Introduction. In clinical practice the state of the lungs could be assessed by a large number of functional, laboratory and instrumental tests, including a powerful approach like radiodiagnosis. Reliable, timely detection of hemodynamic disorders in the lungs, as well as their correct interpretation, are important for effective treatment. Objective. To show the diagnostic significance of SPECT in the detection of lung pathology in patients with a relatively normal radiographic picture. Materials and methods. SPECT data of patients had a relatively normal X-ray picture of the lungs were analyzed to assess changes in lung circulation. Patients (n=176) were divided into groups according to diseases: group 1 – patients (n=78) with post-COVID syndrome; group 2 – patients (n=23) with heart failure, PH; group 3 – patients with vasculitis (n=48); group 4 – patients with lymphoproliferative diseases (n=27) (acute lymphoblastic leukemia, peripheral T-cell lymphoma, diffuse B-cell lymphoma). Results. SPECT was shown to be useful in detecting disorders in the microvasculature of the lungs in patients with various pathologies. The results of X-ray and radionuclide methods were compared for patients with lesions of the bronchopulmonary system. The diagnosis errors of a radiologist caused by non-obvious changes on radiographs of the chest cavity organs were analyzed. Conclusions. Lung radiological examination is a complementary to X-ray method and in some cases it is preferred to establish the causes of the disease due to the higher sensitivity. The radiological algorithm, qualitative and quantitative assessment of the results of radiological examination, allows to detect minimal changes in the lungs.

Introduction. The COVID-19 pandemic not only caused a surge of viral pneumonia patients, but also opened up new opportunities in the field of radiology. One of the conditional «pluses» was the quantitative damage assessment of the lung parenchyma and microcirculation in COVID-19 using an artificial intelligence program. Objective. To evaluate the AI capabilities to detect the severity of anatomical and microcirculatory post-inflammatory disorders by CT and SPECT of pneumonic patients data. Materials and Methods. We analyzed prospective and retrospective data obtained by radiological studies of 187 patients with community-acquired pneumonia from 2006 to 2022 in the clinics of the St. Petersburg State Medical University named after acad. I.P. Pavlov. The follow-up period varied from 3 months to 8 years. The mean age of the patients was 34.3±9.2 years (w/m – 107/80). All patients underwent CT scan, a comprehensive functional examination of external respiration (KFIVD), SPECT. Results. The community-acquired pneumonia before the COVID-19 pandemic was generally characterized by signs of exudative bronchiolitis/bronchopneumonia, infectious viral alveolitis and pleuropneumonia. The first two forms in contrast to pleuropneumonia were associated with microcirculation disturbances. Signs of lung damage in COVID-19 had staging pattern based on morphological changes: edema, reticulation (increased severity of edema, cellular infiltration, intraalveolar fibrin), organization=consolidation (cellular infiltration, intraalveolar fibrin, fibroblast proliferation). Residual anatomical changes were accompanied by clinical symptoms (shortness of breath of varying severity, dry cough, weakness, intoxication). Conclusions. Using the artificial intelligence for post-processor CT and SPECT image processing seems to be relevant to assess the postinflammatory anatomical and microcirculatory disorders severity. Experience accumulation in combined AI and radiological study of patients with community-acquired pneumonia is capable to quantify residual anatomical and microcirculatory changes and useful for treatment tactics.

