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© Medicina Oral S. L. C.I.F. Background: The knowledge of root canal anatomy and of the anatomical relationship should be considered mandatory when planning surgical endodontics. The aim of the study was to investigate the anatomical features of mandibular premolars, evaluating their relationship with mental nerve. Material and Methods: CBCT scans were evaluated recording the number of roots, root canal configuration and the relationship with mental nerve of 100 mandibular premolars. After simulating a resection of 3 mm of the root, the shape and the number of canals, and the distance to the buccal and lingual bone plate and to the mental foramen was evaluated. Results: The one root - one canal configuration was the most common configuration. The mental foramen was located at the level of MSPs in 40% cases, and it was between MSP and MFP in 46% of cases. The distance between the apex and the vestibular plate was lower than the distance to the lingual one. Conclusions: We found a significant heterogeneity in the anatomy of mandibular premolars. CBCT could be considered important when planning surgical endodontics in this region.

© 2018 Contemporary Clinical Dentistry | Published by Wolters Kluwer - Medknow. Background: The success of endodontic treatment depends on the knowledge of root canal system. The root canals have complex morphology and wide individual variations. The aim of this study was to evaluate the root canal morphology of the maxillary first molars among residents of the Moscow region using cone-beam computed tomography (CBCT) scanning. Materials and Methods: Three hundred CBCT images of patients aged 20-70 years old were analyzed to study the root canal system (the number of canals and the configuration according to Vertucci's classification) of the maxillary first molars. The prevalence of a second mesiobuccal (MB2) in the mesiobuccal root (MB) was recorded in each age group. Results: three separated roots of the maxillary first molar were observed in 100% of cases. MB2 canals were found in 59.8% of cases. A second distobuccal canal was observed in 0.5% of cases. The canal morphology in the MB root was 40.2% in Type I, 22.4% in Type II, and 37.3% in Type IV. Conclusion: The prevalence of MB2 canals was 59.8%, and the most common canal morphology was Vertucci's Type I. Using CBCT scanning is a useful technique to evaluate and analyze the root canal system.

© 2018 Russian Electronic Journal of Radiology.All right reserved. In plastic surgery we often have the need for soft tissue volume restoration of different localization, to close congenital or acquired defects as well as associated with agerelated changes in soft tissue. Autologous adipose tissue in many properties is the ideal filler for the correction of the body contour defects. However, despite its advantages, this minimally invasive technique has been secondary to more complex methods of reconstruction - flap transplantation. The main significant drawback of fat grafting is the unpredictable and ineffective survival of transplanted fat (20 to 60%, according to different authors). Currently, factors that can influence the degree of survival of adipose tissue and make it more predictable are being actively studied, in particular, the effect of Leucocyte and Platelet Rich Plasma (L-PRP). Purpose: To prove the stability of transplanted adipose tissue survival with the addition of L-PRP in breast surgery via multispiral computed tomography (MSCT) with the calculation of resorption rate of adipose tissue before transplantation in the early and in late postoperative stages. Materials and methods: In the period from 2013 to 2016, a total of 48 patients underwent surgery at the plastic surgery clinic in I.M. Sechenov First Moscow State Medical University. All patients complained of dissatisfactory appearance of the breast. Patients underwent breast lipofilling in order to correlate contour deformities. Monitoring of adipose autografts consisted of the following methods: MSCT was performed in 12 cases (5 patients after transplantation of pure adipose tissue and 7 patients after transplantation of adipose tissue enriched with L-PRP). Results: The study of the sample volumes and thickness of soft tissues after the transplantation was performed both with and without the addition of L-PRP. A steady increase in the soft tissue thickness in the breast region was revealed and an increase in volume was noted in the main group. At the same time, in patients of the control group three months after surgery a decrease in the volume and thickness of the breast soft tissues was revealed. Conclusions: The results of the study show that the improvement of breast contour after transplantation of adipose tissue both with and without the addition of L-PRP provides a steady increase in the thickness and volume of breast soft tissues. The average loss of adipose tissue after transplantation ranges from 11.62% to 17.13%. The results also confirm that MSCT is an adequate method of visualization of adipose autografts and volumetric changes in the late postoperative period.