[Multispiral computed tomography for the assessment of the extent of surgical intervention in patients with chronic suppurative otitis media].

The utility of the data obtained by multispiral computed tomography (MSCT) for the choice of surgical techniques is discussed with special reference to chronic suppurative otitis media. Specific features of bone tissue destruction are described in patients with cholesteatoma and without it. Results of MSCT were used to estimate the optimal extent of surgical intervention. Intraoperative findings were in excellent agreement with MSCT data.

[Computed tomography at the outpatient stage of differential diagnosis of destructive inflammations and tuberculosis of the lung].

The authors retrospectively analyzed the quality of RCT differentiation of destructive lung lesions at outpatient diagnostic units of multidisciplinary polyclinics. At the first stage, the recognition accuracy rate was not more than 73%, which is attributable to the high macroscopic similarity of bacterial destructive inflammations and specific tuberculous processes. Both conditions were frequently complicated by the addition of fungal invasion that made their differentiation all the more difficult. It has found that during the tense epidemiological situation associated with tuberculosis, there is its explainable, but not always justified hyperdiagnosis. The ratio of false-negative to false-positive tuberculosis results was 1:2. The paper is illustrated by different types of destructive inflammations that mimic tuberculosis and by the trend of some of the types is shown. Emphasis is laid on the neglects and errors that cause diagnostic differences. A half of them is attributable to the objective complexities of its diagnosis; the other (subjective) half is a potential reserve for upgrading the quality of differential diagnosis in phthisiopulmonology.

[Multispiral computed tomography in diagnosis of tumors of the mammary gland].

For the first time, results of multispiral computed tomography (MSCT) with intravenous contrast enhancement in diagnosis of difficult case of breast tumors are presented. This method permits localization and staging of tumor. Contrast enhancement aids to reveal small tumors (less 1 cm). Thin sections and algorithm of high image resolution permit to diagnose microcalcinates which are early and important symptoms of malignant tumor. Evaluation of state of regional lymph nodes, analysis of bones permits to evaluate generalization of the process. MSCT-mammography may be used as amplifying method in diagnosis of breast diseases. This method is also indicated in atypical location of cancer. Further studies of MSCT-mammography permit to increase diagnostic value of this method.

[Diagnostic approach in mechanical jaundice, complicated by purulent cholangitis]. / Diagnosticheskii podkhod pri mekhanicheskoi zheltukhe, oslozhnennoi gnoinym kholangitom.

Up-to-date high-informative non-invasive diagnostic methods were used in 54 patients with obstructive jaundice (OJ) complicated by purulent cholangitis (PC). Treatment-diagnostic algorithm can to improve results of diagnosis. This algorithm is the following: ultrasonic examination as a screening method; if a case of jaundice is unclear and obturation is prolonged magnetic-resonance tomography and magnetic-resonance cholangiopancreaticography are carried out; in block of a distal part of the common bile duct--spiral computed tomography with bolus amplification and duodenoscopy. Invasive diagnostic methods--endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography (PTCG) are performed in buit indications in possibility to perform lithextraction and effective endoscopic decompression or in the tumor of Vater's papilla in case of low block. PTCG is used in high block and finished by percutaneous transhepatic bile outflow. General diagnostic efficacy of the complex in OJ was 97.8%. Diagnostic algorithm permitted us to make diagnosis and to start treatment in 85% during 1-2 days after hospitalization. Bile ducts decompression as a main stage of PC treatment was performed in the first 2 days after hospitalization. Diagnostic quest was performed at the same time with therapy after detoxication and correction of hemostasis disturbances.

[The digital processing of tomograms in the diagnosis of peripheral lung cancer]. / Tsfrovaia obrabotka tomogramm v diagnostike perifericheskogo raka legkogo.

The paper is devoted to the description of the methods and results of digital processing of linear tomograms of the lungs in 347 patients with "small" lesions (2 cm in diameter in 67%), densitometry of abnormal lesions was performed in 167 of them. Roentgenomorphological comparisons were done in 326 cases, where diagnosis was verified at operation. Digital processing of images and densitometry provided additional diagnostic information. The diagnostic accuracy of the proposed method for lung cancer was 92%.

[Digital processing and densitometry of tomograms in central lung cancer]. / Tsifrovaia obrabotka i densitometriia tomogramm pri tsentral'nom rake legkogo.

Additional information on an x-ray picture of peribronchial changes in tumorous and non-tumorous lesions of the lungs were obtained in 54 patients (40 with bronchogenic, mostly central cancer and 14 with chronic inflammatory diseases) in order to study roentgenological symptomatology before and after computerized processing of tomographic images using a method of linear filtration. Image processing with the measurement of densitometric indicators provides additional information for the estimation of bronchial affection by tumor infiltration. The same method can be of value for the detection of early signs of lung cancer in patients with peribronchial changes of obscure etiology.

[Radiodiagnosis of vesicoureteral reflux in the early postoperative period following adenectomy of the prostate gland]. / Luchevaia diagnostika pyzyrno-mochetochnikovogo refliuksa v blizhaishem posleoperatsionnom periode posle adenoméktomii predstatel'noi zhelezy.

Altogether 204 patients aged 43 to 81 were examined in the early postoperative period after adenomectomy of the prostate: 167 transvesical and 37 transureteral adenomectomies were performed. Vesicoureteral reflux (VUR) was usually noted on the 4th-5th day after operation therefore investigations aimed at its detection, were conducted at that time. Passive VUR was detected in 72 patients, active VUR in 31 patients. Both passive and active VUR were diagnosed in 23 patients. Passive VUR was detected by means of routine cystography, X-ray TV cystography, direct radionuclide cystography and ultrasonic investigation. The presence of VUR in ultrasonic investigation was established by the signs of dilatation of renal pelves and calyces in filling in of the bladder with antiseptic solution. Ultrasonic investigation made it possible to diagnose VUR of III-IV degree. Its sensitivity was 32%. The sensitivity of direct radionuclide cystography was 92%, that of cystography 51%. Active VUR was detected by miction cystography and X-ray TV miction cystography on the day of removal of drainage tubes from the bladder. The sensitivity of these two methods was 57 and 100%, respectively. Unlike the radionuclide and ultrasonic methods, these two methods made it possible to assess the state of the bladder cervix and urethra. The authors proposed an optimum sequence of the use of diagnostic methods for early detection of VUR and prevention of severe complications.

[Ultrasonic scanning of the thyroid during dispensary care at an industrial plant]. / Ul'trazvukovoe skanirovanie shchitovidnoi zhelezy pri dispanserizatsii na promyshlennom predpriiatii.

The paper is devoted to the assessment of potentialities of ultrasonic scanning of the thyroid during mass screening at an industrial enterprise. A total of 488 persons were investigated. Ultrasonic and thermographic investigations were performed in all of them to detect pathology of the cardiovascular system, abdominal cavity, breast and thyroid. Quantitative assessment of questionnaire data was performed in 100 persons. A group of persons aged 35 (7.5%) was selected for a further ultrasonic investigation. Among them 19 persons (54.3%) had diffuse enlargement, stage I-II, 13 (37.1%) had nodular changes, and 3 (8.6%) were after strumectomy. A special additional investigation was required for 13 persons, of them 9 had nodular types of the goiter, the rest of them were followed-up. 4 patients underwent surgical intervention. A conclusion was made of the effectiveness of the use of ultrasonic investigations during mass screening for the detection of early and latent pathological processes in the thyroid.