Possibilities Of Magnetic Resonance Imaging Research Articles

Imaging of bones dysbarogenic changes in navy divers

The number of diving descents in the world is steadily growing, as is the complexity of the work performed under conditions of increased environmental pressure. Also, in order to increase efficiency and expand the range of tasks performed, the intensity, depth of dives and the time divers spend in hyperbaric conditions are increasing. These factors contribute to an increase in the number of diving pathologies, including damage to the skeletal bones of dysbarogenic genesis. X-ray diagnostic methods used during annual medical examinations of divers do not always allow the detection of dysbarogenic changes in the bones; in addition, the clinical manifestations of this pathology do not have obvious specificity. In this regard, it can be assumed that the occurrence of this pathology among divers has not been reliably established to date. This article is devoted to a review of the literature on the possibilities of radiodiagnosis of dysbarogenic changes in skeletal bones in specialists whose work involves being in conditions of high environmental pressure. The article highlights the results of a literature review of English-language and Russian-language publications presented in the databases of PubMed and scientific electronic libraries of Russia (eLIBRARY.RU and CYBERLENINKA.RU). In order to determine the optimal methods of radiation diagnostics, the etiological and pathogenetic aspects of the development of dysbarogenic degenerative and necrotic changes in the bones of the skeleton, as well as the experience of scientists in determining the corresponding radiation semiotics, were analyzed. Considering that the worst manifestation of bone pathology of dysbarogenic origin is dysbaric (aseptic) osteonecrosis, we studied the literature on the issues of its clinical and instrumental diagnosis. One of the directions in scientific research was the work of authors exploring the possibilities of early instrumental diagnosis of changes in bone tissue, in particular the possibilities of magnetic resonance imaging in the diagnosis of dysbaric osteonecrosis. In addition, data on modern x-ray methods were analyzed, which may be promising as a screening diagnosis of dysbarogenic degenerative and necrotic changes in the bones of the skeleton.

MODERN IMAGING TECHNIQUES IN THE ASSESSMENT
 OF MALIGNANCY IN GLIAL BRAIN TUMORS:
 LITERATURE REVIEW

Relevance: Gliomas represent a major group of primary central nervous system tumors, accounting for approximately 80% of all
 malignant brain neoplasms. Recent advances in molecular diagnostics, including the identification of mutations in the isocitrate dehydrogenase(IDH) gene, offer new opportunities to improve the classification of gliomas and to understand the mechanisms of their development. IDH
 mutations, which are found in a large proportion of gliomas, are associated with a better prognosis and represent an important biomarker
 for the development of targeted therapeutic strategies. Diagnostic techniques, particularly magnetic resonance imaging (MRI), also play
 an important role, providing additional ways to assess the morphological and biological characteristics of gliomas, contributing to a more
 accurate determination of tumor malignancy and molecular profile, which is key to treatment decisions.
 The purpose: To study the possibilities of magnetic resonance imaging in assessing the degree of malignancy of glial brain tumors.
 Method: A literature review was performed using the keywords: glioma, IDH mutation, IDH wild-type, MRI, magnetic resonance
 spectroscopy (MRS), apparent diffusion coefficient (ADC), diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), diffusion kurtosis
 image (DKI), Susceptibility Weighted Imaging (SWI) in PubMed, BMC Medicine, and Google Scholar databases. The review includes the results
 of an analysis of 45 literature reviews on the diagnostic capabilities of molecular diagnostics and MRI to assess the malignancy of gliomas.
 Results: This review highlights the importance of current approaches to the diagnosis of gliomas, demonstrating that different grades of
 malignancy and IDH mutation status are associated with unique features on MR imaging, including differences in localization, signal, and
 enhancement patterns. DTI and DWI extend the ability of MRI to assess tissue microstructure, allowing for more precise tumor characterization.
 Studies combining MRI morphologic features, ADC and DTI parameters offer a non-invasive approach to glioma prognosis, highlighting the
 importance of integrated use of imaging modalities to improve diagnosis and therapy.
 Conclusion: The use of magnetic resonance imaging allows for more accurate morphologic and metabolic characterization of gliomas
 in assessing the degree of malignancy, allowing physicians to make more accurate prognostic assessments and select the most appropriate
 treatment strategy.
 Keywords: Glioma, IDH mutation, wild-type IDH, MRI, magnetic resonance spectroscopy, ADC, DWI, DTI, DKI, SWI

