54 research outputs found

    Profiling of polishing circles for the shaped cutters with a sloping tooth

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    Розглянуто особливості ΠΏΡ€ΠΎΡ„Ρ–Π»ΡŽΠ²Π°Π½Π½Ρ Π°Π±Ρ€Π°Π·ΠΈΠ²Π½ΠΈΡ… ΡˆΠ»Ρ–Ρ„ΡƒΠ²Π°Π»ΡŒΠ½ΠΈΡ… ΠΊΡ€ΡƒΠ³Ρ–Π² для формоутворСння Π·Π°Π΄Π½ΡŒΠΎΡ— ΠΏΠΎΠ²Π΅Ρ€Ρ…Π½Ρ– дискових фасонних Ρ„Ρ€Π΅Π· Π· ΠΏΠΎΡ…ΠΈΠ»ΠΈΠΌ Π·ΡƒΠ±ΠΎΠΌ. ΠžΡ‚Ρ€ΠΈΠΌΠ°Π½ΠΎ ΠΌΠ°Ρ‚Π΅ΠΌΠ°Ρ‚ΠΈΡ‡Π½Ρ– залСТності, які ΠΎΠΏΠΈΡΡƒΡŽΡ‚ΡŒ полоТСння Ρ€Ρ–ΠΆΡƒΡ‡ΠΎΡ— ΠΊΡ€ΠΎΠΌΠΊΠΈ Π² просторі для Ρ„Ρ€Π΅Π·, які одночасно ΠΌΠ°ΡŽΡ‚ΡŒ як ΠΏΠΎΠ·ΠΈΡ‚ΠΈΠ²Π½ΠΈΠΉ ΠΏΠ΅Ρ€Π΅Π΄Π½Ρ–ΠΉ ΠΊΡƒΡ‚, Ρ‚Π°ΠΊ Ρ– ΠΏΠΎΡ…ΠΈΠ»Ρƒ струТкову ΠΊΠ°Π½Π°Π²ΠΊΡƒ. Розглянуто загальний Π°Π½Π°Π»Ρ–Ρ‚ΠΈΡ‡Π½ΠΈΠΉ ΠΌΠ΅Ρ‚ΠΎΠ΄ визначСння ΠΏΡ€ΠΎΡ„Ρ–Π»ΡŽ ΡˆΠ»Ρ–Ρ„ΡƒΠ²Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ ΠΊΡ€ΡƒΠ³Π°, який ΡƒΡ‚Π²ΠΎΡ€ΡŽΡ” Π·Π°Π΄Π½Ρ– фасонні ΠΏΠΎΠ²Π΅Ρ€Ρ…Π½Ρ– Ρ„Ρ€Π΅Π·ΠΈ. Π—Π°ΠΏΡ€ΠΎΠΏΠΎΠ½ΠΎΠ²Π°Π½ΠΎ Π΄Π²Π° способи Ρ‡ΠΈΡΠ΅Π»ΡŒΠ½ΠΎΠ³ΠΎ визначСння ΠΊΠΎΠΎΡ€Π΄ΠΈΠ½Π°Ρ‚ ΠΉΠΎΠ³ΠΎ Ρ€Π°Π΄Ρ–Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ ΠΏΠ΅Ρ€Π΅Ρ‚ΠΈΠ½Ρƒ. Бпосіб визначСння ΡˆΡƒΠΊΠ°Π½ΠΈΡ… ΠΊΠΎΠΎΡ€Π΄ΠΈΠ½Π°Ρ‚ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠΌ послідовного порівняння Ρ€ΠΎΠ·Ρ€Π°Ρ…ΡƒΠ½ΠΊΠΎΠ²ΠΈΡ… ΠΏΠ°Ρ€Π°ΠΌΠ΅Ρ‚Ρ€Ρ–Π². Π† спосіб Π±Π΅Π·ΠΏΠΎΡΠ΅Ρ€Π΅Π΄Π½ΡŒΠΎΠ³ΠΎ Ρ€ΠΎΠ·Ρ€Π°Ρ…ΡƒΠ½ΠΊΡƒ ΠΊΠΎΠΎΡ€Π΄ΠΈΠ½Π°Ρ‚, заснований Π½Π° ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ– ΠΡŒΡŽΡ‚ΠΎΠ½Π°, який Π·Π°ΡΡ‚ΠΎΡΠΎΠ²ΡƒΡŽΡ‚ΡŒ ΠΏΡ€ΠΈ Π²ΠΈΡ€Ρ–ΡˆΠ΅Π½Π½Ρ– трансцСндСнтних Ρ€Ρ–Π²Π½ΡΠ½ΡŒ. ΠžΡ‚Ρ€ΠΈΠΌΠ°Π½ΠΎ ΠΌΠ°Ρ‚Π΅ΠΌΠ°Ρ‚ΠΈΡ‡Π½Ρ– залСТності для Π·Π°ΠΌΡ–Π½ΠΈ ΠΊΡ€ΠΈΠ²ΠΎΠ»Ρ–Π½Ρ–ΠΉΠ½ΠΎΠ³ΠΎ ΠΏΡ€ΠΎΡ„Ρ–Π»ΡŽ Ρ‡Π°ΡΡ‚ΠΈΠ½ΠΎΡŽ ΠΊΠΎΠ»Π°.Purpose. Creating a method of profiling tools, which forms the rear surface shaped cutters. Analysis of the established methods. The study of the error in determining the profile of the tool. Design / methodology / approach. The back surface of the shaped cutter produces abrasive tools. To determine the profile of abrasive tools using the kinematic method. The surfaces of the tool and parts have a common perpendicular. The tool moves along its trektorii. The point where the common perpendicular intersects with the trajectory is the center of the abrasive tool. There are two methods for determining the position of this point. The method of constructing the table. The center of the abrasive wheel is determined by the tables. The table can make before you start. The table is suitable for any instrument. Using