Purpose. To assess the efficacy of MRI and MSCT in measuring the depth of invasion of tongue squamous cell carcinoma.

Materials and methods. A total of 53 patients (100%) with primary diagnosed and histologically confirmed squamous cell carcinoma (SCC) of the tongue were examined. All patients underwent contrast-enhanced MSCT and MRI. The correlation between the data obtained from MRI and MSCT and the clinical-histological data of SCC of the tongue was assessed in evaluating the depth of invasion.

Results. The results of MRI and MSCT in evaluating the depth of invasion of SCC of the tongue were analyzed for 53 patients, including 32 (60.4%) men and 21 (39.6%) women with a mean age of 52 ± 6 years. Contrast-enhanced MSCT showed a lesser depth of invasion compared to postoperative pathological examination (Me–9.7 mm and 10.5 mm, respectively, with an interquartile range (Q1–Q3) of 6.75–13 mm and 8.2–13.1 mm, respectively, p < 0.001), while MRI showed a greater depth of invasion compared to postoperative pathological examination (Me–11,9 mm and 10,5 mm, respectively, with an interquartile range (Q1–Q3) of 9.3–15.1 mm and 8.2–13.1 mm, respectively, p < 0.001). The correlation between the data from radiation methods and pathological examination was higher for MRI (r = 0.9749) compared to contrast-enhanced MSCT (r = 0.9341).

Discussion. A comparative analysis of the MSCT and MRI results revealed their significance in determining the depth of invasion of SCC of the tongue compared to postoperative histological examination data. Our study results demonstrated differences from those obtained by other authors, who primarily focused on contrast-enhanced MSCT as the preferred diagnostic method for this category of patients. Although the correlation coefficient for MSCT in our study was also high (r = 0.9341, p < 0.001), MRI showed higher diagnostic value in determining the extent of tumor spread (r = 0.9749, p < 0.001) compared to contrast-enhanced MSCT. MRI in evaluating the depth of invasion in SCC of the tongue demonstrated a higher result, complementing information about the extent of the tumor process and clarifying the stage of the disease, which is crucial for selecting the optimal treatment strategy.

Conclusion. Thus, in measuring the depth of invasion in SCC of the tongue, the sensitivity and specificity for MSCT were 85.7% and 90.9%, respectively, while for MRI, the sensitivity and specificity made up 93.3% and 88.9%, respectively, confirming the high efficacy of MRI in examination of the oropharyngeal area. 

Purpose. To compare the degree of skull bone deformation and brain perfusion parameters using computerized tomography and magnetic resonance imaging (MRI) in children with craniosynostosis before surgery.

Materials and methods. In the period from 2018 to 2024, we examined 51 children at the Almazov National Research Medical Center with various types of craniosynostosis. We used CT scans to assess the cranial sutures and degree of skull deformation by morphometric measurements, and MRI to evaluate the structural and perfusion parameters of the brain, supplemented by dynamic contrast-enhanced T2* MR perfusion. Statistical analysis was performed using the R programming language version 4.4.1.

Results. The study revealed characteristic morphometric and perfusion disorders in various types of craniosynostosis. The largest increase in the cephalic index was found in brachycephaly (118.0 ± 4.6%), and the smallest in sagittal synostosis (67.4 ± 10.4%). Significant cranial asymmetry was observed in patients with posterior plagiocephaly (12.4 ± 1.1%) and coronal synostosis (5.8 ± 4.8%). A decrease in the frontal angle was characteristic of trigonocphaly (91.6 ± 9.9), anterior plagiocephaly (93.2 ± 7.0) and sagittal synchosis (87.4 ± 9.1). In all groups, there was a decrease in cerebral blood flow velocity (rCBF: 66.8–82.1%), cerebral blood volume (rCBV:57.3–88.7), an increase in mean transit time (MTT:108–120.5) and time to peak (TTP:103.7–121.1). The most pronounced perfusion abnormalities were recorded in brachiocephalic and triangulocephalic.

Conclusion. Dynamic contrast MR perfusion can be a promising technique for assessing cerebral circulation in children with craniosynostosis. The use of this technique allows evaluating the main parameters of perfusion in the most compressed areas of the brain. The data obtained demonstrate the systemic effect of craniostenosis on cerebral hemodynamics, in the absence of a direct correlation between the degree of morphological and perfusion changes, this emphasizes the role of individual compensatory mechanisms. Further research on this technique could expand the diagnostic criteria for surgical treatment and serve as a tool for evaluating its effectiveness in postoperative stages. Dynamic contrast MR perfusion can become a tool for evaluating the effectiveness of surgical interventions performed in the early and late postoperative stages.

In recent years, an increasing number of publications have linked ischemic events to features of atherosclerotic plaque instability, drawing growing attention to the potential of noninvasive imaging modalities for detecting such features, including dual-energy computed tomography (DECT).

