Lučevaâ diagnostika i terapiâ最新文献

{"title":"Preconditions for radiomics-based approach in differential diagnosis of pancreatic cystic lesions: critical evaluation of meta-analyses and international guidelines","authors":"A. A. Kovalenko, G. G. Karmazanovsky","doi":"10.22328/2079-5343-2023-14-3-27-38","DOIUrl":"https://doi.org/10.22328/2079-5343-2023-14-3-27-38","url":null,"abstract":"INTRODUCTION : Pancreatic cystic lesions (PCLs) are a heterogenous group of lesions ranging from benign to malignant with variable histological, pathomorphological and prognostic characteristics. The development and improvement of radiation methods provides a great opportunity to diagnose such neoplasms. However, there are still difficulties in differential diagnosis and prediction malignant potential in pancreatic cyst subtypes due to their similar radiation characteristics. OBJECTIVE : To determine the diagnostic performane and difficulties of differentiating PCLs by invasive and non-invasive radiological methods. To determine the preconditions for radiomics-based approach in differential diagnosis of pancreatic cystic lesions based on a review and analysis of international guidelines. MATERIALS AND METHODS : We searched for scientific publications in the PubMed and Springer information and analytical systems for 2009–2023 by keywords: «pancreatic tumors», «pancreatic cyst», «pancreatic cystic lesion», «pancreatic radiomics», «intraductal papillary mucinous neoplasm», «pancreatic cystadenoma». As a result, 49 articles were selected for analysis. RESULTS : Despite the high potential of modern non-invasive radiation methods in the detection of pancreatic cysts, differentiation of PCLs subtypes is still very difficult. Due to the variability of international guidelines and a lack of their specificity, there is no universal consensus for management PCLs. In this regard, introduction new alternative diagnostic methods and markers is an important direction of research. At the moment, the assessment of the malignant potential of PCLs is comes down to only two main signs — the main pancreatic duct diameter and the vascularized solid component. CONCLUSION : Currently, common semiotic features, limitations of invasive diagnostic methods and increasing risks of recurrence and malignancy dictate the need to apply new diagnostic approaches to evaluation of PCLs. Searching and introduction new markers will allow us to analyze the lesion structure, to stratify risks and long-term prognosis more accurately. Textural image analysis is a new and promising noninvasive method with high power. This tool plays an important role to estimate those structural parameters which are impossible to judge according to the standard radiologic features, and to offset the problems of traditional diagnostic approach.","PeriodicalId":489012,"journal":{"name":"Lučevaâ diagnostika i terapiâ","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135646092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echogenicity of carotid atherosclerotic plaques as a predictor of adverse cardiovascular events in patients aged 40–64: prospective study","authors":"V. V. Genkel, A. S. Kuznetcova, E. V. Lebedev, A. O. Salashenko, A. Yu. Savochkina, V. A. Sumerkina, K. V. Nikushkina, L. R. Pykhova, I. I. Shaposhnik","doi":"10.22328/2079-5343-2023-14-3-39-45","DOIUrl":"https://doi.org/10.22328/2079-5343-2023-14-3-39-45","url":null,"abstract":"INTRODUCTION: Noninvasive assessment of carotid atherosclerotic plaque (CAP) morphology represents a promising direction, allowing to optimize not only cardiovascular event risk assessment, but also the selection of patients for carotid revascularization. Determination of CAP echogenicity by means of GSM-analysis can be used as part of multiparametric assessment of CAP instability and prediction of adverse cardiovascular events. OBJECTIVE: To assess the predictive value of echogenicity of carotid atherosclerotic plaques in relation to the development of adverse cardiovascular events in patients 40–64 years old. MATERIALS AND METHODS : The study included 191 patients with carotid atherosclerosis aged 40–64 years. All patients underwent duplex scanning of the arteries of the carotid basin with determination of the echogenicity of carotid ASBs. The combined end point (CEP) consisted of the following possible events: nonfatal myocardial infarction or unstable angina, nonfatal stroke, coronary revascularization or peripheral artery revascularization, and death from cardiovascular causes. Data on the onset of CVD were collected during follow-up visits and using medical information systems. Statistics : Data were analyzed using MedCalc software (version 20.216). Frequencies and percentages were used to describe nominal data, and medians and quartiles were used for quantitative data. The Kaplan-Meier survival analysis method was used to estimate the probability of events constituting the combined endpoint. Cox regression analysis was used to estimate the risk of the event and the influence of independent variables on the risk. RESULTS: By correlation analysis, carotid AP echogenicity (GSM) was inversely correlated with BMI (r=-0,355; p<0,0001), waist circumference (r=-0.37; p<0.0001), triglyceride levels (r=-0.163; p=0.027), uric acid (r=-0.188; p=0.028). The duration of the follow-up period was 15.1 (12.2; 22.9) months. Events constituting CEP occurred in 15 (7.85%) patients: nonfatal myocardial infarction in 2 (1.05%) patients, nonfatal stroke in 2 (1.05%) patients, myocardial revascularization in 6 (3.14%) patients, unstable angina in 5 (2.61%) patients. The presence of carotid AP with echogenicity ≤39 conventional units allowed predicting the development of events constituting CEP with sensitivity of 53.3% and specificity of 80.7%. Kaplan-Meier survivalanalysis revealed that cumulative survival of patients with carotid AP with echogenicity ≤39 conventional units was statistically significantly lower compared to patients with carotid ASB with echogenicity >39 conventional units. DISCUSSION: It should be noted that in the presented study, decreased echogenicity of carotid AP was associated with the risk of adverse cardiovascular events only in the simple and sex- and age-adjusted models, but not in the full-adjusted model. It is likely that this may be due to the fact that the echogenicity of CAP is closely related to the cumulative burden of cardiovas","PeriodicalId":489012,"journal":{"name":"Lučevaâ diagnostika i terapiâ","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135646087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skull and scalp ultrasound in children: a review","authors":"I. A. Kriukova, A. S. Iova, E. Yu. Kryukov, R. S. Kulieva","doi":"10.22328/2079-5343-2023-14-3-7-17","DOIUrl":"https://doi.org/10.22328/2079-5343-2023-14-3-7-17","url":null,"abstract":"INTRODUCTION : An important task of modern pediatrics is to ensure radiation safety of diagnostic examinations, especially in young children. One of the options for reducing radiation exposure at the stages of screening diagnostics and dynamic monitoring is a wider use of ultrasound. OBJECTIVE: To analyze the data of domestic and foreign literature on the possibilities of ultrasound examination of the cranial vault bones, cranial sutures and scalp in children. MATERIALS AND METHODS : The literature search was performed in open Russian and English databases Medline, PubMed, Web of Science, RSCI, eLIBRARY using keywords and phrases: «skull ultrasound», «scalp ultrasound», «cranial sutures ultrasound», «point of care ultrasound», «pediatric POCUS» without limitation of retrospective depth. RESULTS: Based on the literature data and our own long-term experience in the use of cranial ultrasonography in clinical practice, the indications and examination technique, as well as the key ultrasound signs of the most frequent types of pathology are described. Prospects of scalp and skull ultrasonography within PoCUS, FAST, including the use of portable sonoscopes based on smartphones and tablets are outlined. CONCLUSION : Ultrasound of the skull and scalp is a quick, simple, affordable, harmless method of screening and monitoring the most frequent types of pathologies of the cranial vault bones, cranial sutures, and soft tissues of the scalp in children (for example, fractures, synostoses, neoplasms).","PeriodicalId":489012,"journal":{"name":"Lučevaâ diagnostika i terapiâ","volume":"100 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135645492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}