Introduction. The currently used ionizing or invasive instrumental methods are considered to be unsuitable for haemodymanics monitoring. Contrast Enhanced ultrasound (CEUS) can provide better images of renal blood flow. Objective. To assess the renal haemodynamics changes in patients with different course of type 2 diabetes on the CEUS evidences. Materials and methods. From 2019 to 2022 118 patients 62 women (52.5 %), 56 men (47.5 %), average age 64±5.2) were examined. The control group was (n=48). The same study design used for all patients included case history, physical examination, SR-36 and DEBQ questionnaires, laboratory examination, multiparametric examination, CEUS. Results. When assessing BMI the 41.02 %, 52.27 % and 42.85 % of patients were found to be overweighted in the 1, 2 and 3 groups, respectively. By the ROC analysis the quantitative parameters of the CUI were obtained: on day 1 AUC=0.6544, after 6 months AUC=0.6492, after 12 months AUC=0.7418, after 24 months AUC=0.7515, after 36 months AUC=0.7529. For ΔPI according to the data, the optimal threshold for cutting off the transition of diabetic kidney disease to CKD is 76.3 dB. Conclusions. 1. The use of ultrasound contrast agents in the diagnosis of CKD enhances the importance of the ultrasound method. 2. qualitative and quantitative parameters of the CUSI allow to assess the renal haemodynamics changes in patients with different course of type 2 diabetes. 3. ΔPI corresponds to a high quality of prognostic model for the CKD dynamics (AUC=0.7418) with an optimal threshold for cutting off the transition of diabetic disease kidneys in CKD 76.3 dB.

Introduction. Nowadays post-COVID respiratory symptoms that could be associated with pulmonary fibrosis progression are of concern. Objective. To compare CT and SPECT data of patients with post-COVID pulmonary fibrosis, and to define whether the lung fibrosis progression could be predictable. Material and Methods. Changes in chest CT scan, microcirculation disorders (SPECT) and impaired lung function parameters (DLCO) were analyzed in 74 post-COVID patients with residual consequences of COVID-19. Results. A year or more after the disease, 17 % of patients had isolated ground-glass areas, 24 % of patients had ventilation mosaics and air traps, most patients had compaction of the interlobular interstitial tissue of a short UIP type (67 %); consolidation zones (38 %); zones of pulmonary fibrosis of different lengths (57 %); discoid atelectasis (39 %); bronchiectasis (26 %), pulmonary hypertension (PH) (36 %). Significant decrease of the diffusion capacity and great microcirculation disorders accompanied by more than 50 % perfusion lack were detected. We demonstrated that significant radiological and functional effects of viral pneumonia were likely to be associated with post-viral interstitial lung disease. Conclusions. 1. Complete X-ray examination with lung diffusion capacity determination can contribute to optimal dispensary observation of post-COVID patients. 2. Microcirculation disorder greater than 50 % of the norm is a predictor of the lung parenchyma changes and can contribute to the prediction of long-term effects of the disease. 3. Complete radiation monitoring is required for patients over 60 years of age; post-COVID patients having severe form of the disease; patients having respiratory complaints for more than a year, regardless of the severity of COVID-19.

Aim. Pathological accumulation of contrast-paramagnetic by the aortic wall interrelated with volume of ischemic myocardial infarction damage and left ventricular ejection fraction (EFLV) were studied in patients with acute myocardial infarction (AMI). Materials and Methods. By contrast-enhanced MRI (CE-MRI) and quantitative methods of image processing left ventricular mass (ММLV) and mass of myocardial damage (МDAMI) were calculated. 25 patients having AMI within 2–4,5 weeks (19 male, 6 female, age 60.6±3.8 years), 12 patients with stable angina without AMI (7 male, 5 female, age 57.6±3.3 years) and 11 practically healthy people without heart disease (6 male, 5 female, age 63.1±3.2 years) were studied. Results. Paramagnetic contrast enhancement of the aortic wall was found to be significantly correlated with severity of infarction damage (the index (МDAMI/ММLV))). Enhancement index T1-WI of the aortic wall less than 1.18–1.20 means that only 2 of 10 patients had myocardial damage higher 20 % (i. e., (МDAMI/ММLV)>0.2); the index greater than 1.20 means 10 of 15 patients had the damage (p<0.02). Furthermore, the proportion of the damaged myocard (МDAMI/ММLV) was found to be related with left ventricular ejection fraction (EFLV). When (МDAMI/ММLV) ranged in 0.2–0.25, the EFLV per normal value was slightly decreased; when higher the upper limit EFLV sharply decreased and achieved 20–35 % when LV myocardium had more than third of damage. Conclusion. Mechanisms of the damage of aortic wall and functioning of the ascending aorta faced to risk of myocardial infarction should be studied along with coronary and myocardial pathology.><0.02). Furthermore, the proportion of the damaged myocard (МDAMI/ММLV) was found to be related with left ventricular ejection fraction (EFLV). When (МDAMI/ММLV) ranged in 0.2–0.25, the EFLV per normal value was slightly decreased; when higher the upper limit EFLV sharply decreased and achieved 20–35 % when LV myocardium had more than third of damage. Conclusion. Mechanisms of the damage of aortic wall and functioning of the ascending aorta faced to risk of myocardial infarction should be studied along with coronary and myocardial pathology.