Possibilities of magnetic resonance imaging in visualizing the pudendal nerve in normal and pathological conditions

Until recently, imaging of peripheral nerves was limited from a technical point of view, as there was no established “gold standard” study protocol for the purpose of qualitative visualization of nerve trunks in normal and pathological conditions. With technical advances in magnetic resonance imaging and the advent of specialized high-resolution magnetic resonance neurography, it has become possible to visualize peripheral nerves of varying diameters. A literature search in the Pubmed, Medline, EMBASE, Cochrane Library, and eLibrary databases demonstrated the presence of several studies examining the capabilities of magnetic resonance imaging in visualizing the pudendal nerve in normal and pathological conditions. It must be emphasized that the results of these studies are consistent and largely complement each other. A generalization of the available data on the capabilities of magnetic resonance neurography of the pudendal nerve was the impetus for writing this literature review. Magnetic resonance neurography is a tissue-specific imaging method optimized for assessing the condition of peripheral nerves, including changes in the morphology of their bundle structure, signal, the diameter and length of nerve trunks, which can be caused by both anatomical features and pathological processes. Three-dimensional (3D) imaging is critical for studying the topography of peripheral nerves, identifying areas of compression or traumatic injury, and for preoperative planning. Magnetic resonance imaging in certain modes and sections allows to clearly visualize the pudendal nerve along almost its entire length, determine the nature of its branching and the features of its topographic and anatomical location. The anatomical characteristics of the pudendal nerve and its pathological changes obtained using magnetic resonance neurography can be used in everyday clinical practice by urologists, obstetricians-gynecologists and neurosurgeons for planning surgical interventions.

Possibilities of magnetic resonance imaging in the diagnosis of ischemic stroke in children

Research objective. To study the features of visualization of ischemic stroke in children at the early stages of the formation of the pathological process using magnetic resonance imaging.Material and methods. The results of magnetic resonance imaging (MRI) examination of 34 children with clinical manifestations of ischemic stroke (IS) were analyzed. The analyzed group included patients aged from the 29th day of life to 18 years who had focal changes in the brain substance (BS) during an MRI examination within a period of not more than 48 hours from the onset of neurological symptoms.Results. MRI makes it possible to establish in the early stages of the development of the pathological process the ischemic lesion of the BS in 100% of cases, as well as to evaluate the time indicators of the occurrence of focal changes, based on the analysis and comparison of pulsed MRI sequences, which allow characterizing the severity of the process.Discussion. The analysis of data obtained confirms the results of studies described earlier in the foreign and domestic literature. Moreover, there is a difference in the MR signal specifications from the IS focus during the first 6 hours upon occurrence of the neurological symptoms.Conclusions/findings. The MRI studies in children are important and necessary to determine the IS formation, evaluate the onset and dynamics of the pathological process that contribute to the timely detection of focal changes in the brain structures at the early stages.

Evaluation of the Possibilities of Magnetic Resonance Imaging in Monitoring the Treatment of Locally Advanced Cervical Cancer

Background: Cervical cancer occupies one of theleading places in cancer incidence in women. Preservation of residual tumor in patients with cervical cancer after completion of combined chemoradiotherapy is a prognostically unfavorable factor. Detection of an early tumor response to chemoradiation therapy is of great importance for choosing the optimal treatment tactics.Purpose: To study the possibilities of MRI in assessing the effectiveness of detecting an early tumor response in patients with locally advanced cervical cancer after combined chemoradiotherapy.Material and methods: The results of magnetic resonance imaging of the pelvic organs, data of laboratory, cytological and postoperative histological studies of 174 patients with locally advanced cervical cancer were analyzed and compared.MRI of the pelvic organs was performed before the start of treatment to assess the extent of the process (primary study) and 6 weeks after the completion of combined chemoradiotherapy to assess the effectiveness of the treatment and detect residual tumor (control study).Conclusion: Magnetic resonance imaging of the pelvic organs using a standard research protocol, including obtaining diffusion-weighted images and dynamic contrast studies, is a highly informative method for staging locally advanced cervical cancer and assessing the tumor response to treatment.

