Ultrasound of Acute Appendicitis in the Admission Room of a Multidisciplinary Surgical Hospital

Ultrasound (US) for diagnosing acute appendicitis (AA) and its complications in the admission room may be used as a primary diagnostic method in urgent patients. A total of 180 adult patients underwent US for suspected appendicitis; these results showed high possibilities in pathology screening and differential diagnosis from similar clinical diseases. The accuracy of US in detecting AA with obvious clinical findings and typical position is 100%, but in retrocecal and retroperitoneal forms, it decreases to 84%. With our algorithm of the right iliac and localized pain regions, US scanning optimizes the screening of patients with suspected AA presented in the admission room

The Imaging of Legg-Calve-Perthes Disease

Diagnosis of hip joint pathology remains a serious problem in childhood and adolescence. A wide range of pathologies—including dysplastic, dystrophic, inflammatory, oncological and post-traumatic diseases of the musculoskeletal system—leads to the advancement of imaging methods and techniques. Legg-Calve-Perthes disease (LCPD) is a common cause of hip pain in children that may be initially clinically and radiographically difficult to diagnose Radiography of the pelvis in two views (anteroposterior and Lauenstein) is the main method of diagnosing aseptic necrosis. Destructive changes of the femoral head and neck of the femur are clearly determined. However, the presence of X-ray negative patterns at the first stage of the disease and the impossibility of visualizing all the anatomical structures induce us to improve the diagnostic algorithm of this difficult pathological process

ИССЛЕДОВАНИЕ ПЕРИФЕРИЧЕСКИХ ЛИМФАТИЧЕСКИХ УЗЛОВ ПРИ ОНКОЛОГИЧЕСКИХ ЗАБОЛЕВАНИЯХ ГОЛОВЫ И ШЕИ С ИСПОЛЬЗОВАНИЕМ ЭЛАСТОГРАФИИ СДВИГОВОЙ ВОЛНОЙ

Between December and September 2018 123 patients with head and neck tumors underwent ultrasound examination. The median age of the patients was 57 years (range 19–76 years). Metastatic lymph nodes were suspected in all patients. A fine needle aspiration biopsy was performed prior to treatment. Aplio 500 (Тoshiba, Japan) ultrasound device was used. According to findings of cytological examination, all patients were divided into 2 groups. Group I consisted of 58 patients with cytologically confirmed metastatic lymph nodes. Group II comprised 65 patients with lymphoid reticular hyperplasia. The values of Young’s modulus for metastatic lymph nodes were: median – 134.2 kPa, 2.5–97.5 percentiles – 7.3–181.7 kPa. The corresponding values for hyperplastic lymph nodes were: 20.1 kPa, 6.9–138.3 kPa. Thus, significant differences in the values of Young’s modulus between metastatic and hyperplastic lymph nodes were detected in patients with head and neck cancer (p<0.001). The best diagnostic values for detecting metastatic lymph nodes in patients with head and neck cancer were achieved with a threshold value of the Young’s modulus of 33.2 kPa (sensitivity – 89.7 %, specificity – 84.6 %), AU C – 0.899. The values of the Young’s modulus in the metastatic lymph nodes did not depend on the primary tumor and on the localization of the lymph nodes studied (submandibular, paratracheal, cervical, supraclavicular groups).С декабря по сентябрь 2018 г. проведены ультразвуковые исследования 123 пациентам с опухолями головы и шеи в возрасте 19–76 лет (медиана – 57 лет). У всех пациентов заподозрены метастатические изменения в лимфоузлах различной локализации. В каждом случае была выполнена тонкоигольная аспирационная биопсия до начала лечения. Исследования проводились на аппарате Aplio 500 (Тoshiba, Япония) линейным датчиком 7–18 МГц. По данным цитологического исследования пункционного материала пациенты были разделены на две группы. Первую группу составили 58 человек с цитологически подтвержденным метастатическим поражением лимфатических узлов. Во вторую группу вошли 65 пациентов, у которых выявлена гиперплазия лимфоидно-ретикулярной ткани. Значения модуля Юнга для метастатически измененных лимфоузлов составили: медиана – 134,2 кПа, 2,5–97,5 процентили – 7,3–181,7 кПа, для гиперплазированных лимфатических узлов: 20,1 кПа, 6,9–138,3 кПа соответственно. Таким образом, выявлены значимые различия в значениях модуля Юнга между метастатически измененными и гиперплазированными лимфатическими узлами у пациентов со злокачественными опухолями органов головы и шеи (р<0,001). Наилучшие показатели диагностической информативности для выявления метастатического поражения исследуемых лимфоузлов при опухолях органов головы и шеи достигнуты при пороговом значении модуля Юнга 33,2 кПа (чувствительность – 89,7 %, специфичность – 84,6 %), AU C – 0,899. При этом показатели значений модуля Юнга в метастатических узлах не зависели от первичной опухоли и от локализации лимфатических узлов (подчелюстные, паратрахеальные, шейные, надключичные группы).

