[Magnetic resonance imaging of the brain in multiple sclerosis]. / Magnitno-rezonansnaia tomografiia golovnogo mozga pri rasseiannom skleroze.

The paper deals with the diagnosis of demyelinating diseases of the central nervous system, including multiple sclerosis, by means of magnetic resonance imaging (MRI). The low-magnetic induction tomographs "Obraz" ("Image") and "Ellips" ("Ellipse") made in Russia were used to perform MRI of the brain in 255 patients diagnosed as having multiple sclerosis. Whether low-magnetic induction MRI can detectfocal changes in the brain in the presence of multiple sclerosis was assessed; the tomographic signs of the disease were clarified and classified. There was a relationship between the detection of focal changes in the brain and the duration of the disease. Particular emphasis is laid on the cases of various abnormalities at MRI, which clinically mask multiple sclerosis. The cases are summarized and a list of conditions to be particularly emphasized while making a differential diagnosis is drawn up.

[Single-photon emission-computed tomography in evaluation of cerebral microcirculation of patients with epileptiform syndrome]. / Odnofotonnaia émissionnaia komp'iuternaia tomografiia v otsenke sostoianiia mikrotsirkuliatsii golovnogo mozga u bol'nykh s épileptiformnym sindromom.

One-photon emission computed tomography (OPECT) was used to examine 87 patients with the epileptiform syndrome. Eighty five patients had impaired drug distribution which was suggestive of varying degree cerebral circulatory disorders. OPECT with a Tc-99m-gm-pao used in patients with the epileptiform syndrome revealed the morphological substract of brain structures. OPECT findings in the patients suggested the brain structural microcirculatory changes to be diffuse and focal, of varying magnitude. There was no clear correlation between clinical manifestations and OPECT and CT findings.

[A mathematical analysis of the relationship of the clinical manifestations of side effects to the blood biochemical indices in subjects undergoing x-ray contrast studies]. / Matematicheskii analiz sviazi klinicheskikh proiavlenii pobochnykh reaktsii s nekotorymi biokhimicheskimi pokazateliami krovi liudei pri provedenii rentgenokontrastnykh isledovanii.

During 73 single contrast investigations with 76% triobrast, 76% verographin, 76% urographin, urotrast and omnipaque-300, 65% of patients had clinical adverse reactions which were mainly mild. In 79% of cases, the syndrome of side effects consisted of one clinical manifestation. The occurrence of clinical adverse reactions caused by diatrizoate derivatives was proved to be associated with the elevation of blood levels of histamine and prostaglandin F2 alpha, with the activation of the complement system by an alternative pathway and to be independent of the sex and age of patients. According to the effects of contrast media on these blood biochemical parameters, patients are classified as "tolerant" and "sensitive", the proportion of the latter is 50-80%. With this, plasma histamine levels greater than values of the capacity of the complement system to activate by the alternative pathway greater than blood prostaglandin F2 alpha amounts may serve as mathematically significant criteria for the likelihood of side reactions occurring in the contrast diagnosis with diatriazoates. An elevated diastolic pressure is a valid symptom of side effects of the radioopaque media tested by us on the human body.

[Ultrasonic and x-ray studies in urolithiasis]. / Ul'trazvukovoe i rentgenologicheskoe issledovanie pri mochekamennoi bolezni.

Ultrasonic and x-ray investigations were performed in 208 urolithiasis suspects. Concrements were diagnosed in 156 of them. X-rays failed to find concrements in 25 patients out of 128 with calyceal concrements diagnosed ultrasonically because of the concrements' small size, their x-ray negativity and ultrasonic hyperdiagnosis. Pelvic concrements were registered in 12 patients by both the methods. Detection of ureteroliths (16 cases) was not an easy task for echography which was, however, rather successful after the lumen extension up to 1 cm. Excretory urography provided additional information on the upper urinary tracts: stricture of the ureteropelvic segment, juxtavesical ureteral stricture, incomplete renal and ureteral doubling (15, 3 and 7 subjects, respectively), etc. Combined application of ultrasonography and excretory urography in urolithiasis facilitates the choice of optimal treatment for it can both localize concrement and assess the condition of the urinary tracts.

[Potentialities of lymphography using chromethiotrast, a new x-ray contrast medium]. / Vozmozhnosti limfografii pri ispol'zovanii novogo rentgenokontrastnogo sredstva khrométiotrast.

A study was made of the potentialities of lymphography using a new radiopaque medium chromethiotrast (a solution of harmless fat-soluble anthraquinone dyes fixed with ethiotrast). The agent is intended for combined x-ray and visual investigation of the lymphatic system. Lymphograms of 76 patients (with Hodgkin's disease, prostatic cancer, cancer of the female organs, breast, bladder, rectal cancer, and secondary limb lymphedema) were analyzed. Chromethiotrast is easily administered in the lymphatic bed ensuring a good contrast density of the lymphatic vessels permitting the detection of their structure. Chromethiotrast is quickly discharged from the lymphatic system, causing no marked side-effects provided all precautions necessary for the administration of iodobutyric radiopaque media, are taken.

[The degree of tumor vascularization as a prognostic factor of the efficacy of neoadjuvant polychemotherapy in breast cancer]. / Stepen' vaskuliarizatsii opukholi kak prognosticheskii faktor éffektivnosti neoad''iuvantnoi polikhimioterapii pri rake molochnoi zhelezy.