Introduction. The article describes the role of computed tomography in the diagnosis of hemangiomas in various types of hepatic arterial circulation. Aim. To determine the features of contrast enhancement of hemangiomas in multislice computed tomography with multiphase contrast enhancement in patients with abnormalities of the arterial supplement of the liver. Materials and methods. The results of 60 computed tomographic angiographies of patients with hemangiomas of various sizes (mean age of patients 59.2±12.3 years, the study included 34 (57 %) men, 26 (43 %) women) were analyzed. Results. The most common anatomical variants of the vasculature, concomitant anomalies of the arterial supply of other abdominal organs, as well as features of contrast enhancement of hemangiomas depending on their size are described. The analysis of vascular architectonics revealed that the first type of arterial supply according to Mitchels (p <0.05) ) is prevailed, however, 3 (3.3 %), 5 (3.3 %), 6 (6.6 %) types were also determined. Thus, a correlation analysis using Fisher’s exact test was not detected a significant correlation between the presence of hemangiomas in the liver parenchyma and the presence of aberrant (r=0.11, p=0.36) or replacement arterial vessels (r=0.14, p=0.35). At the same time, when visually assessing the contrast enhancement of hemangiomas in different phases of contrast enhancement, both in the presence of aberrant and replacing vessels and without them, the main radiation patterns of changing hemangiomas density remained unchanged. Conclusion. Based on the obtained data on the liver arterial system, the absence of a significant correlation between the type of arterial blood supply, the presence of an additional or replacement vessel, and the type of contrast enhancement of hemangiomas during multiphase computed tomography of the abdominal organs was demonstrated.

Background. Carotid chemodectoma is rare, slow growing, richly vascularized lesion. It is a single unilateral or bilateral tumor, localized mainly in the area of the carotid triangle. Different forms and bilateral cases are also known. A complex of radiological studies, including MRI and CT with intravenous contrast, can help in determining the surgical treatment strategy, as well as treatment monitoring. Objective. To determine the role of MRI and CT with intravenous contrast in the assessment of carotid chemodectoma at the preoperative stage and at post-surgery monitoring. Materials and Methods. We analyzed the results of a comprehensive radiological examination of 12 patients with suspected carotid chemodectoma, including MRI and MSCT with intravenous contrast, and X-ray angiography. All patients got operated, the results were confirmed by histological and immunohistochemical study. Results. Multislice computed tomography, supplemented by CT angiography, allows visualizing chemodectoma, determining its size, shape, structure, and relations with the nearby vessels. In addition to size, shape, structure of chemodectoma MRI can provide a detailed picture of the internal vascular network, the walls of adjacent vascular structures, as well as the soft tissue structures of the peripharyngeal area, which is helpful for vascular surgeons in surgical intervention. It was not possible to determine the histogenesis of the tumor according to the methods of radiation diagnostics. Conclusions. In order to determine the option of surgical treatment of carotid chemodectomas and reduce the risk of intraoperative complications at the preoperative stage, it is necessary to carry out the entire spectrum of radiation diagnostic methods (including ultrasound, MSCT, MRI and X-ray angiography).

