The article demonstrates the first Russian experience of prenatal proton magnetic resonance spectroscopy (¹Н MRS) of the brain. The results of the study are analyzed, the metabolic changes during the gestation period is evaluated. Neuroimaging methods of assessing brain metabolism may play a role in the diagnosis and prognosis of some perinatal neurological disorders, that is why the information about normal cerebral metabolic processes is extremely important. Prenatal ¹Н MRS of the brain is an informative, non invasive diagnostic method that is performed complementary to MRI and provides unique information about the cerebral biochemical composition. Brain metabolic changes may precede structural, e.g. the appearance of changes in the spectrograms may outgo the changes in traditional MRI, therefore, the method may be useful in the early detection of a pathology. Early detection of abnormal metabolic brain processes may be helpful in identifying future potential therapeutic strategies.

The review presents an analysis of the literature on the diagnosis of gliomas and the study of their structural and biological features based on implementation of new techniques in clinical practice of diagnostic imaging. These techniques include perfusion technologies for multislice spiral computed tomography (MSCT), magnetic resonance imaging (MRI), functional MRI, proton magnetic resonance spectroscopy (MRS), single photon emission computed tomography (SPECT), and positron emission tomography (PET) with various radiopharmaceuticals (RPHs), first and foremost, labeled amino acids, such as ¹¹C-L-methionine and ¹⁸F-Fluoroethyltyrosine. There is presented that with the application of these two methods (MRI and PET), the most important biochemical processes underlying oncogenesis of malignant tumors might be studied by non-invasive way. The obtained data can be crucial for an early detection of tumor lesions, staging the pathological process, rationale for therapeutic tactics, personalization of treatment, evaluation of the efficiency of therapy at early stages and prognosis of the disease result.

Glioma is one of the most common primary tumors among adults. Glioblastoma multiforme (GBM) is the most aggressive form of glioma with very poor prognosis. The median patient survival is about 15 months. Treatment of glioma requires a complex approach combining surgical resection, chemotherapy and radiation therapy. Definition of the tumor border is the important step of radiation therapy treatment planning. The rapid development of the diagnostic methods made it possible to address this challenging task. However, the optimal treatment volume is still a matter of debate due to the complex biological behavior and high invasiveness of the tumor. Furthermore, the subjective interpretation of the visual information by the expert existed. So far, the application of machine learning in image analysis is a promising tool for glioma segmentation in multimodal MRI imaging. This review aims to summarize recent works using machine learning in high — and low — grade glioma segmentation.

Peritoneal carcinomatosis is a common variant of metastasis of malignant tumors of the abdominal cavity and pelvis. Modern methods of complex and combined treatment of peritoneal carcinomatosis can significantly increase the survival of patients with this pathology. Determining the prevalence of peritoneal lesions is crucial for both planning and evaluating treatment. The lecture presents the anatomy and function of the peritoneum, the epidemiology of peritoneal carcinomatosis, the analysis of the capabilities of existing methods of computed tomography and magnetic resonance imaging in detecting signs of tumor dissemination of the peritoneum, reflects the principles for assessing the peritoneal carcinomatosis index (PCI) and its role in choosing a treatment strategy in cancer patients.

Aim of the study. We attempted to obtain the Mn-HMPAO complex (Mangoxim) and to evaluate the possibility to apply as a paramagnetic contrast agent for enhancement of tumors at MRI. Materials and methods. The synthesis of HMPAO was carried out by using R. D. Neirinckx — J. Pijarowska-Kruszyna technique (2017), without separation of enantiomers. The Mn-HMPAO was obtained by mixing Manganese(II) carbonate with HMPAO, pH 6,2–6,5, 0,5 M. Also the quantum chemistry calculations were carried out on the structure of Mn-HMPAO using method of functional of density DFT rb3lyp/6–31+g(d,p) for isolated molecules and for water solutions (CPCM). MRI study of Mn-HMPAO uptake carried out in twelve laboratory mouses with transplanted Lewis sarcoma, in T1-w. SE mode, TR=500 ms, TE=15 ms, 256×256 matrix, FOV 15×15 cm, 3 mm thin slice. MRI acquired in 15–17 min and 60–90 min after intravenous injection of the Mn-HMPAO. The uptake was quantified as index of enhancement: IE=(Int. T1-w.MRI)Mn-HMPAO/(Int. T1- w.MRI)pre-contrast. Results. The N,N-Mn-dioxim is more stable than O,O-Mn-dioxim for 50,5 KCal/mol, so in the nature only N,N-Mn-dioxim exists. R1 of Mn-HMPAO was 3,35 1/(mM•s), below R1 of gadopentetate=3,96 1/(mM•s). The highest value of early IE was over the tumor (3,36±0,31) and over lungs (3,07±0,43). At 60 min the IE over tumor decreased to 1,58±0,14, remaining far over IE values over any other location. Conclusion. The Mn-HMPAO complex demonstrates paramagnetic properties for the application as the contrast MRI agent and probably will improve the selective enhancement of tumors.

