In this clinical case, a patient who had an instrumentally detected aneurysm with the lumen expanding up to 60 mm underwent a surgically flawless prosthetic replacement of the ascending aorta. This treatment led to decreased exercise tolerance, decreased contractile function of the left ventricular myocardium at rest, and enlarged pulmonary artery. The leading factor was a decrease in the volume of systolic expansion of the aorta down to 5 mL (at the initial 13 mL), despite a noticeable increase in the extensibility and a decrease in mechanical stiffness compared with initial indexes of the affected aortic wall. In the literature review, considering mechanical extensibility and elasticity, problems in creating aortic prostheses equivalent to those for healthy biological tissues were discussed.

Цель. Проанализировать взаимосвязи картины магнитно-резонансной томографии (МРТ) сердца и органов грудной клетки с парамагнитным контрастным усилением и постковидных наджелудочковых нарушений ритма сердца, у пациентов после перенесенной ковид-ассоциированной пневмонии.

Цель: оценить органопротективные свойства при хирургической коррекции гипоплазии дуги аорты у детей с применением глубокой гипотермической остановки кровообращения и метода полнопоточной перфузии с двойной канюляцией аорты.

Цель. Провести сравнительный анализ эффективности использования различных методов лучевой диагностики (эхокардиография (ЭхоКГ), компьютерно-томографическая ангиография (КТА), магнитно-резонансная томография (МРТ)) в оценке особенностей корня аорты у пациентов с выраженным аортальным стенозом для улучшения процессов биотехнического проектирования при разработке новых моделей искусственного аортального клапана (АК).

Unified terminology is a necessary condition for successful interdisciplinary communication within the field of oncology. The variety of anatomical, pathomorphological, and clinical terms used in rectal cancer is often accompanied by their ambiguous interpretation both in domestic and foreign scientific literature. This not only complicates the interaction between specialists, but also complicates the comparison of the results of rectal cancer treatment obtained in different medical institutions. Based on the analysis of recent domestic and international scientific and methodological literature on rectal cancer, the key terms used in the diagnosis and treatment planning of rectal cancer were selected, followed by a two-time online discussion of their interpretations by experts from the Russian Society of Radiologists and Therapeutic Radiation Oncologists, the Association of Oncologists of Russia, and the Russian Association of Therapeutic Radiation Oncologists until reaching consensus (80%) of experts on all items. Terms that fail to attain consensus were excluded in the final list. A list of anatomical, pathomorphological, and clinical terms used in the diagnosis, staging, and treatment planning of rectal cancer has been compiled and, based on expert consensus, their interpretation has been determined. A lexicon recommended in the description and formulation of the conclusion of diagnostic studies in patients with rectal cancer is proposed.

Background. Chest MRI allows diagnosing in the acute period of covid-associated pneumonia (CAP) and assessing the dynamics of treatment. The potential of MRI in postcovid pulmonary arterial hypertension (PAH) study remains unclear. Objective. To examine the chest MRI picture in CAP patients and to quantify the signs of post-COVID PAH. Design and methods. The study included 34 patients who underwent COVID-19 within 3.5–7 months with involvement of the parenchyma of mild severity upon admission of CT1–CT3 according to spiral X-ray CT. All patients underwent chest MRI in ECG- and respiratory-synchronized T1- (T1-WI), T2 (T2-WI) and diffusion-weighted MRI protocols and ultrasound of the heart and large vessels of the chest cavity, with the calculation of systolic pressure in the right ventricle (SPRV). Results. Three groups were distinguished: CT1 (group 1), CT2 (group 2) and CT3 (group 3). The frequency of subsegmental/segmental signs of LA branches thromboembolism was significantly higher in groups CT2 and CT3. LA diameter, SPRV and T1-WI intensity ratio index {Lung/LA} progressively increased from group 1 to group 3. The dependence of SPRV on the {Lung/LA} was fitted using Boltzmann curve (r = 0.92, p < 0.01). Conclusion. Chest MRI in T1- WI allows assessing the degree of post-covid changes in the lung parenchyma thickness and predicting early forms of increased pulmonary arterial pressure and the formation of PAH.

