The purpose of the study. Study of the possibilities of ultrasound examinations (ultrasound) in assessing the blood supply of the nasal cavity in comparison with the parameters of hemodynamic parameters of the carotid arteries.

Material and methods. Ultrasound of the nasal septum (NS) and the Kisselbach–Little area (plexus) was performed in 98 patients (57 women and 41 men aged 18 to 55 years). Of these, 30 patients (18 women and 12 men) in the control group, 68 patients (39 women and 29 men) of the study group after interventions on the NS – septoplasty for perforations (56 patients) and curvatures of the NS (12 patients). Ultrasound scans were performed before and after plastic surgery on the NS. The studies were carried out on high-level and expert-level ultrasound devices, linear transducers with a frequency of 3–20 MHz, in B-mode and duplex scanning mode. The hemodynamic parameters of the carotid arteries were compared with the maximum indicators of the artery in the Kisselbach–Little area (AKA) and their relationship was studied.

Results. The relationship between the parameters of blood flow of the external carotid artery (ECA) and the internal carotid artery (ICA) with the AKA was studied. The analysis of correlations between the parameters of blood flow in the ECA and the AKA did not reveal any significant dependencies. The RI values also did not correlate with the velocity characteristics. There was no correlation between the velocity characteristics of blood flow in the ICA and the AKA. A correlation of the average strength between the values of RI in the AKA and V_max in the ICA was found (r = 0.430; p = 0.05). In the control group, the range of maximum blood flow velocity in the AKA was 15–35 cm/s, RI was from 0.5 to 0.59 units. A decrease in V_max less than 15 cm/s and an increase in Ri greater than 0.59 units are significantly associated with an increased risk of necrosis of the displaced endonasal flap and NS mucosa in the area of intervention.

Conclusion. No significant dependencies between the parameters of carotid artery blood flow and the AKA were revealed. In terms of predicting the survival rate of displaced endonasal flaps from the overlying parts during plastic surgery of the perforated opening of the NS and during septoplasty for NS curvatures, the parameters of the blood flow of the AKA are more important. The parameters of the blood flow of the AKA reflect the state of the arterial vessels of the overlying parts of the nasal cavity. 

Purpose. The purpose of this study is to compare the values obtained from echocardiography (echoCG) and computed tomography angiography (CTA) for measuring the end-diastolic volume (EDV) of the right ventricle (RV) and its ejection fraction (EF). This comparison will be done using 3D modeling of the heart chambers.

Materials and Methods. A retrospective analysis of CTA and echoCG data will be performed on 12 patients diagnosed with pulmonary artery atresia and an intact interventricular septum. These patients have been undergoing treatment from January 2014 to March 2025, and their data from various stages of correction for congenital heart disease will be included in the analysis.

Results. According to the results of 3D modeling based on CTA, the average end-diastolic volume of the right ventricle was 9.9 [2.7–12.9] ml, the end-systolic volume was 4.7 [1.7–6.6] ml, and the ejection fraction was 42 [18–70]%. When comparing the results of the 3D modeling with EchoCG data, there was a discrepancy in volumetric measurements and functional analysis. However, when comparing EDV of the right ventricle based on CTA with its linear measurements based on EchoCG, a strong correlation was found, with r = 0.86 for end-diastolic size in the basal region, r = 0.84 in the middle region, and r = 0.80 along the long axis. Additionally, when comparing the ejection fraction calculated from CT data with the fraction of change in area of the right ventricle, a moderate positive correlation of r = 0.31 was observed.

Conclusion. The use of 3D modeling and 3D printing for children with pulmonary artery atresia and intact interventricular septum allows for personalized planning of surgical interventions on the heart, enabling a more accurate analysis of the anatomical features of the defect and more precise assessment of end-diastolic volumes and ventricular ejection fractions during patient follow-up.

Objective. Testing the hypothesis about the possibility of using shear wave ultrasound elastography to assess the instability of atherosclerotic plaque in the carotid artery.

