Brain tumors are the second most common etiology in pediatric patients with focal seizures undergoing surgery for drug-resistant epilepsy. These neoplasms have a number of distinctive features from those found in adult patients, one of which is a wide polymorphism of structural architectonics during neuroradiological examination. Given the tremendous biological stability of these tumors, not in all cases of pre-surgical examination it is possible to verify the presence of a neoplastic process in the structure of the epileptogenic substrate using routine neuroimaging methods. In some complex diagnostic cases, a multimodal imaging approach and in-depth complex examination are required for reliable diagnosis and success of the results of epileptic surgery.

Introduction. Recently, surgeons have been using minimally invasive methods to treat parathyroid gland pathology. More selective surgical approaches are based on the accuracy of preoperative diagnostic methods. Various radiological diagnostic techniques are used to visualize parathyroid gland pathology. New modalities are entering clinical practice along with long-known techniques. The attending physician should be guided by the most clinically effective and economically reasonable algorithm when choosing diagnostic algorithm. The aim of the study was to find the optimal diagnostic protocol for preoperative diagnosis of parathyroid gland pathology on the basis of available data. Conclusion. Preoperative imaging of parathyroid glands continues to evolve with changes of old techniques and appearance of new ones, though none of modalities has a clear advantage. The choice of imaging algorithm is largely based on the availability of techniques and the experience of particular diagnostic centers. Ultrasound and planar scintigraphy are well established and most widely used. The combination of these techniques remains the first line of diagnosis in preoperative imaging. However, there is no consensus on the choice between planar scintigraphy tech niques: the washout method or the subtraction method. Replacing planar scintigraphy with SPECT/CT improves the detectability of pathological masses and clarifies their topographic location. Computed tomography and MRI techniques are used as a second-line technique and have an advantage in small adenoma sizes, multiple lesions, ectopias, reoperations, and in case of ambiguous ultrasound and scintigraphy data. The significance of PET/CT in the diagnosis of thyroid pathology has not yet been defined, the data are still scarce and published studies are very heterogeneous, but due to the excellent diagnostic characteristics the method seems very promising, in particular in patients with persistent disease.

Introduction. Artificial intelligence is one of the fastest-growing areas of great importance to radiology. Purpose. In this article, we aimed to study the current state of the use of computer-aided imaging analysis in acute ischemic stroke. Results. There are many artificial intelligence softwares that automatic image processing can successfully identify neuroradiology image in stroke: early detection by diagnostic imaging methods, assessment of the time of disease onset, segmentation of the lesion, analysis of the presence and possibility of cerebral edema, and predicting complications and treatment outcomes. Conclusion. The first results of using artificial intelligence to evaluate neuroimaging data showed that machine-learning methods could be useful as decision-making tools when choosing a treatment for acute ischemic stroke.

Introduction. Cognitive epileptiform disintegration is a complex of disorders of higher mental functions in a person with a pathological EEG pattern characteristic of epilepsy. In this case, the patient should not have epileptic seizures or a history of single seizures is allowed. The study of biomarkers of the pathological condition under consideration using proton magnetic resonance spectroscopy as indicators that can be objectively evaluated and measured determines the practical relevance of this work.

The aim of the study was to determine the diagnostic significance of the metabolites of N-acetylaspartate, choline and creatine according to proton magnetic resonance spectroscopy in the brain of children with cognitive epileptiform disintegration. 

Material and methods. Using routine MRI and proton magnetic resonance spectroscopy, 6 children with a diagnosis of mental retardation, cognitive epileptiform disintegration at the age of 2 to 7 years (5 boys; 1 girl) were examined. The patients underwent EEG followed by identification of a typical QED pattern. All children had no history of seizures characteristic of epilepsy. Results. А decrease in the ratio of the concentration of NAA/Cr (p<0,05) in the temporal lobes on both sides and the hippocampus on the right was revealed, due to a decrease in the concentration of N-acetylaspartate. There is also an increase in the Cho/NAA concentration ratio (p<0,05) in the hippocampus on the right, and an increase in the Cho/Cr concentration ratio (p<0,05) in the prefrontal cortex, postcentral gyri on both sides, the temporal lobe on the right and the region of the inner capsule on the left, by increasing the concentration of choline. 