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Purpose. To present the relevance of cone-beam computed tomography (CBCT) in diagnostics of nasal cavity fungus ball before surgery. Materials and methods. The clinical observation of the patient with nasal cavity fungus ball is provided. Patient's examination included anterior rhinoscopy, forward-viewing endoscopy, and CBCT. Results. After comprehensive clinical examination of the patient including CBCT accurate diagnosis was established: fungus ball in the left half of the nasal cavity. Endoscopic foreign body removal had been carried out with endotracheal anesthesia. It is required to perform histological examination. Conclusion. The presented clinical case demonstrates the importance of CBCT application in pre-admission diagnostics of nasal cavity fungus ball.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Mainly, intracoronary thrombosis is the cause of acute coronary syndrome. The structure of the atherosclerotic plaque plays an important role in the development of the mechanism of intracoronary thrombosis. Currently, there are various radiological methods for diagnosis of atherosclerotic plaques of the coronary arteries. The current review reveals the theme of "indirect" signs of instability of atherosclerotic plaques, their combinations and occurrence, detected by computed tomography. Retrospective studies have shown the feasibility of these signs of plaques in the assessment of the prognosis of acute coronary events. The review compares the results of computed tomography (CT) and intravascular ultrasound, which is the gold standard in the diagnosis of atherosclerotic plaque morphology.

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. Until today, there are no universally accepted methods for detection of unstable atherosclerotic plaques, even though many recent studies were devoted to this issue. In this article we present modern possibilities of computed tomography in visualization of atherosclerotic coronary lesion, including the detection of unstable lesions, whot in turn, can help in diagnosing subclinical exacerbation of ischemic heart disease and in the stratification of risks of acute coronary events.

© 2018 Medical Education. All Rights Reserved. Chest computed tomography (CT) helps better understanding clinical and pathological features of respiratory diseases. However, interpretation of CT images is difficult without information on clinical course of the disease in the given patient. Therefore, the definite diagnosis could be reached through cooperation of a clinician and a radiologist. This publication presents a lecture aimed at improving a physician's knowledge on interpretation of lung computed tomography (CT) patterns including imaging, structure and extension of abnormal signs. This information is believed to help the clinician to diagnose and differentiate pulmonary diseases based both on CT syndromes and clinical signs. A particular attention is paid on lung tissue attenuation pattern as the most common chest CT abnormality that includes five key entities, such as ground glass opacity, mosaic attenuation, consolidation, atelectasis, and soft-tissue mass.

© 2018 Russian Electronic Journal of Radiology.All Rights Reserved. Purpose. To reveal the important clinical and radiologic characteristics of bony defects developing near vertical root fractures according to cone-beam computed tomography findings, which can be used for the diagnosis and differential diagnosis of root fractures. Material and methods. Eighty clinical cases suggestive for vertical root fractures were analyzed in the study. Teeth with vertical root fractures confirmed after extraction (n = 65) were divided according to tooth group and fracture propagation pattern as well as associated bone resorption according to cone-beam computed tomography. Clinical and radiographic features of vertical root fractures were compared with the mimicking conditions to reveal the differences. Results. From 80 teeth 65 were fractured; the conditions mimicking vertical root fractures included chronic periodontitis (2 cases), periapical pathology (13 cases), strip perforations (5 cases), and accessory canals (3 cases). The characteristic combination of clinical and radiographic features of vertical root fractures included a deep narrow periodontal pocket (52,3%), dehiscence-like defect of the buccal cortical plate with no or a lesser extent of periodontal destruction reflection on the other sites of the dentition and at the proximal surface(s) of the fractured root. Discussion: The differential diagnosis of vertical root fractures is a challenging task. The detection of fracture with cone-beam computed tomography is not always possible. However, this method may be used for the diagnosis of fractures by ascertaining the form and location of the bony defect. Conclusions. The analyses of characteristic features of the bony defect in conjunction with clinical findings allowed for diagnosis of vertical root fractures.

