound looked like a finely dispersed suspension in the dialysate, later there was organization of dialysate with the formation of a grid of organized fluid. The possibilities of echographic diagnosis of intestinal obstruction due to PD are analyzed, rare cases of visualization of encapsulating peritoneal fibrosis in children are presented. The possibilities of ultrasound in the assessment of scrotal complications of PD in infants, variants of visualization of ventral hernias are shown. Such rare complications of PD in children as tunnel and hemorrhagic complications are presented.

Conclusion

1. Abdominal ultrasound with targeted PC's imaging should be performed on a patient on PD immediately if any abdominal pathology is
2. Changes in the consistency of dialysate on ultrasound in PD allow us to judge the dynamics of the disease and predict the prospects of resumption of
3. PC disruption and dislocation in children can be accurately assessed echographically
4. Intestinal obstruction in children on PD, may be due to PC position, but it is rarely possible to visualize this on In the vast majority of cases, nonspecific changes typical of low bowel obstruction are visualized.
5. If children have hernias provoked by PD, ultrasound can reliably assess the size of the hernia’s sac or dialysate accumulation, visualize the size of the hernia gate and differentiate hernial

Objective. To highlight the history of development and the current state of radiation diagnostics for spinal canal stenosis at the cervical level based on the analysis of domestic and foreign publications published in open access databases.

Materials and Methods. The search and selection of publications was carried out on the basis of the online resources eLibrary and PubMed in the period from 2019 to 2024.

Results. The presented literature review analyzes publications with research data on the morphometric characteristics of spinal canal stenosis, the causes of stenosis, its complications and clinical manifestations, the biochemistry of the degeneration process, and etiopathogenetic characteristics depending on the innate features of the spinal canal.

Conclusion. Despite a sufficient number of publications, there is no unified approach to the method of quantitative assessment of the degree of stenosis. Imaging diagnostic methods should be used in various combinations, complementing the information obtained to select the optimal treatment method

Objective. To demonstrate different approaches to head and neck computed tomography in cancer patients depending on the presumed or established diagnosis.

Materials and Methods. A search was conducted for scientific publications and information- analytical systems PubMed, eLibrary, Google Scholar by key words: CT head and neck protocol, CT dynamic maneuver, CT head and neck protocol contrast administration, CT head and neck scanning protocol.

Results. On the basis of the data of the scientific literature analysis and our own experience the peculiarities of contrast administration during CT of the head and neck region in oncologic practice with the use of monoand biphasic scanning protocols, as well as the patient's performance of additional commands during the study are presented.

Conclusion. Despite the standardization of computed tomography, there are different approaches to the CT head and neck protocol in the form of monophasic and biphasic contrasting, as well as the use of various functional tests by the patient. To improve visualization and adequate assessment of the tumor process, it is advisable to apply in practice CT with additional functional tests during scanning depending on the presumed or established diagnosis.

Objective. Evaluation of existing approaches to cancer risk stratification of thyroid nodules based on ultrasound data.

Materials and Methods. The study of literature data in the historical aspect, modern scientific publications, specialized clinical protocols and consensuses.

Results. Currently, there are many scales that are similar or close in name, but differ fundamentally in the methods of evaluation («ultrasound models», algorithms, number of cancer signs, scores, etc.), the number and value of categories and subcategories, and the recommendations made. The most famous among them are: TIRADS – E. Horvath et al. (Chile, 2009), which includes 6 categories, including 2 subcategories; THIRADS – A. D. Zubov et al. (currently in Russia, 2010): 5 categories, including 2 subcategories; TIRADS – Jin Kwak et al. (Republic of Korea, 2011): 5 categories, including 3 subcategories; TIRADS – G. Russ et al. (France, 2011): 7 categories, including 3 subcategories; ACR TI-RADS – (USA, 2017): 5 categories; EU-TIRADS (international group, 2017): 5 categories; TI-RADS (Russia, 2020): 6 categories. It has been established that at the present stage, clinicians (oncologists, endocrinologists) do not have sufficient information about the diversity of existing stratification scales. This has led to ambiguity of wording and incorrect references in current clinical recommendations and other regulatory documents defining the use of a particular stratification scale. Practitioners doctors of ultrasound diagnostics in the vast majority of cases do not indicate or incorrectly indicate the stratification scale used. Since the same figure in different scales may indicate clinically different situations, missing, incorrect or ambiguous indication may lead to errors in cancer risk assessment and patient management.

Conclusion. Thus, unification and standardization of the used stratification scales is necessary to ensure mutual understanding of specialists and to exclude different interpretations of ultrasound conclusions. The obligation to use a single scale at all stages of the treatment and diagnostic process by all specialists in all regions, and the indication of which one, should be correctly and unambiguously defined in all relevant regulatory documents.