Possibilities of Magnetic Resonance Imaging in the Diagnosis of Ductal Adenocarcinoma of the Prostate (Clinical Case)

This article presents a clinical case demonstrating the possibilities of MRI of the pelvic under the assumption of a histological variant of a prostate tumor. The main MR-patterns of the ductal adenocarcinoma, as well as the variants of their occurrence are considered. The authors present an analysis of data of differential diagnosis of various histological variants of prostate cancer.

Magnetic resonance imaging in acute traumatic injuries of ligaments and soft tissues of cervical spine in children

Aim of the study: to study the role and possibilities of magnetic resonance imaging (MRI) in the diagnosis of injuries of ligaments and soft tissues of the cervical spine in emergency care. Materials and methods. MRI was performed in fifty two children with trauma of the cervical spine, in 1 of them with contrast enhancement. Boys predominated - 33 (63.5%), girls were 19 (36.5%). The age of the patients varied from 3 to 17 years, the mean age was 14 ± 1.4 years. The study was carried out on a Phillips Achieva dStream 3T scanner. The study protocol includes MR-myelography in sagittal and coronary projections, T2WI sagittal projection in PS STIR, T2WI SE, T1WI SE, DTI, axial projection of T2WI SE or T2*WI GRE. Results. Trauma of cervical spine was combined in 46% (n = 24) of all 52 cases, and in 54% (n = 28) it was isolated. During the clinical and neurological examination according to the ASIA impairment scale, there were 13 (25%) children with grade A, 3 (5.8%) with grade B, 9 (17.3%) with grade C, 4 (7.7%) with degree D and 23 (44.2%) with grade E. Spinal cord injuries in the form of hematomyelia were detected in 13 (25%) children, contusion and swelling of the spinal cord - in 15 children (29%). According to MRI results, 4 (7.7%) had a traumatic hernia with a decrease in disc height, 15 (28.8%) had secondary stenosis of the spinal canal at the time of the study, 28 (53.8%) had spinal cord compression and changes in the MR signal, 5 (9.6%) had epi- and subdural hematomas, 45 (86.5%) had vertebral fractures. Conclusion. MRI, as a method more sensitive than other imaging modalities in the diagnosis of soft tissue and spinal cord injuries, allows radiologist directly assessing the condition of spine soft tissues and, therefore, is critical in the evaluation of a patient with ligament injury and instability. Recognition of soft tissue injuries affects patient management and outcome.

Magnetic resonance imaging in the diagnosis of acute hematogenous osteomyelitis in children

Aim of the study: to show the possibilities of magnetic resonance imaging for the diagnosis of acute osteomyelitis. Materials and methods. One hundred thirty two children with hematogenous osteomyelitis (n = 112 - 84.8%), including BCG-osteomyelitis (n = 20 - 15.2%), aged 1 to 17 years, average age - 9.1 ± 4.9 years, were examined between 2011 and 2020. Out of 132 children, 77 were operated on (58.3%). Boys predominated - 70 (53%) patients, girls - 62 (47%). MRI was performed on a Philips Achieva dStream 3.0 T. Results. Over the first three days after onset of the disease, when radiography and CT did not reveal bone pathological changes, according to MRI acute osteomyelitis was detected in all patients (n = 51). The topical location of osteomyelitis foci was clearly established. Discussion. MRI is the most informative method for visualizing acute hematogenous osteomyelitis over first days of the disease. MRI clearly shows initial bone remodelling and bone marrow edema, including the such earliest sign as perifocal myositis. The most effective MRI sequences are STIR and T2WI, regardless of the pulse sequence, in which a pronounced hyperintense signal is visualized. Whole body MRI combined with clinical data is considered a promising method for distinguishing inflammatory processes from other specific diseases.

