[Efficiency of ultrasound study in the diagnosis of cholangiocellular carcinoma].

OBJECTIVE: To evaluate the efficiency of ultrasound diagnosis in detecting and staging cholangiocellular carcinoma. MATERIAL AND METHODS: An ultrasound study (USS) was conducted in 120 patients aged 19 to 84 years with cholangiocellular carcinoma. The patients were divided into 3 groups by the location of a tumor process: 1) 47 (39.2%) patients with intrahepatic tumor; 2) 49 (40.8%) with portal duct or Klatskin's tumor; 3) 24 (20%) with distal one. Ninety (75%) patients were operated on; the others underwent minimally invasive X-ray surgical interventions as percutaneous transhepatic cholangiostomies. The data of ultrasound diagnosis were compared with the results of other studies, intraoperative assessment and morphological examination of a removed gross specimen. RESULTS: A tumor was detectable by USS only in 90 (75%) patients; its sensitivity was 100% for intrahepatic cholangiocellular carcinoma; 69.4 and 37.5% for portal duct and distal ones, respectively. It is most difficult to diagnose distal carcinomas of the common bile duct. USS reveals no semiotic signs of intrahepatic cholangiocellular carcinoma, which could distinguish the latter from other liver cancers. The specific features of the infiltrative growth of a bile duct tumor, such as hyperechoic infiltration along the external outlines of the ducts or hypoechoic infiltration during thickening of the duct walls, were ascertained. The sensitivity of intraoperative USS in identifying intrahepatic and portal duct cholangiocarcinoma was 100%. That of USS in detecting lymph node metastases was 61%; developed the semiotics of altered metastatic lymph nodes. CONCLUSION: The findings have indicated the high informative value of ultrasound diagnosis in determining the dilatation of the bile ducts and the spread of a tumor to the liver and lymph nodes. It is recommended that the indications for intraoperative USS should be expanded in intrahepatic cholangiocellular carcinoma to define the extent of duct carcinoma.

[The ultrasound diagnosis of regional recurrent cancer of the thyroid gland].

Examination of 220 patients was performed using ultrasound investigation (USI) in B-regimen, color and energy Doppler encoding, 3D-reconstruction of image and sonoelastography. There were 49 recurrences in the regional lymph nodes. Main semiotic signs of regional recurrences were identified. USI with the application of the methods described is highly informative: sensitivity--94.2%, specificity--92.5%, accuracy--91.7%.

[Radiation diagnosis of malignant neoplasms at the current stage]. / Luchevaia diagnostika zlokachestvennykh opukholei na sovremennom étape.

The paper presents all currently available oncological radiation diagnostic tools as compared to the well-known ones. It discusses different methods of obtaining images depending on their physical features: digital plain radiography, computed tomography, magnetic resonance imaging, bone scintigraphy, positron emission tomography, radioimmunoassay, ultrasonography (by using Doppler, intraoperative ultrasound, laparoscopy and thoracoscopy ultrasound, endoscopy ultrasound, contrast-medium ultrasound). The feasibilities of interventional radiology in malignancies are more precisely defined. There are prospects for developing different radiology techniques with the advent of high-performance computer technologies that make it possible to set up a digital radiology unit. The developed PACS system of data reception, keeping, and transmission will accumulate and keep images during unlimited time, transmit them at any distances, process them in different 3 ways, modify and improve, make paper and film hard disks at any time.