© 2018 Russian Electronic Journal of Radiology. All Rights Reserved. Purpose. The purpose of this study was to determine possibilities of functional computed tomography for diagnostics of the knee endoprosthesis loosening. Materials and methods. A total of 12 patients with suspected knee endoprosthesis loosening were observed. We performed dynamic computed tomography on the Toshiba Aquilion One 640. On MIP images in the three planes of the joint in the static position, we marked up to 5 lines. Every line connected the point in prosthesis component with the point in the periprosthetic cortical bone. After that, the computer analysed the functional research reconstruction and showed the length of the same lines at each stage of knee flexion. If the length of at least one of the lines changes by more than 1.1 mm, we can confirm loosening of the endoprosthesis component. Results. According to data of dynamic computed tomography, in 2 patients we identified loosening of the tibial components, 1 patient – the loosening of the femoral component and 1 patient – the loosening of both components. In 8 patients knee implants were stable. In 10 patients we performed total revision knee arthroplasty. Computed tomography data were fully confirmed by intraoperative examinations. 4 patients were operated because of components loosening, 6 patients were operated because of patellofemoral in-congruence. 2 patients were treated conservatively with good results. Conclusion. The dynamic computed tomography of the knee after total arthroplasty showed high efficiency in diagnostics of the knee endoprosthesis loosening.

© 2018 Tomsk National Research Medical Center of the Russian Academy of Sciences. All Rights Reserved. The differential diagnosis of pulmonary diseases is extremely difficult and requires high qualifications of the radiologist and clinician. The differential diagnosis is used to distinguish different lung diseases: nonspecific inflammatory lung diseases (empyema, abscess, pneumonia), tuberculosis, sarcoidosis, benign tumors, lung cancer, lymphogranulomatosis, metastatic changes, and inflammatory changes in lung tissue. We present a clinical case, in which the differential diagnosis between tumor and inflammatory changes in lung tissue allowed the choice of optimal treatment tactics.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: To assess the role of modern imaging techniques in the planning and implementation of hybrid interventions for an aortic arch aneurysm in an elderly patient with a burdened comorbid background. Materials and methods: Hybrid intervention in patient, 80 years, with acute rupture of the thoracic aorta was performed - aortic arch endografting from the level of the brachiocephalic trunk with endoprosthesis Zenit Alpha endoprosthesis with simultaneous "chimney" stent-graft Advanta V12 implantation in left common carotid artery and left-side carotid-subclavian bypass with Gore-Tex 6 mm prosthesis. Results: A female of 80 years with acute rupture of the thoracic aorta, massive rightside hemothorax has been successfully treated with hybrid intervention - endoprosthetics of the aorta with a subclavian left subclavian shunt. On the second day after procedure the patient underwent puncture of the right pleural cavity with subsequent drainage because of persisting respiratory failure. On the fourth day the patient was transferred from intensive care unit in stable condition, on the twelfth day the patient was discharged on postoperative day 12. Multislice computed tomography (MSCT) is commonly used for diagnosis of acute aortic pathology and planning the optimal method of surgical treatment, as it allows to obtain detailed images of the entire aorta and surrounding anatomical structures, three-dimensional reconstructions of blood vessels, to give an accurate assessment of the morphological characteristics of the aneurysmal sac, proximal and distal neck, degree of calcification and parietal thrombus, localization and extent of aortic wall defect. Conclusion: The use of new methods of endovascular and hybrid surgery in the treatment of aortic rupture of thoracic aortic aneurysms makes it possible to achieve clinical success even in extremely severe patients of elderly and senile age. The leading role in the planning of these operations belongs to actual imaging methods, primarily MSCT.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: Presentation of diagnostic possibilities of volume computed tomography (VCT) of a heart combined with pharmacological vasodilation agent adenosine triphosphate (ATP) test in estimation of myocardial perfusion and detection of left ventricle myocardial ischemia diagnosis with non-obstructive coronary arteries. Materials and methods: VCT combined with ATP test was performed at female 53-year-old patient with non-obstructive coronary arteries verified by coronary angiography. The VCT «Aqulion ONE 640 Vision Edition» (Toshiba, Japan) was used. The non-ionic iodinecontaining contrast agent Ultravist-370 (Bayer, Germany) was infused in a quantity of 60 ml at rest and during ATP test. The clinical and instrumental data were also performed. Conclusion: The presented clinical case shows the possibilities in myocardial ischemia of the left ventricle in non-obstructive coronary arteries diagnostics by a volume CT combined with ATP pharmacological test.