Objective: to assess the capabilities of dual-energy computed tomography angiography (DECT angiography) in identifying and differentiating components of carotid atherosclerotic plaques and to compare these findings with histological analysis.

Materials and Methods. The study comprised 30 patients admitted to the Almazov National Medical Research Centre (Ministry of Health of the Russian Federation) for planned carotid endarterectomy. All patients provided written informed consent to participate. Preoperative DECT angiography of the brachiocephalic arteries was performed. Resected plaques underwent histological analysis to morphologically identify key components: fibrous, lipid-rich necrotic core, hemorrhagic, and mixed. Correlation between DECT data and histological sections was conducted at corresponding regions of interest (ROI). Statistical analysis was performed using the Jamovi software package, employing analysis of variance (ANOVA) with Tukey’s post hoc test for intergroup comparisons.

Results. Histological examination identified 72 key plaque components: fibrous (n = 18), lipid-rich necrotic core (n = 28), intraplaque hemorrhage (n = 8) and mixed components (n = 18). Mean minimum Z-effective values were significantly higher in fibrous regions compared to lipid-necrotic cores (p < 0.001), hemorrhagic areas (p < 0.01), and mixed components (p < 0.05). A diagnostic threshold of minimum Z-effective ≥ 7.7 was established, enabling differentiation of stable fibrous components from lipid-rich necrotic cores, intraplaque hemorrhages and mixed components–features of plaque instability–with high sensitivity (85.2%) and specificity (88.9%). No statistically significant differences were found among the unstable plaque components.

Conclusions. Dual-energy CT angiography demonstrates high diagnostic value for the noninvasive differentiation of stable and unstable components of atherosclerotic plaques. Further studies with larger patient cohorts are suggested to refine threshold values and standardize the methodology.

Introduction. Differential diagnosis of pheochromocytoma from adrenal adenoma is extremely important at the stage of planning surgical intervention. In some cases, laboratory data and computed tomography (CT) are insufficient for making an accurate diagnosis. In our study, we aimed to evaluate the possibilities of magnetic resonance imaging in the diagnosis of adrenal pheochromocytoma.

Aim. Evaluation of the possibilities of using multiparametric magnetic resonance imaging in the differential diagnostic of adrenal pheochromocytoma.

Materials and Methods. The study included 69 patients with adrenal gland tumors who underwent surgery due to the clinically malignant potential of the tumor or its hormonal activity. All patients underwent multiparametric magnetic resonance imaging. During the postprocessing, the signal intensity of the adrenal gland tumors, signal intensity indices (including in comparison with the spleen and muscles) were evaluated in various series in order to assess the differences between these indicators in pheochromocytomas and other adrenal gland tumors.

Results. Pheochromocytomas are characterized by the following thresholds: signal intensity index on T2-weighted lesion compared to the muscles (T2 index) > 2.630: signal intensity index on dual-echo series (SI index) < 16.600, chemical shift index compared to the spleen (ASR) > 0.840.

Conclusions. Each of the studied parameters had a number of exceptions and limitations, therefore, the results of this study and the proposed thresholds are necessary for confirmation in future multicenter studies that could provide a more accurate differential diagnosis of adrenal gland tumors in clinical practice.

Digital radiography has solved the central problem of patient’s radiation exposure. In addition, due to the high sensitivity of digital detector, the quality of the images obtained has significantly increased. The combination of the characteristics made it possible to obtain a single image of the entire spine as routine task. Spine radiographs are made with the patient in an upright position, so this investigation has called “postural radiography”. The value of these images lies in the fact that, in addition to morphological features, they display the position of each vertebra, spine part, and a spine as a whole. It is widely used for the purpose of prognosis of orthopedic surgical interventions. The method of spine radiograph system analysis allows to register the data on a single examination protocol.

The purpose of this work was to demonstrate the possibilities of postural radiography and system analysis of spinal radiographs to study the morphological features and vertebra positions of all spine parts simultaneously.

In the last decade, much attention has been paid to the development of objective criteria for assessing the results of visualization studies in medicine, allowing to minimize diagnostic errors and facilitate the interaction of doctors of different specialties. To assess the condition of the lymph nodes, a scale for the stratification of ultrasound signs LN-RADS has been proposed.

Purpose: assessment of the reproducibility of the results of using the LN-RADS scale for stratification of ultrasound signs of lymph nodes and assessment of the consistency of decisions of ultrasound diagnostic doctors who used this classification.

Materials and methods. To assess an inter-rater agreement for LN-RADS scale, sixteen  experienced specialists in ultrasound independently assessed fifty ultrasound images of the lymphatic nodes with various benign and malignant changes.

Results. The inter-rater agreement in utilisation of the LN-RADS scale was moderate, reaching a significant level when assessing malignant changes in the lymph nodes.