Role of limbic system, first of all, hippocampal formation, is carefully analyzed in literature because of its involvement in different psychiatric diseases. Results are contradictory, may be because of insufficient data of normal volumes of structures involving in cognitive and affective functioning of the brain. Hippocampus is very complex organized structure consisting of different subfields and subregions which probably differently changes in different psychiatric diseases. Aim of our study was to analyzed changes in volumes of the whole hippocampus, its subregions and subfields in different psychiatric diseases. In our study we have analyzed MRI morphometry of hippocampal formation in healthy volunteers, patients with Alzheimerdisease (AD) in early stage, vascular dementia (VD), depression based on medical literatureandourexperience. Patients were divided on 4 groups: 10 patients with early Alzheimer disease, 10 normal volunteers, 10 patients with vascular dementia and 10 patients with depression. We have determined method of definition and volume evaluation of different hippocampal subfields. We find difference in the volumes of CA3, molecular stratum and fascia dentatain early stage of AD; in the volume of hippocampal tail, molecular stratum of fascia dentataand CA3 in patients with VD; in molecular stratum of fasciadentata, fimbria and CA3 in patients with depression because of role of these fields in coordination of hippocampal activity.

As a consequence of the cerebral tracts’ damages, encephalopathy comes with cognitive disorders. Diffusion-tensor MRI is a cerebral tracts’ integrity quantitative measurement method. The main purpose of the study was to develop criteria of cerebral tracts integrity using DT-MRI to predict vascular dementia, to find threshold CFA level in liable tracts to measure dementia risk. DT-MR results were compared with neuropsychological tests of subjects with diagnosed encephalopathy. Identified statistically significant (р<0,005) FA decrease in three regions for those subjects with cognitive impairment: front sections of corona radiata, inferior longitudinal fasciculi and anterior horn of internal capsule. Threshold FA level calculated for these 3 region of interests, they can be predictors of the risk of cognitive disorders for subjects with diagnosed encephalopathy.

The aim of the study was to compare the volumes according to MR morphometry and diffusion values according to diffusion-tensor MRI (DT-MRI) of the corpus callosum in children with spastic diplegia. Methods: the main group consisted of 12 children aged from 1 year 8 months to 4 years 3 months, the comparison group — 5 children with normal motor development, who did not have motor impairments, at the age from 1 year and 3 months up to 3 years 8 months. All patients underwent MR-morphometry, DTI. A comparison was made between the volumes and diffusion values of the corpus callosum between groups. Results: Significant differences were found (p<0,05) in the volume of the genu, splenium and the middle third of the trunk of the corpus callosum. Significant differences (p<0,05) of diffusion values in the middle and posterior third of the trunk of the corpus callosum were also revealed. The data obtained demonstrate the diffuse nature of pathological changes in the corpus callosum in children with spastic diplegia.

Community-acquired pneumonia (CAP) in patients with interstitial lung diseases is a terrible complication and has an atypical course. Diagnosis of CAP is difficult, since the clinical symptoms of inflammation are similar to those of ILD. The results of radiation studies are not pathognomonic, they are not always correctly interpreted, which leads to errors in diagnosis, delay in the examination and treatment of the patient. Aims: to evaluate the possibilities of CT in the detection and differential diagnosis of pneumonia in patients with ILD. Material and methods. The results of a complex clinical and radiological studies of 336 patients with IZL, 48 patients showed infiltrative changes in the lungs that were not characteristic of the main process. Results. Nonspecific inflammatory changes in the lung tissue were manifested by the following CT symptoms: alveolar type with local infiltration of the lung tissue corresponding to the segmental structure of the lungs (segment, lobe), the appearance of peribronchial alveolar type lung tissue that is not characteristic of radiation semiotics of the underlying disease. Conclusions: рerforming CT and VRKT reveals the appearance of infiltrative and focal changes that are atypical for IL, characteristic of specific and non-specific inflammatory processes, which affects the treatment tactics of patients.

