Subject of the inquiry: 116 patients with rheumatoid arthritis of the hand joints and 25 healthy subjects.
Aim of the inquiry: improvement of the diagnosis of rheumatoid arthritis of the hand joints using sonography and magnetic resonance imaging.
Methods of inquiry: X-ray, sonography, magnetic resonance imaging and magnetic resonance imaging with contrast enhancement.
The results achieved and their novelty: For the first time data were presented on the role of sonography, magnetic resonance imaging and magnetic resonance imaging with contrast enhancement in the diagnosis of rheumatoid arthritis of the hand joints. The findings have shown that sonography in hand joint rheumatoid arthritis allowed detection of changes in soft tissues, synovial capsule, joint surfaces and ligaments. Diagnostic value was given of sonography in revealing characteristic sonographic signs of rheumatoid arthritis. Magnetic resonance imaging was highly informative radiological method to detect synovitis, changes of synovial capsule and subchondral cysts. Magnetic resonance imaging with contrast enhancement reliably detected the degree of activity and severity of the rheumatoid process.
Practical value: consisted in revealing and describing characteristic sonographic and MRI signs of hand joint rheumatoid arthritis and in the developed radiological algorithm of the disease.
Degree of embed: the results of the investigation were introduced in the practice of rheumatology and radiology departments of the First Tashkent Medical Institute, in teaching process of the Radiology Chair of the First Tashkent Medical Institute.
Sphere of usage: radiology, rheumatology, traumatology and orthopedics.
Subject of the inquiry: 148 patients with degenerative dystrophic diseases of the hip joint, of them 103 with osteoarthritis and 45 with avascular necrosis of the femoral head.
Aim of the inquiry: improvement of the diagnosis of degenerative-dystrophic diseases of the hip using possibilities of ultrasonography and magnetic resonance imaging.
Methods of research: X-ray, ultrasonography and magnetic resonance imaging.
The results achieved and their novelty: For the first time, the role of ultrasonog-aphy and magnetic resonance imaging in osteoarthritis and avascular necrosis of the hip was established in comparison with conventional X-ray. The result have shown that sensitivity of ultrasonography in osteoarthritis was low (57.7%) in the detection of femoral head deformation. In avascular necrosis of the hip detection of femoral head deformation was revealed better - 89.7%, which can be explained by differences in the mechanism and localization of deformation in these diseases. Ultrasonography was quite sensitive to changes of the joint capsule both in osteoarthritis and avascular necrosis, the sensitivity 86.0% and 84.6% respectively. MRI was superior to X-ray in the assessment of space orientation of the joint surfaces, necrosis zone, synovitis, subchondral cysts, structural changes and joint effusion. X-ray was more preferable for the detection of ostephytosis, subchondral sclerosis and changes of the joint space in osteoarthritis.
Practical value: of the work consisted in the concretization of sonographic and MRI signs of degenerative dystrophic diseases of the hip joint and in the suggested algorithm of using radiological methods for establishing the nature of hip joint pathology.
Degree of inculcate: the results of research were introduced in the Radiology Department of First Tashkent Medical Institute and the Department of Large Joint Pathology Department of the Traumatology and Orthopedy Research Institute.
Sphere of usage: radiology, traumatology and orthopedy, rheumatology.
Использование управляемого хирургического подхода с помощью компьютерного моделирования позволяет обеспечить установку имплантата с точностью около 98%, управляемая хирургия выгодна для обычного размещения имплантата, немедленного имплантата размещение и потенциальная немедленная провизионализация.
Уровень заболеваемости пневмониями и их осложнениями продолжает оставаться на высоких показателях проблема своевременной, неионизирующей диагностики данной патологии у детей является одной из актуальных в педиатрии.
Relevance of the problem. The difficulties of diagnostics of orbital diseases are well known. Especially difficult is intraspecies differentiation among the multitude of tumour, pseudotumour, inflammatory, vascular, endocrine and other diseases occurring here, manifested by the symptom complex of unilateral exophthalmos [Beradze I.N., 1978; Brovkina A.F., 1993].