Conclusions. Тhe obtained data suggest that changes in neurometabolism in the cholinergic system in children with cognitive epileptiform disintegration are possibly caused by damage to neuronal connections, mainly in the hippocampus and temporal lobes.

Introduction. The identification of early edematous changes using MRI and the assessment of the nature of their distribution among the muscles is important for the diagnosis of dysferlinopathy and the differentiation of hereditary muscular dystrophies from inflammatory myopathies. 

Purpose of the study: to assess the capabilities of STIR and T2 MSME methods in the diagnosis of early edematous changes in the muscles of patients with LGMDR2. 

Materials and methods: We examined 20 patients with clinical manifestations of dysferlinopathy, with an average age of 35 (24; 44) years. Magnetic resonance imaging of the muscles of the pelvic girdle and lower extremities was performed by 20 patients and a control group equivalent in sex and age.

Results. The T2 MSME (ms) method based on the calculation of relaxation time has the highest diagnostic accuracy in detecting early edematous changes in muscles. The sensitivity of the STIR method was 56%, and the specificity was 100%. 

Conclusion. Dysferlinopathy is characterized by diffuse edema of the least affected muscles. STIR is optimal for differential diagnosis of myopathies characterized by edematous changes. Whereas, for the assessment of minimal edematous changes, T2 MSME is the most acceptable.

Introduction. The CT patterns of coronavirus pneumonia are clear and represent certain pathomorphosis at the period of coronavirus pandemic. However, there are a lot of questions about influence of CT-patterns and their dynamic change on a disease’s severity. The aim of the study. To evaluate the dynamics of pulmonary CT changes of novel coronavirus (2019-nCoV) pneumonia in relation to clinical and laboratory data. Materials and methods. CT studies in dynamics of 108 patients with a of novel coronavirus (2019-nCoV) pneumonia were analyzed. The first CT study was performed on admission (6,7±4,1 days of the disease), the first control CT on 11,1±4,9 days of the disease, and the second CT control was performed on 16,7±5,6 days of the disease. Results. The volume of the lesion and the predominant CT symptom at admission did not affect the prognosis. However, changes in the repeated CT study had a high prognostic value. Thus, the occurrence of a pattern of organizing pneumonia during repeated study is associated with a good prognosis, while an increase in the zones of «crazy paving» and a larger volume of damage are unfavorable prognostic signs. An increase in the volume of changes in the type of ground glass and «crazy paving» correlated with increased levels of C-reactive protein, lactate dehydrogenase, and lymphopenia. Conclusion. Data from CT studies in dynamics for novel coronavirus (2019-nCoV) pneumonia have a prognostic value and, in combination with clinical and laboratory data, can influence decision-making on patient management.

Introduction. Respiratory distress syndrome (RDS) is characterized by immaturity of lung tissue, surfactant deficiency and is a common cause of mortality in premature infants. X-ray is the main method for determining the causes and severity of respiratory failure in newborns.

Purpose. Systematization of the results of X-ray examination of the lungs of newborns with varying degrees of prematurity, compared with autopsy data.

Materials and methods. The analysis of X-ray data and sectional material of 32 premature infants with low and extremely low body weight who died with clinical manifestations of RDS was performed.

Research results. The article provides a comparative analysis of various types of radiological changes in the lungs (reticulo-nodular pulmonary pattern (n=10), cellular deformity of the pulmonary pattern (n=5), «air bronchogram» (n=20), «air leakage» syndrome (n=6), focal-confluent shadows/infiltrative-like foci of darkening (n=9)) and autopsy results of premature newborns.

Conclusion. The greatest number of coincidences of radiological and histological data took place in BPD (80%), the smallest — in pulmonary hemorrhages (20%). The coincidence of conclusions for pneumonia and GM disease is 58–56%, respectively. Difficulty in the differential diagnosis of the X-ray picture of the lungs in low birth-weight infants lies in the frequent combination of pathological conditions. Respiratory failure with a wide range of pathological changes in the lungs developed in 15 (53,6%) newborns in the absence of criteria for surfactant insufficiency against the background of respiratory support.

Introduction. Nowdays, CT and/or MRI do not have sufficient specificity for the differential diagnosis of benign renal masses (oncocytoma and angiomyolipoma with minimal fat) from malignant tumors, and therefore all patients undergo surgical treatment.

