Puropose of the study. Basing on the previously obtained results on the proven high efficiency of magnetic resonance imaging (MRI) of the chest organs in the visualization of major lung diseases, in the current period of mass incidence of viral pneumonia (VP) caused by COVID-19, we tried to study the possibility of using MRI OGK to image lung damage in this pathology both in primary detection and for follow-up reconvalescence control.Material and methods. MRI of the chest in T1 -, T2-weighted modes (T1-w, T2-w), also with fat suppression, diffusion-weighted, STIR-modes, in the axial and frontal planes, with breath holding, or with automatic synchronization of acquisition with breathing was carried-out in 47 patients with VP of various severity, 32 of them were confirmed by PCR as COVID-19, all did have a clinic of pneumonia. The control group comprised 15 volunteers, of them 8 non-smokers, and 7 smokers. In 18 patients, an CT study of the chest was also performed, with a step of 0.5–1.25 mm, with full coverage of the chest and reconstruction of axial and frontal slices, with a comparison of MRI and CT of the chest. In 8 patients, MRI of the chest was then performed again, for follow-up control of clinical recovery. There were no deaths among our patientsResults. The duration of a complete MRI examination of the chest was less than 25 minutes in all cases (21 ± 4 minutes on average), and less than 10 minutes in the chest CT. In all cases, MRI imaging of the affected area was achieved using a group of MRI protocols, which included axial T1-w and axial and frontal T2-w, and lasted < 12 minutes, counting the time for laying the patient.In normal patients without pathology of the lungs, not smoking, the lung was visualized as a diffuse homogeneous air region with a minimum share interstitial and vascular space. In patients - smokers, lung MRI was slightly enhanced in the dorsal parts of both lungs, disorders of airiness and interstitial exudative changes weren't present. In the acute phase of the disease, pulmonary ventilation disorders and interstitial exudative changes that form the morphological basis of lung damage in COVID-19 were visualized as local, corresponding to the location and nature (sub-segmental, segmental, polysegmental) of the pathological focus, both T1-w and T2-w modes. MRI of the chest provided diagnosis of lung pathology in all cases, while the extent of the pathological focus on the MRI image in T2-w was 14–19% greater than on the CT. The correlation of the calculated volume of affected lung tissue between CT and MRI of the chest wasas high as r = 0.95 (p < 0.001). The values of the volume of the affected tissue in T1-w and T2-w did not differ from each other in the intergroup comparison and correlated strongly and reliably, r = 0.985 (p < 0.001). MRI in DWI mode showed a sensitivity of 81% (38/47) in detecting COVID-lung lesions. The duration of DWI in all cases was more than 6 minutes, more than twice as long as all other MRI protocols together. The volume of pleural effusion, clearly visible with T2-VI, in all our cases did not exceed 100 ml. In a prospective follow-up of 8 patients with COVID-19, chest MRI ptovided evidence-based visualization of the recovery process in all cases, with a decrease or complete regression of the exudation component.Conclusion. MRI of the chest with respiratory synchronization or with breath-holding can be used for early diagnosis of inflammatory lung lesions in COVID-viral pneumonia and for subsequent follow-up control, is not accompanied by radiation exposure and closely correlates with the results of chest CT recruited as a modern standard for the diagnosis of pneumonia.

The article presents the possibilities of the complex application of methods of radiation diagnostics: bone x-ray, dual-energy X-ray absorptiometry, computed tomography, positron emission tomography combined with computed tomography using fluorodeoxyglucose labeled with 18-fluorine (PET/CT with 18F-FDG) in a patient with multiple myeloma, which was treated in the amount of high-dose therapy with autologous transplantation of hematopoietic stem cells. The diagnosis was established immunohistochemically. The use of these methods allowed us to dynamically assess the pathological changes characteristic of multiple myeloma.

Purpose. To assess changes in the degree of pulmonary injury in patients with Sars-CoV-2 after extracorporeal hemocorrection methods (ECHCM).Material and methods. 27 patients with Sars-CoV-2 underwent 48 ECHCM procedures - plasma separation, nonselective cytosorption hemoperfusion, dialysis-filtration techniques. After arriving in the hospital all patients underwent MSCT of the chest organs. The examination was conducted according to the standard protocol of MSCT of the chest organs and reconstruction of soft and high-resolution on a Philips Ingenuity CT 64 multi- detector computed tomograph. The following scanning parameters were used for the standard protocol: 64 × 0.625 collimation, 1 mm reconstruction, 0.5 mm increment. The patient was lying on his back with his arms thrown back behind his head during the procedure. A scan area including the chest was planned by the plan scan. Assessment of the scans was carried out in the Diсom-images viewing module of medical hardware- software complex “ArchiMed” (Med-Ray. Russia, 2004). The percentage of lung parenchyma lesions as well as the severity (CT-1–4) were evaluated according to the recommendations “Radiation diagnosis of coronavirus disease (COVID-19): organization, methodology, interpretation of the results”. CT examinations were compared not earlier than 4 days before ECHCM and not later than 5 days after.Result. With isolated plasmaseparation, the “ground glass” zones passed into the consolidation zones, the total volume of the lesion decreased and the pneumatization increased. In isolated hemoperfusion the dynamics is multidirectional: there are more consolidation zones, less ground glass zones in general, the process is stabilized and the zones of lung tissue damage are reduced. With isolated hemodiafiltration, the consolidation zones decreased, the pneumatization of the lung tissue increased, and subsequently the volume of the lesion and the consolidation zones increased significantly. By combined procedures there are multidirectional dynamics.Conclusion. The effect of ECMGC use on the degree and volume of lung tissue damage in patients with Sars- CoV-2 was not revealed.

