The article discusses the objectification of the clinical need for contrast enhancement in CT and MRI studies under economic pressure exerted by the situation on the currency market, the position of insurance companies and health care management. The possibility of substitution of CT-MRI studies with a view to avoid the need for contrast enhancement is studied. New techniques that can replace the need for contrast in future are described.

HIV-associated neurocognitive disorders are on the second place after immune system injury in HIV infection. Despite the large amount of studies, their mechanisms remain unclear especially in the subclinical stage. The purpose of our research was to study changes of brain functional state in HIV patients in different stages of the disease and revealing the early and probably prognostic features (characteristics) of subclinical neurocognitive disorders on the basis of combined analysis of the positron emission tomography (PET) and magnetic resonance spectroscopy (MRS). The obtained data demonstrated local metabolic disturbances in gray and white matter in the early stages of HIV infection. These findings raise the question about the early implication of the highly active anti-retrovirus therapy (HAART) and neuroprotectors. The abundance of the metabolic changes increases with the progression of HIV clinical symptoms. Revealed characteristics of the glucose metabolic pattern in HIV patients and threshold values of the basic metabolites ratios in MRS could be used as a predictors of the further neurocognitive disorders.

The corpus callosum (CC) volume loss in patients with multiple sclerosis (MS) is a long been known phenomenon, considered by many authors as an indicator of disease severity. Meanwhile the relationship between CC atrophy and disease severity in MS patients not always found in studies, which may be due to the features of somatotopical CC structure. The aim of our study was to determine the relationship of atrophy in different parts of CC with the severity of clinical manifestations in MS patients to clarify the pathogenesis of these disorders and find opportunities for the development of tools for control and correction. The article presents results of morphometric analysis of 117 patients with different types of MS and 25 healthy volunteers. The original MRI image postprocessing algorithm is used. The initial parameters used for the statistical analysis were: age, duration of disease, the type of the disease, numerical score of FS and EDSS scales, the results of morphometry. Correlation analysis showed that the volume of the CC isthmus and corpus inversely correlated with disease duration and severity of a pyramidal, cerebellar, sensory, pelvic disorders and degree of disability. Analysis of variance in groups of patients with different types and severity of MS showed that atrophy of the CC isthmus and corpus is associated not only with the degree of disability, but also with the disease type. The study results confirm the important role of the atrophy of certain brain regions in the development of clinical picture and types of MS. It is shown that changes in the volume of the CC isthmus and corpus are independent markers of the development stage and severity of the disease, and their measurement can be an instrumental tool for objective assessment of the effectiveness of personalized neurorehabilitation techniques in patients with demyelinating diseases of the central nervous system.

Trigeminal neuralgia in most cases caused by compression of trigeminal nerve or its branches with vessels. Compression may locate in root entry zone (REZ) or in a distance from it. The aim of the study is to compare distances from REZ of trigeminal nerve to offending vessel on the symptomatic side to distance to the same vessel on asymptomatic side. Comparing this distances showed significantly shorter distance on symptomatic side. Thus, it could be concluded that this factor has its part in development of trigeminal neuralgia.

In the past decade, there has been a significant increase in the prevalence tuberculosis of the peripheral lymph nodes. This is the reason for improvement the methods of medical imaging of the tuberculous lymphadenitis. The most informative methods include a morphological study of tuberculosis of lymph node biopsy. The article presents the results of ultrasound investigations in detecting early changes in tuberculous lymphadenitis. The results of ultrasound examination were compared to the multislice-computed tomography (MSCT), findings of histological examination and autopsy.

The problem of improving the health care of patients with injuries of the musculoskeletal system every year is becoming increasingly important due to the number of casualties and the levels of disability from injuries in people of working age. The aim of our research was to demonstrate that Dual-Energy Computed Tomography with Rapid kV-Switching (DECT, discovery 750 HD, GE Healthcare) could be used for the callus maturity evaluation and to develop accurate criteria for the effectiveness of reparative regeneration and determine the bone fixation time. The study included 18 patients aged from 18 to 55 years with open diaphyseal tibia fractures, all treated with extrafocal transosseous osteosynthesis. The patients were divided into two groups: those treated with the contact ultrasound regeneration stimulation and control group with no additional treatment. All patients underwent dual energy CT to evaluate treatment result. The callus calcium concentration was quantified with DECT to detect signs of delayed consolidation. Studies shown that calcium concentration is better indicator of the fracture consolidation and well correlates with the clinical test of supporting ability. The calcium concentration 260 mg/cm³ and above can be accurate indicator of the callus maturity and an indication for removal of external fixation. The use of contact ultrasound in the treatment of open tibial fractures promotes rapid regeneration of bone fragments.

