Background. A safe removal of the liver right lobe and restoration of arterial blood supply to the liver graft is possible only with a full understanding of the anatomy of the hepatic artery in a donor.Objective. To describe new and extend contemporary data on anatomical variations of the arterial blood flow in a donor of the right liver lobe.Material and methods. From 2009 to 2021, 306 living donor liver transplantations were performed in the State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. The vascular anatomy of 518 potential donors was analyzed. Hepatic artery anatomical variants of a right lobe graft were assessed.Results. Eleven types of right lobe arterial supply and 7 subtypes of the arterial anatomy of liver segment 4 were identified. The case rates of types and subtypes where reconstruction could be performed were following: type A, subtypes 1, 2, 3, 4, 5 (57.5%, 26.1%, 5.5%, 1.9%, 0.3%, respectively); type B, subtypes 1, 4, 5 (0.3% each); type С, subtypes 1, 2 (2.9%, 1.3%, respectively); type D, subtypes 1, 3 (0.3% each); type Е subtype 1 (0.6%), types F-J subtype 1 (0.3% each). Liver right lobe harvesting and arterial reconstructions were fully performed in all types and subtypes excluding anatomical type K, subtype 7. Arterial postoperative complications (11 cases) were detected in 3.5% observed cases of 306 transplants and in 5.9% of all patients with complications (184). Mortality rate due to arterial complications was 1.9% (6 cases).Conclusion. The existing classification of right liver graft hepatic artery anatomy was updated and detailed regarding the applicability in right lobe liver transplant. The arterial anatomy of right lobe liver graft shows great variability and complexity for systematization and thus may need further studies.

Due to the implementation of transplantation technologies for combined liver resections in pa-tients with liver lesions different etiologies, when planning surgical treatment the role of the radiologist as part of a multidisciplinary team is increasing. To reduce the burden on the radiologist when preparing for the consilium, the in-house report of the computed tomography (CT) should contain all the information neces-sary to determine the possibility and extent of liver resection. An audit of the quality of reports of in-house CT in 50 patients was conducted, based on the results of which an algorithm of reporting of CT was developed, adapted to planning combined liver resection. Widespread implementation of the algorithm in practice will reduce the burden on the radiologist in the hospital when preparing for the consilium.

Background. Liver transplantation remains a priority treatment option for hepatocellular carcinoma in the presence of liver cirrhosis; yet precise outcome prediction post-operation continues to be a complex challenge. Existing prognostic model often overlook patient age and donor type. Enhanced models that incorporate these parameters can improve prediction accuracy and treatment efficacy, which is critically important in the dynamically evolving field of transplantation.Objective. The aim of this study is to develop a prognostic model for liver transplantation outcomes in patients with hepatocellular carcinoma and liver cirrhosis.Material and methods. This retrospective study included 69 patients with hepatocellular carcinoma on the background of liver cirrhosis who underwent liver transplantation between May 2010 and December 2022. Of these, 42 patients (61%) received organs from living donors, and 27 (39%) from deceased donors. The study involved analysis of alpha-fetoprotein levels in blood, as well as assessment of radiological (maximum tumor nodule size, number of nodules) and histological parameters (maximum tumor nodule size, number of nodules, presence of vascular invasion). Cox regression model was used to predict recurrence-free survival, and the results for five-year recurrence-free survival, recipient age, and donor type were reused in the Cox model to predict overall survival.Results. Four models for predicting recurrence-free survival and overall survival based on histological and radiological data were developed, demonstrating high prognostic value with C-indexes on training/test data of 0.76/1; 0.73/1; 0.78/0.8; 0.6/0.8 respectively. All models showed recurrence-free survival prediction accuracy comparable to the Milan criteria. The model outcomes are available as a calculator on the website https://nadit.ru/calculate_HCC.Conclusion. The developed prognostic models are vital tools for personalized outcome prediction after liver transplantation for hepatocellular carcinoma. To enhance the accuracy of these models, further amalgamation and validation of data from various medical centers, as well as open scientific collaboration, are necessary.