Conclusions. The LN-RADS stratification system allows for the detection of malignant changes with fairly good reproducibility, which is especially important from a diagnostic point of view.

Axillary mapping and assessment of axillary lymph node status remains a key staging issue for determining treatment strategies and algorithms for patients with invasive breast cancer. Various ultrasound techniques (elastography, color Doppler, and SMI) are used to improve diagnostic accuracy. In recent years, ultrasound contrast agents have been widely adopted, increasing the diagnostic capabilities of ultrasound.

The aim: to evaluate the diagnostic efficiency of CEUS and multiparametric ultrasound with the inclusion of the ultrasound contrast technique in preoperative detection and prediction of metastases in the SLN.

Materials and methods. This study included a comprehensive analysis of data from 120 up-front patients with invasive breast cancer to evaluate the diagnostic value of qualitative (contrast patterns), quantitative, combined and multiparametric (combined CEUS parameters + B-mode) models.

Results. Axillary lymph node metastases were detected in 29.2% of cases; the proportion of pN+ patients increased from patterns I–II to IV–V (up to 71–100%; p<0.001); combining patterns III–VI versus I–II yielded an OR of 6.0. B-mode showed a leading role in predicting metastasis based on cortical thickening of more than 3 mm (p < 0.001; AUC 0.84), transverse size and blood flow type in the color Doppler imaging mode had moderate information content (p = 0.02 and p = 0.077, respectively). Integration of features improved accuracy: combined model – AUC 0.686, sensitivity – 60%, specificity – 81.2%, and multiparametric (combined with the addition of B-mode and color Doppler imaging) – the highest values (AUC 0.78; sensitivity 65.8%, specificity 80%).

Conclusion. Intradermal paraareolar ultrasound injection of contrast agent provides a high rate of lymph node (SLN) identification and predict the status and metastatic burden of axillary lymph nodes. Multiparametric ultrasound, combining B-mode, color Doppler, and CEUS improves the diagnostic accuracy of axillary staging in patients with breast cancer.

Abstract. Diabetes mellitus (DM) during pregnancy is associated with an increased risk of complications for both the mother and the fetus, and may also have adverse long-term consequences for the newborn. The incidence of DM among pregnant women is steadily increasing, which emphasizes the relevance of this problem. Despite progress in diagnostic methods and glucose control in pregnant women with DM, complications during pregnancy remain common, occurring in 80% of women with this disease.

Objective: to study the clinical, laboratory and ultrasound features of patients with gestational diabetes mellitus to determine the risk factors for the development of this pregnancy complication.

Materials and methods. The study included 86 patients and their newborns, who were divided into two groups according to pregnancy outcomes. Group I (main) – 43 women whose pregnancy was complicated by the development of diabetic fetopathy, Group II (control) – 43 patients whose pregnancy ended with the birth of a live full-term baby without signs of diabetic fetopathy.

Results. The following features were identified in the group of women with gestational diabetes mellitus: obesity (53% vs 11%), chronic arterial hypertension (11% vs 2%), thyroid disease (13% vs 4%) (p < 0.05). The presence of obesity increases the chance of developing gestational diabetes mellitus by 8.7 times (OR = 8.7; 95% CI: 2.885–26.478; p = 0.001). Laboratory parameters demonstrated an increase in cholesterol levels (p = 0.04), while no differences in glucose and glycated hemoglobin levels were found between the groups. Ultrasound parameters of the fetus revealed significant differences between the groups: abdominal circumference exceeded the 75th percentile (p = 0.001), double contour of the head was observed (p = 0.044), subcutaneous fat thickness of the neck exceeded 0.32 cm (p = 0.014), and subcutaneous fat thickness of the chest and abdomen exceeded 0.5 cm (p = 0.007). In the control group, with a fetal weight of more than 3000 g, the subcutaneous fat thickness of the neck was more than 0,3 cm, while in the main group it was 0,35 cm, which indicates the need to revise the threshold values in order to increase the prognostic value of the current sign. Statistically significant differences in uteroplacental and fetal-placental blood flow between the groups were not found. Anthropometric parameters of newborns, such as height and weight, also did not show significant differences between the groups. In the main group, periventricular edema was more often recorded (p = 0.02), and laboratory parameters in newborns indicated a significant increase in the frequency of hypoglycemia (p = 0.0002).

Conclusion. The study revealed significant features in women with gestational diabetes mellitus, including an increased risk of comorbidities such as obesity and chronic arterial hypertension, which emphasizes the importance of careful monitoring of the health of pregnant women and regular ultrasound examinations to assess the condition of the fetus. Ultrasound parameters showed changes that require further study and possible revision of existing standards. In addition, due to the lack of significant differences in glucose and glycated hemoglobin levels, it is necessary to analyze glucose variability using a continuous monitoring system, which will provide more accurate glycemic control in patients and have a positive effect on their health. Key words: ultrasound diagnostics, diabetic fetopathy, metabolic disorders, obesity, gestational diabetes mellitus, pregnancy risks, perinatal outcomes, maternal diseases.