Possibilities of magnetic resonance imaging in the diagnosis of acute aseptic sacroilitis in children

INTRODUCTION: Children and adolescents with juvenile spondyloarthritis (JSA) are at risk of developing sacroiliitis. MRI is the most preferred method of diagnosing sacroiliitis in adults over radiography and computed tomography. However, in the case of diagnosing childhood sacroiliitis, there is little information about the capabilities of MRI, and the reliability of the results in studies varies.OBJECTIVE: To show the possibilities of MRI in the diagnosis of infectious-allergic sacroiliitis.MATERIALS AND METHODS.: In this report, we present an analysis of data from 16 patients with aseptic (infectious-allergic) sacroiliitis only. Boys and girls aged 6 to 17 years (mean age 12.2±4.9) were equally divided. Magnetic resonance imaging, including contrast-enhanced imaging (used in 14 patients out of the total), was performed on a 3 T scanner (Achieva dStream Phillips) using a standard protocol that included multiplanar 3D T1-, T2WI, FLAIR and STIR with oblique coronal projection, diffusion-weighted images (DWI).RESULTS: MRI in all 16 patients revealed changes, even in those cases when X-ray and CT did not reveal pathological changes in bone or the changes were on the verge of normal (n=15). Of the 16 children, 10 (62.5%) had unilateral changes (50% on the right, 50% on the left) and six (37.5%) had bilateral changes. The bone marrow edema affected the sacrum in 10 patients, the ilium in three, and both bones of the joint in three patients. On DWI (10 children), increased diffusion was observed in five patients, on the right — in three, and on the left — in two patients.CONCLUSION: Currently, the best imaging modality for suspected acute sacroiliitis is MRI, which is more sensitive and specific, allowing early diagnosis of the disease and, accordingly, initiation of treatment, improving the prognosis. Disadvantages of MRI are long scan times, susceptibility to motion artifacts that require sedation or anesthesia in young children.

The possibilities of magnetic resonance imaging in the differential diagnosis of diabetic osteoarthropathy and osteomyelitis

Introduction. The problem of differential diagnostics of diabetic osteoarthropathy (DOAP) and osteomyelitis (OM) of the foot bones for patients with diabetes mellitus is still not finally solved, even with the use of MR imaging.The aim of the study. To find the MR signs that most accurately indicate the development of osteomyelitis (OM) of the foot bones in patients with diabetic osteoarthropathy (DOAP).Materials and methods. The study included 62 patientswho successfully completed treatment of uncomplicated or complicated DOAP and had the whole set of diagnostic criteria. They were divided into three groups: acute form of DOAP (n=31), DOAP+soft tissue infection (STI) (n=11) and DOAP+OM (n=20). There were identified6 MR-signs, which could become significant independent classifiers for the differential diagnostics of complicated and uncomplicated forms of DOAP. The diagnostic significance of MR symptoms was assessed in several steps with the use of various methods of statistical analysis.Results. There was revealed that the groups differ among themselves by 4 MR signs: characteristics of bone marrow edema (p=0.003); swelling of the supporting surfaces (p=0.006); restriction of diffusion in the bone marrow (p=0.001); fistulous course (p=0.001). Points were assigned to these MR criteria. According to the total MR score, groups 1 and 3 (p<0.001); 2 and 3 (p=0.001) differed among themselves. With the use of logistic regression and ROC analysis, we determined the significance of the total MR score for the diagnostics of osteomyelitis. Conclusion. The use of the MR-score summation system helped in the diagnosis of OM. The sum of MR scores ≥3 in the developed scoring system allowsto diagnose OM with high sensitivity (94.1%) and specificity (83.3%). >˂0.001); 2 and 3 (p=0.001) differed among themselves. With the use of logistic regression and ROC analysis, we determined the significance of the total MR score for the diagnostics of osteomyelitis.Conclusion. The use of the MR-score summation system helped in the diagnosis of OM. The sum of MR scores ≥3 in the developed scoring system allowsto diagnose OM with high sensitivity (94.1%) and specificity (83.3%).