Purpose: To describe two cases of diagnostic of intrahepatic portacaval shunt based on the computed (CT) and magnetic resonance tomography (MRI). Provide a brief review of the literature on this pathology. Material and methods: Two case reports of patients with intrahepatic portacaval shunts which were diagnosed by CT and MRI with contrast enhancement. Results and discussion: A peculiarity of the presented case reports was that in both cases the patients had oncopathology and were examined for the purpose of staging the disease. Due to the risk of cancer when analyzing CT and MRI images, focal changes in the liver can be mistakenly interpreted as metastases. In various situations, the attending physician may choose tactics for further observation, or decide to verify the identified changes in the liver. In the latter case, minimally invasive intervention can damage the shunt wall and cause bleeding. To avoid any complications, the radiologist have to identify and interpret vascular abnormalities in the liver confidently and unambiguously. The two presented case reports demonstrated typical signs of an intrahepatic porthocaval shunt, both according to CT and MRI. These include the connection of the lesion with the main vessels with similar dynamics of contrast enhancement, and the absence of signs of diffusion restriction. Conclusion: The presented semiotics of the intrahepatic portacaval shunt according to CT and MRI data allows to diagnose it confidently and thus avoid the need for repeated studies or surgical intervention.

Aim. To evaluate the accuracy and feasibility of using the most common criteria and models for predicting the survival and risk of hepatocellular carcinoma recurrence in clinical practice based on own experience in liver transplantation.Materials and methods. The single-center retrospective study included data on 70 patients who underwent transplantation from May 2010 to December 2022. Compliance with the criteria (Milan, UCSF, 5-5-500, etc.) was determined and the values of predictive models (Metroticket 2.0, Pre-ALRAL, etc.) were calculated for each observation. Survival rates, as well as efficiency of criteria and models were analyzed using sensitivity, specificity, F1 score, and C-index.Results. At the time of transplantation, the interquartile range for the number of tumors comprised 1–3, tumor sizes ranged from 1.8 to 5 cm, total tumor size ranged from 2.4 to 8.5 cm, and alpha-fetoprotein levels accounted for 14.7–150 ng/mL. During the follow-up period, hepatocellular carcinoma recurrence was recorded in 26% of patients. Disease-free and overall survival at 1, 3, and 5 years amounted to 89%, 76%, 63%, and 89%, 74.3%, 68%, respectively. The F1 score and C-index for predicting hepatocellular carcinoma recurrence after liver transplantation varied from 0.65 to 0.83, with the 5-5-500 criterion demonstrating the best performance. This criterion provided a five-year disease-free survival rate of 86% and an overall survival rate of 79%, with non-compliance leading to a decrease in survival to 33% and 46%.Conclusion. The studied criteria and models can be used to assess the risk of hepatocellular carcinoma recurrence after liver transplantation, although their predictive accuracy remains imperfect. An online calculator has been created to assess patient compliance with criteria and to predict disease-free and overall survival (https://nadit.ru/criterii). The development of own model and criteria within the framework of a Russian multicenter study, as well as the search for new objective methods for assessing the risk of hepatocellular carcinoma recurrence after liver transplantation, remain promising research areas.

OBJECTIVE:To systematize tactical and technical aspects of liver resections with reconstruction of afferent and efferent blood supply and/or inferior vena cava; to study postoperative outcomes in patients with focal liver lesions using transplantation technologies.MATERIAL AND METHODS:We enrolled 413 patients with parasitic lesions, primary and secondary liver tumors involving great vessels (portal vein, hepatic artery, hepatic veins, inferior vena cava, right atrium). All ones underwent liver resections with vascular resection and reconstruction, as well as liver autotransplantation in vivo, ante situ (ex situ in vivo), extracorporeal liver resections with autotransplantation (ex vivo).RESULTS:We obtained satisfactory immediate results after liver resections using transplantation technologies.CONCLUSION:Transplantation technologies in liver surgery can significantly increase resectability of tumors and survival of patients. Transplantation technologies are an important new surgical strategy and necessary option in modern hepatic surgery.