the table you can define any profile. For each point shaped profile cutters always have two answers. The method of solution of the transcendental equation. The center of the abrasive tool is determined by Newton's method. You can calculate the coordinates of each point of the profile shapes of abrasive tools. These points are treated with a ribbon, which is located on the tooth cutters. Calculations can be done with a given accuracy. Findingsa. Created by two methods for determining the profile of abrasive tool that handles the back surface of the contoured mills. Found the equations for determining the parameters of the circle that replaces the curved line Originality/value. These results allow us to determine the profile instrument for the formation of the back of the cutter to the desired accuracy.РассмотрСны особСнности профилирования Π°Π±Ρ€Π°Π·ΠΈΠ²Π½Ρ‹Ρ… ΡˆΠ»ΠΈΡ„ΠΎΠ²Π°Π»ΡŒΠ½Ρ‹Ρ… ΠΊΡ€ΡƒΠ³ΠΎΠ² для формообразования Π·Π°Π΄Π½Π΅ΠΉ повСрхности дисковых фасонных Ρ„Ρ€Π΅Π· с Π½Π°ΠΊΠ»ΠΎΠ½Π½Ρ‹ΠΌ Π·ΡƒΠ±ΠΎΠΌ. ΠŸΠΎΠ»ΡƒΡ‡Π΅Π½Ρ‹ матСматичСскиС зависимости, ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Π΅ ΠΎΠΏΠΈΡΡ‹Π²Π°ΡŽΡ‚ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠ΅ Ρ€Π΅ΠΆΡƒΡ‰Π΅ΠΉ ΠΊΡ€ΠΎΠΌΠΊΠΈ Π² пространствС для Ρ„Ρ€Π΅Π·, ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Π΅ ΠΎΠ΄Π½ΠΎΠ²Ρ€Π΅ΠΌΠ΅Π½Π½ΠΎ ΠΈΠΌΠ΅ΡŽΡ‚ ΠΊΠ°ΠΊ ΠΏΠΎΠ»ΠΎΠΆΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹ΠΉ ΠΏΠ΅Ρ€Π΅Π΄Π½ΠΈΠΉ ΡƒΠ³ΠΎΠ», Ρ‚Π°ΠΊ ΠΈ Π½Π°ΠΊΠ»ΠΎΠ½Π½ΡƒΡŽ ΡΡ‚Ρ€ΡƒΠΆΠ΅Ρ‡Π½ΡƒΡŽ ΠΊΠ°Π½Π°Π²ΠΊΡƒ. РассмотрСн ΠΎΠ±Ρ‰ΠΈΠΉ аналитичСский ΠΌΠ΅Ρ‚ΠΎΠ΄ опрСдСлСния профиля ΡˆΠ»ΠΈΡ„ΠΎΠ²Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ ΠΊΡ€ΡƒΠ³Π°, ΠΊΠΎΡ‚ΠΎΡ€Ρ‹ΠΉ ΠΎΠ±Ρ€Π°Π·ΡƒΠ΅Ρ‚ Π·Π°Π΄Π½ΠΈΠ΅ фасонныС повСрхности Ρ„Ρ€Π΅Π·Ρ‹. ΠŸΡ€Π΅Π΄Π»ΠΎΠΆΠ΅Π½Ρ‹ Π΄Π²Π° способа числСнного опрСдСлСния ΠΊΠΎΠΎΡ€Π΄ΠΈΠ½Π°Ρ‚ Π΅Π³ΠΎ Ρ€Π°Π΄ΠΈΠ°Π»ΡŒΠ½ΠΎΠ³ΠΎ сСчСния. Бпособ опрСдСлСния искомых ΠΊΠΎΠΎΡ€Π΄ΠΈΠ½Π°Ρ‚ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠΌ ΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°Ρ‚Π΅Π»ΡŒΠ½ΠΎΠ³ΠΎ сравнСния расчСтных ΠΏΠ°Ρ€Π°ΠΌΠ΅Ρ‚Ρ€ΠΎΠ², Π° Ρ‚Π°ΠΊΠΆΠ΅ способ нСпосрСдствСнного расчСта ΠΊΠΎΠΎΡ€Π΄ΠΈΠ½Π°Ρ‚, основанный Π½Π° ΠΌΠ΅Ρ‚ΠΎΠ΄Π΅ ΠΡŒΡŽΡ‚ΠΎΠ½Π°, ΠΊΠΎΡ‚ΠΎΡ€Ρ‹ΠΉ ΠΏΡ€ΠΈΠΌΠ΅Π½ΡΡŽΡ‚ ΠΏΡ€ΠΈ Ρ€Π΅ΡˆΠ΅Π½ΠΈΠΈ трансцСндСнтных ΡƒΡ€Π°Π²Π½Π΅Π½ΠΈΠΉ. Π’Ρ‹Π²Π΅Π΄Π΅Π½Ρ‹ матСматичСскиС зависимости для Π·Π°ΠΌΠ΅Π½Ρ‹ ΠΊΡ€ΠΈΠ²ΠΎΠΉ Ρ‡Π°ΡΡ‚ΡŒΡŽ окруТности

    Research of MPLS-based virtual private networks. –Manuscript.