Informative value of whole-body magnetic resonance imaging with diffusion-weighted images for the detection of bone marrow infiltration in patients with multiple myeloma (literature review)

Magnetic resonance imaging (MRI) is increasingly being used to diagnose bone marrow lesions in patients with multiple myeloma (MM). Since 2014, the results of MRI have been included in the updated criteria of the International Myeloma Working Group. The presence of >1 bone marrow lesion larger than or equal to 5 mm on MRI is considered sufficient for the diagnosis of symptomatic MM, requiring initiation of treatment. MRI assessment of bone marrow is also possible with functional sequences such as diffusion-weighted imaging (DWI), which provide additional information about the bone marrow. This article provides an overview of the possibilities of MRI with anatomical sequences and with DWI for diagnosing, monitoring and evaluating the response to treatment in patients with MM. In patients with monoclonal gammopathy of undetermined significance and smoldering myeloma, in some cases, pathological changes in the bone marrow can be detected by MRI. The presence of >1 bone marrow lesion on MRI is a cut-off value as a prognostic factor for the progression of monoclonal gammopathy of undetermined significance or smoldering myeloma to symptomatic MM. In symptomatic MM, there are four patterns of bone marrow infiltration on MRI – focal, diffuse, “salt-and-pepper” infiltration, and combined diffuse and focal pattern, which have prognostic significance. Patients with diffuse pattern of infiltration on MRI had a 3-year overall survival of 35 % versus 92 % in patients with normal MRI bone marrow. During treatment of MM patients, residual bone marrow lesions are often identified on MRI. MRI residual bone marrow lesions increase the risk of MM relapse. In the group of patients who had residual bone marrow lesions on MRI on the 100th day after autologous hematopoietic stem cell transplant, 2-year progression-free survival was 50 % versus 89 % in patients without bone marrow lesions at the same time. The addition of DWI to the scan protocol helps to differentiate persistent focal bone marrow lesions that can lead to MM relapse after the treatment phase. Apparent diffusion coefficient is a quantitative indicator of DWI. MRI can serve as a valuable tool for assessing the treatment response in patients with MM.

Magnetic resonance imaging in diagnosis of complications of kidney and ureteral injury in different periods of traumatic disease

To assess the possibility of magnetic resonance imaging in diagnosis of complications of kidney and ureteral injury in different periods of traumatic disease. There were 139 patients with kidney and ureteral injuries between 2015 and 2019. We clarified the MR-signs of renal complications in different periods of traumatic disease. We analyzed the effectiveness of MRI in identification of renal complications compared to ultrasound, excretory urography, computed tomography, intraoperative and follow-up data. High diagnostic accuracy of MRI for early and late manifestations of traumatic disease was demonstrated.

Possibilities of Magnetic Resonance Imaging in the Diagnosis of Changes in the «Vascular Wall» in Giant Cell Arteritis

The aim of the study: to identify features of extracranial carotid and vertebral arteries vessel wall MRI in norm and pathology using layer-by-layer analysis of the arterial wall components. MRI results were compared at the same anatomical level with data of ultrasound examination of vertebral arteries in patients with giant cell arteritis and in health individuals. It was revealed that in normal arteries MRI signal from the vessel wall mainly formed by vascularized adventitia and venous plexuses. Media and intima visualization becomes possible in cases of their pathological transformation. Thus, it was defined which structures of the vessel wall take part in MRI signal forming in health individuals and patient with pathology. Also MRI patterns of different stages of large arteries vasculitis were identified.

