[Diagnosis of cysts in the pancreas in the mediastinum: what has changed over the past 25 years].

The paper describes a case of pancreatic pseudocyst atypically located in the mediastinum. The objective and subjective reasons for the untimely diagnosis were analyzed.

[Ureteral diverticulum].

The article reports a case of congenital ureteral diverticulum found by chance at dynamic IVU with fluoroscopy. The diagnosis was confirmed at non-contrast MR tomography, CT and repeated target ultrasonography using color Doppler mapping and 3D. This is the first description in the Russian literature of ultrasound, IVU with fluoroscopy and non-contrast MR urography findings before and after intravenous injection of 2.0 ml lasix on MR tomograph in ureteral diverticulum.

[Changes in renal tumor contrasting in multiphasic SCT].

Changes in renal tumor contrast and renal parenchyma-tumor density gradient were determined at multiphasic spiral computed tomography (SCT). A hundred and seven patients with renal tumors underwent SCT in the native phase and after bolus intravenous contrasting in the corticomedullary, nephrographic, and early excretory phases of the study. According to the level of contrast-enhancement in the corticomedullary phase, the neoplasms were divided into three groups: intensive, moderate, and low contrasting. Intensively and moderately contrast-enhancement tumors showed the maximal contrast in the corticomedullary phase of the study with a significant reduction in density values in the nephrographic and early excretory phases. Lowly contrast-enhancement tumors generally demonstrated a slow gradual increase in their contrast from the native phase to the corticomedullary and nephrographic ones with their minimum contrast changes between the nephrographic and early excretory phases. In this group of patients, the difference was frequently insignificant between the neoplasmic density values in the native and corticomedullary phases in this group of patients, so it is expedient to use a combination of native and nephrographic or native and early excretory phases to make a differential diagnosis of hypovascular tumors and renal cysts. The maximum intact renal parenchyma-tumor density gradient was detectable in the nephrographic phase therefore this study phase is of the greatest information value in detecting renal tumors.

[Ultrasonic and x-ray diagnosis of concrements in the kidney calyceal diverticuli].

Literature and original data of ultrasound and x-ray diagnosis in 5 patients with concrements and calcium milk phenomenon in renal calyceal diverticuli (CMP) were discussed in terms of the concrements and CMP differential diagnosis and choice of therapy. Both ultrasound and x-ray diagnoses are found valuable.

[Ultrasound and X-ray urethrography and urethroscopy during endoscopic operations on the urethra]. / Ul'trazvukovaia i rentgenologicheskaia uretrografiia i uretroskopiia pri éndoskopicheskikh operatsiiakh na uretre.

In 41 patients are made x-ray ascending and descending and transrectal US (TRUS) of an urethrography and endoscopy before and after transurethral (TUR) of operations on a urethra. For 35 patients there were posttraumatic strictures and obliterations of a urethra, for 3--postinflammatory strictures, for 2--iatrogenic false courses of a urethra and for 1--congenital diverticulum of a urethra. The comparative estimation ultrasonic and x-ray urethrography and urethroscopy has shown, that they are not competitive, but complementary techniques. Thus TRUS of a urethra, as the technique irrelevant with radial load on the patient, can and should more widely be used born for primary diagnostic, and for monitoring outcomes TUR on a urethra.

[Nomenclature issues and hypertrophic Bertin's columns or renal parenchymal and pelvicalyceal intersections outline congruence symptom]. / Voprosy terminologii i simptom kongruéntnosti konturov "gipertrofirovannykh" kolonn Bertini ili "peremychek" parenkhimy i chashechno-lokhanochnykh sistem pochek.

Analyzing the data available in the literature and examining echographic, urographic, and computed tomographic findings in 153 patients having various types of the doubled pelvicalycus and other structures of the kidney have led to the conclusion that it is more correct to use term "renal parenchymal intersections" rather than that "Bertin's column hypertrophy" since they are a variant of the anatomic structure of the renal parenchyma. The renal parenchymal and pelvicalyceal intersections outline congruence symptom, which was first noted while comparing echo- and urographic data and studying computed tomographic contrast-enhanced images, may be helpful in the differential diagnosis of the intersections with renal tumors.

[Symptom of asymmetric bladder filling defect in the presence of ureteral prevesical calculus]. / Simptom asimmetrichnogo defekta napolneniia mochevogo puzyria pri kamne predpuzyrnogo otdela mochetochnika.

Examining descending cystograms in 357 patients with renal colic caused by calculi in the ureteral prevesical portion revealed that 34 (9.5%) had the asymmetric bladder filling defect which was ipsilateral to the calculus. In 11 patients with the calculi strangulating in the ureteral ostium, the outlines of filling defect took the form of a rim around the calculus. Echography provides direct ultrasonic evidence for a calculus in 186 (52%) patients and the asymmetric shape of the bladder only in 1 patient. The described symptom caused by urinary detrusor spasm and, in some cases, by perifocal tissue edema at the site of the ureteral ostium with its strangulated calculus may serve as indirect evidence for a lower ureteral calculus.

[The ultrasonic diagnosis and treatment of benign kidney tumors]. / Ul'trazvukovaia diagnostika i lechenie dobrokachestvennykh opukholei pochek.

Literature data and first-hand experience with 31 patients having benign renal tumors support high diagnostic efficacy of ultrasound scanning (USS) in this disease. USS reveals angiomyolipomas the typical picture of which permits ultrasound monitoring thereof. However, USS appearance of renal adenoma is similar to that of renal cancer. In view of frequent malignant transformation of renal adenoma, nephrectomy is thought valid in renal adenoma patients.

[Ultrasonographic and x-ray diagnosis of nephrolithiasis]. / Ekhotomograficheskaia i rentgenologicheskaia diagnostika nefrolitiaza.

Neither the ultrasonic, not the x-ray method alone cannot provide the correct diagnosis in nephrolithiasis. Ultrasonic scanning of the kidneys is indicated at the first stage of the diagnosis. In case of a concrement detection without dilatation of the pelvic calyceal system and the presence of a typical pattern of a calcified papilla or coral-like concrement on the picture the diagnosis can be considered made. If ultrasonic scanning detects, besides the concrement shade, a dilatation of the pelvic calyceal system, excretory urography and x-ray television pyeloscopy are necessary to specify the urodynamic state, that is important to predict the concrement of its fragments elimination under the effect of conservative therapy or long-distance lithotripsy.