Objective. To evaluate the outcomes of internal carotid artery (ICA) redressment with transposition into the «new orifice» with a severe pathological elongation of the internal carotid artery. Materials and methods. In 2021, 42 operations were performed in 38 patients having severe deformations of the ICA required the transposition of ICA orifice by 2 or more diameters from the old orifice are presented. Four patients underwent reconstructions on both sides. All patients were symptomatic, with chronic cerebrovascular insufficiency grade 2–4 (according to the classification of A. V. Pokrovsky, 1978). 29 women (76.3 %), 9 men (23.7 %) were enrolled in the study. The average age was 69.1±7.7 years. 18 patients (47.4 %) were found to have a combination of hemodynamically significant pathological deformities with atherosclerotic lesions of the carotid arteries. All patients underwent ultrasound duplex scanning and computed tomography with contrasting brachiocephalic arteries in the preoperative period. Results. Most deformations are represented by S- and Z-shaped (73,8 %) оr ICA loops (21,4 %). The maximum level of transposition was required for loop deformations (25.6 mm±6.17) and was comparable for S- and Z-shaped deformations (17.8 mm±6.3; 17.5 mm±8.0). In the postoperative period, there were no signs of cerebral circulation disorders in this group of patients. In 84 % of cases, 32 patients showed clinical improvement with partial or complete regression of cerebral neurological symptoms. In 1 case (2.4 %), there was a hematoma of a postoperative wound that did not require specific surgical or medical treatment. During postoperative duplex control in the postoperative period, turbulent flows, stenosis and deformity in the area of the new orifice were not observed. Conclusion. The results confirm the data reported by other authors about the safety of the surgical method. ICA reconstruction with orifice transposition may be an alternative method of surgical treatment with minimal risk of complications. To achieve the best result, during the creation of a new orifice of the ICA, it is necessary to preserve as much as possible the original anatomy of the bulb of the ICA and the bifurcation of the common carotid artery. For a more detailed assessment of the results, further study is planned on a large clinical material.

Introduction. Yoga breathing exercises make it possible to change the minute ventilation (MV) within a wide range, reaching states of hyper- and hypoventilation with corresponding shifts in gas exchange. In this work, the interrelations between external respiration, parameters of gas metabolism and the skin microcirculation were evaluated. Materials and methods: 22 experienced volunteers performed yoga breathing exercises at a frequency of 3–3.5 times per minute and 1–1.5 times per minute for 5 minutes, as well as free breathing for 6 minutes before and after breathing exercises. Respiratory rate (RR), minute ventilation (MV), tidal volume (TV), partial pressure of CO₂ in exhaled air at the end of exhalation (PetCO₂), percentage of O₂ in exhaled air (FeO₂ ) were recorded using spirometry and gas analysis; by laser Doppler flowmetry and a distributed system of wearable analyzers parameters of skin microcirculation such as index of microcirculation (IM), nutritive blood flow (Im_n ), amplitudes of endothelial (Ae), neurogenic (An), myogenic (Am), respiratory (Ar) and cardiac (Ac) oscillations were recorded in six body areas. Results. After the breathing exercises, the index of microcirculation of the supraorbital artery pool increased from 14.7 p. u. to 16.7 p. u., in the fingers from 24.8 p. u. to 29.4 p. u. and in toes from 8.2 p. u. to 10.2 p. u. with hypoventilation (RR=1–1.5 ­times/ minute) and in the skin of the supraorbital artery pool from 14.7 p. u. to 16.0 p. u., in the fingers from 27.1 p. u. to 29.8 p. u. and in toes from 11.5 p. u. to 13.5 p. u. with hyperventilation (RR=3–3.5 times / minute), nutritional blood flow increased from 14.4 p. u. and 14.3 p. u. to 17.8 p. u. and 16.9 perf.u. on the upper and from 4.7 p. u. and 6.1 p. u. to 6.8 p. u. and 7.5 p. u. on the lower extremities with hypo- and hyperventilation, respectively; an increase of the amplitude of endothelial blood oscillations after a hypoventilation and an increase of the amplitude of neurogenic oscillations after both types of breathing in the forehead skin were observed. Conclusion. The absence of differences between the effect of hypo- and hyperventilation exercises on Im suggests that the main mechanism of action may not be shifts in MV and gas exchange, but the depth of breathing; the influence of cognitive mechanisms (conscious control of breathing in both modes) is also discussed. The absence of changes in nutritive blood flow in the head can be explained by regional features of microcirculation regulation. The hypoventilatory mode of breathing significantly activates the endothelial mechanism of regulation; the neurogenic (sympathetic) mechanism of regulation is activated by both hypo- and hyperventilation respiratory modes.

