[Orbital radiographic anatomy. Part 1. The osseous orbit and its apex].

OBJECTIVE: To study the characteristics of the osseous orbit and its apex in health. MATERIAL AND METHODS: The computed tomography scans of 210 individuals (266 orbits) without orbital disease were examined. RESULTS: The paper presents linear indicators (horizontal input, vertical input, length) of the osseous orbit and its apex in health. It is emphasized that the volume of the osseous orbit and its apex in healthy men and women has statistically significant differences. Individual asymmetry of osseous orbital volumes in health was detected in 80.95% of the men and in 82.85% of the women; asymmetry of orbital fat volume was in 47.61% of the men and in 51.42% of the women. CONCLUSION: The asymmetry of the mean normal osseous orbital volumes in the population is only within the margin of statistical error. At the same time the individual asymmetry of osseous orbital volumes in health is as much as 3.0 cm3; that of osseous orbital apical volumes is not greater than 1.0 cm3. The linear and volume characteristics of the osseous orbit and its apex are useful in estimating the degree of clinical symptoms. These should be kept in mind in the differential diagnosis of true and false exophthalmos and these can also play a crucial role in choosing surgical tactics.

[Whole-body diffusion-weighted magnetic resonance imaging by estimating the measurable diffusion coefficient in Hodgkin Iymphoma].

OBJECTIVE: To determine whether the measurable diffusion coefficient (MIC) may be used to differentiate normal and lymphomatosis-altered lymph nodes (LNs) in patients with Hodgkin lymphoma (HL). MATERIAL AND METHODS: Whole-body magnetic resonance (MR) imaging was used to compare the MICs of LNs in 27 apparently healthy individuals and 41 patients with a verified diagnosis of HL. RESULTS: Construction of 95% confidence intervals showed that the MICs of normal LNs were in the range of 1.00 to 1.73 x x10(-3) mm2/sec and significantly higher (p < 0.05) than those of lymphomatosis-affected LNs (MIC, 0.59 to 0.94 x 10(-3) mm2/sec). The cut-off point (for discretization) of normal and lymphomatosis-altered LNs was in the range of 0.94 to 1.00 x 10(-3) mm2/sec. Consequently, the LN with a MIC of less than 0.94 x 10(-3) mm2/sec may be thought of as affected by the lymphomatous process. CONCLUSION: MIC calculation permits differentiation of normal and affected LNs having equal signal characteristics (including those on diffusion-weighted MR images).

[Characteristics of lung foci revealed by computed tomography in high-risk children and adolescents for tuberculosis].

OBJECTIVE: To give an X-ray pattern of single lung foci revealed by computed tomography (CT) in children and adolescents examined for tuberculosis. MATERIAL AND METHODS: The results of CT in 52 children and adolescents infected by Mycobacterium tuberculosis were analyzed. All the followed up children and adolescents underwent X-ray study using a two-slice spiral Somatom Emotion Duo (Siemens). The study used first the conventional chest spiral CT scanning procedure for children according to the Thorax Routine program and then reconstruction. Target spiral scanning of the area of interest was, if needed, carried out by employing high resolution CT with 2-mm thick images taken at 1.5-mm spacing. A maximal intensity project program was used to separate vessels and foci. RESULTS: The single foci were encountered frequently in the lung of the examinees and characterized by a perilymphatic site; in 88.0% they were connected with the interlobular interstitium, interlobar fissure, and paracostal pleura; in 92.2% the foci were detectable in the subpleural and cortical parts of the lung, had a moderate intensity, well-defined outlines, and were 2-6 mm in size. At the same time, there were no pathological changes in the lymph nodes of the lung roots and mediastinum. The long-term (2-month-to-5-year) followup in this group of children indicated that there were no X-ray changes in the lung foci revealed by CT. CONCLUSION: The single foci in the lung of Mycobacterium tuberculosis-infected children without X-ray changes in the lymph nodes of the lung roots and mediastinum may be manifestations of the normal lung structure--these may be intrapulmonary lymph nodes. Further follow-up in this group of these children must be in agreement with the management tactics of those infected with Mycobacterium tuberculosis.

[Magnetic resonance imaging in the staging of malignant lymphomas].

Computed tomography, 18FDG-PET and the hybrid FDG-PET/CT are the most commonly used diagnostic tools for the initial staging and treatment response assessment of malignant lymphomas. MRI techniques such as whole-body MRI and diffusion-weighted imaging may become good radiation-free alternatives to FDG-PET/CT. Diffusion-weighted imaging is characterized by high sensitivity for the detection of lesions and allows quantitative assessment of diffusion that may aid in the evaluation of malignant lymphomas. This article will review the value of these emerging MRI techniques for the staging and response assessment of malignant lymphoma.