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    Π”ΠΈΠΏΠ»ΠΎΠΌΠ½Ρƒ Ρ€ΠΎΠ±ΠΎΡ‚Ρƒ магістра присвячСно Π°Π½Π°Π»Ρ–Π·Ρƒ Ρ‚Π° ΠΏΡ€ΠΎΠ΅ΠΊΡ‚ΡƒΠ²Π°Π½Π½ΡŽ Π²Ρ–Ρ€Ρ‚ΡƒΠ°Π»ΡŒΠ½ΠΈΡ… ΠΏΡ€ΠΈΠ²Π°Ρ‚Π½ΠΈΡ… ΠΌΠ΅Ρ€Π΅ΠΆ Π½Π° Π±Π°Π·Ρ– Ρ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΠ³Ρ–Ρ— MPLS. Π—Ρ€ΠΎΠ±Π»Π΅Π½ΠΎ загальний огляд ΠΏΡ€ΠΈΠ½Ρ†ΠΈΠΏΡ–Π² ΠΏΠΎΠ±ΡƒΠ΄ΠΎΠ²ΠΈ сучасних Π³Π»ΠΎΠ±Π°Π»ΡŒΠ½ΠΈΡ… ΠΌΠ΅Ρ€Π΅ΠΆ зв’язку, Ρ‰ΠΎ Π·Π°ΡΡ‚ΠΎΡΠΎΠ²ΡƒΡŽΡ‚ΡŒΡΡ для ΠΎΡ€Π³Π°Π½Ρ–Π·Π°Ρ†Ρ–Ρ— VPN-ΠΌΠ΅Ρ€Π΅ΠΆ Π· встановлСнням Ρ‚Π° Π±Π΅Π· встановлСння з’єднання. Π”Π΅Ρ‚Π°Π»ΡŒΠ½ΠΎ дослідТСно Ρ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΠ³Ρ–ΡŽ MPLS VPN Ρ‚Π° Ρ—Ρ— ΠΏΡ€ΠΈΠ½Ρ†ΠΈΠΏΠΈ Ρ€ΠΎΠ±ΠΎΡ‚ΠΈ. ЗдійснСно порівняння Π· Ρ–Π½ΡˆΠΈΠΌΠΈ VPN-тСхнологіями, встановлСно ΠΏΠ΅Ρ€Π΅Π²Π°Π³ΠΈ. Π‘ΠΏΡ€ΠΎΠ΅ΠΊΡ‚ΠΎΠ²Π°Π½ΠΎ модСль ΠΌΠ΅Ρ€Π΅ΠΆΡ– для міТобласного ΠΏΡ€ΠΎΠ²Π°ΠΉΠ΄Π΅Ρ€Π° Π½Π° Π±Π°Π·Ρ– Ρ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΠ³Ρ–Ρ— IP/MPLS, яка ΠΏΡ–Π΄Ρ‚Ρ€ΠΈΠΌΡƒΡ” Π²Ρ–Ρ€Ρ‚ΡƒΠ°Π»ΡŒΠ½Ρ– ΠΏΡ€ΠΈΠ²Π°Ρ‚Π½Ρ– ΠΌΠ΅Ρ€Π΅ΠΆΡ–, Π° Ρ‚Π°ΠΊΠΎΠΆ Π·Π°Π±Π΅Π·ΠΏΠ΅Ρ‡ΡƒΡ” Ρ„ΡƒΠ½ΠΊΡ†Ρ–Ρ— якості обслуговування. ЗдійснСно конфігурування спроСктованої ΠΌΠ΅Ρ€Π΅ΠΆΡ–. ДослідТСно характСристики Ρ€ΠΎΠ±ΠΎΡ‚ΠΈ ΠΏΠΎΠ±ΡƒΠ΄ΠΎΠ²Π°Π½ΠΎΡ— ΠΌΠΎΠ΄Π΅Π»Ρ– VPN-ΠΌΠ΅Ρ€Π΅ΠΆΡ–.Master’s Thesis is dedicated to the analysis and designing of virtual private networks based on MPLS technology. A general overview of principles of modern global communication networks construction were made. They are used for the organization of VPNs with connection establishment and without it. Analysis of MPLS VPN technology and its principles were examined. A comparison with other VPN technology was performed and the benefits were established. An IP/MPLS-based interregional provider’s network model was designed. It supports virtual private networks and provides Quality of Service features. Configuration of designed network was carried out. The characteristics of constructed VPN model were investigated

    ARRANGEMENT OF HIGH-TECH CARE FOR PATIENTS WITH MALIGNANT NEOPLASMS OF THE ORGAN OF VISION AT THE EXAMPLE OF CHELYABINSK REGION

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    The articles raises the issues that occur in the course of diagnostics of malignant neoplasms of the organ of vision. Description of structural units and personnel of the formed oncological ophthalmology center is provided. Research, therapeutic, and diagnostic activities of each structural unit of the center is described. Characteristics of the ultrasonic and computed tomography method of examination are provided. Peculiarities of the ultrasonic and computed tomography examination results are described regarding patients with malignant neoplasms of the organ of vision of the periorbital, intraocular, and orbital localization. Results of reorganization of the oncological ophthalmology service are assessed (detailed description of management of patients with malignant neoplasms of the organ of vision at different stages before and after formation of the specialized oncological ophthalmology center is provided with illustrative diagrams that demostrate the need for integration of ophthalmic services in oncology, scientifically grounded and statistically proven results of quality of specialized care at the prehospital and the hospital stage, as well as changes in the structure of stages of patients with malignant neoplasms of the organ of vision). The feasibility of creation of specialized oncological ophthalmology centers is justified on the basis of the results received

    MOLECULAR-GENETIC CHARACTERISTICS OF PRIMARY TUMOR AND METASTATIC LYMPHATIC NODES IN BREAST CANCER