Cardiovascular syphilis has a variety of localizations and signs including an aortic aneurysm. Syphilitic aneurysms are most commonly localized in the ascending aorta, less in the aortic arch and descending aorta. Multiple aneurysms of syphilitic etiology are rare. A clinical case of a 56-year-old patient with multiple aneurysms of the aorta and brachiocephalic trunk of syphilitic etiology has been reported. Computed tomography showed multiple aneurysms of various localization, rupture of the ascending aortic aneurysm with partial thrombosis, its localization and the formation of an aortopulmonary anastomosis. The data obtained made it possible to carry out surgical treatment.

Introduction. Interstitial lung diseases in newborns associated with diffuse pulmonary developmental disorders are a difficult to detect, as they are rare, formed at the early stages of embryonic development, clinically manifested in the first hours of life as severe respiratory distress syndrome in newborns. The aim. To demonstrate the role of radiation research methods and the difficulties of differential diagnosis of rare forms of interstitial lung diseases associated with diffuse impaired lung development. Materials and methods. Clinical cases of congenital alveolar dysplasia and alveolar-capillary dysplasia with an abnormal location of the pulmonary veins are described in detail, the radiological data, confirmed by the histological data, are presented. Results. Specific changes in the lungs in ILD of newborns associated with a diffuse disorder of lung development, according to X-ray data in the first day of life, are not determined, however, a progressive negative trend has been noted. The lungs computed tomography allows a detailed diagnosis of structural changes in the lung parenchyma, their severity and prevalence. Issues of differential diagnosis of diffuse disorders of lung development in newborns are discussed; the obtained results correlate with the published data. Conclusions. Histological examination is the “gold standard” in the diagnosis of interstitial lung diseases associated with diffuse lung developmental disorders in newborns, but is most often performed at autopsy. The role of radiological methods in the algorithmic approach of diagnostics is increasing due to the accumulated data, the improvement in the quality of detection and recognition of rare variants of interstitial lung diseases in newborns according to CT of the chest organs.

We report an analysis of published data concerning the measurement of systemic hemodynamic parameters in experiments on laboratory animals. The article highlights the influence of such issues as housing and husbandry, handling, the frequency of person contact, animal surgical modification and pharmacological support in the perioperative period on blood pressure and heart rate, the most frequently recorded parameters both in experiment and clinic. Published data should be taken into account when planning and preparing an experiment using biomedical animal models, as well as when developing and submitting a protocol to the bioethical commission. Assessment of systemic hemodynamics is an integral part of physiological monitoring in any surgery of animals allowing better standardization of experimental endpoints and timely correction of possible deviations.

Data processing systems for non-invasive evaluation of cerebral autoregulation are time-consuming and take 2–3 hours to collect, convert and process the data. Development of systems of real-time evaluation of cerebral autoregulation seems to be critical to reduce the time of data processing, obtaining results and to monitor its parameters in functional tests and monitoring the treatment of patients in intensive care units. The developed software and hardware platform of real-time non-invasive evaluation of cerebral autoregulation based on continuous recording of the phase shift between the linear blood flow velocity in the arteries at the base of the brain and systemic arterial pressure uses Fourier and wavelet transform in the Mayer wave range. The hardware-software complex was shown to be effective and informative under standardized loads and can be used to real-time diagnose the state of cerebral autoregulation and to study the mechanisms of regulation of cerebral blood flow in healthy volunteers.