INTRODUCTION: Radiomics is a promising area of diagnostics. In clinical practice, ultrasound and magnetic resonance imaging are widely used for Cervical Cancer (CC). The lack of standards when carrying out examinations entails the problem of distinguishing different signs, i.e. there is no possibility to compare results of different institutions. OBJECTIVE: To review radiological diagnostic procedures and optimize a model to enable expanded large-scale multicentre mathematical analysis of radiological findings in comorbid women with CC. MATERIALS AND METHODS: The data from 362 magnetic resonance imaging (MRI) procedures (Philips Achieva, The Netherlands, 1.5T), 500 pelvic ultrasound procedures (US), and 500 retroperitoneal US in 77 comorbid women with cervical squamous cell cancer and cardiovascular disease, carried out between 2012 and 2022, were retrospectively examined. FIGO pretreatment stage 1А–4А. Age: 48.3±13.1. Follow-up period: 3.7±1.3 years. Statistics: Data analysis was carried out using the Stata 13 program (StataCorpLP, CollegeStation, TX, USA). The normality of the distribution of features was assessed using the Shapiro-Wilk criterion. The condition of equality of variances of the distribution of features was calculated according to the Leven criterion. For descriptive statistics of normally distributed features with equality of variances, the calculation of averages and standard deviations was used. Qualitative variables are represented as numbers (%). Logistic regression is performed. The significance level for all the methods used is set as p<0.05. RESULTS: The possibility of segmentation was 2.6% according to US and 100% according to MRI. We analyzed 1443 T2 TSE, 531 T1 TSE, 563 diffusion-weighted images (DWI), 389 STIR, 1987 post-contrast series (in 272 cases (75%) the study was accompanied by contrast agent administration). An MRI model for subsequent feature extraction in patients with CC should consist of T2TSE in the sagittal plane, DWI in the axial plane with automatic construction of apparent diffusion coefficient (ADC) maps. The most reproducible and valuable components of the model are found to be the DWI with automatic ADC map. The ADC value from the parametral fat significantly increased the probability of recurrence, and the cut-off point for ROC analysis was 1.1×10 –3 mm 2 /sec. DISCUSSION: An analysis of medical ultrasound and MRI images in terms of their value for radiomics was carried out. According to the results, MRI is the preferred method. An important next step is to standardize series to extract additional value from diagnostic studies and to carry out multicentre retrospective studies using a multicomponent model. CONCLUSIONS: MRI is a reproducible and frequently used method with the ability to extract additional value from images. T2 TSE in the sagittal plane and DWI in the axial plane with automatic ADC map, followed by segmentation of the parametral area adjacent to the tumor, are considered the most frequently used techniques. Postcontrast imaging are not a reproducible technique and have no added value. A model MRI procedure to determine additional textural characteristics in patients with СС consists of T2-TSE in the sagittal plane, DWI in the axial plane with automatic ADC map.

Aim. To obtain extended data on the impact of collateral circulation on the recovery of left ventricular (LV) function after recanalization of chronic coronary total occlusion (CTO), especially in patients with reduced left ventricle ejection fraction (LVEF). Material and methods. This single-center, prospective, non-randomized study included 20 patients with single-vessel CTO with reduced LVEF (<50%), confirmed by magnetic resonance imaging (MRI), who underwent successful recanalization. All patients were divided into 2 groups depending on the severity of collateral circulation. After 1, 3 and 6 months, MRI was repeated to assess LV function recovery. Results. All patients had prior myocardial infarction, while in 70% of cases — in the area of the occluded artery. A previous attempt to recanalize CTO was noted in 30%. The mean baseline LVEF according to echocardiography was 38,80±6,72%. The most common target vessel was the right coronary artery (n=17, 85%), followed by the circumflex and anterior descending arteries — 1 (5%) and 2 (10%) patients, respectively. In the group with high collateral circulation, the initial LVEF according to MRI was higher compared to the group with mild collateral circulation (35,8±7,33% vs 30,7±8,82%, p=0,17). After 6 months, MRI showed significant changes in end-diastolic volume (from 226±71,1 ml to 203±55,2 ml) and LV endsystolic volume (from 153±72,8 ml to 118±57,6 ml), as well as mean increase in LVEF by 3,3%, 4,8% and 5,2% at 1, 3 and 6 months, respectively (p=0,01 compared with baseline). The predictors of LVEF recovery in multivariate regression analysis were the initial LVEF according to MRI, and the filling rate of distal CTO bed on coronary angiography (R 2 =0,63). Conclusion. Successful percutaneous coronary intervention with CTO improves LV function in patients with ischemic cardiomyopathy, regardless of the degree of collateral circulation. LV function recovery generally occurs within 3 months after revascularization.