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    The purpose of systemic treatment in patients with breast cancer is based largely on the molecular characteristics ofΒ the primary tumor, but many clinical recommendations suggest also the study of metastatic nodes with an assessmentΒ of their receptor status (estrogen receptor ER, progesterone receptor RP, human epidermal growth factor receptorΒ 2 Her2/neu). This is due to the fact that according to numerous studies, the discrepancy between the status of the primaryΒ tumor and the secondary nodes can reach high rates: 3–54 % for ER, 5–78 % for RP, and 0–34 % for Her2/neu. At theΒ same time, more and more data actively demonstrate the imperfection of immunohistochemical analysis and the need toΒ study additional parameters to improve the quality of diagnosis of patients with breast cancer. Material and methods.Β A morphological and immunohistochemical study of the tumor tissue of the primary node and axillary lymph nodesΒ was performed in 199 patients with breast cancer (T1-3N0-3M0) using standard methods, and RT-PCR was also studiedΒ with the expression of 24 genes. Results. The incidence of differences between the molecular phenotypes of the mainΒ tumor and metastatic axillary lymph nodes was 26 (26 %) of 99 cases. Most often, differences were noted in cases ofΒ breast cancer with luminal A type – 13 cases (50 %). According to the results of a comparative PCR analysis of tissueΒ samples from the primary tumor and metastatic regional lymph nodes, only the expression of the CD68, ERSR1, GRB7Β and MMD11 receptors was statistically significant. Conclusion. The results indicate the need for an integrated approachΒ and additional methods for the diagnosis of breast cancer, which will undoubtedly improve the quality of planning andΒ the effectiveness of systemic treatment in patients with breast cancer

    ΠœΡƒΠ»ΡŒΡ‚ΠΈΡΠΏΠΈΡ€Π°Π»ΡŒΠ½Π°Ρ ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½Π°Ρ томография Π² Ρ€Π°Π½Π½Π΅ΠΉ диагностикС ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ, Π²Ρ‹Π·Π²Π°Π½Π½ΠΎΠΉ SARS-CoV-2

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    The high informative value of chest computed tomography in the diagnosis of pneumonia caused by SARS-CoV-2 is generally recognized, but there is no enough data on the diagnostic capabilities of this method within 5 first days of the clinical manifestations of the disease. The paper presents the results of chest multispiral (multislice) computed tomography (MSCT) of 56 patients with COVID-19 pneumonia in the early days of the disease. The aim of the study was to analyze the semiotics of pathological changes in the lungs in the first days of the onset of clinical symptoms of COVID-19 and to clarify the methodology for conducting MSCT. Methods. The data of chest MSCT of 56 patients with clinical symptoms of a new coronavirus infection SARS-CoV-2 were analyzed. MSCT was carried out in the first 4 – 5 days of the disease. Results. Five variants for the development of the disease were revealed, including atypical, characterized by the prevalence and CT semiotics of lung damage and apparently due to the different response of the patients to SARS-CoV-2 infection. The leading signs of COVID-19 pneumonia in the early stages of the disease were foci of ground glass opacification (GGO), multifocal lesions of the lungs, edema of the interalveolar pulmonary interstitium, which distinguishes it from pneumonia of another etiology. Conclusion. Comparison of MSCT data and the clinical picture of the disease during the first 5 days suggests with high confidence the pneumonia associated with COVID-19. A prerequisite for conducting MSCT in case of suspicion of this type of pneumonia is the implementation of thin 0.5 – 1.5 mm sections, MSCT performance at suspended full inspiration, post-processing of unenhanced tomogram data in MinIP mode.