Material and methods. Twenty-six patients aged 69.1 ± 6.1 years with carotid artery stenosis were examined using Duplex (DS) on a Samsung V7 scanner. SWE of the atherosclerotic plaque was performed with a linear LA2-14A probe. Multiple circular regions of interest (ROI) of different sizes were used to maximize plaque capture. After carotid endarterectomy (CEA), histological examination of hematoxylin-stained atherosclerotic plaques was performed. Analysis of variance (ANOVA) was used.

Results. Young's modulus (E) of carotid atherosclerotic plaques was associated with the degree of ICA stenosis, the presence of a lipid-rich necrotic core (LRNC) in the plaque and the ultrasound characterization of the Geroulakos plaque type. The median value of the plaque stiffness index (E, IQR) were associated with the histological assessment of the thickness of the fibrous cap.

Conclusion. SWE can be used and is promising for the quantitative assessment of instability of carotid atherosclerotic plaques.

Objective. To specify the role of computed tomography (CT) in complex diagnostic of the acquired type of TracheoEsophageal Fistulas (TEFs).

Methods. CT results of 36 (17 men, 19 women, mean age – 53 ± 18) consecutive patients with TEF, presented to N.V. Sklifosovsky Research Institute of Emergency Medicine, were analyzed retrospectively. Multiple screening CT-scans were held in 23 patients (64%) throughout the treatment process.

Results. The sensibility of CT was as high as 92 % with correctly depicted TEFs in 33 of 36 patients. CT imaging demonstrated precise and accurate assessment of TEFs: localization, diameter and length of tracheal defect, type and length of fistulous tract. In 6 observations (18%) the TEF was associated with tracheal stenosis.

In patients with non-traumatic TEFs (n = 10; 30%) CT was of use not only in delineating fistulous tract, but also in detecting possible etiologies, such as esophageal cancer or inflammatory lesions of the mediastinum.

The results of adjacent soft tissues assessment showed various stages of pulmonary inflammation in the majority of patients (n = 25; 69%).

Multiple CT examinations were performed to monitor fistulas, surrounding soft tissues, including evaluation of lung and mediastinal inflammatory changes, and effectiveness of surgical management.

Conclusion. CT is an integral aspect of complex diagnostic in patients with TEFs, that allows to detect fistulas (92% sensitivity) along with the detailed anatomical information upon them. One of the major advantages of the modality is the ability to visualize surrounding structures. Preoperative CT is particularly helpful in deciding the surgical approach, and multiple CT benefits in validation of treatment efficacy.

Aim: to determine the diagnostic role of lung tissue density maps in acute lung injury (ALI) in the assessment of Post-Intensive Care Syndrome (PICS) in patients in the intensive care unit.

Materials and Methods. 129 patients who were in inpatient and outpatient treatment with suspected risk of development and presence of acute lung injury (ALI) of primary and secondary origin were examined. The patients were observed from 2023 to 2026: they were hospitalized in the Clinical Hospital No. 1 (August 2023 – August 2024), and subsequently (September 2024 – August 2026) they were observed on an outpatient basis. All patients underwent computed tomography (CT) with additional assessment of lung tissue density maps

Study results. Based on patient follow-up data, PICS developed within 12 months in 89 (68.9%) of 129 patients. It was established that 24 (26.9%) of the 89 patients (patients with a “red pattern” based on lung tissue density maps) had PICS that developed within 12 months. Based on patients follow-up data over 24 months, signs of chronic disorders that can manifest as a consequence of critical  condition, i.e., PICS, were assessed in both the study group (n = 89) and the group of patients who did not undergo lung tissue density maps assessment (n = 57). In 21 (23.5%) cases of PICS in the main group, it occurred in isolation, while in the comparison group, the number of isolated cases was 40 (70.1%).

Conclusions.

1. Lung tissue density maps in acute lung injury have important diagnostic value in predicting and assessing PICS in ALI.
2. Patients follow-up period has shown that PICS develops within 12 months in patients with a history of ALI.
3. Diagnostic criteria of lung tissue density maps in PICS are: qualitative characteristic – “red pattern”, quantitative – more than 14%.
4. Diagnostic and prognostic role of lung tissue density map in assessing PICS (AUCROC 0.959, CI 0.914–0.986) and chest CT (AUCROC 0.793, CI 0.623–0.801) (n = 89).

