The relevance of developing an intelligent automated diagnostic system (IADS) for lung cancer (LC) detection stems from the social significance of this disease and its leading position among all cancer diseases. Theoretically, the use of IADS is possible at a stage of screening as well as at a stage of adjusted diagnosis of LC. The recent approaches to training the IADS do not take into account the clinical and radiological classification as well as peculiarities of the LC clinical forms, which are used by the medical community. This defines difficulties and obstacles of using the available IADS. The authors are of the opinion that the closeness of a developed IADS to the «doctor’s logic» contributes to a better reproducibility and interpretability of the IADS usage results. Most IADS described in the literature have been developed on the basis of neural networks, which have several disadvantages that affect reproducibility when using the system. This paper proposes a composite algorithm using machine learning methods such as Deep Forest and Siamese neural network, which can be regarded as a more efficient approach for dealing with a small amount of training data and optimal from the reproducibility point of view. The open datasets used for training IADS include annotated objects which in some cases are not confirmed morphologically. The paper provides a description of the LIRA dataset developed by using the diagnostic results of St. Petersburg Clinical Research Center of Specialized Types of Medical Care (Oncology), which includes only computed tomograms of patients with the verified diagnosis. The paper considers stages of the machine learning process on the basis of the shape features, of the internal structure features as well as a new developed system of differential diagnosis of LC based on the Siamese neural networks. A new approach to the feature dimension reduction is also presented in the paper, which aims more efficient and faster learning of the system.

Routine spinal MRI can be used for bone marrow lesions detection. The most useful standard pulse sequence is T1- WI, which helps both in local and diffuse bone marrow diseases. Additional new pulse sequences, including chemical shift imaging and diffusion weighted imaging, can be used as solving-problem techniques.

In order to improve the capabilities of duplex Doppler ultrasound of morphofunctional features of vertebral arteries we investigated duplex Doppler ultrasound of major neck vessels in 279 patients with stages 1–2 arterial hypertension (149 patients with stage 1 hypertension and 130 patients with stage 2 hypertension). The control group included 196 subjects with normal blood pressure values. Duplex Doppler ultrasound included the following hemodynamic parameters of vertebral arteries: peak systolic velocity, end-diastolic velocity, time-averaged mean velocity, pulsatility index, resistance index, and also the asymmetry of vertebral arteries diameters — the ratio of the diameter of the left vertebral artery to the diameter of the right vertebral artery; volumetric blood flow. The reactivity of the vertebral arteries was studied by assessing the response of hemodynamic parameters to head rotation. The severity of muscle sleeve fibrosis surrounding the vertebral arteries in the C5–C6 segments of the cervical spine was evaluated at 7 degrees (from 0 to 6). The study found differences in the morphology of the vertebral arteries as well as the ultrasound parameters of the muscle sleeve surrounding the vertebral arteries in the C5–C6 segments but the greatest differences were observed precisely in the indicator of the reactivity of the vertebral arteries on head rotation. Reactivity indicators were expressed as changes in the parameters of pulsatility index and resistance index. The results of the study showed that early changes in the muscle sleeve surrounding the vertebral arteries in the C5–C6 segments lead to changes in the diameters of the vertebral arteries and their reactivity during further traumatization of vessels and sympathetic fibers caused by rotation of the head. Reactive indicators express to a far greater degree on the left vertebral artery and their progression increase with the progression of hypertension occurred.

For many reasons spondylodiscitis (SDC) is a complicated pathology. It is caused by difficulty in early diagnostics, the need for surgical treatment (including repeated interventions), long term and high cost of antibiotic therapy. Objective. The goal is to identify and describe the main CT and MRI symptoms of SDC, to assess their frequency and specificity. The next aim is to note the peculiarities of the radiologist’s practice with such patients. Materials and methods. We studied the data of 25 patients with proved SDC, and we analyzed CT and MRI symptoms (both common and rare), and the role of contrast enhancement (СE) in both methods and important clinical and laboratory aspects. Results. The infiltration of vertebral bodies and intervertebral discs were the most frequent SDC signs, abscesses also were very common. The most significant type of abscess was epidural which led to the formation of vertebral canal stenosis and  to neurological deficit. The important methodological aspects of the MRI study were noted to improve its quality. Conclusion. We recommend performing both CT and MRI, if possible, for all patients with SDC because of the different diagnostic tasks that are important for clinicians.CE significantly increases the MRI informativity.