Background. Adequate restoration of blood flow through the portal vein in the graft is only possible with a clear understanding of its anatomy in the donor.The aim was to describe new and extend current data on the portal vein anatomy in a donor of the right liver lobe, to describe variants and formulate principles of portal reconstruction in right lobe living donor liver transplantation.Material and methods. 306 living donor liver transplantations were performed from 2009 to 2021 in the State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. The vascular anatomy of 518 potential donors was analyzed. Portal vein variants of the anatomy of right lobe graft were assessed.Results. Nine types and 3 subtypes of portal vein branching were evaluated. A, B, C, D, E types match the types described earlier in Nakamura classification. Subtypes B1, B2 и D1 are specifications of types B and D. Types F, G, H, I have been described additionally. The incidence of types and subtypes where reconstruction was made: type A (82%), B (4.6%), B1 (3.9%), B2 (1.3%), C (3.9%), D (3.9%). The incidence of E, G, H, I types among 518 potential donors was 0.4%, 0.6%, 0.2%, 0.4%, respectively. The recipient portal vein complications were detected in 12 cases (3.9%), where 3(25%) were Class 3b according to Clavien-Dindo and 9(75%) of Clavien-Dindo Class 2. There were no correlations between portal vein complications and the method of portal vein reconstruction. (p<0.05). No complications occurred with portal vein in donors.Conclusion. The existing classification of right liver graft portal vein has been updated and detailed. A certain way of reconstruction has been proposed for each portal vein type. Anatomical types in which donation and transplantation are contraindicated have been specified.

Aim. To describe new data and to complement the existing information about the anatomic features of the hepatic vein structure in the donor of the right hepatic lobe, to formulate the principles of donor selection proceeding from vascular anatomy. Materials and methods. 306 liver transplantations from living related donors were performed at A.I. Burnazyan Federal Medical Biophysical Center of Federal Medical and Biological Agency of Russia from 2009 to 2021. The vascular anatomy of 518 potential donors was analyzed. The prevalence of different vein structures of the right hepatic lobe was assessed. Results. The authors identified 14 subtypes of anatomy of efferent vessels. They were classified into 3 types depending on the contribution of the median vein to the blood outflow from the right hepatic lobe: caval (67.3%), cava medial (semi-separate, 29%), and separate (3.6%). Conclusion. The anatomy of the efferent vessels of the right lobe graft is characterized by variability and complexity. It requires accurate assessment at the preoperative stage (CT scanning) to be ready for reconstruction of any complexity.

Aim . To present the technical features and results of transplantation of the right hepatic lobe from a living donor with various types of efferent venous anatomy. Materials and methods. 306 liver transplantations from living related donors were performed from 2009 to 2021. Patients with previously described 14 subtypes of efferent vascular anatomy and classified into 3 types, were divided into 4 groups depending on the number of reconstructed vessels. The author analyzed anatomy variants of the right hepatic lobe, duration of surgery and anhepatic period, postoperative morbidity, volume of blood loss, including with allowance for the number of reconstructed vessels, as well as survivability. Results . The study demonstrated the principles and features of the reconstruction of the efferent veins of the graft. Time of surgical intervention, duration of anhepatic period, and postoperative morbidity were greatest with a separate type of blood outflow ( p < 0.05) Blood loss was greatest during reconstruction veins 3 and 4 ( p < 0.05). No difference in blood loss was detected between groups 3 and 4. Survivability within 12, 36, 60 and 120 months accounted for 84%, 83%, 81% and 71%, correspondingly, without any difference between groups. Conclusion . Successful transplantation of the right hepatic lobe requires precision mapping of the venous anatomy of the donor, preserving all potentially important efferent vessels, and commitment to the most complete reconstruction of them, irrespective of the vascular anatomy complexity.