© 2018 Russian Electronic Journal of Radiology.All right reserved. The literature data which demonstrate the possibilities of using computed tomography (CT) with contrast agents for the analysis of the deceased patients' bodies are presented. It is shown that postmortem CT angiography significantly expands the possibility of so-called noninvasive autopsy. The information on the features of the use of different types of con-trast agents as well as the main methods of postmortem CT angiography are presented. The use of targeted postmortem CT angiography allows to study the features of blood supply and to identify pathological changes in blood vessels of certain organs, in particular, coronary heart disease and cerebrovascular lesions. CT angiography of the whole body, especially multiphase postmortem CT angiography, allows to visualization of the cardiovascular system as a whole. The use of CT angiography is most effective for determining the source and volume of internal bleeding, the severity of thrombosis and the degree of stenosis of blood vessels, the type and prevalence of vascular malformations. We noted the complexity of the application and possible artifacts of postmortem CT angiography. It was concluded that postmortem CT angiography can be used to analyze of the bodies and clarify the tanatogenesis of deceased patients. We accented that postmortem CT angiography cannot fully replace the traditional autopsy despite its high specificity and sensitivity with regard to visualization of fatal bleeding.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Purpose. The purpose of this study is to compare the diagnostic performance of coronary computed tomographic angiography (CCTA) and stress test as a first-line examination for the diagnosis of stable coronary artery disease in outpatient settings. Materials and methods. The study prospectively enrolled 74 patients with typical and atypical angina symptoms lasting longer than three weeks, mean age-63,9±10,4 years, 28 (37,8%) women. Exclusion criteria: contraindications to iodine-containing contrast media, statins; GFR <45ml/min/1,73 sq m; inability to perform stress testing. All patients consistently underwent stress testing (standard Bruce protocol and The Modified Bruce protocol) and standard CCTA on a 640-slice CT scanner Toshiba Aquilion ONE. We determined pretest probability of CAD and stratified risks using SCORE and ACC/AHA scales. Statistical processing was performed with SPSS version 11,5 software. Results. Treadmill test results were positive in 51,4% of patients, among them according to CCTA: 19,15% had stenosis = 70%, 35,3% had stenosis 50-69%. CCTA revealed that 28,6% of males and 46,2% of females with typical and 66,7% of males and 50,0% of females with atypical angina symptoms with positive treadmill test had no evidence of atherosclerotic lesions. 4,05% of patients with negative stress testing had evidence of significant arterial lesions (stenosis >70%). According to the SCORE risk estimation, 67,6% of patients with atherosclerotic changes in coronary arteries had high risk, ACC/AHA score-70,6%. The sensitivity and specificity of the SCORE and ACC/AHA scales in revealing coronary atherosclerosis were 83% and 71%, 81% and 88%, respectively (p> 0.05). Conclusion. CCTA can be considered as a method for the primary diagnosis of stable coronary artery disease in outpatient practice.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Purpose. To present the possibility of the computed tomography (CT) in determination of a kidney injury for improving the quality of diagnostics and treatment of this group of patients. Materials and methods. Analyzed data comes from 72 T-researches with 50 patients with kidney injury at the closed injury of a stomach who were on treatment in Sklifosovsky Research and Clinical Institute for Emergency Medicine. Data of T was verified with the results of operations and autopsies. For determination of injury severity of a kidney the scale of Organ Injury Scale (OIS) was used. Results and