Association of Cardiovascular Surgeons of Russia Russian Society of Cardiology (RSC) Association of Pediatric Cardiologists of Russia Russian Scientific Society of Specialists in X-Ray Endovascular Diagnostics and Treatment All-Russian Public Organization for the Promotion of Radiation Diagnostics and Therapy "Russian Society of Radiologists and Radiologists". Task Force members declared no financial support/conflicts of interest. If conflicts of interest were reported, the member(s) of the working group was (were) excluded from the discussion of the sections related to the area of conflict of interest.

Актуальность. Отсутствие стандартов при выборе метода хирургической реваскуляризации стенозов сонных артерий и объективных методов оценки предикторов эмболических осложнений определяют необходимость поиска диагностических алгоритмов для оптимизации лечебной тактики.

In routine clinical practice, methods of radiation diagnostics are widely used in the provision of medical care to patients with common diseases of the brachiocephalic vessels (BCV). This article provides recommendations on methods for performing time-consuming and expensive radiological methods (ultrasound (US), computed tomography (CT), computed tomography angiography (CTA) arteries, CTA veins, magnetic resonance imaging (MRI)) in patients with diseases of the brachiocephalic vessels. Based on the recommendations of experts, literature sources and practical experience in the application of radiology methods. This guide contains structured information regarding the technology of US, CTA and MRI in patients with artery stenosis, artery dissection, vascular malformation, venous sinus thrombosis, and atherosclerosis. These recommendations are universal and are suitable for most medical institutions that perform US, CT and MRI of brachiocephalic vessels. Compliance with these rules will improve clinical and economic efficiency in the diagnosis, treatment and rehabilitation of patients with diseases of the brachiocephalic vessels by standardizing procedures of US, CT, MRI, and effectively use the resources of a Healthcare at all levels when performing radiological methods. The manual is intended for all categories of medical stuff performing radiological methods in diseases of brachiocephalic vessels (US doctors, functional diagnostics doctors, radiologists) and using their results in clinical practice (cardiologists, cardiovascular surgeons, neurologists, neurosurgeons, anesthesiologists, therapists).

Abstract Background: Occurrence of cerebrovascular events in neonates after reconstruction of the aortic arch remains a common. The purpose of the study was to analyze immediate neurologic outcomes in neonates with aortic coarctation/hypoplastic aortic arch based on modified brain MRI after a reconstructive surgery. Methods: A total of 40 neonates with aortic coarctation/hypoplastic aortic arch underwent reconstructive aortic arch reconstruction. All patients were divided to two groups: group 1 comprised patients who underwent aortic arch repair (AAR) with deep hypothermic circulatory arrest (DHCA); group 2 comprised patients with antegrade cerebral perfusion by double arterial cannulation (ACP). All individuals underwent brain examination with MRI (DWI, SWI, T1, double echo) five to seven days after surgery.Results: According analysis MRI examination must include diffusion-, T2*-, T1 and dual-echo weighted imaging during perioperative period of AAR. The frequency of cerebrovascular events (CVE) was significantly higher in group 1 compared with group 2 (70 vs. 30%; p = 0.025). Air embolic occlusion and infarction of watershed zones were observed in the group with deep hypothermic circulatory arrest (35.7% vs. 0%; p = 0.25). The incidence rates of cortical laminar necrosis and intracranial hematoma was similar between groups. Conclusion: Double arterial cannulation was a more protective technique in terms of preventing CVE. Targeted MRI administration for the brain examination of neonates in the early postoperative period allowed to identify intracranial CVE that occurred in the early postoperative period and detect the pathology of the brain structures that were not associated with surgical treatment.

