[Clinical and computed tomographic comparisons of analysis of the condition in children with brain injury of 13-15 scores by the Glasgow Coma Scale on admission to hospital].

Clinical and computed tomographic comparisons were made in 590 children with mild brain injury (BI). The children admitted for BI of 13-15 scores assessed by the Glasgow coma scale (GCS) in the first hour after injury were examined. They all underwent brain computed tomography (CT), skull X-ray study, and neurological studies. Their history data were analyzed. 73% of the children were admitted within the first 12 hours following injury. Falling from the growth height was mainly responsible for BI (45.2%). The frequency of the CT signs of BI was 36.3%. Surgical treatment was required in 5.8% of the children; among them 4.4% and 1.4% were operated on for depressed fractures and intracranial hematomas, respectively. A relationship was found between the presence of the CT signs of BI and the GCS scores on admission. With 15 and 13 GCS scores, the positive CT pattern was detected in 16 and 70% of cases. Well-defined focal neurological symptoms and multiple vomiting (38 and 57%, respectively) are predictors of acute pathology on a CT scan. X-ray skull fracture increases the likelihood of CT pathology up to 62%. Consciousness disturbance of as high as 13-14 GCS score concurrent with noticeable neurological symptoms and skull fracture increases the probability of the positive CT pattern up to 93%. X-ray and CT studies did not reveal acute traumatic injuries when there were traces of skull injury in the presence of clear consciousness and in the absence of vomiting.

[Spiral computer tomography in diagnosis of hepatic diseases]. / Spiral'naia komp'iuternaia tomografiia v diagnostike zabolevanii pecheni.

Spiral computer tomography (SCT) is a new method of computer tomography by which, in contrast to conventional CT, the information about absorptional capacity of tissues is obtained without omission of images which makes it possible to build MPR and 3D of a very high quality. 205 patients with diseases of hepatopancreatoduodenal area were examined, in 189 patients the diagnosis being verified. Optimal technique of intravenous bolus contrasting in SCT was developed. Using various time interval between the start of the scanning and the beginning of infusion of contrast media, it is possible to obtain primary image of the arteries (arterial phase of contrasting, time of delay 18-25 sec.), the picture of veins and the image of saturation of hepatic parenchyma--(venous return phase, time of delay 60-80 sec.), to reveal characteristics of contrasting of the liver masses during delay (8-15 min) phase. The largest quantity of masses are revealed in arterial phase of contrasting. Specific features of contrasting in hemangiomas and malignant tumors of the liver has been revealed. Hemangiomas absorb contrast medium already at the early phase as hypercontrasted lacunas in an outlying areas, at a late phase they are hyperdenced in relation to hepatic parenchyma. Primary and metastatic tumors of the liver accumulate contrast medium in an early phase along the whole area and quickly lose contrast medium during parenchymal phase. The method of contrast intensification enables evaluation of interrelation between tumor and vessels, to determine passage of hepatic arteries and branches of portal and hepatic veins, to visualise choledochal duct, to determine the distance between hepatic and tumor surface, and to produce these data as a view of multiplanar and three-dimensional image (reconstruction). The effectiveness of obtained reconstructions in planning of the extent of surgical intervention is demonstrated.