A procedure for obtaining microcirculation coefficient is described. It is based on the phenomenon of formation of a focus of radionuclide hyperfixation on scintigrams of tumor area due to embolization of its arterioles and precapillaries with radionuclide. The method was used in 26 breast cancer patients before neoadjuvant chemotherapy. A direct correlation between the microcirculation coefficient and degree of tumor-induced pathomorphosis of tumor cells was established. The coefficient values proved more or less predictive of tumor response to chemotherapy.

[New methods of image creation in the diagnosis of superior vena cava syndrome]. / Novye metody polucheniia izobrazheniia v diagnostike sindroma verkhnei poloi veny.

A program for the examination of patients with the superior vena caval syndrome, including digital subtraction angiography and computed-tomographic phlebography, is discussed. A combination of these methods is optimal and makes it possible to obtain detailed diagnostic information which is necessary for determining the therapeutic tactics in cases with the compression syndrome.

[Combined digital subtraction angiography and cholangiography in assessing the spread of the tumor process in pancreatobiliary cancer]. / Sochetannaia digital'naia subtraktsionnaia angiografiia i kholangiografiia v otsenke rasprostranennosti opukholevogo protsessa pri pankreatobiliarnom rake.

The paper is concerned with comparative assessment of the efficacy of digital subtraction angiography and routine angiography in assessing tumor spreading in pancreatobiliary cancer. A combined method of digital subtraction angiography and cholangiography was developed and performed in 41 patients with pancreatobiliary cancer permitting maximum information on the topical location and spreading of a tumor process. The clinical importance of the obtained results permitted recommending simultaneous digital subtraction angiography and cholangiography in patients with hepatobiliary cancer.

[Study of the renal venous outflow using digital subtraction angiography]. / Izuchenie venoznogo ottoka ot pochki s pomoshch'iu tsifrovoi subtraktsionnoi angiografii.

A venous phase of digit subtraction angiography (DSA) of the kidneys was evaluated in 87 urologic patients. The subtraction allows satisfactory visualization of the renal veins. Amplification of the image and its early emergence indirectly suggest pathological arteriovenous shunt confirmed by intraoperative rheography. Investigation of the renal veins and venous outflow from the kidneys with DSA bears sufficient information and is less traumatic versus standard retrograde venography.

[Roentgeno-endovascular prosthetics of the superior vena cava in compression syndrome]. / Rentgenoéndovaskuliarnoe protezirovanie verkhnei poloi veny pri kompressionnom sindrome.

The paper discusses the first Soviet experience of transcatheter intravascular application of endoprosthesis into superior vena cava for compression with paratracheal lymph nodes in a patient suffering Hodgkin's disease. The patient had failed to respond to 3 cycles of combination chemotherapy and 46 Gy of radiation to the mediastinum. Application of the procedure brought the vascular lumen and blood flow to normal which led to regression of compression syndrome. The self-fixing endoprosthesis dilates and forms an interior frame for the vessel thus preventing relapse of compression in case of progression of disease.

[Phlebography of the mediastinum in lung cancer]. / Flebografiia sredosteniia pri rake legkogo.

The state of the major mediastinal veins was studied in 113 patients with central cancer of the right lung upper lobe with metastases to the regional lymph nodes. Routine angiography was performed in 92 patients, digital subtraction angiography--in 21 patients. Vascularization was shown to be more common in and adenocarcinoma. The authors identified 2 groups of angiographic signs: marked and doubtful ones. They have been of opinion that only the presence of marked signs can be a contraindication for surgical intervention. The informative value of routine angiography was compared with that of digital subtraction angiography.

[Combined diagnosis of kidney tumors]. / Kompleksnaia diagnostika opukholei pochki.

A total of 127 patients were examined to determine the efficacy of the use of sonography, angionephroscintigraphy and roentgenocontrast angiography in renal tumors and the importance of these methods in diagnostic studies with suspicion for a renal tumor. All the patients were given ultrasound and radionuclide examination, 86 roentgenocontrast angiography. The study has shown a high sensitivity of all three methods in the diagnosis of sizable renal lesions though each one has a different diagnostic tendency. In vascularized tumors the combined use of sonography and angionephroscintigraphy practically ensures 100% diagnosis in a patient even at the out-patient stage of examination. The main difficulties occur in the differential diagnosis of hypovascular sizable tumors when the comparison of the results of all three methods makes it possible to establish correct diagnosis. The advantage of sonography is the absence of traumatism, that of angiography a possibility to determine the functional activity of both involved and intact kidneys. Roentgenocontrast angiography plays the leading role in defining the involvement of the renal and cava inferior veins by a tumor thrombus.

[A 10-year experience with combined diagnosis of pancreatic diseases]. / Desiatiletnii opyt kompleksnoi diagnostiki zabolevanii podzheludochnoi zhelezy.

Optimum multimodality examination of the pancreas includes sonographic, radioimmunological, scintigraphic and angiographic studies. Sonography is a method of choice to study anatomotopographic features of the pancreas. The radioimmunoassay is intended both for the mass screening of patients with hepatogastro-duodenal diseases and for the differential diagnosis of chronic pancreatitis by the nature and type of disease. The use of pancreatoscintigraphy should be restricted in view of considerable exposure of patients. Angiography and angioscanning should be performed strictly according to indications with suspicion for a pancreatic tumor.