Purpose: To estimate the potential of imaging methods in the diagnosis of non-alcoholic fatty liver disease (NAFLD) based on the example of a clinical case. Material and methods: A 42 years-old man with suspected of NAFLD, by the clinical and laboratory tests results, underwent a quantitative assessment of fatty hepatosis using radiodiagnosis imaging methods. We used US “liver protocol” with attenuation imaging technique (ATI), shear wave elastography (SWE), shear wave dispersion imaging (SWD), computed tomography (CT) with quantitative and qualitative assessment using the liver-spleen index (CTL-S); MRI with application that provides volumetric whole-liver fat fraction (FF) measurements by proton density (PDFF), on the basis of IDEAL IQ program. The morphological verification of liver biopsy was also performed. Results: All imaging method used in this clinical case showed severe degree of fatty hepathosis, that correlated with biopsy of liver. In repeated studies, on the background of treatment, the quantitative indicators of all imaging methods had a similar dynamics of reduction of the degree of fatty hepatosis. Conclusion: The clinical case of verified acute steatohepatitis shows the possibilities of its diagnostics by means of the radiation modalities. We used US with ATI, SWE и SWD, CT with CTL-S, MRI with FF that demonstrated high diagnostic efficiency for determination fatty hepatosis and the possibility of its quantification. These technologies are suitable for widespread implementation into clinical practice providing good diagnostic accuracy. CT associated with higher doses of radiation is not considered to be the basic method of choice for diagnosing NAFLD, but still may provide a physician with necessary information to determine further treatment strategy.

Rationale . The refinement of liver transplantation technique, the development and implementation of new surgical technologies into clinical practice, including those for inferior vena cava reconstruction, are important for the improvement of surgery outcomes. The study purposes were to present our own modification of cavocavostomy and options for its technical implementation in deceased donor liver transplantation, as well as to study the clinical effects and the impact of new surgical technique on the outcomes. Material and methods . A retrospective, single-centre study included the data from 109 consecutive deceased donor liver transplantations performed between 2012 and 2021. In 106 procedures, inferior vena cava reconstruction was performed either according to the classic technique (group 1, n=23, 22%), or using our own modification of cavocavostomy (group 2, n=83, 78%). To assess the clinical efficacy and safety of the new surgical technique, we compared the characteristics of donors and recipients, intraoperative parameters, features of early postoperative course, incidence of surgical complications, initial function, immediate and long-term graft survival. Three piggyback procedures were not included in the comparative analysis. Results . Two groups were generally comparable in terms of the characteristics of donors and recipients, however, the classic inferior vena cava was significantly more often used during transplants for unresectable parasitic liver lesions (17% vs. 1%, p=0.008) and retransplantations (30% vs. 5%, p=0.002). There were no statistically significant differences in the main intraoperative parameters between groups 1 and 2. The duration of transplantations was 8.0 h (interquartile range: 6.5–8.5 h) and 7.0 h (interquartile range: 6.0–8.0 h), p=0.112; anhepatic phase lasted 70 min (interquartile range: 60–75 min) and 70 min (interquartile range: 59–90 min), p=0.386; warm ischemia time was 45 min (interquartile range: 38–52 min) and 45 min (interquartile range: 38–50 min), p=0.690; inferior vena cava was clamped for 47 min (interquartile range: 40–55 min) and 50 min (interquartile range: 40–55 min), p=0.532. The volumes of intraoperatively transfused blood components were, respectively: packed red cells 630 ml (interquartile range: 0–1280 ml) and 600 ml (interquartile range: 0–910 ml), p=0.262; blood reinfusion 770 ml (interquartile range: 360–1200 ml) and 700 ml (interquartile range: 0–1200 ml), p=0.370; fresh frozen plasma 2670 ml (interquartile range: 2200 and 3200 ml) and 2240 ml (interquartile range: 1880–2900 ml), p=0.087. When using classic caval reconstruction technique, the proportion of grafts with early dysfunction was higher: 44% vs. 17% (p=0.011), due to the higher rate of retransplantations in this group. The incidence of acute kidney injury (by RIFLE > I) was 35% and 19% (p=0.158), the need for renal replacement therapy was 22% and 15% (p=0.520) in group 1 and group 2, respectively. The total incidence of surgical complications in the early postoperative period was 30% and 16%, p=0.110. Conclusions . The proposed technique of cavocavostomy can be considered as a priority method for caval reconstruction during deceased donor liver transplantation, with the exception of specific indications for the use of the classic technique (retransplantation, involvement of the inferior vena cava wall in a parasitic process or presentation of a tumor node to it, as well as in cases of widespread adhesive process in the abdominal cavity, hypertrophy of the 1 segment of the native liver, the presence and location of TIPS, thinning of the wall of the retrohepatic inferior vena cava, the risk of graft compression with its large size). The choice of the cavocavostomy variant should be carried out taking into account the size ratio of the graft to the recipient's right subdiaphragmatic space, and the topography features of the recipient's hepatic veins.