[Differential diagnosis of focal changes on computed tomography].

The paper gives differential diagnostic signs in different pulmonary focal changes detected on computed tomography, characteristics of the major types of pulmonary foci, and a diagnostic algorithm in the detection of focal dissemination or mixed changes in lung tissue.

[Effectiveness of multislice computed tomography for evaluating vascular invasion in retroperitoneal tumors].

The potential of combined application of multislice computed tomography and angiography for evaluation of vascular invasion in retroperitoneal tumors has been assessed. The predictive value of the method was tested by comparing preoperative CT and angiographic data with intraoperative findings on vascular invasion--abdominal part of the aorta and its large branches, inferior vena cava and common iliac veins--in 44 patients; primary tumor--26, recurrent--18, pelvic localization--7, intraperitoneal--37. Thirty-one combined operations were performed. Multislice scans were obtained by using 4 rows of solid-state detectors. For intravenous injections, non-ionic contrasting substance Omniak (loxegol, Amersham, Ireland), 350 mg I/ml was used.

[High technologies in radiodiagnostics: possibilities and prospects].

Diagnostic radiology includes several basic techniques such as conventional radiography, computed tomography, magnetic resonance imaging, radionuclide study, ultrasonography, and positron emission tomography as the most important methods. Radiological screening procedures or preclinical diagnostic techniques, as well as interventional radiological procedures, are being used more and more widely in clinical medicine. The integration and combination of different technologies, the introduction of digital diagnostic technologies, and the creation of radiological information systems on their basis are important factors increasing diagnostic efficiency. Improved technologies make it possible to change diagnostic tactics in the majority of diseases; the diagnostic process shortens because preference is given to most informative methods. Intensive technological development requires changes in the arrangement of radiologists' work.

[Computed tomographic angiography of the thoracic vessels: the method, initial experience and outlook for its use]. / Komp'iuterno-tomograficheskaia angiografiia sosudov grudi: metodika, pervyi opyt i perspektivy isol'zovaniia.

The paper presents the data available in the literature on computed tomographic angiography and the first experience with it to study thoracic vessels. It details the principles of spiral computed tomography and CT angiography. Practical aspects of their implementation, as well as basic concepts are outlined. It is concluded that CT angiography is promising in studying thoracic vessels in various abnormalities.

[Disseminated pulmonary tuberculosis: significance of high-resolution computerized tomography]. / Disseminirovannyi tuberkulez legkikh: znachenie vysokorazteshiushchei KT.

Clinical and X-Ray studies were performed in 85 patients with disseminated pulmonary tuberculosis. All the patients underwent routine computerized tomography (CT) and high-resolution CT. According to the pathogenetic process, the authors identified hematogenic (n = 38), lymphogenic (n = 19), bronchogenic (n = 18) and mixed (n = 10) disseminations. High-resolution CT was found to have great advantages in detecting various types of tuberculous disseminations and in assessing the pattern of pulmonary abnormalities. Disseminated tuberculosis was revealed in 7 patients who had no pathological changes on routine lung X-ray films. The specific signs of hematogenic, lymphogenic disseminations and bronchgenic inoculations were identified in other forms of pulmonary tuberculosis. CT symptomatology is shown to be determined by the pathogenetic variant of its development and the stage of the process. Small focal changes in the lung were prevalent in patients with acute and subacute hematogenic forms of the disease. Infiltrates with decay cavities, thin-wall caverns, emphysema and bronchoectases were detected over the chronic course. Lymphogenic disseminations were characterized by the predominance of interstitial changes along with multiple minor foci. High-resolution CT had advantages in identifying decay cavities, signs of fibrosis and in evaluating mediastinal lymph nodes. CT data are of great significance for differential diagnosis of disseminated tuberculosis with lung metastases and diffuse interstitial diseases.

[Value of computed tomography in the differential diagnosis of infiltrative changes in the lungs]. / Znachenie komp'iuternoi tomografii v differentsial'noi diagnostike infil'trativnykh izmenenii v legkikh.