The clinical and neurological status and magnetic resonance imaging (MRI) of the spine were studied in successively examined 100 patients with suspected infectious spondylitis. The study design is a prospective monocentric cohort with a period of recruitment of the material in 2015–2017. Level of evidence — III. The prevalence of intramedullary changes in the form of gliosis/myeloischemia-edema in comparison with other variants of the detected changes was revealed; the presence of a higher degree of spinal sagittal stenosis (SCSs) and spinal cord kifosis (SCK) and also the average number of affected vertebrae in tuberculous spondylitis than in non-specific ones has been proven. In HIVpositive patients, higher values of the degree of maximum sagittal canal stenosis (SCSs) were observed than in HIVnegative ones. The statistical dependence between the severity of neurological disorders estimated by the Frankel scale with the etiology of the process and with specific variants of structural changes in the spinal cord has not been proven. Indicators of tactile and pain sensitivity were significantly higher in patients with intramedullary changes in the form of gliosis / myeloischemia-edema than in myelomalacia.

Symptoms of neuromuscular dysfunction are quite common in patients with hypothyroidism. Structural changes of myelin and dysfunction of oligodendroglial processes in axons have pathogenetic significance in patients with neuropathies against the background of hypothyroidism. However, the etiopathogenesis of the development of neuropathies in hypothyroidism is not fully understood. Magnetic resonance imaging (MRI) is a modern imaging method that now provides an image of nerve trunks with a quality sufficient to assess their condition. The main task of MRI is to assess the difficult and atypical cases of nerve compression. We examined 26 patients diagnosed with hypothyroidism, including 8 patients with degenerative-dystrophic diseases of the spine, 1 patient — an anomaly of nerves and muscles, 2 patients were found to have the consequences of injuries, 1 patient was diagnosed with De-Kervin disease, and 14 patients with comorbidity, leading to nerve compression, was not found. The aim of the study was to assess the diagnostic capabilities of magnetic resonance imaging for compression-ischemic neuropathies of the hands in patients with hypothyroidism. Neurological examination and data from stimulation electroneuromyography allows you to accurately determine the area of investigation for MRI. The article shows the diagnostic capabilities of MRI, as well as its place in the diagnostic algorithm of compression-ischemic neuropathies of the hands in patients with hypothyroidism.

Introduction: The study of the possibilities of perfusion computed tomography (PCT) in determining the nature of focal lung formations in the absence of morphological verification, doubtfulness of the data of native CT — the actual problem of thoracic radiology. The aim of the study was to Refine the methodology and capabilities of PCT in determining the nature of formations of the lungs. Material and methods of research: The data of PCT of 29 patients with benign and malignant changes in the lungs on 128 slice computed tomography with data processing at the workstation were analyzed. Conclusion: Low-dose scanning Protocol for lung PCT allows to obtain reliable data on the angiogenesis of focal lung formations. Upon receipt of the perfusion map, the ROI is placed on the area of the highest blood flow. With sufficient PCT data on the nature and prevalence of lung disease from CT with contrast enhancement may refuse. Average PS, TTP are the main and leading factors in determining the nature of the lesion in the lungs. Qualitative and quantitative analysis of PCT data allows to speak reliably about the nature of foci in the lungs.