Для диагностики саркопении в популяциях различных стран и регионов мира определены собственные пороговые значения индексов мышечной массы. Для получения аналогичных данных в отношении населения России проведен ретроспективный КТ-анализ органов брюшной полости 310 доноров печени (151 женщина, 159 мужчин), проживавших в различных регионах страны. Анализ, который проводили два врача-рентгенолога со стажем работы более 10 лет, включал определение площади скелетных мышц на уровне позвонков Th и L с последующим вычислением индексов мышечной массы с нормализацией по росту. Продемонстрирована высокая степень корреляции результатов определения площади скелетных мышц на уровне Th и L ( r =0,98). Пороговые значения индексов мышечной массы вычислены двумя методами: как разница среднего значения и двух стандартных отклонений, а также как 2,5 процентиль. На уровне Th у женщин пороговые значения составили EMI Th 6,4 и 7 см/м, SMI Th 15,7 и 18,6 см/м соответственно; у мужчин EMI Th 8,4 и 9,2 см/м, SMI Th 20,1 и 23,1 см/ м соответственно. На уровне L у женщин пороговые значения составили PMI L 2,4 и 2,4 см/ м, SMI L 28,4 и 32,1 см/ м соответственно; у мужчин PMI L 2,9 и 4,9 см/ м, SMI L 38,2 и 41,1 см/ м соответственно. There are original cut-off values of muscle mass indices measured by computed tomography for the diagnostic of sarcopenia in the different countries and regions of the world. In order to get corresponding data for Russia a retrospective analysis of computed tomography data of abdomen of 310 liver donors (151 women, 159 men) presented different country´s regions was performed. The analysis was carried out by two radiologists with more than 10 years of experience and included the determination of the areas of skeletal muscles at the level of the Th and L vertebrae, followed by the calculation of muscle mass indices with height normalization. A strong correlation was demonstrated between the results of the work of the two radiologists ( r =0,98). Cut-off values of muscle mass indices were calculated by two methods: as the difference between the mean and two standard deviations and as the 2,5 percentile. At the Th level in women, the cut-off values were EMI Th 6,4 and 7 cm/m, SMI Th 15,7 and 18,6 cm/ m, respectively; in men EMI Th 8,4 and 9,2 cm/m, SMI Th 20,1 and 23,1 cm/m, respectively. At the L level in women, the cut-off values were PMI L 2,4 and 2,4 cm/m, SMI L 28,4 and 32,1 cm/m, respectively; in men PMI L 2,9 and 4,9 cm/m, SMI L 38,2 and 41,1 cm/m, respectively.