discussion. Kidney injuries of the 1 degree (a contusion of a kidney and a subcapsular hematoma) were found in 12 patients, including the one with pre-existing pathology. Injuries of a kidney of the II degree were revealed in 14 patients: a cortical gap-in 9 cases, a subcapsular hematoma of a kidney with gap signs-in 3 cases; a subcapsular cyst with symptoms of hemorrhage and a gap-in two patients. Kidney injuries of the III degree were diagnosed in 7 patients in the form of a rupture of cortical substance from 12 mm to 18 mm deep. Damages of the IV degree were revealed in cases of 11 patients, including thrombosis of a segmentary branch of a renal artery in 6 patients. Injuries of a kidney of the V degree were revealed in 6 patients mainly in the form of fragmentation of a kidney. For an assessment of efficiency of treatment of 22 patients CT research in dynamics was executed, identification of complications served as the indication for repeated surgical intervention. Conclusions. T is an informative method which is possible to define not only an injury of a kidney, but also the degree of its severity. It allows to choose rational tactics for the treatment and to avoid an unreasonable nephrectomy. Performance of T in dynamics allows to estimate efficiency of treatment and in due time to diagnose complications.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Purpose. To improve the diagnosis of urolithiasis using the latest technique-dualenergy computed tomography (DECT). Materials and methods. A prospective study of a group of 91 (100%) patients was conducted at the department of radiology and urology at the Russian-Japanese Center in Sechenov University. All patients underwent a dual-energy CT scan to predict the chemical composition of urinary stones "in vivo". All patients underwent surgical treatment after diagnostics: distance lithotripsy (DLT), percutaneous nephrolithotripsy (PHNLT), contact ureterolithotripsy (CULT). All the stones after operations were subjected to physico-chemical analysis (X-ray phase analysis, infrared spectroscopy) in order to verify the composition. Further, the diagnostic value of the dual-energy computed tomography was assessed by comparing the DECT results with the physico-chemical analysis data. Results. Using DECT in the preoperative period, the following results were obtained: 40 patients had vevellit stones, 34 patients had Ca-containing stones without vevellit, 10 patients had stones with uric acid, in 7 patients stones were classified in the group of cystine/struvite. After verification studies in the postoperative period, the following urinary stone composition was determined: 42 stones-vevellit, 34 stones-Ca-containing stones without vevellit, 10 stones with uric acid, 5 stones-struvite stones. At the same time the following results were obtained incorrectly using DECT: 7 stones with vevellit from which 4 stones were postoperatively confermed to the group of Ca-containing stones without vevellit, 3 stones-struvite/cystine stones; 4 Ca-containing stones without vevellite were classified in the group of the vevellite; 2 struvite stones: 1 stone was incorrectly assigned to the group of uric acid, 1 stone-to the group of the vevellite; 1 stone uric acid was incorrectly assigned to the group of struvite stones. It should also be noted that 1 stone had a mixed composition (uric acid 70% + vevellit 23% + veddellite 7%), according to the results of DECT it was incorrectly assigned to the group of stones from uric acid, at the same time the prevailing component was determined correctly. Conclusions. In order to predict the chemical composition of the stone "in vivo" with a high degree of reliability DECT in the preoperative period can differentiate not only the urate and Ca-containing stones, but also separately identify the stones in which vevellit is the predominant component. The detailed differentiation of Ca-containing stones, as well as of more rare stones, such as struvite and cystine, requires further studies with more significant groups of stones.

