The review discussed the need for the introduction of contrast agents during cardiac MRI in patients with cardiovascular diseases. Global studies highlighted the ability of gadolinium enhancement (LGE) technique provide detailed in vivo tissue characterisation to help identification cardiac lesions of different etiology. In agreement with the medical literature and own experience and data, the authors offer arguments in favor of mandatory inclusion of MRI with contrast enhancement in the standard diagnostic algorithm in patients with suspected cardiovascular disease of various origins.

Particular problem in the diagnosis of the results of the combined treatment of brain gliomas is the evaluation of possible radiation lesions. The importance of proper diagnosis of changes in the brain tissue after gliomas combined treatment is difficult to overestimate, because this information affects the further tactics of patients. Available modern methods of diagnostic radiology reliably detect cases of radiation lesion of the brain tissue, but not enough data in the literature about semiotics and its variation over time for focal radiation lesions, various concepts of pseudoprogression and radiation necrosis were found. The aim of this publication was to clarify radiological patterns of pseudoprogression by perfusion CT, revealing its differences from radiation necrosis. This article describes the different variants of pseudoprogression and its flowing, while it is determined that local radiation injuries after combined treatment may develop in the area of perioperative ischemia.

Tuberculosis is one of the actual socially important diseases. The most severe and prognostic unfavorable manifestation of tuberculosis is the tuberculosis of the meninx and central nervous system, which is difficult to diagnose. The magnetic resonance imaging method is one of the most perspective one in diagnosing the tuberculosis of the central nervous system. The MRI-semiotics of the most typical clinical form of the central nervous system tuberculosis has been presented: tuberculous meningitis, tuberculous meningoencephalitis, tuberculous meningoencephalomyelitis, CNS tuberculoma. The MRI investigation of the brain promotes increasing the central nervous system tuberculosis diagnosis level, and consequently, effective treatment of such patients.

Hirayama disease (HD) is a rare neurological condition typically thought to be endemic for South Asia andJapanregion. Disease is characterized by juvenile muscular atrophy of unilateral distal upper extremity with benign course. MRI of the cervical spine is the way to confirm HD in clinically supposed case. Some typical MR-signs can be visualized in neutral position (abnormal cervical curvature, loss of attachment between the posterior dural sac and subjacent lamina, localized lower cervical cord atrophy with asymmetric spinal cord flattening and hyperintensity) and in flexion position (anterior shifting of the posterior dura and posterior epidural space enlargement). Here we describe 5 HD cases in Russian population with a detailed MRI description and MRI protocol recommendations in case of HD suspicion. 

Recurrent respiratory papillomatosis (RRP) — laryngeotraсheal papillomatosis — a rare disease caused by the human papilloma virus (HPV). It characterized by presence of multiple papillomas found in the upper respiratory tract, usually on the vocal folds. The spread of below — the trachea, main bronchi — a rare phenomenon observed in 2–29% of cases, and parenchymal lung occurs in 1–7% of cases. The paper presents three cases of pulmonary papillomatosis in adult patients. CT-scan and enndobronchoscopy findings analysis was provided. 

The aim of this study was to evaluate the densitometric parameters of coronary arteries by volume MDCT coronary angiography for coronary artery stenosis and after percutaneous coronary stenting procedures. Volume MDCT coronary angiography was performed on 38 patients aged 47 to 75 years. The study was conducted on a 320-slice Aquilion One (Toshiba,Japan) computed tomographic machine, with prospective ECG-gating. The assessments of the results of stenting and coronary artery stenosis were determined density characteristics in Hounsfield units (HU) cross-sectional area of the vessel in the central departments, at a distance of5 mmproximal and distal to the stent or stenotic areas. In the absence of significant in-stent restenosis DI was >0,45, with a DI>< 0,8, with a DI< showed signs of significant in-stent restenosis. In the absence of significant stenosis of the vessel DI was >0,8, with a DI< 0,8 showed signs of significant stenosis or occlusion of the vessel. Thus, densitometric analysis with a volume MDCT coronary angiography can be used in the evaluation of coronary artery stenosis and in-stent restenosis for improving diagnostic informativity method. Volume scanning with prospective ECG-gating can significantly reduce the radiation exposure to the patient. 