Purpose of the study: optimization of the technique and study of the possibilities of perfusion computed tomography (PCT) in assessing the functional state of the pancreatic parenchyma in normal conditions. Materials and methods. PCT was performed in 30 patients with a lack of history and clinical and laboratory data indicating the presence of pancreatic disease, which were examined for other pathological conditions. Using the standard protocol and the deconvolution method, a quantitative assessment of the average perfusion indices in the head, body and tail of the pancreas was performed, and a qualitative analysis of the state of its parenchyma on color parametric maps. Results. The pancreas is an organ with high blood flow rates (BF 136±6,74 ml/100 g/min), blood volume (BF 16,6±0,67 ml/100 g/min), characterized by bright red staining on the corresponding parametric maps. The pancreas is characterized by average values of the average transit time of the contrast agent (MTT 10,25±0,47 s) and the time to maximum tissue density (TTP 17,3±0,6 s), green parenchyma staining on the corresponding parametric maps, low permeability of the capillary walls (PS 3,5±0,72 ml/100 g/min) and blue staining on the permeability map. No statistically significant difference in the average values of perfusion indices in the head, body and tail of the pancreas and the dependence of perfusion parameters on the age of the patients was revealed. Conclusion PCT is an informative method of quantitative and qualitative assessment of the functional state of the pancreatic parenchyma.

The aim. The possibility of applying a unified methodological approach to the problems of pattern recognition and information modeling of the process of diagnosis of various forms of malignant tumors with the help of CAD-analysis of medical images is substantiated. Material and methods. A retrospective analysis of medical histories and results of scintigraphy from 168 patients with newly diagnosed disseminated prostate cancer treated on the basis of the Khabarovsk regional clinical Oncology center in the period from 2003 to 2016. Considered original methodological approaches to the study of metastatic lesion of the skeleton using computer-aided analysis of planar osteoscintigraphy. Results. Volume of lesions of the skeleton were calculated with the use of computer systems for automated diagnostics based on the principles of image recognition and has the features of expert analysis. and the degree of tumor differentiation are independent of each other predictors of high risk of death in patients with disseminated prostate cancer. The high efficiency of CAD-analysis in the evaluation of bone metastatic index for this form of malignant advanced tumors is shown.

Bone metastases occur in 20–35% of patients with generalized renal cell carcinoma (RCC), and osteoclastic (lytic) metastases prevail. Diagnosis of metastatic lesion of the skeleton during RCC is of clinical importance for timely treatment, improving the quality of life and reducing mortality of patients. The article discusses modern methods of radiation diagnosis of bone tissue changes in metastatic RCC.

Ewing’s sarcoma is a malignant tumor, with an extremely aggressive growth pattern and a high risk of metastasis. In our work we demonstrated a case of primary lesion of Ewing’s sarcoma of the thoracic vertebra in a 10-year-old girl. Localization, in this situation, the tumor poses a serious threat to the development of neurological deficits, which is associated with a high need for early recognition of this neoplasia with the help of modern methods of radiation diagnosis (computed tomography and magnetic resonance imaging, SPECT).

Antenatal death is the cessation of fetal heart contractions during pregnancy for more than 22 weeks prior to the onset of labor. Objective: to evaluate the capabilities of the method of ultrasound in antenatal fetal death. Tasks of ultrasound in the presence of a dead fetus: a statement of his death; determining the position, presentation, size, estimated fetal weight and gestational age; detection of congenital malformations (CM) and possible causes of death; clarification of the statute of limitations of death. We have analyzed 126 standard ultrasound protocols of pregnant women with antenatal fetal death. Ascertaining the cessation of heart contractions and determining the location of the fetus present no difficulties for the ultrasound doctor. The assessment of the conformity of the size of the fetus to the gestational period during antenatal death is better determined by measuring the diaphysis of the long bones. Head sizes are used only when it is possible to clearly assess the typical structures of a biparietal slice. The determination of the estimated mass of the fetus is difficult due to autolytic changes and, usually, lack of water. The diagnosis of CM, first established after ascertaining antenatal fetal death, should cause the doctor to doubt that it is in front of us — a developmental defect, as a possible cause of intrauterine death or post-mortem changes that depend on previous intravital changes, cause and duration of death. The article describes the dynamics of the appearance of post-mortem changes. Conclusions: with antenatal fetal death, it is impractical to determine the expected mass of the fetus, it is preferable to estimate the period of probable cessation of development from the measurement of long tubular bones; during an ultrasound of the deceased fetus, it is often impossible to reliably determine the presence/absence of CM and the exact time of death; change in the amount of amniotic fluid is not a reliable diagnostic criterion for the duration of death.