MRI- and CT-venography in the diagnosis of hemodynamic disorders in patients suffering from lower extremities chronic venous disorders. Part II. Possibilities of MRI in diagnostics of the deep vein thrombosis

In this literature review, the analysis of the studies of venous blood flow pathology in the inferior Vena cava system using magnetic resonance imaging (MRI) is carried out. Special attention is paid to the attempts made to use this method in the diagnosis of chronic lower limb vein disorders (CVD) through magnetic resonance venography (MRV). Historically and methodically, the gradual introduction of MRV methods in the diagnosis of lower limb vein thrombosis (LEDVT) and venous thromboembolism (VTE) has been shown.Methods of non-contrast MRV based on the effect of blood flow, as in the case of MR-Angiography, are divided into two principal groups: methods based on the amplitude effects of Time-of-Flight (TOF) and methods based on Phase Contrast effects (PC). Techniques for conducting contrast-free MRV are described in detail. Attention is paid to pulse sequences used in the world for visualization of veins in contrast-free MRV in TOF and PC mode (FR-FBI, SPADE, SSFP) and post-processing methods: 2D-TOF MRV FLASH, 2D-TOF MRV CRASS, FIPS, VED, VENS.Contrast-enhanced MRV (CE MRV) is based on the use of “blood pool” contrast agents, which feature the ability to form stable compounds with blood plasma proteins. Worldwidesubstances with magnetic and supermagnetic properties based on gadolinium or iron oxide are used as contrast agents for CE MRV. The result of using these contrast agents is an increase in the quality of visualization due to a better signal to noise ratio (SNR) using 3D image processing (3D CE MRV) using fast sequences: GRE, TFLAS, VESPA, CAT, in conditions of direct and indirect CE MRV.It is noted that in recent years, certain restrictions have been imposed on certain linear contrast agents containing gadolinium in their further use. Therefore, for the purpose of CE MRV, it is efficientl to use only cyclic contrast agents to avoid unnecessary risks.Contrast-free MRV has again received intensive development in recent years, due to the restrictions imposed, one of these methods is direct thrombus imaging (Direct Thrombus Imaging – DTI or Magnetic Resonance Direct Thrombus Imaging - MRDTI) using fast pulse sequences: bSSFP, BBTI, DANTE. The latest research on this LEDVT diagnostic method was published in 2019 and has shown high diagnostic value.For all the most commonly used methods of MRV, specificity and sensitivity are shown.Further MRV in patients with CVD and DVT is a promising diagnostic task in modern phlebology. MRV should be introduced into clinical practice more actively than it is today.

Diagnostic opportunities of magnetic resonant imagingmri of heart in differential diagnosis of phenotypical forms of hypertrophic cardiomyopathy

Introduction. Phenotype variants of left ventricular (LV) remodeling in patients with hypertrophic cardiomyopathy (HCM) are often associated with abnormalities of the mitral valve (MV), myocardiumstructure, contributing to the development of medium and/or subaortic obstruction. Itcauses the detail visualization of morphological obstruction substrates, tissue characteristics.Aim. To evaluate the possibilities of magnetic resonance imaging (MRI) in the diagnosis of various forms of HCM and combined abnormalities.Materials and methods. 75 patients with suspected HCM were examined. For verification, all patients underwentMRI using protocol: short-pulse T1w-TSE/ T2w-TSE (STIR), gradient echo in cine (CINE), T1-weighted post-contrast images (Inversion Recovery IR-MDE). Results. Patients classified into 4 types according to the anatomical principle (Wiggle E.D. et al., 1985). In addition to the most frequent forms affecting the interventricular septum (IVS) — 64 patients, unusual forms covering the apical zones and papillary muscles — 11 patients. The majority of patients were diagnosed with abnormalities of MV, divided into abnormalities of the number and position of papillary muscles, as well as the ratio of chords and muscles. Myocardial crypts were diagnosed in 12 patients, some combined with areas of non-compact myocardium. Post-contrast visualization using the delayed contrast technique allowed differentiating HCM with accumulation diseases, excluding cavity thrombosis, and evaluating the severity of myocardial fibrosis.Conclusions. MRI allows to estimate in details anatomic picture of LV remodeling, to diagnose features of the mitral valve, tissue characteristics that allows to stratify risk of sudden death, classify the HCM phenotype form and to determine the volume of surgical intervention.