Aim. To develop a universal technology of thrombectomy from the veins of the mesenteric portal system and to evaluate the outcomes of liver transplantation for cirrhosis combined with non-tumorous portal vein thrombosis.Materials and methods. Immediate and long-term results of 309 transplantations in patients with liver cirrhosis of various etiologies were studied. In 46 cases (14.9%), transplantation was performed in patients with liver cirrhosis and concomitant thrombosis in the veins of the mesenteric portal system. Results. A versatile method of thrombectomy, depending on the degree of thrombosis in the veins of the mesenteric portal system was proposed (M.A. Yerdel et al., 2000). Mesenteric portal vein thrombosis increased duration of transplantation and volume of intraoperative blood loss as compared to patients without concomitant thrombosis. No statistically significant differences were found in the overall incidence of postoperative complications, hospital mortality and duration of hospitalization of the patients after liver transplantation with concomitant venous thrombosis compared to the patients without thrombosis. The incidence of thrombotic complications, including hepatic artery thrombosis, was significantly higher after liver transplantation supplemented with thrombectomy from the portal vein system. Five-year survival rate of the patients after liver transplantation with concomitant thrombosis in the veins of the mesenteric portal system was 94.9% (median – 40 months), patients without thrombosis in the veins of the mesenteric portal system – 93.2% (median – 60 months).Conclusion. Transplantation in patients with cirrhosis and thrombosis in the veins of the mesenteric-portal system shows good immediate and long-term results in case proper thrombectomy is carried out.

Purpose: To present a clinical case of a benign bone tumor of rare localization – chondromyxoid fibroma of the temporal bone, simulated chronic inflammation. Material and methods: A clinical case of chondromyxoid fibroma of the right temporal bone is presented. X-ray computed tomography (CT) and magnetic resonance imaging (MRI) of the temporal bones were performed before and during hospitalization. Results: Patient T., 29 years old, has been complaining about discomfort, congestion and noise in the right ear for the past 10 years without clear history of acute media otitis in anamnesis. According to the results of MRI of the temporal bones, a tumor of the right temporal bone was revealed. To clarify the diagnosis and for surgical treatment, the patient was referred to the clinic. During hospitalization CT of the temporal bones with contrast enhancement was performed and a tumor in the mastoid process of the right temporal bone with a ring-shaped accumulation of a contrast was determined, differential diagnosis included tumor and chronic abscess. According to the results of morphological examination after radical surgery of the temporal bone, chondromyxoid fibroma was diagnosed. Conclusion: Localization of chondromyxoid fibroma in the temporal bone is extremely rare and having by chance some features can simulate chronic inflammatory process. The absence of a clear history of acute otitis allows more likely suggest the tumor.

Neuroendocrine tumors are a rare and heterogeneous group of neoplasms with different malignant potential. They often metastasize to the liver and require active combined therapy. For unresectable neuroendocrine tumors with liver metastases, transplantation has become a potential definitive treatment due to the slow growth and the clinical course of the metastatic process. We conducted a review of relevant literature, the criteria for including and excluding patients considered for liver transplantation as well as alternative methods of treatment of neuroendocrine tumors. The paper presents a clinical observation of a staged combined therapy of a patient with a neuroendocrine tumor of the small intestine and bilobar unresectable liver metastases. The study demonstrates satisfactory long-term results of liver transplantation.

Purpose: Description of a clinical case of surgical treatment of nontraumatic rupture of the renal calyx fornix, with extravasation of contrast agent into the perirenal tissue. Material and methods: Provided surgical treatment to a patient with spontaneous rupture of the calyx fornix on the background of ureteral obstruction caused by a stone. Results: Considering the concomitant pathology in the form of obstructive pyelonephritis, it was decided to drain the upper urinary tract with an external stent. After 7 days, the patient underwent replacement of the external stent with the internal one. The patient underwent antibacterial, anti-inflammatory therapy, with a positive clinical, laboratory effect. Retrograde pyelography was performed 7 days later. Violations of the integrity of the cavity system of the left kidney were not revealed. The external stent was replaced with an internal one. After 2 months, ureterolitho-extraction was performed on the left. Conclusion: From the data of the world literature and our own experience, we can conclude that spontaneous, non-traumatic rupture of the fornix is an extremely rare, urgent urological disease. We assume that the development of this process is similar to the Burhave syndrome, since smooth muscle fibers are present in the esophagus as well as in the esophagus. In order to provide immediate assistance to such patients, it is necessary to urgently drain the upper urinary tract. Timely diagnosis of this condition requires rapid tactics in the form of immediate ultrasound, radiological diagnostic methods, as well as computed tomography. The operational manual on the removal of stones in this case should be postponed for 2–3 weeks.