A testicular abscess is a rare disease and occurs in 1% of cases of acute inflammatory diseases of organs of a scrotum. Timely diagnosis of testicular abscess is difficult. Problems in the diagnosis of testicular abscess caused by specific clinical, laboratory, and radiation pattern, rarity of disease and lack of awareness of physicians. Diagnostic possibilities of radiological methods are under study. The purpose of this article was to study the possibilities of clinical, laboratory and ultrasound diagnosis of testicular abscess. The paper presents the results of a retrospective analysis of clinical, laboratory and ultrasonographic examinations and treatment of 10 patients with testicular abscess in the period from 2005 to 2015. Because of the delay in diagnosis of testicular abscess in the prehospital period was dominated by a complicated stage of the disease, and among the methods of treatment - orchiectomy. The ultrasound has high efficiency in the diagnosis of testicular abscess. A differential diagnosis of abscess of the testis and similar for clinical and ultrasonographic picture of the diseases such as tumor, hematoma, and torsion of the testis are discussed. It is possible to see a rare combination of an abscess and testicular tumors. Patients over the age of 50 years with acute inflammatory diseases of the testis and epididymis and burdened by the background of immunodeficiency have an increased risk of development of testicular abscess and should be kept under strict dynamic clinical, laboratory, and sonographic monitoring during treatment conducted in a specialized hospital.

A clinical observation of a patient with lingering, asymptomatic clinical course of unusual and rare form of alveolar disease of liver, evidencing of significant diagnostic complexities and successful treatment, is given in the article.

This article reviews recent developments in pediatric contrast-enhanced MRI and offers recommendations on current best practice. Gadolinium-based contrast media with high relaxivity and high concentration (Gadovist) are recommended for enhancing imaging quality. The choice of most appropriate contrast medium should be based on criteria of safety, tolerability, and efficacy, characterized in age-specific clinical trials and personal experience.

The number of CT-examinations in Russia, like all over the world, is constantly increasing. Nevertheless, the analysis of routine practice in our country demonstrates the insufficient usage of intravenous contrast enhancement. One of the main factors defining this situation is poor awareness of radiologists about practical safety aspects of contrast media administration. This article represents a review of risk management plan to be applied in connection with the intravenous administration of contrast agents.

Stimulation of vagus nerve by means of internal implants is increasingly being used nowadays in the treatment of patients with epilepsy and several other diseases of the central nervous system. However, when necessity arises to examine a patient implanted with vagus nerve stimulator in a magnetic-resonance machine, radiologists face a number of issues concerning safety of the patient as well as of the neurostimulating device. Present article summarizes specific conditions of magnetic-resonance imaging in patients with vagus nerve stimulating system, and also illustrates clinical observations carried out by the authors.

In the article there are presented the results of the pilot project for improvement of attainments in reasoned assignation of radiological examinations, investigation of modern diagnostic algorythms, problems of the organisation of the Radiological service in the system of obligatory medical insurance.

The preoperative cardiac risk assessment of patients undergoing non-cardiac surgery is common daily practice of medical consultants. At present, there are several noninvasive diagnostic methods for cardiac risk evaluation. In daily practice, common used methods are stress test with myocardial imaging (stress-Echo; myocardial perfusion imaging with gated-SPECT, etc.). Recently, some studies demonstrated that both coronary angiography by multidetector computed tomography and magnetic resonance with stress test have a good prognostic value in cardiac risk evaluation. A common question that arises between medical specialists in preoperative assessment is which of noninvasive diagnostic methods should use for cardiac risk evaluation. The easiest one is standard stress test. However, the preoperative evaluation has some difficulties in elderly because of reduced physical activity and inability to achieve the submaximal heart rate during stress test. For this category of patients, stress test with pharmacological agents followed by gated-SPECT or Echo-CG is to be considered. This article provides medical specialists to assess cardiac risk with appropriate non-invasive diagnostic methods in patients undergoing non-cardiac surgery.

The literature review analyzes studies on postmortem CT as an alternative to the conventional autopsy in forensic examination of the bodies of an adults. The main objective of the review is to give a brief analysis of the characteristics of post-mortem CT imaging, which do not face the clinical radiologists in their practice. The analysis comes up with 72 literature sources. The basic Internet resources were used during preparation of the study: Scientific Electronic Library (elibrary), SciVerse (ScienceDirect), Scopus, PubMed, and Discover. The review includes articles which discuss both the advantages and limitations of CT in the posthumous forensic examination of the bodies of an adults, and especially post-mortem CT imaging the most common pathological processes and artefacts. Conclusions. Early and late postmortem changes, such as rigor, autolysis, putrefaction and others largely change the normal pattern in CT imaging clinical radiologists are used to. In particular, the interpretation of CT images of the corpse must consider common specific and non-specific artefacts which result from: agonal changes (alteration in anatomical appearance, decomposition); autolysis, putrefaction; regurgitation of gastro-intestinal contents, aspiration; lividity and hypostasis; postmortem blood clotting; resuscitation effects; postmortem handling/autopsy technique; insect activity; and many others. These artefacts are not pathological findings, and should always be taken into account when interpreting the postmortem CT images.