BACKGROUND: Extra-axial tumors are one of the tumor groups with difficult primary differential diagnostics. Detection and standardization of radiomic markers are one of the main problems of our time. AIM: To detect radiomic markers for preoperative assessment of extra-axial tumor grade. MATERIALS AND METHODS: This study retrospective analyzed the magnetic resonance imaging (1.5 T) data of 156 patients with extra-axial tumors. Patients were divided into 2 groups: Group 1 (n=106) with perifocal changes and Group 2 (n=50) with extra-axial tumors without perifocal changes. Diffusion and perfusion sequences were included in the scanning protocol. The areas of interest include (1) the lesion and (2) the area of perifocal changes. Measurements were made from the lesion and the area of perifocal changes on ACD and DSС maps, DCE was analyzed. RESULTS: The maximum lesion size in Group 1 was 2.2 cm (1.4; 4.3), whereas in 1.2 cm in Group 2 (0.9; 3.5). In Group 1, the diffusion restriction from the lesion was detected in 42 patients (39.6%), whereas 7 (14%) in Group 2. The maximum size of perifocal changes in Group 1 was 2.85 cm (1.5; 4.7). Diffusion restriction was detected in 52 (49.1%) cases. In Group 1, patients with verified meningioma multivariable linear regression analysis showed 3.3-times increase of rCBF of the maximum size of the lesion from the area of perifocal changes (coef. 3.3, CI: 1.27; 5.28), p=0.003; however, it demonstrated a 4-time decrease of rCBF (coef. 4 CI: -7.46; -0.71), p=0.02. CONCLUSIONS: Perfusion and diffusion methods combined with anatomical sequences show potential use as radiomic markers for diagnostic assessment and treatment of extra-axial tumors. Further detection of radiomic functional markers from the area of perifocal changes has potential.

Background. The state of the aorta is a key factor in the prognosis of the patient’s life, since the distension of the ascending aorta in systole determines the blood supply to the myocardium in diastole. Paramagnetic contrast-enhanced MRI provides a reliable assessment of pathological neoangiogenesis, however, in fact, studies of the aorta are performed descriptively, without calculating mechanical strength and extensibility. Objective. To develop and clinically test on the patients with atherosclerotic lesions and myocarditis a method for quantitative assessment of extensibility and mechanical elasticity of the aortic wall.Design and methods. Were examined 12 patients with acute myocardial infarction with ST segment elevation, as a control group 11 patients without clinical and instrumental signs of atherosclerosis of large arteries and aorta. All underwent MRI of the chest and heart with paramagnetic contrast enhancement (PMCE) and ECG synchronization. The indices of aortic distensibility, distensibility normalized to pulse BP, Young’s modulus of the aortic wall, systolic distension of the ascending aorta (mL), index of strengthening of the aortic wall in PMCE were calculated.Results. Ascending aortic distensibility decreased in patients with myocarditis and acute infarction. Young’s modulus and distensibility of the ascending aorta significantly correlated with the value of the aortic wall enhancement index in PMCE. Myocardial damage in acute infarction and myocarditis was noted with a decrease in systolic expansion of the ascending aorta below 10 ml due to its reduced elasticity.Conclusion. There is a relationship between pathological accumulation of a paramagnet in the wall of the ascending aorta, a decrease in its elasticity, a decrease in the volume of systolic aortic dilation, and the development of hypoperfusion myocardial damage. Magnetic resonance elastometry of the aortic wall makes it possible to assess violations of aortic distensibility and predict the development of ischemic damage in the myocardium of the left ventricle.

The aim of the study was to identify new anatomical landmarks of the aortic root and the relationship between the sizes of anatomical structures using the method of computed tomography angiography to improve models of heart valves and the methods for their selection in clinical practice.Materials and Methods:The dataset of computed tomography angiography prior to aortic valve replacement in 262 patients was analyzed. The mean age was 75.0±5.9 years. 99 (37.8±3.0%) men and 163 (62.2±3.0%) women took part in the study. The annulus fibrosus, sinotubular junction, and height of the sinuses of Valsalva were measured.Results:In the tricuspid aortic valve group (n=251), in more than 50% of the cases, the diameter of the annulus fibrosus ranged from 23 to 26 mm. No significant association between the diameter of the annulus fibrosus and patient height (r=0.35; p=0.01) or body surface area (r=0.25; p=0.01) and the height of the sinuses of Valsalva (r=0.34; p=0.01) were revealed. Based on the ratio of the height of the sinuses of Valsalva and the diameter of the annulus fibrosus, three variants of the structure of the aortic root were identified: type A - K>1.05; type B- 0.95≤K≤1.05; type C- K<0.95. Type C of the aortic root was found to predominate in most cases, namely, in 98.0±0.9% (n=246).In the bicuspid aortic valve group (n=11), 2 patients had a type A of the aortic root, 1 patient had a type B, and 8 patients had a type C.Conclusion:A classification of variants of the aortic root structure has been proposed, which will be useful not only for practitioners when choosing a treatment method, but also for researchers to understand the structural characteristics of the aortic root in patients with its pathology.