Высокая ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½ΠΎΠΉ Ρ‚ΠΎΠΌΠΎΠ³Ρ€Π°Ρ„ΠΈΠΈ (КВ) ΠΎΡ€Π³Π°Π½ΠΎΠ² Π³Ρ€ΡƒΠ΄Π½ΠΎΠΉ ΠΊΠ»Π΅Ρ‚ΠΊΠΈ (ΠžΠ“Πš) Π² диагностикС COVID-19-ассоциированной ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ ΠΎΠ±Ρ‰Π΅ΠΏΡ€ΠΈΠ·Π½Π°Π½Π½Π°, ΠΎΠ΄Π½Π°ΠΊΠΎ Π΄Π°Π½Π½Ρ‹Π΅ ΠΎ диагностичСских возмоТностях ΠΈ особСнностях выполнСния этого ΠΌΠ΅Ρ‚ΠΎΠ΄Π° Π² ΠΏΠ΅Ρ€Π²Ρ‹Π΅ 5 суток клиничСских проявлСний заболСвания ΠΎΡ‚ΡΡƒΡ‚ΡΡ‚Π²ΡƒΡŽΡ‚. Π’ Ρ€Π°Π±ΠΎΡ‚Π΅ прСдставлСны Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ ΠΌΡƒΠ»ΡŒΡ‚ΠΈΡΠΏΠΈΡ€Π°Π»ΡŒΠ½ΠΎΠΉ КВ (МБКВ) ΠžΠ“Πš ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² (n = 56) с COVID-19-ассоциированой ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠ΅ΠΉ Π² ΠΏΠ΅Ρ€Π²Ρ‹Π΅ 4–5 суток развития симптомов Π±ΠΎΠ»Π΅Π·Π½ΠΈ. ЦСлью исслСдования явилось ΠΈΠ·ΡƒΡ‡Π΅Π½ΠΈΠ΅ сСмиотики патологичСских ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ Π² Π»Π΅Π³ΠΊΠΈΡ… Π² ΠΏΠ΅Ρ€Π²Ρ‹Π΅ Π΄Π½ΠΈ появлСния клиничСских симптомов COVID-19 ΠΈ описаниС особСнностСй ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈΠΊΠΈ провСдСния МБКВ. ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. ΠŸΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Ρ‹ Π΄Π°Π½Π½Ρ‹Π΅ МБКВ ΠžΠ“Πš ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с клиничСской симптоматикой Π½ΠΎΠ²ΠΎΠΉ коронавирусной ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ SARS-CoV-2. МБКВ Π²Ρ‹ΠΏΠΎΠ»Π½ΡΠ»Π°ΡΡŒ Π² ΠΏΠ΅Ρ€Π²Ρ‹Π΅ 4–5 суток заболСвания. Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. ВыявлСно 5 Π²Π°Ρ€ΠΈΠ°Π½Ρ‚ΠΎΠ² развития заболСвания, Π²ΠΊΠ»ΡŽΡ‡Π°Ρ Π°Ρ‚ΠΈΠΏΠΈΡ‡Π½Ρ‹ΠΉ, Ρ€Π°Π·Π»ΠΈΡ‡Π°Π²ΡˆΠΈΡ…ΡΡ Ρ€Π°ΡΠΏΡ€ΠΎΡΡ‚Ρ€Π°Π½Π΅Π½Π½ΠΎΡΡ‚ΡŒΡŽ ΠΈ КВ-сСмиотикой пораТСния Π»Π΅Π³ΠΊΠΈΡ… ΠΈ обусловлСнных, ΠΏΠΎ-Π²ΠΈΠ΄ΠΈΠΌΠΎΠΌΡƒ, Ρ€Π°Π·Π»ΠΈΡ‡Π½ΠΎΠΉ Ρ€Π΅Π°ΠΊΡ†ΠΈΠ΅ΠΉ ΠΎΡ€Π³Π°Π½ΠΈΠ·ΠΌΠ° ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² Π½Π° ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΡŽ SARS-CoV-2. Π’Π΅Π΄ΡƒΡ‰ΠΈΠΌΠΈ ΠΏΡ€ΠΈΠ·Π½Π°ΠΊΠ°ΠΌΠΈ COVID-19-ассоциированной ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ Π² Ρ€Π°Π½Π½ΠΈΠ΅ сроки заболСвания являлись ΠΎΡ‡Π°Π³ΠΈ Β«ΠΌΠ°Ρ‚ΠΎΠ²ΠΎΠ³ΠΎ стСкла», ΠΌΡƒΠ»ΡŒΡ‚ΠΈΡ„ΠΎΠΊΠ°Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ пораТСния Π»Π΅Π³ΠΊΠΈΡ…, ΠΎΡ‚Π΅ΠΊ ΠΌΠ΅ΠΆΠ°Π»ΡŒΠ²Π΅ΠΎΠ»ΡΡ€Π½ΠΎΠ³ΠΎ Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠ³ΠΎ интСрстиция, Π² Ρ‡Π΅ΠΌ ΠΈ состояли отличия COVID-19-ассоциированной ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ ΠΎΡ‚ Ρ‚Π°ΠΊΠΎΠ²ΠΎΠΉ Π΄Ρ€ΡƒΠ³ΠΎΠΉ этиологии. Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. БопоставлСниС Π΄Π°Π½Π½Ρ‹Ρ… МБКВ ΠΈ клиничСской ΠΊΠ°Ρ€Ρ‚ΠΈΠ½Ρ‹ заболСвания Π² Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ ΠΏΠ΅Ρ€Π²Ρ‹Ρ… 5 суток заболСвания позволяСт с высокой Π΄ΠΎΡΡ‚ΠΎΠ²Π΅Ρ€Π½ΠΎΡΡ‚ΡŒΡŽ ΠΏΡ€Π΅Π΄ΠΏΠΎΠ»ΠΎΠΆΠΈΡ‚ΡŒ Π½Π°Π»ΠΈΡ‡ΠΈΠ΅ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ, ассоциированной с COVID-19. НСобходимым условиСм провСдСния МБКВ ΠΏΡ€ΠΈ ΠΏΠΎΠ΄ΠΎΠ·Ρ€Π΅Π½ΠΈΠΈ Π½Π° пнСвмонию Π΄Π°Π½Π½ΠΎΠ³ΠΎ Ρ‚ΠΈΠΏΠ° являСтся Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½ΠΈΠ΅ Ρ‚ΠΎΠ½ΠΊΠΈΡ… (0,5–1,5 ΠΌΠΌ) срСзов, ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»ΡŒ Π·Π° ΠΏΠΎΠ»Π½ΠΎΡ‚ΠΎΠΉ Π²Π΄ΠΎΡ…Π° ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°, постпроцСссинговая ΠΎΠ±Ρ€Π°Π±ΠΎΡ‚ΠΊΠ° Π΄Π°Π½Π½Ρ‹Ρ… Π½Π°Ρ‚ΠΈΠ²Π½ΠΎΠΉ Ρ‚ΠΎΠΌΠΎΠ³Ρ€Π°ΠΌΠΌΡ‹ Π² MinIP-Ρ€Π΅ΠΆΠΈΠΌΠ΅

    ΠšΠΎΠ»ΠΈΡ‡Π΅ΡΡ‚Π²Π΅Π½Π½Ρ‹Π΅ характСристики Π»ΡƒΡ‡Π΅Π²ΠΎΠ³ΠΎ поврСТдСния Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ Ρ‚ΠΊΠ°Π½ΠΈ Ρƒ онкологичСских ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² ΠΏΡ€ΠΈ Π»ΡƒΡ‡Π΅Π²ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Π½Π° основании Π΄Π°Π½Π½Ρ‹Ρ… РКВ

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    Objective. Comparison of the magnitude of the change in the density of lung tissue and the volume of these changes after radiation therapy over time based on the data obtained using the new method of quantitative analysis developed by us and with the usual visual assessment of the CT data.Materials and methods. We used the data of dynamic observation of 90 patients who underwent RT for the tumors of thoracic localization during the period from 2014 to 2021 at the Federal Institution β€œRussian Scientific Center of Roentgenoradiology”. These patients had CT examinations performed before and after RT. Control CT studies were performed 1–237 days after RT (mean control interval 96 Β± 64.3 days). A total of 238 CT studies of these patients were analyzed, with an