Malignant intraocular neoplasms are the main cause of death of patients with diseases of the organ of vision, with 45-48% of patients dying from metastases in the first 5 years after enucleation [Alekseeva I.B., 1990, Barkhash S.A.1978, Brovkina A.F..1991, 1997; Keizer R.W.. Viclvoyc G.L.,1986],
Retinoblastoma is the most frequent malignant neoplasm in children. According to different authors, the frequency of its occurrence is 1 case per 14000 - 35000 newborns. [Bobrova N.F. and Vit V.V., 1993; Brovkina A.F., 1997; Provenzale J.M., et al., 1995; Skulski M., et al., 1997; Weber A.L., Mafee M.F, 1992; Wilms G., et al., 1989]. The frequency of patients with the most malignant intraocular tumour in adults - uveal melanoma has recently reached 7-9 people per 1 million population [Brovkina A.F., 1997; Kotslyansky E.O., 1989; Yushko N.A., Peskova L.I., Kalenich L.A., 1989; Peyster R.G., Augsburger J..I., Shields J.A., 1988; Romani A.. Baldeschi L., ct al 1998; Scott I.U., 1998].
The fundamental difference in treatment tactics, depending on the stage of development, size and topography of the tumour, as well as the seriousness of the prognosis in retinoblastomas and melanomas sharply increase the requirements for the accuracy of their differential diagnosis. At the same time, the number of diagnostic errors in ocular tumours continues to be 10-30% even when complex clinical and instrumental examination is applied in specialised ophthalmological centres [Ternovoy S.K., Panfilova G.V., Rogozhin V.A., 1979; Friedman F.E., Malyuta G.D., Kodzov M.V., 1995; Song G.X., 1991].
Widely used in ophthalmological practice traditional diagnostic methods (ophthalmoscopy, gonioscopy, diaphanoscopy, fluorescence angiography, laboratory tests) are insufficient to obtain comprehensive information about the localisation, nature of growth and prevalence of volumetric pathological formations of the eye and orbit. This circumstance and not quite satisfactory results of surgical treatment are the causes of high mortality of patients [Muratova T.T., Nigmanova N.H., Kozlovskaya G.M.. 1989, Naches A.I., 1980; Cheremisin V.M., Trufanov G.E., Kholin A.V., 1991]. Untimely or erroneous recognition of pathological processes of the orbit leads to a sharp deterioration of visual functions, up to blindness, and in some cases to the death of the patient [Yuzhakov A.M., Travkin A.G., Kiseleva O.A., 1991]. All this determines the importance of timely and accurate diagnosis of diseases of the orbit, on the one hand, and the difficulty of such diagnosis - on the other [Gabunia R.I., Kolesnikova E.K., Tumanov L.B., 1982].
The fact that the orbit is closed from direct inspection and palpation by bone walls and the eyeball, indicates the advantage of radial diagnostics in comparison with other methods of examination. In the arsenal of clinicians there is a great variety of methods of clinical-radial diagnostics of orbital pathology, however, at present the information in the literature about their resolving capabilities and significance in comparative aspect is incomplete and not fully studied. The priority of using one or another instrumental investigation, their sequence and expedient combination have not been determined yet. This makes it difficult to choose the optimal standardised approach for diagnosis and adequate treatment [Cheremisin V.M., Trufanov G.E., 1993, Weber A.L., Sabates N.R., 1996; Wenig V.M., Mafee M.F., 1998].
Thus, the study of these and other questions, contributing to the improvement of diagnostics and treatment of patients with neoplasms of the eye and ocular cavity, should be recognised as urgent urgent.
Purpose of the study. Comparative evaluation of magnetic resonance tomography capabilities and development of algorithms for complex radial diagnostics of volumetric formations of the visual organ. To solve this goal we set the following tasks.
1. To study the normal picture of the magnetic resonance image of the visual organ in comparison with other methods of visualisation.
2. To find out the possibilities of magnetic resonance tomography, ultrasound and computed tomography in detection and evaluation of intraocular neoplasms.
3. To determine the role and place of magnetic resonance tomography in differential diagnostics of volumetric pathological formations of the eye cavity in comparison with other radial methods of research.
4. To determine the indications and to develop an algorithm for the complex application of radiography, ultrasound, computer and magnetic resonance tomography for diagnostics of volumetric formations of the eye organ.