© 2018 Russian Electronic Journal of Radiology.All Rights Reserved. Purpose. To determine the role of MSCT in the development of pneumoconiosis. Materials and methods. A total of 109 patients with the pneumoconiosis: silicosis and pneumoconiosis from mixed dust were examined at the Clinical IRIOH (Moscow) and the Orenburg Regional Clinical Hospital №2 (Orenburg). Patients underwent complex clinical and laboratory research, external respiration function examination, bronchos-copy and radiation examination. Results. Concomitant pulmonary tuberculosis was detected in 11%. Dissemination and interstitial changes were determined. Foci were located chaotically, perilymphatically. At the time of the initial study, the fusion of foci was 67.5%, with a dynamic study - in 100%. Interstitial changes were characterized by thickening of intra-lobular and interlobular interstitium. 19 patients had fibrous conglomerates, which were heterogeneous due to the presence of calcifications, necrosis and sometimes destruction cavities, which were later replaced by fibrotic changes. 57 patients were observed in dynamics during 3-19 years. 44 patients had a negative dynamics. There was no connection with the experience in the conditions of the impact of aerosol and profession. A great influence was exerted by the dispersion of dust and the concentration of silicon dioxide in it. Progression was characterized by an increase in the number of foci, their size, fusion and formation of fibrosis areas, an increase in the thickness of interstitium. Conclusions. Pneumoconiosis has progression even in the post-contact period. The growth of fibrotic changes led to emphysema of the lungs and respiratory failure. The dust dispersion affects the character of the progression.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: This article is dedicated to analysis of use PET-CT with 18F-FDG for the last 10 years. Determining the presence of metastasis in regional lymph nodes and distant sites in endometrial cancer is an important diagnostic step aimed at the choice of treatment tactics and improvement of surgical treatment results. If the process is beyond the uterus itself, it significantly worsens the prognosis of survival. In addition, in these cases, it is necessary to change the treatment and surgical tactics. Determination of stage 1 and 2 of the process gives an optimistic prognosis for the survival of patients. Currently, ultrasound, magnetic resonance imaging and, to a much lesser extent, computed tomography are used to assess the prevalence of the process. The diagnostic value of these methods according to some authors does not exceed 66-73%. In this regard, it is justified to work on finding more reliable methods that will more accurately determine the presence of metastatic disease in, both regional lymph nodes and distant organs. One of such promising methods is the use of positron emission tomography combined with computed tomography (PET/CT), using as radiotracer 18 - fluorodeoxyglucose. This article is a review of the scientific literature on this problem over the past 10 years and is devoted to the evaluation of the diagnostic accuracy of PET/CT with 18F-FDG.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: This scientific review of the literature presents the most relevant discussions in the world community, aimed at improving the implementation of the diagnostic algorithm in patients with severe combined trauma. Materials and methods: The work deals with the main traumatic injuries of various anatomical zones, the criteria of the Advanced Trauma Life Support (ATLS) protocol and diagnostic methods aimed at detecting acute traumatic pathology. Conclusion: The authors consider unsolved issues, as well as the improvement of the multislice computed tomography (MSCT) algorithm in the "whole body" mode, to optimize diagnostic activities aimed at managing patients with severe combined trauma.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: Assessing the dynamics of vulnerability of atherosclerotic plaques in patients with angina pectoris on atorvastatin therapy (40 mg for 10-12 months) based on coronary computed tomography angiography (CCTA) data. Materials and methods: The study prospectively enrolled 74 patients with angina pectoris not medicated with statins. All patients underwent CCTA. 30 patients with vulnerability of atherosclerotic plaques were selected for further observation and atorvastatin was administered to them at dose of 40 mg. Repeated tomography scans were recorded 10-12 months later. Images were analyzed by "Vitrea" workstation in a blind manner. Statistical processing was performed on SPSS version 11.5 software (BioStat). Results: Statistically insignificant decrease in: total plaque volume (from 188.64 ± 35.8 to 184.96 ± 34.45 mm3), low-attenuation plaque (from 60.46 ± 12.87 to 57.06 ± 12.34 mm3), degree of stenosis (from 41.6 ± 3.16 to 40.65 ± 3.26%), spotty calcification (from 86.0 to 90%), remodeling index (from 1.25 [1,0;1,4] to 1.1 [1,0;1,4]), napkin-ring sign (from 69.76 to 60%), irregularity of the contour (from 79.1 to 65%). LDL levels decreased from 3.23 ± 0.33 to 2.76 ± 0.27 mmol/L. Statistically significant decrease of total cholesterol was from 5.75 ± 0.45 to 4.42 ± 0.57 mmol/L. The study also revealed statistically significant positive correlation between decrease of LDL levels and total plaque volume decrease (R=0.51, P=0.002), mainly because of lowattenuation components. Conclusion: We review our experience of using CCTA for noninvasive monitoring of vulnerability of atherosclerotic plaques in dynamics and show that atherosclerotic plaques stabilize on long-term atorvastatin treatment.