average number of RCT studies per patient of 2.6. Among the selected patients, there were 36 (40%) men and 54 (60%) women aged 23 to 86 years (the average age was 51.9 Β± 15.6 years).Results. Radiation damage in the lungs using the method of quantitative analysis of CT data is detected starting from the value of Ξ”HU = 20 and volume from 3.2% for the early period (15–35 days) after the end of treatment. Starting from 15–25 to 50 days after the end of RT, quantitative analysis reveals primary changes in the lung tissue, incl. and undetectable visually (from 20 to 80 HU), and to suggest further dynamics of these changes depending on the characteristics of the performed RT. From 50 to 80 days – reveals the real volume of radiation pulmonitis by taking into account the changes invisible during visual analysis in the lung tissue irradiated at a dose of 20 Gy to 30 Gy. From 80 to 120 days – allows you to assess the presence and dynamics of changes in the lung tissue with the threshold radiation dose in the lung tissue 30–35 Gy. From 120 onwards, quantitative analysis of CT data, as well as visual assessment, reveals damage in areas of the lungs with the dose of more than 30–35 Gy, which is caused by post-radiation pneumofibrosis. On the basis of the obtained quantitative data on radiation lung damage, the mathematical regularities of the development of this process were calculated, taking into account the time and dose factors.Conclusions. Quantitative assessment of changes in lung density according to CT data in dynamics, carried out using the technique developed by us, is a radiomic indicator of their radiation damage during therapeutic irradiation in cancer patients, which, in combination with the presented mathematical model, can be used for diagnostic purposes to quantify the severity and predicting the dynamics of radiation damage to the lungs in general, as well as identifying individual radiosensitivity.The results obtained can be presented not only in the form of graphs, but also in the form of color maps with preservation of anatomical landmarks, which is convenient for use in clinical practice to support medical decision-making on patient management.ЦСль исслСдования: сопоставлСниС Π²Π΅Π»ΠΈΡ‡ΠΈΠ½Ρ‹ измСнСния плотности Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ Ρ‚ΠΊΠ°Π½ΠΈ ΠΈ объСмов этих ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ послС Π»ΡƒΡ‡Π΅Π²ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ (Π›Π’) с Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ΠΌ Π²Ρ€Π΅ΠΌΠ΅Π½ΠΈ Π½Π° основании Π΄Π°Π½Π½Ρ‹Ρ…, ΠΏΠΎΠ»ΡƒΡ‡Π°Π΅ΠΌΡ‹Ρ… с ΠΏΠΎΠΌΠΎΡ‰ΡŒΡŽ Ρ€Π°Π·Ρ€Π°Π±ΠΎΡ‚Π°Π½Π½ΠΎΠΉ Π½Π°ΠΌΠΈ Π½ΠΎΠ²ΠΎΠΉ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈΠΊΠΈ количСствСнного Π°Π½Π°Π»ΠΈΠ·Π° ΠΈ ΠΏΡ€ΠΈ ΠΎΠ±Ρ‹Ρ‡Π½ΠΎΠΉ Π²ΠΈΠ·ΡƒΠ°Π»ΡŒΠ½ΠΎΠΉ ΠΎΡ†Π΅Π½ΠΊΠ΅ Π΄Π°Π½Π½Ρ‹Ρ… РКВ.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π» ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. Использовались Π΄Π°Π½Π½Ρ‹Π΅ динамичСского наблюдСния 90 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², ΠΊΠΎΡ‚ΠΎΡ€Ρ‹ΠΌ Π±Ρ‹Π»Π° ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π° Π›Π’ ΠΏΠΎ ΠΏΠΎΠ²ΠΎΠ΄Ρƒ ΠΎΠΏΡƒΡ…ΠΎΠ»Π΅ΠΉ Ρ‚ΠΎΡ€Π°ΠΊΠ°Π»ΡŒΠ½ΠΎΠΉ Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ Π·Π° ΠΏΠ΅Ρ€ΠΈΠΎΠ΄ с 2014 ΠΏΠΎ 2021 Π³. Π² Π€Π“Π‘Π£ β€œΠ ΠΎΡΡΠΈΠΉΡΠΊΠΈΠΉ Π½Π°ΡƒΡ‡Π½Ρ‹ΠΉ Ρ†Π΅Π½Ρ‚Ρ€ рСнтгСнорадиологии”. Π£ всСх этих ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² имСлись РКВ-исслСдования, Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½Π½Ρ‹Π΅ Π΄ΠΎ ΠΈ послС Π›Π’. ΠšΠΎΠ½Ρ‚Ρ€ΠΎΠ»ΡŒΠ½Ρ‹Π΅ исслСдования Π²Ρ‹ΠΏΠΎΠ»Π½ΡΠ»ΠΈΡΡŒ Ρ‡Π΅Ρ€Π΅Π· 1–237 сут послС Π›Π’ (срСдний ΠΈΠ½Ρ‚Π΅Ρ€Π²Π°Π» контроля 96 Β± 64,3 сут). ВсСго Π±Ρ‹Π»ΠΎ ΠΏΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½ΠΎ 238 РКВ-исслСдований со срСдним количСством РКВ-исслСдований Π½Π° ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° 2,6. Π‘Ρ€Π΅Π΄ΠΈ ΠΎΡ‚ΠΎΠ±Ρ€Π°Π½Π½Ρ‹Ρ… ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² Π±Ρ‹Π»ΠΎ 36 (40,0%) ΠΌΡƒΠΆΡ‡ΠΈΠ½ ΠΈ 54 (60,0%) ΠΆΠ΅Π½Ρ‰ΠΈΠ½Ρ‹ Π² возрастС ΠΎΡ‚ 23 Π΄ΠΎ 86 Π»Π΅Ρ‚ (срСдний возраст 51,9 Β± 15,6 Π³ΠΎΠ΄Π°).Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. ΠŸΡ€Π΅Π΄Π»Π°Π³Π°Π΅ΠΌΠ°Ρ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈΠΊΠ° количСствСнного Π°Π½Π°Π»ΠΈΠ·Π° Π΄Π°Π½Π½Ρ‹Ρ… РКВ выявляСт ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΠ΅ плотности ΠΎΠ±Π»ΡƒΡ‡Π΅Π½Π½Ρ‹Ρ… участков Π»Π΅Π³ΠΊΠΎΠ³ΠΎ начиная с Π²Π΅Π»ΠΈΡ‡ΠΈΠ½Ρ‹ ΠΎΡ‚ 20 HU ΠΈ объСма ΠΎΡ‚ 3,2% для Ρ€Π°Π½Π½Π΅Π³ΠΎ ΠΏΠ΅Ρ€ΠΈΠΎΠ΄Π° (15–35 сут) послС окончания Π›Π’. Начиная с 25-Ρ… ΠΏΠΎ 50-Π΅ сутки послС окончания Π›Π’ количСствСнный Π°Π½Π°Π»ΠΈΠ· позволяСт Π²Ρ‹ΡΠ²ΠΈΡ‚ΡŒ ΠΏΠ΅Ρ€Π²ΠΈΡ‡Π½Ρ‹Π΅ измСнСния Π² Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ Ρ‚ΠΊΠ°Π½ΠΈ, Π² Ρ‚ΠΎΠΌ числС ΠΈ Π½Π΅ опрСдСляСмыС Π²ΠΈΠ·ΡƒΠ°Π»ΡŒΠ½ΠΎ ΠΏΠΎ ΡΡ€Π°Π²Π½Π΅Π½ΠΈΡŽ с исходной ΠΏΠ»ΠΎΡ‚Π½ΠΎΡΡ‚ΡŒΡŽ ΠΎΡ‚ 20 Π΄ΠΎ 80 HU, ΠΈ ΠΏΡ€Π΅Π΄ΠΏΠΎΠ»ΠΎΠΆΠΈΡ‚ΡŒ Π΄Π°Π»ΡŒΠ½Π΅ΠΉΡˆΡƒΡŽ Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΡƒ этих ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ Π² зависимости ΠΎΡ‚ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈΠΊΠΈ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠΉ Π›Π’. Π‘ 50-Ρ… ΠΏΠΎ 80-Π΅ сутки количСствСнный Π°Π½Π°Π»ΠΈΠ· выявляСт Ρ€Π΅Π°Π»ΡŒΠ½Ρ‹ΠΉ объСм Π»ΡƒΡ‡Π΅Π²ΠΎΠ³ΠΎ ΠΏΡƒΠ»ΡŒΠΌΠΎΠ½ΠΈΡ‚Π° Π·Π° счСт ΡƒΡ‡Π΅Ρ‚Π° Π½Π΅Π²ΠΈΠ΄ΠΈΠΌΡ‹Ρ… ΠΏΡ€ΠΈ Π²ΠΈΠ·ΡƒΠ°Π»ΡŒΠ½ΠΎΠΌ Π°Π½Π°Π»ΠΈΠ·Π΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ плотности Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ Ρ‚ΠΊΠ°Π½ΠΈ, ΠΎΠ±Π»ΡƒΡ‡Π΅Π½Π½ΠΎΠΉ Π² Π΄ΠΎΠ·Π΅ ΠΎΡ‚ 20 Π΄ΠΎ 30 Π“Ρ€. Π‘ 80-Ρ… ΠΏΠΎ 120-Π΅ сутки – позволяСт ΠΎΡ†Π΅Π½ΠΈΡ‚ΡŒ Π½Π°Π»ΠΈΡ‡ΠΈΠ΅ ΠΈ Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΡƒ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ Π² Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ Ρ‚ΠΊΠ°Π½ΠΈ, ΠΎΠ±Π»ΡƒΡ‡Π΅Π½Π½ΠΎΠΉ Π² Π΄ΠΎΠ·Π΅ Π±ΠΎΠ»Π΅Π΅ 30–35 Π“Ρ€. Начиная со 120-Ρ… суток ΠΈ Π΄Π°Π»Π΅Π΅ количСствСнный Π°Π½Π°Π»ΠΈΠ· РКВ Π΄Π°Π½Π½Ρ‹Ρ…, ΠΊΠ°ΠΊ ΠΈ Π²ΠΈΠ·ΡƒΠ°Π»ΡŒΠ½Π°Ρ ΠΎΡ†Π΅Π½ΠΊΠ°, выявляСт Ρ„ΠΎΡ€ΠΌΠΈΡ€ΠΎΠ²Π°Π½ΠΈΠ΅ стойкого постлучСвого ΠΏΠ½Π΅Π²ΠΌΠΎΡ„ΠΈΠ±Ρ€ΠΎΠ·Π° Π² участках Π»Π΅Π³ΠΊΠΈΡ…, ΠΎΠ±Π»ΡƒΡ‡Π΅Π½Π½Ρ‹Ρ… Π² Π΄ΠΎΠ·Π΅ Π±ΠΎΠ»Π΅Π΅ 30–35 Π“Ρ€. На основС ΠΏΠΎΠ»ΡƒΡ‡Π΅Π½Π½Ρ‹Ρ… количСствСнных Π΄Π°Π½Π½Ρ‹Ρ… ΠΎ Π»ΡƒΡ‡Π΅Π²ΠΎΠΌ ΠΏΠΎΠ²Ρ€Π΅ΠΆΠ΄Π΅Π½ΠΈΠΈ Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ Ρ‚ΠΊΠ°Π½ΠΈ Π±Ρ‹Π»Π° рассчитана матСматичСская Π·Π°ΠΊΠΎΠ½ΠΎΠΌΠ΅Ρ€Π½ΠΎΡΡ‚ΡŒ развития этого процСсса с ΡƒΡ‡Π΅Ρ‚ΠΎΠΌ Π²Ρ€Π΅ΠΌΠ΅Π½Π½FΠΎΠ³ΠΎ ΠΈ Π΄ΠΎΠ·ΠΎΠ²Ρ‹Ρ… Ρ„Π°ΠΊΡ‚ΠΎΡ€ΠΎΠ².Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. ΠšΠΎΠ»ΠΈΡ‡Π΅ΡΡ‚Π²Π΅Π½Π½Π°Ρ ΠΎΡ†Π΅Π½ΠΊΠ° измСнСния плотности Π»Π΅Π³ΠΊΠΈΡ… ΠΏΠΎ Π΄Π°Π½Π½Ρ‹ΠΌ РКВ Π² Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ΅ ΠΏΠΎ Ρ€Π°Π·Ρ€Π°Π±ΠΎΡ‚Π°Π½Π½ΠΎΠΉ Π½Π°ΠΌΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈΠΊΠ΅ являСтся радиомичСским ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»Π΅ΠΌ ΠΈΡ… Π»ΡƒΡ‡Π΅Π²ΠΎΠ³ΠΎ поврСТдСния ΠΏΡ€ΠΈ тСрапСвтичСском ΠΎΠ±Π»ΡƒΡ‡Π΅Π½ΠΈΠΈ онкологичСских ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², ΠΊΠΎΡ‚ΠΎΡ€Ρ‹ΠΉ Π² сочСтании с прСдставлСнной матСматичСской модСлью ΠΌΠΎΠΆΠ΅Ρ‚ Π±Ρ‹Ρ‚ΡŒ использован Π² диагностичСских цСлях для количСствСнной ΠΎΡ†Π΅Π½ΠΊΠΈ стСпСни тяТСсти ΠΈ прогнозирования Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠΈ Π»ΡƒΡ‡Π΅Π²ΠΎΠ³ΠΎ поврСТдСния Π»Π΅Π³ΠΊΠΈΡ… Π² Ρ†Π΅Π»ΠΎΠΌ, Π° Ρ‚Π°ΠΊΠΆΠ΅ выявлСния ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡƒΠ°Π»ΡŒΠ½ΠΎΠΉ Ρ€Π°Π΄ΠΈΠΎΡ‡ΡƒΠ²ΡΡ‚Π²ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΠΈ.ΠŸΠΎΠ»ΡƒΡ‡Π΅Π½Π½Ρ‹Π΅ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ ΠΌΠΎΠ³ΡƒΡ‚ Π±Ρ‹Ρ‚ΡŒ прСдставлСны Π½Π΅ Ρ‚ΠΎΠ»ΡŒΠΊΠΎ Π² Π²ΠΈΠ΄Π΅ Π³Ρ€Π°Ρ„ΠΈΠΊΠΎΠ², Π½ΠΎ ΠΈ Π² Π²ΠΈΠ΄Π΅ Ρ†Π²Π΅Ρ‚ΠΎΠ²Ρ‹Ρ… ΠΊΠ°Ρ€Ρ‚ с сохранСниСм анатомичСских ΠΎΡ€ΠΈΠ΅Π½Ρ‚ΠΈΡ€ΠΎΠ², Ρ‡Ρ‚ΠΎ ΡƒΠ΄ΠΎΠ±Π½ΠΎ для использования Π² клиничСской ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΠ΅ с Ρ†Π΅Π»ΡŒΡŽ ΠΏΠΎΠ΄Π΄Π΅Ρ€ΠΆΠΊΠΈ принятия Π²Ρ€Π°Ρ‡Π΅Π±Π½Ρ‹Ρ… Ρ€Π΅ΡˆΠ΅Π½ΠΈΠΉ ΠΏΠΎ вСдСнию ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ²