Study objective: Determination of optimal parameters of ultrasound scanning of urinary stones for effective visualization of Doppler twinkling artifact.

Materials and Methods: A search of modern literature (from 2015 to 2025) devoted to the influence of ultrasound scanner settings on twinkling artifact visualization in Russian and English was conducted in the scientific databases Pubmed, Scopus and Elibrary.

The influence of scanning parameters on the intensity of Doppler twinkling artifact visualization studied using a specially designed phantom, in which a calcium oxalate urinary stone with a diameter of 5 mm placed.

The study performed on the following ultrasound machines: Philips Affinity 70, ALOKA ProSound F75, Canon Aplio i700, Siemens ACUSON NX3 Elite, GE Healthcare LOGIQ E9, Mindray DC-60 Pro X-Insight using a convex abdominal probe in Doppler mapping mode.

The following ultrasound parameters were determined: Transmitter power, Color Doppler reference frequency, B-mode probe frequency, Focal length, Color window width, Harmonic, Pulse repetition frequency, Multibeam scanning, Color-write priority, Doppler signal gain (C-gain), B-mode gain (B-gain), Tissue harmonic mode, Interframe averaging, Color mapping averaging, Flash suppression, and Vessel wall oscillation filter.

Results. The paper analyzes settings such as ultrasound frequency, signal gain level, and time setting parameters, clearly demonstrating how these factors affect image clarity and diagnostic accuracy. The following ultrasound scanner settings have been determined to increase twinkling artifact visualization efficiency: increasing the transmitter power to maximum; decreasing the color Doppler reference frequency; setting the focal zone below the object location depth; decreasing the color window width and increasing the pulse repetition rate. The influence of software solutions aimed at artifact suppression can be reduced by setting the priority to the color value; disabling flash suppression; increasing the wall filter values; disabling flash suppression and tissue harmonics.

Conclusions. Optimization of ultrasound scanning parameters can significantly increase the efficiency of twinkling artifact detection in urinary stones.

In this article we describe a rare clinical case of rupture of hepatic echinococcal cyst into the pleural cavity. Direct rupture of a hydatid cyst, resulting in a communication with the pleural cavity, is one of the rarest complications of this disease.

Material and method. A 59-year-old female patient sought help with complaints of heaviness, aching pain in the right hypochondrium and right half of the chest for six months. The patient underwent a comprehensive preoperative examination, including an ultrasound examination of the abdominal and pleural cavities, computed tomography and magnetic resonance imaging of the chest and abdominal cavity.

Description of a clinical case. Diagnostic studies revealed a large mass in the right lobe of the liver with evidence of communication with the right pleural cavity through a diaphragmatic defect. Its structure was heterogeneous; attention was drawn to the uneven ribbon-like accumulation of the contrast agent in the central part with decrease in density along the periphery.

The patient's serological tests for echinococcosis were negative, and cytological examination of the pleural contents revealed reactive exudate. The patient underwent surgery, and intraoperative confirmation of a ruptured echinococcal cyst and a cystobiliary fistula were also identified.

Conclusion. Echinococcosis remains a severe public health problem despite advances in modern medicine. The disease can present without obvious symptoms or specific manifestations, highlighting the importance of diagnostic methods for accurate diagnosis.

Objective. The lack of standardized protocols and reference values for quantitative parameters in contrast-enhanced ultrasound (CEUS) of stable functioning renal transplants limits its clinical application. This study aimed to analyze CEUS quantitative parameters in recipients with stable graft function and no significant pathology on protocol biopsy, as well as to assess inter-operator reproducibility.