Aim. To evaluate possibilities of CT-perfusion and PET methods with ¹⁸F-FDG and ¹⁸F-ftorholin in the complex diagnosis of hepatocellular carcinoma. Materials and Methods. The study included the results of PET/CT with ¹⁸F-FDG, ¹⁸F-ftorholin and CT-perfusion of the liver in 18 patients with histologically confirmed diagnosis of hepatocellular carci noma (HCC). Depending on the degree of tumor differentiation, all patients were divided into 3 groups — patients with highly differentiated (6 patients), moderately differentiated (4 patients), and poorly differentiated HCC (8 patients). PET/CT with ¹⁸F-FDG was performed on an empty stomach with water load 308–501 MBq of ¹⁸F-FDG was administered intravenously for 50–60 minutes before scanning, depending on the patient’s weight. PET/CT with ¹⁸F-ftorholinom was performed 2–3 days after studies with 18F-FDG. The relaxation time was 40 minutes after administration of the radiopharmaceutical. The duration of each PET analysis was 3 minutes per slab. The accumulation levels of the radiopharmaceutical (maxSUV — standardized uptake value) were measured in the solid areas of tumor nodules, in the areas of necrosis (if available) and in the unmodified liver parenchyma. CT-perfusion was performed after the PET/CT in the single scanning with intravenous administration of «Omnipak» 300 mg/ml — 50 ml, the rate of introduction — 2,5–4 ml/s, the time from the introduction of a contrast agent till the scanning — 8 seconds, total scan time — 45 seconds. Data processing was carried out at the Siemens Multy Modality Workplace. Quantitative analysis was performed on the following parameters: BV (blood volume) — ml/100 ml, BF (blood flow) — ml/100 ml/min, ALP (arterial liver perfusion) — ml/100 ml/min, PVP (portal vein liver perfusion) — ml/100 ml/min by measuring the values in the areas of solid tumor nodules, in the areas of necrosis and in the unmodified liver parenchyma. Results. Average values of maxSUV in the group of patients with highly differentiated HCC in PET/CT with ¹⁸F-FDG and ¹⁸F-ftorholin in a solid component of tumor reached 3,51 and 18,24, respectively; in patients with moderately differentiated HCC — 3,91 and 12,32, respectively; in patients with poorly differentiated HCC — 9,58 and 9,70, respectively. Average values of CT perfusion imaging in a solid component of the tumor in the group of patients with highly differentiated HCC were the following: BF — 55,33 ml/100 ml/min, BV — 13,71 ml/100ml, ALP — 52,41 ml/100 ml/min, PVP — 10,81 ml/100 ml/min (p≤0,05), in the group of patients with moderately differentiated HCC: BF — 52,78 ml/100 ml/min, BV — 12,23 ml/100 ml, ALP — 47,26 ml/100 ml/min, PVP — 9,10 ml/100 ml/min (p≤0,05), in the solid component of poorly differentiated HCC: BF — 46,96 ml/100 ml/min, BV — 9,49 ml/100 ml, ALP — 40,54 ml/100 ml/min, PVP — 7,66 ml/100 ml/min (p≤0,05). Conclusions. Integrated use of PET with ¹⁸F-FDG and ¹⁸F-ftorholin and CT-perfusion in the single scanning increases differential diagnostic capabilities PET/CT diagnosis, allows to suggest the degree of HCC differentiation that can be used in treatment planning and predicting the course of disease. 

The aim of this study was to estimate possibilities of СТ и CT angiography in the diagnosis of acute mesenteric ischemia and its differential diagnosis with other acute abdominal diseases. In our clinic 126 patients with clinically suspected acute mesenteric ischemia underwent abdominal CT as the first, and usually the sole, diagnostic procedure. Mesenteric ischemia was diagnosed in 64 (50,8%) patients (50 (78,1%) — arterial embolism and arterial thrombosis, 12 (18,8%) — venous thrombosis and 2 (3,1%) — arterial and venous thrombosis). Another cause of acute abdominal pain was found in 62 (49,2%) patients. All positive CT findings were confirmed by surgery or by clinical follow-up.