Objective: optimization of the technique and study of the possibilities of MR-elastography in assessing the rigidity of the pancreatic parenchyma under normal conditions, with fibrotic changes and adenocarcinoma. Materials and methods. MR elastography was performed for 15 patients with no history and clinical laboratory data indicating the presence of pancreatic diseases, 20 patients with pancreatic adenocarcinoma at the stage of preoperative planning to assess the rigidity of the tumor and parenchyma, in order to predict the probability of pancreatic fistulas. With the application of special software, the quantitative values of stiffness in kPa were calculated, a qualitative analysis of the state of the parenchyma was carried out using color parametric maps. Results. The stiffness of the pancreatic parenchyma normally ranged from 1,54 to 2,87 kPa, averaging 2,5 kPa. The unchanged parenchyma was characterized by blue staining on color parametric maps in the hardness range from 0 to 8 kPa, violet in the range from 0 to 20 kPa. In patients with a tumor process in all cases there was a low-grade adenocarcinoma of the pancreatic head, verified by histological data. The rigidity of adenocarcinoma varied from 6 to 9 kPa, on the color parametric maps there was a red staining of the tumor in the range of hardness of 0– 8 kPa, yellow in the range of 0–20 kPa. In the postoperative period, the pancreatic fistula on the background of preoperative preparation was formed only in 3 patients with normal pancreatic parenchyma, according to elastography rigidity indicators. Conclusion. MR-elastography is an informative method for quantitative and qualitative analysis of the stiffness of pancreatic parenchyma, and effective instrument for predicting the development of pancreatic fistulas.

Introduction. The technique of visualization, the definition of «anomalies» of the uterine scar differ in all of publications devoted to the study of morphological changes of the uterine scar after cesarean section (CS) in non-pregnant women. The aim of our study was to determine the optimal algorithm for the diagnosis of uterine scar local thinning. Materials and methods. The ultrasound examination of pelvic organs was performed for thepatients not less than 6 months after CS. 40 women had scar thinning creating the shape of «niche». Next there was performedthe MRI study. One patient had ultrasound the contrast examination with the intrauterine introduction of the physiological solution and for the other one we performed the contrast examination with microbubble preparation of the sulfur hexafluoride. All the patients with the«niche» detectedunderwent the hysteroscopy. Results. The ultrasound examination revealed that the residual thickness of the myometrium of the uterine scar was 3,3±1,54 mm. The sensitivity of the method was 63% and specificity was 62%. The MRI revealed the residual thickness of the myometrium 3,44±1,64 mm. The sensitivity of the method was 80% and the specificity was 71% (p<0,05). During the hysteroscopy the «niche» was visualized in 95% of cases. Conclusion. To reduce the measurement error and to detect the necessity of surgical treatment there is necessary to apply at least two different studies (routine ultrasound, ultrasound with contrast agent and MRI). In the severe cases there is important to use hysteroscopy as the additional technique, which allows to visualize the defect accurately.

Introduction. Rhabdomyolysis is destruction syndrome of striated skeletal muscle characterized by myalgia, an increase of creatine phosphokinase level (CPK), serum myoglobin and myoglobulinuria. This review presents the analysis of five cases of acute postexercise rhabdomyolysis happened to militaries, complicated by pigmentary nephropathy with the description of clinical and laboratory studies, magnetic resonance imaging (MRI), electroneuromyographic and morphological features. The purpose of the study is the clinical assessment of MRI for the diagnosis of postexercise rhabdomyolysis. Results. A comparative assessment demonstrated that in the presented clinical cases in the muscle groups with minimal edematous changes, an increase in the MR signal was observed at T2-WISPAIR, as well as in diffusion-weighted images (factor b — 0, 500, 1000), at the same time on all other pulse sequences (including STIR) changes in signal intensity were not detected. Conclusion. There was shown that in mild cases of rhabdomyolysis, the regression of MR manifestations corresponds to a decrease in laboratory parameters of CPK and myoglobin, whereas in severe forms of rhabdomyolysis, the regression of MR manifestations is significantly slowed down relative to laboratory indicators, and in the place of necrosis areas, the foci of degeneration form (hyperintensive on T1 and T2-WI, hypo-intensive on T1-WI-SPIR and T2-WI-SPAIR). Morphologically confirmed the fact of pronounced hemorrhage in the compartment syndrome due to postload rhabdomyolysis (hyperintensive sites on T1-WI and T1-WI-SPIR, iso-, hypointensive on T2-WI, T2-WI-SPAIR).

This article reviews the correct methodology of MRI in patients with rectal cancer (RC). The technical aspects of scanning, the advantages and disadvantages of the various sequences and methods used, the particularities of preparation and positioning, and their rationale are considered. Compliance with the correct methodology allows to obtain high-quality and high-informative images, thereby allowing to assess the extent of the process, the invasion of adjacent organs and structures with high accuracy.