Scientific novelty.
The present work is the first to give a detailed and detailed description of the complex clinical and radiation examination, with generalisation and standardisation of magnetic resonance, computer and ultrasound semiotics of volumetric pathological formations of the eye and eye cavity. The conducted clinical and instrumental investigations allowed to determine the diagnostic value and resolving capabilities of each of the applied methods. The ultrasound, CT and MRI signs of volumetric formations of the eye organ were studied, clarified and supplemented taking into account the use of low-field magnetic field and general-purpose ultrasound apparatus. The developed standardised diagnostic algorithm of examination of patients with this pathology is new, thanks to which the pre-oppositional diagnosis of tumour and other diseases of the visual organ is improved and the total radiation load on the patient is reduced.
Conclusions
1. MPT will provide an opportunity to study the weight of the soft tissue and anatomical components of the ocular cavity, up to the optic nerve sheath and perineural liquor space, the orbital apex and chiasmal-sellar region, as well as to assess the condition of adjacent structures of the brain and facial skull. The method is limited in the evaluation of changes in the bony walls of the orbital cavity.
2. MRI is inferior in detecting characteristic signs of retinoblastoma (presence of calcification). The sensitivity of MRI was 66.6%, while for ultrasound and CT these values were 96.1 and 100%, respectively. But when the tumour spreads rstrobulbarly outside the eyeball (at 3-4 stages) the informativeness of MRI increases significantly. In uveal melanoma the sensitivity and specificity of MRI reaches 100%.
3. Both MRI and CT have a high detection rate (98.1% and 95.8% respectively) of benign orbital tumours of both primary and secondary origin. However, MRI is the preferred method of investigation. MRI is especially informative when a cranioorbital tumour and pseudotumour are suspected. The sensitivity of the method is 90.9% and 91.6%, respectively
4. In some cases ultrasound can be used to differentiate between encapsulated and diffuse neoplasms, which facilitates the diagnosis. However, when the pathological process is localised near the orbital apex, the diagnostic value of ultrasound decreases. In such cases it is advisable to use MRI.
5. In detection of primary and secondary malignant tumours of the orbital cavity both MRI and CT are quite informative (sensitivity 97,2% and 95,4% respectively), but the most comprehensive information about the state of bone walls will be provided by CT. When the process spreads intracranially, the value of MRI increases significantly, especially with the use of contrast enhancement.
6. The developed algorithm of complex clinical and radiation examination of patients with the use of ultrasound, CT and MRI is the most effective in the diagnosis of volumetric pathological formations of the eye and eye cavity, allowing to reduce to an adequate minimum the total radiation load on the patient and diagnostic period, excluding duplication of research techniques and choosing the most informative in each case, which in turn allows to develop appropriate treatment tactics and reduce the level of disability of the patient.
Остеомиелит - воспаление компактной части кости, надкостницы, костного мозга и окружающих кость мягких тканей. Развитие обусловлено попаданием в костный мозг патогенных микробов. Инвазия микробов в костную ткань происходит при открытом или огнестрельном переломе, а также при операциях на костях с последующим развитием посттравматического или послеоперационного остеомиелит а. Несмотря на определенные достижения в клинике и диагностике значений методов рентгенологических исследований в ранней диагностике заболевания остается высоким.
Коронавирусная болезнь (coronavirus disease 2019, COVID-19) является инфекцией, вызываемой новым коронавирусом nSARS CoV-2. 11 марта 2020 года ВОЗ объявила вспышку нового типа коронавируса COVID-19 пандемией. Представляет собой одноцепочечный, РНК-содержащий вирус, относится к линии Beta- CoV B семейства Coronaviridae, II группа патогенности (как SARS-CoV и MERS- CoV).
Сложность выявления патологически измененных внутригрудных лимфатических узлов заключается в том, что они располагаются глубоко в грудной полости, спереди прикрыты сердцем, крупными сосудами и органами средост ения. В подобных ситуациях решающее значение имеет спиральная компьютерная томография (СКТ) благодаря большой разрешающей способности, возможности получения тонких срезов, скорости компьютерной обработки. Изображение на СКТ определяется конкретным морфологическим субстратом, поэтому является более объективным.