Aim: We evaluated the dependencies of the damage of the arterial wall on the energy of the radiofrequency pulse in renal denervation, as well as the relationships between the MRI features of the perivascular damage around the renal arteri es and the degree of the subsequent decrease of the arterial pressure. Material and methods: 34 patients (as old as 56±17 years) with resistant hypertension were included, in everybody the radiofrequency ablation (RFA) of the sympathetic nerves of renal arteries was carried out. Initially the office measured arterial pressure was as high as 140–230 / 74–162 mm Hg, whereas the average 24-h monitor of the arterial pressure gave the values as high as 137–210/57–148 mm Hg. The MRI studies were performed using MRI scanner «Titan Vantage» (by «Toshiba Medical Ltd», with the field induction 1,5 Т). After this the intravenous contrast enhancement has been carried out (with0,5 Мsolution, 0,2 ml/Kg), with repeat acquisition of Т1-weighted spin-echo images in 3–5 min after contrast injection. Absolute values of the image intensities were obtained from three regions drawn over the arterial wall of the renal artery, on the frontal slices of the aorta and renal region, in T1-weighted spin-echo images in particular — over abdominal aorta and orifice of the renal artery, over the middle part of the renal artery and over the distal branches of the renal arteries, on both sides. The index of enhancement (IE) was then calculated from these data, as ratio of intensities of contrast-enhanced image to the initial non-enhanced MRI scan. Results. Correlation between initial values of IE in proximal and middle parts of the left renal artery and diastolic arterial pressure was significant and in particular expressed as Diastolic AP=(62,26+13,171)×IEproximal (r=0,615; p=0,01) and Diastolic AP=(66,517+8,903)×IEmiddle (r=0,57; p=0,03), respectively. When comparing the IE values over the middle segment of the right renal artery to the indices of power of the ablation procedures carried out, there is a significant correlation as: IE=(0,09+0,03)×(Total energy) (r=0,475; p=0,025), verifying the significancy of direct relationship between delivered energy and periarterial damage of the renal arteries. No significant differences were revealed between proximal and distal regions of the renal arteries. The most essential and valuable fact of the study was that there is highly significant reverse correlation between IE of the arterial wall and arterial pressure in the patients studied in six months after the treatment, in particular as Diastolic AP=(108,82–13,92)×IEmiddle (r= -0,503; p=0,01224) and Diastolic AP=(108,54–13,23)×IEdistal (r=-0,484; p=0,0224) of the right renal artery respectively, and а также Diastolic AP=(94,38–5,28)×IEmiddle (r=-0,296; p=0,15994) as to left renal artery. The damage of the arterial wall was thus of significant prognostic value in regard to decrease of arterial pressure in renal artery denervation. Conclusion: Contrast-enhanced MRI study of renal arteries provides adequate diagnostic information on the anatomic condition of arterial walls and periarterial tissue and should be accepted as both first-line diagnostic techniques in patients with resistant arterial hypertension and for the follow-up of these persons after radiofrequence desympatization, employing set of quantitative methods. 

Lymph node metastasis, as one of the main reasons of rectal cancer recurrence, currently are significant problem in oncocoloproctology in spite of the updating of diagnostic techniques of tumor staging. This becomes even more important with lateral pelvic lymph node metastasis. Lateral lymph node dissection widely used inJapanandKoreainvolves risk of increasing disuric events and sexual disorders. Preoperative chemoradiotherapy realized inRussia, Europe andUnited Statesis often inefficient and followed by side effects. Therefore there is necessity of finding new diagnostic techniques allowing to detect true metastasis and risk factors of lateral pelvic lymph node metastasis in order to optimize treatment policy for this group of patients. 

Neurovisualisation method of the bran investigation: magnetic resonance imaging using T2-gradient echo and susceptibility-weighted imaging, revealed characteristic hemosiderin deposition. This findings combined with clinical manifestation of progressive triade of symptoms: sensorineural hearing loss, cerebellar ataxia and pyramidal signs, led to diagnosis of idiopathic superficial hemosiderosis of central nervous system in patient with duration of disease more than 10 years.

It has been established the necessity of using of one molar contrast media, Gadovist to increase the sensitivity and specificity of the diagnosis of the nodular breast lesions by MRI with dynamic contrast enhancement. MRI study with contrast enhancement should be one of the methods of diagnostic imaging in conjunction with ultrasound and x-ray mammography under the suspect of lesions presence in breast.