Journal of Magnetic Resonance ImagingEarly View Editorial Editorial for “USPIO-SWI Shows Fingolimod Enhanced Alteplase Action on Angiographic Reperfusion in eMCAO Rats” Tatyanа A. Bergen MD, PhD, Corresponding Author Tatyanа A. Bergen MD, PhD bergen_t@meshalkin.ru orcid.org/0000-0003-1530-1327 Department of Radiology, Meshalkin National Medical Research Center, Ministry of Health Russian Federation, Rechkunovskaya, 15, Novosibirsk, 630055 Russian Federation Е-mail: bergen_t@meshalkin.ruSearch for more papers by this authorAlexander A. Shestov PhD, Alexander A. Shestov PhD Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104 USASearch for more papers by this author Tatyanа A. Bergen MD, PhD, Corresponding Author Tatyanа A. Bergen MD, PhD bergen_t@meshalkin.ru orcid.org/0000-0003-1530-1327 Department of Radiology, Meshalkin National Medical Research Center, Ministry of Health Russian Federation, Rechkunovskaya, 15, Novosibirsk, 630055 Russian Federation Е-mail: bergen_t@meshalkin.ruSearch for more papers by this authorAlexander A. Shestov PhD, Alexander A. Shestov PhD Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104 USASearch for more papers by this author First published: 10 September 2021 https://doi.org/10.1002/jmri.27915 Evidence Level:: 5 Technical Efficacy:: Stage 3 Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

Purpose. To establish the methods for estimating the volume of the true and false aortic canals applying computed tomography angiography (CTA) to a clinical case with hybrid stent-graft thoracic aorta with distal stent-graftinduced new entry associated (d-SINE) in the long-term follow-up period in comparison with a widely used technique of measuring diameters of the aorta on different levels.Materials and methods. Sequential analysis of CTA in a 7-year follow-up was performed. Aorta was divided into 3 segments, in each segment total aortic volumes (AV), volume of the true canal (TC), and volume of functional lumen of the false canal (FLFC) were calculated. The following were mathematically calculated: volume of the false canal (FC) via difference in volume between AV and TC, volume of the thrombosed lumen of FC as the difference between FC and FLFC, the coefficient of FC thrombosis, the degree of stent-graft opening. Mathematical assessment of excess volume of the graft was performed.Results. Modelling of aortic cavity, evaluation of changes in the volumes of TC and FC during a long-term follow-up, analysis of the factors inducing the development of the d-SINE syndrome were performed. When comparing the volume of the graft and the volume of the implantation zone, an excess of 234% was found, while the opening of the graft was 80%. When using the reference method based on the diameter of the true lumen of the aorta, the excess was 22% during one-year follow-up period showing no changes subsequently.Conclusion. Potentially, the method of measuring volumes based on CTA results can be used to complement the generally accepted method based on measuring diameters, since it does not require additional financial resources and has the potential to estimate effectiveness of treatment and identify complications predictors in the postoperative period to determine indications for reoperation.

Here we report a case of technological innovation: the use of magnetic resonance imaging to determine surgical strategy. Here is a 47-year-old man who underwent an magnetic resonance imaging and subsequent surgical treatment of the aortic aneurysm. Unlike echocardiography, magnetic resonance imaging enabled us to view the entire thoracic aorta. Unlike computer tomography, magnetic resonance imaging enabled us to detect changes in the aortic wall accurately. Thus, in this case, the use of magnetic resonance imaging allowed us to determine the distal resection edge. The patient`s postoperative course was unremarkable. Use of electrocardiogram-synchronized magnetic resonance imaging of thoracic aorta allows detecting structural changes of the aortic wall and its mechanical properties. It is significant that magnetic resonance imaging results of the aortic wall correlate with histologic examination. The extent of changes in the aortic wall must be determined to accurately plan surgical treatment of patients with aortic aneurism. Magnetic resonance imaging of the aortic wall is promising for further study in multicenter research.