Computed tomography (CT) was performed in 73 patients with pulmonary infiltrative changes of unknown etiology. Their preliminary clinical and X-ray studies suggested protracted pneumonia in 46.6%, malignant neoplasms in 27.4%, tuberculosis in 16.1%, and pyesis in 9.9%. The preliminary clinical and X-ray conclusion fully agreed with the verified diagnosis only in 31.5% of patients. The accuracy of CT in assessing infiltrative changes was much higher and ran to 89.1%. According to CT findings, nontumor diseases were found in 56 (76.7%) patients, malignant tumors in 17 (23.3%). Among inflammatory processes there were prevalent pyesis 23.3%), pulmonary tuberculosis (20.7%) and pneumonias (19.2%). In the group of 17 patients with neoplasms, 8 were found to have central cancer with hypoventilation of a lung portion, 4 had peripheral cancer, and 5 presented with bronchoalveolar carcinoma. The use of high-performance CT is of great importance.

[Potentialities of conventional computed tomography and computed tomography angiography in evaluation of local spread of central type lung cancer]. / Vozmozhnosti komp'iuternoi tomografii i komp'iuterno-tomograficheskoi angiografii v otsenke mestnoi rasprostranennosti tsentral'nogo raka legkogo.

To define the potentialities of conventional computed tomography (CCT) and contrast-enhanced computed tomography (CECT) in the the evaluation of spread of central-type lung cancer, 141 patients were studied. The results of the studies were compared with the data of surgical interventions in 86 patients. The analysis of their efficiency was based on the examination of the accuracy, sensitivity, and specificity of each technique. Analyzing the findings showed that the potentialities of CECT exceeded those of CCT. There were the most manifest differences in the accuracy and sensitivity of these techniques. This was due to the fact that CECT was the leading imaging of vessels, such as the pulmonary artery, superior cava, aorta, which in turn greatly reduced the number of false-negative and false-positive conclusions. No great differences were found in the efficiency of the techniques when the invasion of the trachea, esophagus, and vertebral column was determined.

[Spiral computed tomography in chest injury]. / Spiral'naia komp'iuternaia tomografiia pri travme grudi.

The purpose of the study was to evaluate the potentialities of spiral computed tomography (SCT) in recognizing some symptoms of injury-induced chest changes, to define differential diagnostic signs of some complications occurring in the posttraumatic period. Thirty one studies were made in 23 victims with severe mixed chest injury upon their admissions and during follow-ups. CT data were analyzed on axial slices by means of multiplanar and three-dimensional reconstructions. CT angiography was applied in 8 cases. The CT picture of some pathological symptoms of chest injuries, injury complications, their differential diagnostic criteria were outlined.

[Computed tomography in the diagnosis of respiratory tuberculosis]. / Komp'iuternaia tomografiia v diagnostike tuberkuleza organov dykhaniia.

Analysis of 257 patients with tuberculosis of respiratory organs and 292 patients with other diseases of the organs of thoracic cavity, in whom the previously carried out clinical and roentgenological examinations had failed to exclude the presence of specific process, is presented in this article. The authors discuss the indications for carrying out computerized tomography of the organs of thoracic cavity and specify their application with respect to different forms of tuberculosis. They also present a short description of the method of computerized tomography. The authors concentrate mainly on the analysis of CT's diagnostic power and, particularly, on the differential diagnosis of tuberculosis of respiratory organs. They also discuss the limitations of this method and compare them with the same of traditional roentgenologic examinations, bronchoscopy and other diagnostic methods.

[X-ray diagnosis of hemangiomas of the ribs]. / K rentgenodiagnostike gemangiom reber.

Sixteen patients with hemangiomas of the ribs aged 18 to 51 were examined. Additional data on x-ray semeiotics of this condition are presented: the localization, structure, shape, and contours of these tumors are described in detail. Hemangiomas with an extraosseous component were detected, which should be differentiated from other pathological, mainly neoplastic malignant, processes in the ribs and lungs. The authors demonstrated the potentialities of the traditional x-ray method and computer-aided tomography in the diagnosis of hemangiomas of the ribs.

[Computed tomography in the diagnosis of infiltrative pulmonary tuberculosis]. / Kompíuternaia tomografiia pri infiltrativnom tuberkulëze lëgkikh.

Computer-aided tomography (CAT) was carried out in 67 patients with infiltrative pulmonary tuberculosis. Both standard and high-resolution CAT were used to assess the lung status. The data were correlated to x-ray findings. Advantages of high-resolution CAT in the detection of destruction cavities, foci and interstitial changes were shown. CAT helps differentiate between the changes in the tuberculous infiltrate due to pulmonary tissue caseous necrosis and the perifocal reactions presenting as local edema and serous inflammation. CAT is the most effective in the differential diagnosis of pulmonary infiltration of unknown origin, in specification of the tuberculous process phase, in assessment of the type of residual changes, and in planning of surgery.