Objective. To evaluate the role of magnetic resonance imaging (MRI) in the diagnosis of changes in the temporomandibular joint (TMJ) in patients with rheumatoid arthritis (RA).

Materials and Methods. 79 patients with RA aged 25–63 years were examined at the Clinical Hospital No. 1 (Smolensk) from December 2023 to August 2024: seropositive (n = 43) and seronegative (n = 36). Among them 51 (64.5 %) women, 28 (35.5 %) men. All patients underwent TMJ MRI at the first examination by a dentist and an orthodontist and after complex treatment of the dental system and RA (after 6 months).

Results. Internal TMJ derangements were analyzed according to the Wilkes C. scale. Patients with RA have certain internal derangements, which confirms the relationship of chronic inflammation with the development of changes in the TMJ. All this required joint management of the patient by a rheumatologist and an orthopedic surgeon. It should be noted that bilateral internal TMJ derangements were diagnosed in 31 (72.1 %) patients with seropositive RA and in 11 (30.6 %) with seronegative RA. 6 months after the prescribed orthopedic treatment, according to patients, 33 (41.8 %) people did not follow the recommendations, which was manifested by persistent and more pronounced clinical manifestations of internal TMJ disorders. 46 (58.2 %) of the subjects followed the recommendations, and during the control MR examination of the TMJ, 39 (84.7 %) of them showed stabilization of the process, without deterioration, there was no clinical pain syndrome, which was regarded as a improvement. But in 7 (15.3 %) of 46 patients, the pain syndrome persisted, and in a conversation with patients in this group, they indicated that, unfortunately, the recommended splint was removed overnight, due to the sensation of a foreign body, which led to greater discomfort. So 40 (50.6 %) out of 79 people were in the group of patients who did not follow the doctor's recommendations. In this group of patients, the orthopedic dentist noted the ineffectiveness of the prescribed therapy, according to the rheumatologist, RA remission was not achieved, the dentist's recommendations were not followed.

Conclusion. 1. In patients with clinical manifestations of internal TMJ disorders, MR criteria characteristic of stages 1–4 according to Wilkes C scale were found: significantly more often in patients with seropositive RA.

1. In the absence of complaints from the TMJ, MR characteristic of stages 1 and 2 according to Wilkes scale were found in patients with RA both with seropositive and seronegative variants of RA.
2. TMJ MRI allows to evaluate the effectiveness of therapy in patients with RA on
3. It is necessary to include TMJ MRI in the algorithm of examination of patients as a mandatory diagnostic minimum upon admission and after 6 months of dynamic follow-up period, in order to provide orthopedic care in

Objective. Every day in order to reduce the risk of complications and for early activation of the patient, interest in minimally invasive surgery is growing. One of these areas is X-ray endovascular surgery. It’s quite universal and high-effective, safe and low-traumatic. However, daily work in X-ray conditions is associated with the risk of occupational pathology among medical workers. Accordingly, we proposed a method of special patient positioning to reduce the radiation dose to medical staff. The choice of access is important for transcatheter interventions, in particular uterine artery embolization (UAE). Currently, transradial access is considered preferable, characterized by a low risk of vascular complications compared to traditional transfemoral access and allowing to reduce procedure time and radiation exposure for healthcare workers and patients.

Materials and methods. A prospective analysis of 20 patients was conducted at the Medical Unit of the Kazan Federal University. The patients were randomized into 2 groups: 10 patients underwent UAE via transradial access with standard positioning and 10 patients positioning the lower extremities to the C-arm of the angiographic complex. Indications for UAE were uterine fibroids with clinical manifestations. The patients underwent selective bilateral step-by-step catheterization and angiography of the uterine arteries in a direct projection without C-arm angulation in the DSA Body 4 CARE mode, followed by alternate embolization with 500–900 μm microspheres until stasis of the contrast agent was achieved in distal segments of uterine arteries. During radiation monitoring in the X-ray room procedure room, measurements were carried out using a highly sensitive compact X-ray and gamma radiation dosimeter DKS-AT 1123 at the surgeon’s workplace at 4 main points.

Results. In standard laying the average equivalent dose rate (EDR) value in the operating room of the doctor-operator during radiography was: min EDR 1.881 μSv/h, max EDR — 3.998 μSv/h, during fluoroscopy: min EDR — 0.518 μSv/h, max EDR — 1.088 μSv/h. When laying with lower limbs to the C-arc, the average EDR value in the operating room of the operating physician during radiography was: min EDR — 0.293 μSv/h, max EDR — 0.745 μSv/h, during fluoroscopy: min EDR of the personnel — 0.143 μSv/h, max EDR of the personnel — 0.257 μSv/h.

Conclusion. Using a fundamentally new installation method, it was possible to significantly reduce the radiation dose to the operator, thereby minimizing the risks of professional pathologies of interventional radiologists.