Purpose and objectives. The aim of the study was to evaluate the diagnostic effectiveness of perfusion computed tomography (PCT) for the differential diagnosis of solid renal masses.

Materials and methods. The data of 60 patients (61,28±8,46 years) with primary founded solid renal tumors, who underwent PCT at the preoperative stage, were analyzed. Four perfusion indicators, such as BV, BF, PS and MTT, for the renal masses and normal cortex were evaluated.

Results. According to the results of the statistical analysis, the perfusion parameters BV, BF, PS of the renal cortex were significantly higher than in tumors of any histological type (p<0,05). A statistically significant difference was found between clear cell, chromophobe and papillary types of renal cell carcinoma in terms of BV and BF (p<0,05), between benign and malignant tumors — in MTT.

Conclusions. PCT has great potential in the assessment of neoangiogenesis and differential diagnosis of solid renal masses.

Introduction. Magnetic resonance imaging (MRI) is a highly informative imaging technique, but now days is not recommended for detecting prostate cancer revealing after external beam radiation therapy (EBRT) at localized prostate cancer.

Purpose of the study. To study the magnetic resonance imaging of changes in the prostate gland in patients with localized prostate cancer after radical EBRT. 

Materials and methods. Studied and compared the data of clinical and histological studies of a series of MRI in nine patients with prostate cancer before and after EBRT. Standard sequences (T2-weighted images, diffusion-weighted images, dynamic con trast enhancement) were used for MRI. 

Results. After irradiation, in a delayed period, atrophy and fibrotic changes occur in the structure of the prostate gland, which leads to a decrease in its size, uneven contours, and the impossibility of differentiating the zonal anatomy on T2-VI. After RT, the intensity of the MR signal from the tumor on DWI with a high b-factor decreases, the difference in the ADC of the peripheral, transient zones and the tumor is practically leveled. After RT, the hypervascularity of the tumor progressively decreases, there fore, in the delayed period, in most cases, type 3 of the contrast curve is observed in DCE. In general, MRI gives results consistent with the dynamics of serum PSA levels. However, one patient after EBRT showed signs of local progression on MRI without signs of biochemical progression.

Conclusion. MRI can be used as a method for early diagnosis of local recurrence of prostate cancer after EBRT, however, its clinical significance requires further study.

Introduction. Vessel wall imaging in patients with dissection plays an impotent role in the differential diagnosis of stenoocclusive processes of the main arteries of the head. However, the interpretation of changes in long-term periods remains difficulties. 

Purpose: to determine and compare the imaging patterns of the consequences of the postponed dissection using MRI and ultrasound.

Materials and methods. 30 patients with confirmed dissection were examined for more than 1 year from the date of diagnosis. MRI was performed using vessel wall protocol imaging before and after contrast enhancement.

Results. Postpone dissection imaging patterns were revealed: aneurysmal dilation of the artery (27%) and double lumen (20%) at the site of dissection; prolonged stenosis in 10% of cases, intimal flap — in 3% of cases. Occlusion persisted in 40% of cases.

Conclusion. The use of MRI can improve the differential diagnosis of the causes of the stenоocclusive process of the main arteries of the head.

Resorption of hard tissues in a permanent tooth is manifested by the loss of cement or dentin of the tooth. At the initial stages of development, the disease is asymptomatic, which significantly complicates early diagnosis and reduces the likelihood of a successful outcome of treatment. The pathogenesis of the disease has been studied, while the main etiological factor is not known. The researchers point only to the main factors predisposing to the development of tooth resorption. The prevalence of this condition continues to be studied using the new capabilities of cone-beam computed tomography (CBCT), which allows for the earliest and most reliable diagnosis. The three-dimensional X-ray image of the tooth structures makes it more possible to visualize dentin defects at all root levels, and when they are localized on different surfaces. It is this aspect in the diagnosis of pathological tooth resorption that is crucial, since it determines the treatment tactics in general, and the creation of access in conservative surgical treatment. This method of radiation diagnostics has become the standard for examining a dental patient in the clinics of the Department of Dentistry of the MED Clinic System. The algorithm of reading and interpreting the data of computer tomograms, developed in SPBINST, is also used. Examination of dental patients involves the use of CBCT for the preparation of a comprehensive treatment plan, during all types of endodontic treatment, and for monitoring during follow-up in dynamics.