    БВАНДАРВЫ ΠΠΠΠ›Π˜Π—Π ΠœΠ•Π’ΠΠ‘Π’ΠΠ’Π˜Π§Π•Π‘ΠšΠžΠ“Πž ΠŸΠžΠ ΠΠ–Π•ΠΠ˜Π― КОБВНЫΠ₯ БВРУКВУР ПО Π”ΠΠΠΠ«Πœ Π‘ΠžΠ’Π Π•ΠœΠ•ΠΠΠ«Π₯ ΠœΠ•Π’ΠžΠ”ΠžΠ’ Π›Π£Π§Π•Π’ΠžΠ™ Π”Π˜ΠΠ“ΠΠžΠ‘Π’Π˜ΠšΠ˜

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    The purpose of the study was an attempt to create universal criteria for the diagnostic imaging of bone metastases allowing biopsy to be avoided.Material and methods. Scans from 90 patients with verified primary malignant tumors and focal bone lesions in the (n=278) were analyzed. The minimal size of the focal bone lesion was 1 cm. All patients underwent multiparameter magnetic resonance imaging with a modified scanning protocol and single-photon emission computed tomography combined with computed tomography. Diagnostic evaluation was performed before starting treatment, 1 month after starting therapy, then every 3 months for 1 year.Results. The original Β«principle of 8 diagnostic elementsΒ» had been created, allowing the assessment of the main pathological conditions and processes occurring in bone structures. Based on the analysis and statistic processing of 236 foci of metastatic lesion, the diagnostic informative value of each of the imaging modalities and the algorithm as a whole were assessed, and the reference values were determined. This approach allowed the accuracy of early diagnosis to be improved due to a more reliable evaluation of bone metastases at an early stage, thus reducing or completely avoiding additional biopsies.ЦСлью исслСдования явилась ΠΏΠΎΠΏΡ‹Ρ‚ΠΊΠ° создания ΡƒΠ½ΠΈΠ²Π΅Ρ€ΡΠ°Π»ΡŒΠ½Ρ‹Ρ… ΠΊΡ€ΠΈΡ‚Π΅Ρ€ΠΈΠ΅Π² диагностики мСтастатичСского пораТСния костСй ΠΏΠΎ Π΄Π°Π½Π½Ρ‹ΠΌ соврСмСнных ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠ² мСдицинской Π²ΠΈΠ·ΡƒΠ°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ, ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡŽΡ‰ΠΈΡ… ΠΈΠ·Π±Π΅ΠΆΠ°Ρ‚ΡŒ биопсии. ΠŸΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Ρ‹ Π΄Π°Π½Π½Ρ‹Π΅ 90 Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… с Π²Π΅Ρ€ΠΈΡ„ΠΈΡ†ΠΈΡ€ΠΎΠ²Π°Π½Π½Ρ‹ΠΌΠΈ ΠΏΠ΅Ρ€Π²ΠΈΡ‡Π½Ρ‹ΠΌΠΈ злокачСствСнными опухолями с ΠΎΡ‡Π°Π³ΠΎΠ²Ρ‹ΠΌΠΈ измСнСниями Π² костях (n=278), ΠΌΠΈΠ½ΠΈΠΌΠ°Π»ΡŒΠ½Ρ‹ΠΉ Ρ€Π°Π·ΠΌΠ΅Ρ€ ΠΎΡ‡Π°Π³Π° составлял 1 см.ΠœΠ΅Ρ‚ΠΎΠ΄Π°ΠΌΠΈ обслСдования являлись ΠΌΡƒΠ»ΡŒΡ‚ΠΈΠΏΠ°Ρ€Π°ΠΌΠ΅Ρ‚Ρ€ΠΈΡ‡Π΅ΡΠΊΠ°Ρ ΠΌΠ°Π³Π½ΠΈΡ‚Π½ΠΎ-рСзонансная томография с ΠΏΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΠΌΠΎΠ΄ΠΈΡ„ΠΈΡ†ΠΈΡ€ΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΏΡ€ΠΎΡ‚ΠΎΠΊΠΎΠ»Π° сканирования, ΠΎΠ΄Π½ΠΎΡ„ΠΎΡ‚ΠΎΠ½Π½ΠΎ-эмиссионная ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½Π°Ρ томография, совмСщённая с ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½ΠΎΠΉ Ρ‚ΠΎΠΌΠΎΠ³Ρ€Π°Ρ„ΠΈΠ΅ΠΉ. ИсслСдования ΠΏΡ€ΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈΡΡŒ ΠΏΠ΅Ρ€Π΅Π΄ Π½Π°Ρ‡Π°Π»ΠΎΠΌ лСчСния, Ρ‡Π΅Ρ€Π΅Π· 1 мСс послС Π½Π°Ρ‡Π°Π»Π° Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ, Π΄Π°Π»Π΅Π΅ Ρ‡Π΅Ρ€Π΅Π· ΠΊΠ°ΠΆΠ΄Ρ‹Π΅ 3 мСс сроком Π΄ΠΎ 1 Π³ΠΎΠ΄Π°.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. Π‘Ρ„ΠΎΡ€ΠΌΡƒΠ»ΠΈΡ€ΠΎΠ²Π°Π½ ΠΎΡ€ΠΈΠ³ΠΈΠ½Π°Π»ΡŒΠ½Ρ‹ΠΉ Β«ΠΏΡ€ΠΈΠ½Ρ†ΠΈΠΏ 8 диагностичСских элСмСнтов», ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡŽΡ‰ΠΈΠΉ ΠΎΡ†Π΅Π½ΠΈΠ²Π°Ρ‚ΡŒ основныС патологичСскиС состояния ΠΈ процСссы, происходящиС Π² костных структурах. На основании Π°Π½Π°Π»ΠΈΠ·Π° ΠΈ статистичСской ΠΎΠ±Ρ€Π°Π±ΠΎΡ‚ΠΊΠΈ 236 ΠΎΡ‡Π°Π³ΠΎΠ² мСтастатичСского пораТСния рассчитана диагностичСская ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ ΠΊΠ°ΠΆΠ΄ΠΎΠ³ΠΎ ΠΈΠ· ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠ² ΠΈ Π°Π»Π³ΠΎΡ€ΠΈΡ‚ΠΌΠ° Π² Ρ†Π΅Π»ΠΎΠΌ, ΠΎΠΏΡ€Π΅Π΄Π΅Π»Π΅Π½Ρ‹ рСфСрСнсныС значСния. Π”Π°Π½Π½Ρ‹ΠΉ ΠΏΠΎΠ΄Ρ…ΠΎΠ΄ позволяСт ΠΏΠΎΠ²Ρ‹ΡΠΈΡ‚ΡŒ Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒ Ρ€Π°Π½Π½Π΅ΠΉ диагностики Π·Π° счСт Π±ΠΎΠ»Π΅Π΅ достовСрной ΠΎΡ†Π΅Π½ΠΊΠΈ костных мСтастазов Π½Π° Ρ€Π°Π½Π½Π΅ΠΉ стадии, Ρ‡Ρ‚ΠΎ позволяСт ΡΠ½ΠΈΠ·ΠΈΡ‚ΡŒ ΠΈΠ»ΠΈ ΠΏΠΎΠ»Π½ΠΎΡΡ‚ΡŒΡŽ ΠΈΠ·Π±Π΅ΠΆΠ°Ρ‚ΡŒ Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… биопсий
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