MRI and CT venography in the diagnosis of hemodynamic disorders in patients suffering from the lower extremities veins chronic diseases Part I. Possibilities of MRI in visualization of the vascular blood flow of the lower extremities

Despite the fact that most vascular surgeons in Russia rarely use magnetic resonance imaging (MRI) in their daily practice, today interest in this method of imaging among specialists in the world is steadily increasing. This is due to the desire of clinicians to have another non – invasive method for diagnosing hemodynamic disorders of both the arterial (Magnetic Resonance Angiography – MRA) and venous vascular bed (Magnetic Resonance Venography – VRA). The development of these methods today is associated with the solution of many technical problems, the development of special pulse sequences and post-processing methods for the resulting image. This literature review analyzes published scientific data on the methodology of MRI in relation to the vascular system and the choice of optimal scanning modes. Taking into consideration the fact that this material is intended primarily for vascular surgeons and phlebologists, and not radiologists, the first part summarizes the basic understanding of the physical phenomena underlying the MRI image, without which a thoughtful analysis of the advantages and disadvantages of MR-Angiography and the search for the most optimal scanning mode for MR-Venography is not possible. Based on the constant desire of clinicians to be self-educated, it seems that this part of the presented material will not be difficult to understand. When describing the developed contrast-free and contrast-free MRA methods, attention is paid to the traditional methods of image processing in 2D mode (TOF, PC) using pulse sequences: spin echo (SE), multi-echo (SE T2), turbo spin echo (TSE), fast Advanced Spin Echo (fast Advanced Spin Echo-FASE), gradient echo (Gradient Echo-GE, GRE) and inversion recovery (Inversion Recovery-IR). In addition, the focus is on the most modern solu tions, including: multiplantar reformatting (MPR), maximum intensity projection (MIP), subvolume maximum intensity, surface rendering (SR), volume rendering (VR) and virtual intraluminal endoscopy (VIE). For all the methods used today, MR-Angiography is shown to be specific and informative, with a detailed analysis of the advantages and disadvantages. The nuances of understanding the resulting angiographic image in T1 and T2-weighted images and the phenomena of “bright blood” and “black blood” are shown. Since the absence of information or a brief mention only about the possibilities of using MRI in the diagnosis of hemodynamic disorders in patients with vascular pathology in Russian scientific literature it seems that this material is relevant and will arouse some interest from various specialists. Of particular interest is the potential use of contrast-free and contrast – free MR Angiography in the study of venous pathology of the lower extremities and pelvis, especially with regard to timely and accurate diagnosis of deep venous thrombosis (deep Vein Thrombosis-DVT) and venous thromboembolism (Venous Thrombosis – Embolism – VTE), which occupy a special position in the structure of patients with chronic venous Disorders of the lower extremities (Chronic Venous Disorders-CVD).

MRI-Diagnostics of Injuries and Diseases of the Ankle Joint and Foot (Review of Literature)

Summary. Diseases and injuries of the ankle joint and foot make up 6-12% of the total number of injuries and diseases of the musculoskeletal system. The article is devoted to the main diagnostic possibilities of magnetic resonance imaging (MRI), determination of indications for examination and protocols for the study of the ankle joint and foot. Based on the analysis of literature data, the high diagnostic efficiency of MRI in the identified pathologies of bone and soft tissue structures of this segment of the lower extremity was determined.

Magnetic resonance imaging of a sports injury of the lower extremities in children