Materials and Methods. An interventional prospective study was conducted (October 1, 2024 – March 1, 2025). 23 patients were enrolled. CEUS was performed by Resona 7 system (Mindray, China) with a convex probe (1.2–6 MHz) and SonoVue contrast agent (Bracco, Italy). Time-intensity curve (TIC) parameters were analyzed in: ROI₁ (region of interest): cortex, ROI₂: cortex between pyramids (renal columns), ROI₃: pyramids, ROI₄: combined ROI₁+ROI₂+ROI3. Parameters assessed: Ascending Slope (AS), Arrival Time (AT), Area Under the TIC Curve (AUC), Descending Slope (DS), mean TIC intensity (mTIC), Peak Intensity (PI), Rise Time (RT), Time-to-Peak (TTP), Wash-in Area Under the Curve (WiAUC), Perfusion Index (WiAUC/RT), Wash-out AUC (WoAUC). Analysis was performed using Contrast QA software (Mindray). Inter-operator reproducibility was evaluated via intraclass correlation coefficients (ICC) and Bland-Altman analysis (mean difference, limits of agreement).

Results. Mean TIC parameters (averaged between operators) were obtained for all ROIs. ROI₁: excellent/good reproducibility for most parameters; moderate reproducibility for AS and DS (ICC 0.840 [0.662; 0.928] and 0.859 [0.697; 0.938]). ROI₂: Excellent to good reproducibility; moderate for WiAUC (0.848 [0.678; 0.933]), RT (0.877 [0.733; 0.946]), WiAUC/RT (0.835 [0.628; 0.929]), AS (0.836 [0.653; 0.927]), and DS (0.777 [0.537; 0.899]). ROI₃: Higher variability for WiAUC/RT (0.706 [0.418; 0.864]), AS (0.657 [0.351; 0.838]), and DS (0.752 [0.497; 0.887]). ROI₄: Results comparable to ROI₁.

Conclusion. This study is a crucial step toward standardizing CEUS for renal transplants. It establishes the first quantitative CEUS benchmarks for stable allografts without significant pathology on protocol biopsy. The low inter-operator variability supports the clinical feasibility of using absolute TIC parameters (comparison of normal vs dysfunctional grafts) across different ultrasound systems.

Aim. To systematize data on errors in the pelvic radiology.

Methods. We searched for scientific publications in the information and analytical systems PubMed, e-library, Google Scholar over the past 15 years, using the keywords: “radiology errors in the pelvis imaging”, “diagnostic errors in pelvic radiology”, “bias in radiology”, “pitfalls in radiology”, “radiology mistakes”, “pearls in radiology”.

Results. 36 articles dealing with errors in the pelvic radiology at various stages of examination were analyzed. The results of the analysis – the stages of the pelvic examination were highlighted and the main errors in each of them were listed.

Conclusion. Errors and the prerequisites for their occurrence in the pelvic imaging can occur at different stages of the diagnostic process. Radiologists, clinicians, and technicians need to be aware of the specifics of errors at each stage of the study in order to minimize the risk of their occurrence and mitigate the consequences.

Objective: To summarize current knowledge on the physical nature of reverberation artifact and its impact on the quality of uterine and endometrial ultrasound imaging, including possible effects on three-dimensional power Doppler indices (VI, FI, VFI).

Materials and methods. An analytical review of 85 publications in the PubMed, Scopus and eLibrary databases for 1982–2025, devoted to ultrasound imaging artifacts, reverberation physics and the use of 3D Power Doppler for endometrial assessment.

Results. Reverberation artifact results from multiple reflections of ultrasound waves between acoustically dense interfaces, producing a series of parallel echoes distal to the true structure. In B-mode, it may mimic endometrial thickening or intracavitary lesions; in color or power Doppler imaging, it can generate false flow signals. No direct quantitative studies evaluating the effect of reverberation on VI, FI, VFI were identified. However, theoretically, reverberation may lead to overestimation of VI and VFI due to the appearance of spurious color voxels.

Conclusion. Reverberation should be regarded not only as a source of diagnostic error but also as a potential diagnostic clue. Understanding its mechanisms, optimizing Doppler settings, and standardizing 3D Power Doppler protocols improve the accuracy of morphological and hemodynamic assessment of the uterus and endometrium. Further quantitative studies are warranted to determine the degree of artifact influence on vascular indices.