Objective. To evaluate the echographic characteristics of the normal sciatic nerves structural organization at autopsy. To compare echographic and morphological features. To determine the echographic picture of intact sciatic nerves, which can be used as a standard for assessing the damaged nerves condition.

Materials and methods. The results of ultrasound of 4 sciatic nerves at autopsy were analyzed. The anatomical integrity of the nerves was not violated. No pathology of the sciatic nerves was detected during life. The cause of patients death was cardiovascular diseases.

The condition of all sciatic nerves was assessed using the ultrasound during autopsy by installing an ultrasound sensor directly on the nerve fiber along the back of the thigh after the pathologist had accessed the nerve. Then, material was collected for morphology of the nerve trunks. Postoperative material was delivered for histology in accordance with the rules of laboratory practice.

Results: Ultrasound of the sciatic nerves at autopsy is effective for detailed assessment of the echostructure of intact peripheral nerves.

Discussion. Echographic characteristics of intact peripheral nerves have been revealed, allowing them to be used as controls for intraoperative ultrasound examination of damaged peripheral nerves.

Conclusion. The study of the echographic structure of sciatic nerves during autopsy yielded the following results.

For a detailed assessment of the echostructure of peripheral nerves, it is necessary to use a gel layer, which allows shifting the focus of the ultrasound beam directly to the nerve fiber and makes it possible to examine the structure of the nerve in detail during autopsy.

During autopsy, sciatic nerves in cross section are rounded or oval formations with an ordered fascicular structure. In longitudinal section, they are strands with regular alternation of hypo- and hyperechoic zones, which reflects the morphological structure and ordered fascicular structure of nerve fibers. When performing intraoperative ultrasound examinations, the echographic image of intact sciatic nerves obtained during autopsy can be used as a standard for comparing the normal echostructure of the nerve with its altered analogue.

Purpose of the study: to improve the reliability of prediction of lymphovascular invasion (LVI) by hybrid morpho-radiomic naive Bayesian models in patients with malignant breast cancer (MBC) by elucidating the role of morphologic magnetic resonance (m-MR) features.

Materials and Methods. Data from 191 patients with MBC were analyzed in the form of 13 m-MR features, 6194 radiomic MR (r-MR) indicators of the whole tumor volume, and the target feature, LVI. Among the m-MR features, predictors of LVI were selected using crosstabulation, multivariate logistic regression, and Entropy-MDL discretization. Among 6194 r-MR indicators, predictors of LVI were selected by Entropy-MDL discretization. The selected indicators were used in training the naive Bayes algorithm. The performance of LVI predictors was compared.

Results. According to multivariate logistic regression, the odds of LVI increased when tumor rim feature was detected on DWI image 4.05-fold (OR 4.05, 95%CI: 1.63–10.47, p = 0.003), peritumoral edema 5.66-fold (OR 5.66, 95%CI: 2.27–14.94, p < 0.001). 3 hybrid models with high discriminatory abilities were obtained: 1 model with DWI rim and radiomic signature from 4 p-MR indicators (AUC = 0.886, sensitivity – 89.5%, specificity – 79.1%, classification correctness – 89.5%, correctness of prediction of LVI – 73.3% and its absence – 95.2%), 2 model with peritumoral edema and radiomic signature from 6 p-MR indicators (AUC = 0.879, sensitivity – 82.5%, specificity – 80,9%, classification correctness – 82.5%, correctness in predicting LVI – 80.0% and its absence – 83.3%) and 3 models with peritumoral edema, rim DWI sign and radiomic signature from 8 p-MR indicators (AUS = 0.957, sensitivity – 96.5%, specificity – 90.2%, classification correctness – 96.5%, correctness in predicting LVI – 86.7% and its absence – 100%). Removing the DWI rim feature from 1 model worsens its discriminatory power (AUC-ROC, 0.801 ± 0.074 vs 0.886 ± 0.059, p = 0.001) and correctness of LVI prediction (40 vs 73%, p = 0.066). Similar but less pronounced, non-statistically significant changes were observed after removal of the peritumoral edema feature from the 2 models (AUC-ROC, 0.843 ± 0.067 vs 0.879 ± 0.060, p = 0.190; LVI prediction correctness, 60 vs 80%, p = 0.232). Removing 2 m-MR features from the 3 model worsens its discriminatory power (AUC-ROC, 0.957 ± 0.038 vs 0.901 ± 0.055, p = 0.024) and correctness of LVI prediction (80 vs 86.7%, p = 0.624).

Conclusion. The use of hybrid models combining m-MR traits and r-MR indices improve the discriminatory power of prediction compared to models using only intratumoral r-MR indices.