This article provides an overview of the main literature data of biochemical basics and the clinical application of positron emission tomography, one of the promising technologies of radiation imaging in oncology. In the current part we discuss in detail the biokinetics of radiopharmaceuticals used to visualize various groups of tumor cells receptors. These include angiogenesis markers - RGD peptides, ligands for somatostatin receptors, agents for sex hormone imaging, ligands for prostate-specific membrane antigen and to activating EGFR mutant kinase. It contains results of studies that were dedicated to search for optimal modifications of these radiopharmaceuticals to increase diagnostic efficiency, their comparative analysis is carried out, the results of their use in cancer research and development prospects in this industry are highlighted.

The purpose of this case report is to present a value of gadoxetic acid¬enhanced MRI in the detection of an early recurrent hepatocellular carcinoma in a patient with synchronous multiple malignant tumors. The specific indications of using liver-specific contrast agents were introduced.

Purpose. To study contrast enhancement patterns of hepatocellular carcinoma (HCC) in cases with portal thrombosis and without it.Materials and methods. 61 consecutive patients with HCC were included in the study and divided into two groups: 41 patient with portal vein thrombosis (main group) and 20 patients without thrombosis (control group). Each patient underwent a abdominal CE MDCT for the analysis of the lesion contrast enhancement.Results. The 1st – “classic” – contrast enhancement pattern with a peak at arterial phase was observed in 2 (5%) patients with HCC complicated by portal thrombosis and in 10 (50%) patients without thrombosis (p < 0.01). The 2nd – “hypervascular” pattern with a peak shifted in 60–120s after contrast agent administration and no wash out was observed in 14 (34%) patients in the main group and in 10 (50%) patients in the control group (p = 0.4). The 3rd pattern – inhomogeneous contrast enhancement of liver parenchyma in the territory of thrombosed vein without visible tumor was discovered in 17 (41%) cases (p < 0.01). The 4th pattern – peripheral enhancement in arterial and portal phase with insignificant central enhancement in delayed phase was visualized in 8 cases (20%, p = 0.072).Conclusion. Portal thrombosis, which complicates the course of HCC, significantly changes the patterns of tumor’s contrast enhancement. This should be taken into account when image analysis to avoid diagnostic errors.

This article provides a comparative review of two systems for standardized evaluation of the results of hybrid PET imaging with radiolabeled PSMA ligands – PROMISE and PSMA-RADS version 1.0. The principles of classification, nomenclature and evaluation algorithms, as well as recommendations for structuring research and conclusion protocols, highlighting the advantages and disadvantages of the proposed systems, are considered in detail.

Acute abdominal pain (AAP) is a clinical symptom complex that develops with injuries and acute surgical diseases of the abdominal organs. This condition is one of the most frequent causes of admission of patients to the hospital through the ambulance. Patients with AAP consist of a large and heterogeneous group at the same time due to the etiology and many variations of the clinical picture of this condition. The article presents the results of CT scan of the abdominal cavity and small pelvis in 5 patients with AAP admitted to the S.P. Botkin Moscow City Clinical Hospital emergency department during 2017–2018, without indication of the possible traumatic nature of the pathology. All patients underwent a primary surgeon examination and first-line medical imaging methods such as plane radiography and ultrasound. The selection criterion for inclusion in the search was the need for CT due to the lack of data obtained for diagnosis. Subsequently, the findings of the CT scan were compared with the final diagnosis in the electronic medical file of the patient concerned, to assess the contribution of CT data to the diagnostic process. In a group of 5 patients included in the study, the results of CT were the decisive step in the diagnostic process in 100% of cases. Therefore, the study emphasizes the importance of using CT in patients with AAP. Using this method allows you to complete a diagnostic search as soon as possible from the time the patient enters the hospital, to begin timely treatment.

Invagination is the process of introducing one part of the intestine into another, which is a type of acute intestinal obstruction. Most often occurs in infants. Diagnosis in adults causes difficulties, often the disease simulates the clinic of other diseases of the abdominal cavity (pancreatitis, appendicitis, etc.). Distinguish between different types of invagination of the intestine: the cecal intussusception, colonic intussusception, ileal-colonic intussusception, small bowel invagination. The diagnosis uses ultrasound, CT, X-ray examination. Treatment of intestinal invagination in adults is surgical in most cases. We present a case of iliac-colonic invagination in an adult male with acute abdomen.

The objective . Revelation of informative markers of qualitative analysis CEUS in the differential diagnosis of breast lesions, determination of effectiveness CEUS in the breast cancer examination. Materials and methods . The work is based on the results of a retrospective comparison ultrasound data with the histological results conducted in 145 women with breast lesions at the age of 17-71 years (average age was 45.5 years) from December 2017 until November 2018 year. Results. Statistical analysis of markers of qualitative assessment CEUS showed that more important markers in the differential diagnosis were - indicators of definition of the boundaries of lesion during CEUS (Se 79,27 Sp 63,41); the velocity of accumulation of contrast agent (Se 78,05 Sp 80,95); wash-out velocity from lesion (Se 68,29 Sp 95,24). Conclusion . Qualitative data analysis of CEUS provides to detail of breast lesions and surround tissues vascular architecture, improves differential diagnosis of breast tumors, which allows to reduce the number of additional methods of examination and biopsies, predict the volume of surgical and complex treatment.