Purpose. To study the diagnostic accuracy of software based on artificial intelligence technologies for the diagnosis of maxillary and frontal sinusitis (J01, J32) when used in practical healthcare.

Materials and methods. Prospective diagnostic study (10.2023–12.2024) using the STARD 2015 methodology. The Index Test is four anonymized AI services for analyzing the X-ray imaging of the paranasal sinuses, integrated into Unified Radiological Information Service (ERIS) as part of the Moscow Experiment. The Reference Standard is an original methodology of clinical monitoring with a double expert review, an assessment of accuracy according to the criteria of “interpretation” and “localization”, calculation of sensitivity, specificity and AUC. After testing in the ERIS circuit, the AI services worked with real data and underwent monthly clinical monitoring.

Results. From October 2023 to December 2024, AI services analyzed 126,547 radiographs of the paranasal sinuses, of which 53% were processed by AI service-4. The scope of the research varied due to the different duration of the services.

Regular clinical monitoring covered 2,320 radiographs. The correctness of pathology detection, the accuracy of its classification and localization were evaluated. The highest diagnostic accuracy was found in AI services-1 and 2 (AUC 0.98 and 0.95; integral score – 95.1% and 83.3%). They demonstrated high specificity and precise localization of pathologies.

AI services-3 and 4 demonstrated comparatively lower results (AUC 0.89; integral score – 76.6% and 79.4%), with lower specificity for AI service-3 (0.65).

Conclusions. As part of the Moscow Experiment, AI services successfully analyzed 126,547 radiographs of the paranasal sinuses (2023–2024), showing an average level of accuracy (AUC 0.93) and quality (83.6%). The results obtained confirm the applicability of AI in clinical practice.

Differences in accuracy between services require regular monitoring of safety and quality. The developed methodologies make it possible to effectively carry out such control. The achieved level of quality opens prospects for the transformation of the interaction of doctors of different specialties, which will be the topic of future research.

Degenerative spinal diseases are a major medical problem and a common cause of chronic pain, reduced quality of life, and loss of work capacity. Modern treatment approaches, including conservative methods and surgical interventions, do not always demonstrate sufficient clinical efficacy, highlighting the need for improved diagnostic capabilities.

Magnetic resonance imaging is the primary modality for visualizing spinal pathologies, providing a detailed assessment of structures, including intervertebral discs, the spinal cord, and surrounding tissues. However, routine MRI diagnostics face significant methodological challenges, such as the need to perform numerous standardized measurements. The integration of artificial intelligence into radiology offers a solution to these problems: algorithms can automate image processing, speeding up analysis and enhancing diagnostic accuracy.

Objective: To evaluate the diagnostic accuracy of automated detection of degenerative changes in the lumbosacral spine using AI-assisted MRI.

Materials and Methods. A retrospective diagnostic study was conducted, comprising 100 examinations. Artificial intelligence services (hereinafter referred to as AI service 1, AI-2, AI-3) integrated into the Unified Radiological Information System (URIS) of the Moscow Unified Medical Information and Analytical System (EMIAS) were used as the index test.

A test dataset was prepared by three experts based on MRI scans of the lumbosacral spine (T2 sagittal, T2 axial, 4 mm slice thickness). Inclusion criteria were patients aged 18–90 years without artifacts or comorbid pathologies. The evaluation of the AI services involved analyzing degenerative changes: dorsal intervertebral disc protrusions; measurements (anteroposterior diameter of the dural sac on axial and sagittal images, transverse diameter of the dural sac on axial images); and the cross-sectional area of the dural sac.

Conclusion. Calibration testing confirmed the importance of evaluating the effectiveness of AI services in medicine. AI-1 and AI-3 demonstrated high reliability (AUC >0.95), making them suitable for clinical use. AI-2 requires refinement, as its performance metrics were significantly lower than claimed and further declined in external validation, limiting its practical application.