This paper considers the state of radiotherapy in St. Petersburg. The article is the result of work as a main expert in radiation therapy of the Health Committee of St. Petersburg. Possible mechanisms of the problems and ways to improve the situation should be discussed.

Quantitative characterization of brain lesions may not be only a diagnostic criteria, but also the parameter for dynamic evaluation of various CNS diseases progression. Manual segmentation is the most accurate method of measuring lesions volume, but this method is time- and labor-intensive. There are different methods of automatic lesions segmentation that use different algorithms and have varied accuracy of the results. In this paper we compare two fundamentally different approaches to the automatic lesions segmentation basis on the MRI images and evaluate the possibility of using these methods as an alternative to manual segmentation.

The aim of the work was to develop diagnostic algorithms of the magnetic resonance imaging (MRI) in the diagnosis of localization-related epilepsies (LREs) by using of complex MRI protocols. MRI in 236 patients with the clinically defined diagnosis of LRE was performed. Investigation was based on routine MRI protocols supplemented by specialized high resolution sequences to visualize microstructural changes in the brain, single-voxel proton MR-spectroscopy of the hyppocampi, MR-tractography with the analysis of the fractional anisotropy and volumetry in the hippocampal formation and associated structures. MRI investigation algorithms for the patients with LRE according clinical and electrophysiological data are proposed.

The most adverse outcomes of PCI in patients with ACS-STE occurs during prolonged endovascular correction of complex coronary impairment forms in the absence of coronary arterial flow support. The aim of this study was to assess the effectiveness of retroperfusion support of coronary blood flow during endovascular correction of complex anterior coronary bed impairment forms in patients with ACS-STE. The results of treatment of 12 patients who underwent endovascular image-guided intervention was analyzed from 26.04.2012 to 10.05.2014. 1st group consisted of 6 (50%) patients who underwent retroperfusion support of coronary circulation. 2^nd group consisted of 6 (50%) patients in whom retroperfusion support have not been performed. In 1st group there there was a significant decrease in ST-segment elevation during retroperfusion after 60 seconds of the absence of antegrade blood flow in the anterior coronary bed compared with patients who underwent angioplasty without the coronary blood flow support (ST in V1-V3 with retroperfusion was 2,2±0,4 mm; ST in V1-V3 without retroperfusion was 2,9±0,4 mm; p=0,027). In 2nd group, in the absence of retroperfusion support in all patients after 60 seconds of antegrade flow overlap there was a significant increase in segment elevation ST (ST in V1-V3 was 2,7±0,3 mm; p = 0,027) compared to the initial ECG pattern. Similar dynamics was observed in blood pressure levels. Thus, selective retroperfusion of great cardiac vein can be used as an intraoperative support of cardiac hemodynamics in patients with ASC-STE.

The aim of thi work was to develop methodological approaches to diagnostic imaging of visceral in clinical practice. 59 patients with metabolic syndrome including 20 men and 39 women aged from 18 to 63 years were examined. All patients underwent standard CT or MRI and sonography with assessment of various factors: the thickness of visceral fat, subcutaneous fat, and their ratio, the thickness of preperitoneal fat at the level of interest. We found statistically higher levels of thickness measured by ultrasound in patients with metabolic disorders compared with patients with simple obesity and healthy individuals. The relationship between results of ultrasound, MRI and CT measurments with carbohydrate and lipid metabolism was found. The most informative indicators of ultrasonic evaluation of visceral obesity in patients with metabolic syndrome were showed. Algorithm for imaging in patients with obesity and metabolic syndrome to diagnose the type of abdominal accumulation of adipose tissue is proposed.

The purpose of this retrospective study was to explore peculiarities of pancreatic necrosis in patients with end-stage HIV infection using MDCT and MRI. Comparisons with subsequent pathological studies revealed features of the pancreatonecrosis course: protracted persistent course, with a tendency to relapse, delimitation of exudative processes, depending on the predominance of one or another AIDS-related infections. Pancreatonecrosis on a background of generalized toxoplasmosis was observed in 2 patients (18%) and was accompanied by formation of specific cysts secondary to the presence of hemorrhage and calcination, mesenteric lymphadenopathy, without the presence of additional inflammatory fluid streaks. Pancreatonecrosis on a background of generalized tuberculosis was observed in 4 patients (36%). It noted the severe and widespread destruction of pancreas with miliary parenchymal and mesenteric dissimination, mesenteric lymphadenopathy, the presence of additional inflammatory fluid streaks in the abdominal cavity and retroperitoneal space. The density of inflammatory fluid streaks was relatively high, at 15-30 HU. Out of 5 (46%) evaluable patients with pancreatic necrosis on the background of generalized mycosis 2 had revealed candidiasis, in 1 - cryptococcosis, in 2 - actinomycosis. Destruction of the pancreas on the background of different fungal infection accompanied by the appearance of multiple focal formations (microabscesses) due to rapidly emerging adhesions in exudative changes mild abdominal and mesenteric lymphadenopathy and had no significant differences depending on the pathogen.

The article presents the diagnostic values of the radiological methods for evaluation of the hip joints condition in patients with degenerative lesions, compared with clinical and laboratory data before and after endoprosthesis placement.

The experience of using telemedicine technologies (TM) was analyzed with the purpose of distant consulting of the patients with the with thyroid diseases (TD). The method of primary ultrasound screening and the results of delivery of the compressed pictures were described. Suggested algorithms early diagnostic and treatment of the patients with thyroid diseases by the method of TM consulting can help to provide qualify medical aid to the patients at the remote places.

The article discusses the possibilities of basic MRI techniques in primary prostate cancer diagnosis based on the MRI characteristics of anatomical and histological features of prostate. The assesment of prostate cancer distribution, stratification of risk for progression and the decision for treatment tactics, in accompanying of remedial actions, in treatment effectiveness monitoring and in early detection of relapses is discussed.

Breast is the organ with low natural visibility, this fact don’t let us to produce an image of milk ducts on the plain film. Assessment of the milk ducts is an important condition to identify the earliest signs of diseases like cancer and benign nature. It is known that up to 80% of the cancer develops ductal epithelium of the breast. Traditional ultrasonic scanning because of it’s inefficient resolution capability and physical peculiarities of method enables us to define only 4-5 mm intraductal tumors. Many attempts of improvement of intraductal breast deceases diagnostic were made for many years to come. Different technologies: cytological analysis, radiography, US, MRI were used for achieving these purposes. They didn’t always allow us to think definitely of one ore other process. It led to a need to improve the objective methods of visual diagnostics due to increasing contrast of objects being investigated including radiography.

The article discusses the importance of brain immaturity in preterm neonates that causes brain damage leading to subsequent impairment of neurodevelopment. Neonatal brain imaging is used to assess the patterns of brain immaturity. The criteria for estimation of brain maturation are presented.

The tutorial covers the physical principles of ultrasound imaging and aspects of various tissues interpretation. The material is primarily intended to doctors who start studying ultrasound diagnostics and helps to learn how to interpret a normal ultrasound picture of the various organs and structures, and confidently diagnose various pathological changes.

Magnetic resonance urography is performed by using two basic methods: MR urography of static liquid with heavily weighted pulse sequences and excretory MR urography with contrast enhancement. Both techniques in conjunction with a conventional abdominal and pelvic MRI make it possible to estimate the urinary system throughout.