Dependence of quality on the completed standard x-ray dental installations on the diagnostic process

The article is devoted to determining the dependence of the quality of performance by an x-ray laboratory technician and, especially, by the dental assistant, of standard x-ray dental laying on the process of examining teeth and jaws. A retrospective analysis of 900 intraoral radiographs, orthopantomograms, enlarged panoramic radiographs in direct projection (analog and digital, performed in various medical facilities) of patients in the age group of 18-85 years was performed. The most signfTcant methodological errors of the paramedical staff (especially dental assistants) of the X-ray room were determined, which lead to the appointment of a re-examination, the implementation of additional projections, auxiliary visualization techniques and an increase in the number of false-negative results

EXAMINATION OF PERIPHERAL LYMPH NODES USING SHEAR WAVE ELASTOGRAPHY IN PATIENTS WITH HEAD AND NECK CANCER

Between December and September 2018 123 patients with head and neck tumors underwent ultrasound examination. The median age of the patients was 57 years (range 19–76 years). Metastatic lymph nodes were suspected in all patients. A fine needle aspiration biopsy was performed prior to treatment. Aplio 500 (Тoshiba, Japan) ultrasound device was used. According to findings of cytological examination, all patients were divided into 2 groups. Group I consisted of 58 patients with cytologically confirmed metastatic lymph nodes. Group II comprised 65 patients with lymphoid reticular hyperplasia. The values of Young’s modulus for metastatic lymph nodes were: median – 134.2 kPa, 2.5–97.5 percentiles – 7.3–181.7 kPa. The corresponding values for hyperplastic lymph nodes were: 20.1 kPa, 6.9–138.3 kPa. Thus, significant differences in the values of Young’s modulus between metastatic and hyperplastic lymph nodes were detected in patients with head and neck cancer (p<0.001). The best diagnostic values for detecting metastatic lymph nodes in patients with head and neck cancer were achieved with a threshold value of the Young’s modulus of 33.2 kPa (sensitivity – 89.7 %, specificity – 84.6 %), AU C – 0.899. The values of the Young’s modulus in the metastatic lymph nodes did not depend on the primary tumor and on the localization of the lymph nodes studied (submandibular, paratracheal, cervical, supraclavicular groups)

Observation and comparative analysis of proton beam extraction or collimation by different planar channels of a bent crystal

In the experiment the efficiency of the 50 GeV proton beam extraction from accelerator by means of a bent crystal as a function of crystal orientation was measured. This allowed one to make a comparative analysis of efficiencies of high-energy protons deflection by different crystal atomic planes with different values of the electrostatic field. The results of simulation of high-energy protons deflection by means of crystal atomic planes and crystal atomic strings are also presented in the article. In the case of planar channeling the simulation shows a good agreement with experimental data. In the case of proton motion in the regime of stochastic scattering by bent atomic strings the simulation shows that angles of particle deflection are much greater than the critical channeling angle