Aim. To present the first successful full-split liver transplantation for two adults recipients in Russia.Materials and methods. The first successful full-split liver transplantation for two adults in ex situ way in Russia was made on 26th of September 2014 in the Burnasyan Federal Medical Biophysical Center of FMBA. The deceased donor was inside UNOS, Lee. The GRWR index in both recipients was near 1. The first recipient had been in a waiting list for 1 year, the second for 4 months. Both recipients had got liver cirrhosis in terminal stage.Results. The surgical procedure length was 650 and 660 min. The overall time of cold ischemia was 510 min. We observed a primary function of each graft. ISGLS B and Clavien-Dindo 3A biliary leak complications were observed in both recipients. Both patients were discharged after 33 and 34 days. Overall survival for this moment is 68 months.Conclusion. Full-split liver transplantation for two adults in ex situ way seems to be a complicated procedure both from the technical and organizing points of view. It demanding good mastership and coordination between surgical team members. At the same time, that treatment method has to be spread widely to improve treatment of patients with end-stage cirrhosis results.

Purpose: To develop a methodology for determining the muscle mass index (MMI) at the level of Th12 based on the computed tomography of the chest; to estimate the impact of MMI on the outcome of the COVID19 patients as a prognostic factor. Material and methods: The medical data and computed tomography of the chest of 247 patients with confirmed pneumonia caused by SARS-Cov2 were used. A technique has been developed for determining MMI based on the cross-sectional area of paraspinal muscles at the level of the Th12 vertebra and the length of the thoracic spine. A correlation analysis of MMI calculated based on the length of the thoracic spine MMI(L) and height MMI(H) was performed. A statistical analysis of the differences of the MMI(L) in the groups of male and female patients with fatal outcome and recovered, as well as younger and older than 65 years were performed. Results: A strong correlation was found between the MMI calculated on the basis of the length of the thoracic spine and height (r = 0.861, p <0.001). The age threshold, which was associated with an increase in the likelihood of death, in men was 60 years (Se 77.3 %, Sp 60.5 %, PPV 51.5 %, NPV 83.1 %, Youden's index 0.378, area under ROC- curve 0.728), in women 65 years old (Se 72.2 %, Sp 68.6 %, PPV 49.1 %, NPV 85.5 %, Youden's index 0.408, the area under the ROC curve 0.734). The odds ratio of death when the age thresholds are exceeded was 5.2 for men (95 % CI: 2.3 – 12.0), for women – 5.7 (95 % CI: 2.4 – 13.4). MMI(L) 3.37cm2/m2 is a threshold value, below which the probability of death in male patients under 60 years increased 26.3 times (95 % CI: 4.8 – 143.0). In female patients, there was no statistically significant threshold value of MMI(L), which would be associated with a higher risk of death. Conclusion: MMI, calculated at the level Th12 on the basis of the length of the thoracic spine, can be reliably used as a tool to estimate sarcopenia associated muscle atrophy, if there is no anthropometric data. The MMI(D) less than 3.37 cm2/m2 is a strong predictor of death in men under 60 years of age. Further work is needed to study the effect of sarcopenia on the severity and outcome of COVID19 in female patients, taking into account comorbid conditions.

РЕНТГЕНОНЕГАТИВНОЕ ИНОРОДНОЕ ТЕЛО ГОЛОВНОГО МОЗГА, СИМУЛИРУЮЩЕЕ ПНЕВМОЦЕФАЛИЮБашков А.Н 1 , Дунаев А