Репозиторий Университета

© 2019, Pediatria Ltd. All rights reserved. Skull computed tomography (CT), recognized as the «gold standard» in the diagnosis of craniosynostosis (CS), has a significant drawback associated with radiation exposure. The use of ultrasound in the imaging of cranial sutures is a possible research method, replacing CT. Objective of the research: To assess efficacy in CS diagnosis and postoperative observation of children after endoscopic cranioplasty. Materials and methods: The study includes analysis of ultrasound data of cranial sutures in 45 children aged 4,5±1,2 months (from 1,5 to 12 months), which were examined and treated at the Federal Center of Neurosurgery. Ultrasound of cranial sutures was performed on an expert class device. To assess cranial sutures condition authors developed a simple algorithm and an ultrasound protocol, according to which the study was performed. Additionally, all children underwent CT with skull volumetric reconstruction. Results and discussion: According to cranial sutures ultrasound, 14 children had positional plagiocephaly, 12 - metopic craniosynostosis, 18 - sagittal CS and one child had combined CS - a combination of metopic and right part of coronary sutures lesions. Thus, diagnostic imaging allowed to confirm metopic, sagittal and coronary sutures CS. Ultrasound was also performed in the postoperative period in the bone defect area to assess its and other cranial sutures fusion dynamics. The use of the algorithm and ultrasound protocol, in authors opinion greatly facilitates preoperative surgical planning and dynamic observation in the postoperative period. Conclusion: Cranial sutures ultrasound can be considered as an alternative method of instrumental CS diagnosis and patient postoperative management after endoscopic surgery. Described CS ultrasonic classification allows to use it for screening in the early stages of the disease.

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PURPOSE: To analyze the condition of the lacrimal gland in patients confirmed to have sarcoidosis. MATERIAL AND METHODS: The study included 46 patients (92 orbits) with verified diagnosis of systemic sarcoidosis that were examined during the period of 2009 to 2014. The age of patients ranged from 23 to 65 years and the average was 45.1 years. Among the examined patients, 66% were female and 34% male. In all patients, the diagnosis was verified according to modern criteria. RESULTS: Acoustic structure of 46 lacrimal glands of patients with systemic sarcoidosis (92 orbit), and lacrimal glands of 30 healthy individuals (60 orbits) were examined. In-depth in vivo examination of morphological changes was done using 'advanced' analysis of three-dimensional images. CONCLUSION: The analysis of a large number of studies devoted to changes in the lacrimal glands caused by sarcoidosis revealed a difficult problem: are there any differences between isolated involvement of the lacrimal gland tissue and the defeat of various organs and tissues? For now, the question remains unanswered.