Сопоставление информативности МР-перфузии и ПЭТ с [11С]метионином в дифференциации продолженного роста церебральных опухолей и лучевых поражений головного мозга после комбинированного лечения

The aim of the study was to compare T2*-weighted MR-perfusion (pMRI) and positron emission tomography using [11C]methionine (PET-Met) in differentiating recurrent brain tumor (RT) from posttreatment radiation effect (PTRE). Material and methods. PET-Met and pMRIwere performed in 45 patients with previously treated brain tumor A total 57 lesions were analyzed. The rCBV index and [11C] methionine uptake index (UI-Met) were calculated as the ratios of the highest lesion value to the that in the reference region. The diagnostic accuracy of UI-Met and rCBV for correct identification of recurrent tumor (RT) versus PTRE was evaluated by ROC-analysis using subsequent histologic analysis or clinical and radiological follow-up. Results. According to the final diagnosis patientsexhibitedthetwo typesofabnormalities: recurrent tumor (n = 33) and non-progressive lesions (n = 24). The inter-individual agreement between the both techniques was observed in 93% of cases. In 4 patients results were discordant. High [11C]methionine uptake and low rCBV were detected in 2 cases of radiation necrosis. In 2 patients PET-Met was able to distinguish foci of radionecrosis and the viable tumor tissue. Conclusion. T2*-weighted MR-perfusion and PET-Met could be efficiently used for differentiation RT from PTRE. Inter-individual comparison of the both methods showed that PET-Met was more sensitive in imaging recurrent tumor, but perfusion MRI had higher specificity.Цель исследования: сравнительный анализ результатов Т2* МР-перфузии (пМРТ) и позитронно-эмиссионной томографии с [11С]метионином (ПЭТ-Мет) в дифференциальной диагностике продолженного роста опухоли (ПРО) и лучевого повреждения головного мозга (ЛП). Материал и методы. ПЭТ-Мет и пМРТ были выполнены 45 пациентам после комбинированного лечения церебральных опухолей. Было проанализировано 57 контрастно-позитивных очагов, для каждого из которых вычислялся индекс накопления [11С]метионина и индекс rCBV. Верификация результатов базировалась на патогистологическом исследовании (n = 20) или динамическом клинико-радиологическом наблюдении (n = 24). Для определения информативности выбранных показателей и оптимальных величин для принятия решения использован ROC-анализ. Результаты. Согласно окончательному диагнозу, пациенты были разделены на 2 группы: группа ПРО (n = 33) и группа с отсутствием ПРО (n = 24). Совпадение результатов ПЭТ и пМРТ наблюдали в 93% случаев. У 4 пациентов отмечалось расхождение результатов. В 2 случаях лучевого поражения определялось высокое накопление метионина при пониженных значения rCBV. У других 2 больных ПЭТ позволила выявить участок активной опухолевой ткани на фоне постлучевых изменений. Выводы. nМРТ и ПЭТ-Мет могут быть эффективно использованы для дифференциации ПРО и ЛП головного мозга. Сопоставление результатов показало, что ПЭТ-Мет обладает большей чувствительностью в выявлении и контурировании границ ПРО, но уступает по специфичности nМР

Bioinert Properties of a Coronary Stent with Nanostructural Carbon Coating

ABSTRACT The article is dedicated to study of bioinert properties of a coronary stent with nanostructural carbon coating by the up-to-date methods of intravascular visualization. It was evidenced that use of a stent with nanostructural carbon coating results in reduction of the risk of in-stent stenosis by more then 2 times as compared to endoprostheses made of stainless steel without surface modification and does not induce thrombogenesis when standard antiaggregant doses are used

Essence transformation of the notions of civil and patriotic youth education in a changing world

The paper touches upon the issue of the relevance of civic-patriotic education of young people. Based on the analysis of federal legal documents, it is concluded that today civic-patriotic education is recognized as a priority in modern educational policy. It is noted that the trends of modern science (axiologization, informatization, ecologization, integration, the trend of synergy) subjected the transformation of the concept of "patriotism", "citizenship" as a result of civil and patriotic education of young people in a changing world. The paper presents modern interpretations of these concepts. It is noted that the main goal of civil-patriotic education is the revival of patriotism in our society as the most important spiritual, moral and social value. The concept of "civil-patriotic education of students" was clarified. The purpose of the paper is to theoretically substantiate the methodological foundations for the development of a system of civil and patriotic education of students in a changing world. Theoretical and empirical methods are used. The authors define a set of methodological approaches (value, environment and activity), which determine the content and technological apparatus of the study. These approaches formed the basis for the development of a system of civil-patriotic education of students. The mechanisms of the value approach are identified: the totality and content of values, the definition of technology and methods for the implementation of the totality of values in the process of civil-patriotic education of a person, unity of the content of the system of civil and patriotic education of students and the socio-cultural environment . A system of civic-patriotic education was developed, which is an integration of objective, content, motivational-value, practical-activity, evaluative-effective components. Due attention is paid to the pedagogical conditions for the implementation of the system of civil and patriotic education of students. This system performs analytical, diagnostic, prognostic, design, practice-oriented, adaptive, educational and cognitive, organizational and control and evaluation functions. The results of a survey of students on patriotism, citizenship, the most effective forms, methods and means that contribute to the civil-patriotic education of a person are presented. Among the technologies, students single out subject-oriented technologies that are interactive in nature, contribute to the development of critical thinking, analytical, reflective, research and design skills