Introduction. The number of acute and stressful injuries has been increasing in recent years. Injuries of the musculoskeletal system in children seeking emergency care account for 41%, while children aged from 5 to 17 years with chronic sports injuries account for 53% who need medical attention. The lower extremity is the most frequently affected part of patients aged from 5 to 18 years, which is about 60% of all injuries. Aim of the study. To show the possibilities of magnetic resonance imaging in the diagnosis of sports injuries of lower extremities in children. Materials and methods. MRI was performed on a scanner with a magnetic field strength of 3 T to obtain multi-planar STIR, T1-, T2- and PD-weighted images (WI) SE and GE in axial, oblique frontal and sagittal projections with a slice thickness of 4 mm, as well as 2D and 3D isotropic images that were used to obtain images with contrast gain. Specialized coils were used for MRI. MRI was performed in case of damage to the hip (n = 19), knee (n = 329), and ankle joints (n = 32). Results. Studies of the hip were limited to sports muscle injury - muscle strain due to forced contractile load (75.8%) and muscle bruises (24.2%). According to the MRI results, 320 children with knee injury were diagnosed with ACL ruptures, in 67% - complete (n = 214), 33% (n = 106) - partial. Eight (3.7%) of 214 athletes had isolated full breaks in ACL; the remaining 206 were associated with damage to other structures of the knee joint. ACL ruptures were accompanied in all 320 cases of hemarthrosis. Of 30 patients with an ankle injury, 17 had an anterior talofibular ligament (56.7%), in 8 cases with an avulsion of bone fragments from the lateral ankle. Partial deltoid ligament injuries were detected in 9 patients (30.0%); complete ruptures were rare and were observed in only two patients (6.7%). Conclusion. Among imaging methods, MRI plays a decisive role in the diagnosis of sports injuries in children.

Possibilities of magnetic resonance imaging in SWI mode in differential diagnosis of brain gliomas (G3–G4) and primary lymphomas

The study objectiveis to assess the possibilities of magnetic resonance imaging (MRI) in SWI (susceptibility weighted imaging) in the differential diagnosis of glial brain tumors and primary brain lymphomas.Materials and methods.Fifty-four patients with brain tumors were studied (men – 27 (50 %), women – 27 (50 %)). Average age 57.9 years. Histological examination of the surgical material revealed the glial nature of tumors in 41 patients (26 of them with glioblastoma, anaplastic astrocytomas – 15), primary brain lymphomas – in 13 patients. Brain MRI was performed using tomographs with a magnetic field of 3 and 1.5 T. A semi-quantitative assessment of the data obtained in the SWI mode based on the classification of ITSS (intratumoral susceptibility signals), reflecting the severity of interstitial vascular architectonics and microbleeding.Results.The degree of ITSS was 3 in glioblastomas (G4 ) in 26 (100 %) cases, in the structure of gliomas (G3 ) the ITSS values were 3 in 3 (20 %) cases, in the remaining 12 (80 %) cases – ITSS 2. In the group of primary brain lymphomas, the ITSS 1 was in 4 (30.7 %) cases, ITSS 0 was in 9 (69.3 %) cases.Conclusion.MRI in SWI mode is a promising technique that allows one to quantify the degree of pathological changes in tumor vascular architectonics and intratumoral hemorrhages and has shown high specificity in the differential diagnosis of malignant gliomas and lymphomas of the brain, accompanied by active accumulation of contrast medium.

Highly Efficient 2D NIR-II Photothermal Agent with Fenton Catalytic Activity for Cancer Synergistic Photothermal-Chemodynamic Therapy.

Photothermal therapy (PTT) has emerged as a promising cancer therapeutic modality with high therapeutic specificity, however, its therapeutic effectiveness is limited by available high‐efficiency photothermal agents (PTAs), especially in the second near‐infrared (NIR‐II) biowindow. Here, based on facile liquid‐exfoliated FePS3 nanosheets, a highly efficient NIR‐II PTA with its photothermal conversion efficiency of up to 43.3% is demonstrated, which is among the highest reported levels in typical PTAs. More importantly, such Fe‐based 2D nanosheets also show superior Fenton catalytic activity facilitated by their ultrahigh specific surface area, simultaneously enabling cancer chemodynamic therapy (CDT). Impressively, the efficiency of CDT could be further remarkably enhanced by its photothermal effect, leading to cancer synergistic PTT/CDT. Both in vitro and in vivo studies reveal a highly efficient tumor ablation under NIR‐II light irradiation. This work provides a paradigm for cancer CDT and PTT in the NIR‐II biowindow via a single 2D nanoplatform with desired therapeutic effect. Furthermore, with additional possibilities for magnetic resonance imaging, photoacoustic tomography, as well as drug loading, this Fe‐based 2D material could potentially serve as a 2D “all‐in‐one” theranostic nanoplatform.