Home » Ukrainian Journal of Radiology » 2006, vol XIV, # 3

2006, vol XIV, # 3



2006, vol 14, # 3, page 227

L. O. Shkodin

Complex radiodiagnosis of renal parenchyma diffuse lesions


Objective: To define more exactly the capabilities of ultrasound tomography (UST), computed tomography (CT), helical CT (HCT), magnetic resonance imaging (MRI) and intravenous urography (IVU) in revealing and differential diagnosis of diffuse lesions of the renal parenchyma (DLRP).

Material and Methods: The study involved 132 patients aged 11-82 (38 women and 94 men) with 4 US types of DLRP: syndrome of prominent pyramids (SPP), syndrome of hyperechoic pyramids (SHP), diffuse thickened hypoechoic and diffuse hyperechoic thick parenchyma. Complex clinical laboratory study as well as UST, IVU, MRI CT/HCT were performed.

Results: It was determined that complex radiation diagnosis of diffuse renal parenchyma lesions depended on their type reflecting the morphological changes in the tissue, the volume of the radiological investigation and accuracy of the data analysis.

Conclusion: Ultrasound tomography is a highly effective method of DLRP diagnosis, its efficacy in SPP and SHP is close to 100% as they have a characteristic US picture reflecting the morphological changes in the kidneys. IVU allows to assess the kidney function, the state of the cavitary system and parenchyma, to exclude contracted kidney and to confirm the presence of nephrocalcifications and calculi but the picture apart from contracted kidney is not specific. MRI in T1 weighted imaged in PS MSSE is optimal for evaluation of the kidney anatomy and the parenchyma state but the picture of SPP and SHP is not specific. Nephrocalcifications are demonstrated only by MI in PS RARE on T2 weighted images. Pulsed MR urography is not informative for assessment of the parenchyma state and allows to assess only the state of the urinary system especially in a «silent» kidney. SSP and SHP picture at CT/ HCT without and after contrast enhancement is not specific and demonstrated only diffuse thickening of the parenchyma with decreased volume of the sinus as well as nephrocalcifications in the pyramids. UST, MRI, CT/HCT picture of contracted kidney is specific but US visualization of the organ may be difficult. UST is indicated for screening, diagnosis and dynamic observation of DLPR.

Key words: kidneys, parenchyma lesions, diagnostic images.

2006, vol 14, # 3, page 237

V. I. Sipitiy, V. M. Kucin, Y. O. Babalayn, V. V. Votobyov

Radiation diagnosis of frontal lobe injury combined with frontal-orbital fractures of the skull bones


Objective: To determine the efficacy of methods of radiation diagnosis of frontal lobe injury combined with frontal-orbital fractures

Material and Methods: Complex examination of 77 patients with frontal lobe injury combined with frontal-orbital fractures with use of x-ray (craniography + special positions), planar and helical computed tomography, magnetic resonance imaging was performed.

Results: The analysis showed insufficient informativity of skull x-ray in 13 (16.8 %) cases. Diagnostic capabilities of computed tomography allowed to perform multi-purpose analysis of CT-scans in the following aspects: cerebral parenchyma, fluid-containing spaces, bones, peripheral nerves (visual nerve) and vascular bunches, muscle structures (foremost extraocular muscles). Initial CT research visualized primary intracranial traumatic changes and repeated computer tomography estimated its evolution, secondary ischemic changes, criteria of pyogenic-inflammatory complications of cerebral traumatic disease. Application of MRI allowed to add the information about the sizes of parenchymal hemorrhage in 1 (1.3 %) case, visualized isodense intracranial traumatic changes in 1 (1.3 %) patient.

Conclusion: High informative capabilities of computed tomography makes it the method of choice in examination of patients in acute period of frontal lobe injury, combined with frontal-orbital fractures. Magnetic resonance imaging is an important additional method, which promotes quality of diagnosis of intracranial pathological changes in subacute period .

Key words: frontal-orbital injury, informativity, craniography, computed tomography, three-dimensional reconstruction, magnetic resonance imaging.

2006, vol 14, # 3, page 242

R. Y. Abdullaev, V.V. Gapchenko

Ultrasonography of the stomach and duodenum: methodological aspects and normal anatomy


Objective: To systematize ultrasonography of the stomach and the duodenum (D) and to study their normal echographic anatomy.

Material and Methods: Ultrasonography was performed in 26 healthy persons aged 19-35, of them 17 men and 9 women.

The study was done using Aplio (Toshiba), SA 6000, 8000 and Myson (Medison), Acuson-XP128, Radmir-P20 units with 3.0-7.0 MHz convex transducers. Echography was done on an empty stomach and after drinking 500 ml of water.

Results: Optimum approaches and positions were determined. The study began with visualization of the antral portion on an empty stomach. After drinking 500 ml of fluid complete examination of all portions of the stomach and D were done in the following positions: 1 - on the left side, for visualization of the fundus and middle third of the body; 2 - on the back; 3 - on the right side for investigation of the whole body; 5 - sitting or upright, for the study of the antral portion of the stomach and proximal portion of the duodenum.

3 MHz transducers allowed to distinguish the mucous, muscular and serous layers of the stomach and D, 5 - 7 MHz allowed visualization of the subserous layer. The thickness of each layer of the wall did not exceed 1.5 mm , mean thickness in the middle third was < 4 mm , in the antral portion < 6 mm . Peristalsis was best distinguished in the middle and lower thirds of the stomach. The esophagus is better seen at the moment of swallowing water, when air bulbs appeared in the cardiac portion. In the longitudinal section the esophagus was seen like a structure with a hypoechoic external outline and central echogenic band. The pylorus and D bulb were seen in all cases.

Conclusion: Being an objective and significant method of diagnosis, ultrasonography can be successfully used to study the anatomy and function of the stomach and duodenum.

Key words: ultrasonografihy, stomach, duodenum, methodology.

2006, vol 14, # 3, page 247

N. P. Stroganova, S. Y. Savickiy

Improvement of radionuclide ventriculography efficacy in evaluation of regional contractility of the left heart ventricle after myocardial infarction


Objective: To improve informativity of radionuclide ventriculography (RV) and make more objective the assessment of regional contractility of the left ventricle ( LV ) in patients after myocardial infarction (MI).

Material and Methods: The study involved 93 patients with MI, 46 with anteroapical location and 47 with posterolateral. All patients were performed balanced cardiosynchronized ventriculography with 99 mTc-pyrphotech (individual dose 370-450 NBq). LV area was divided into 6 regions (1, 2-anteroseptal; 3, 4-apical; 5, 6-posterolateral). Activity-time curves for LV area and each region allowed determining LV ejection fraction, regional ejection fraction (REF) and maximum ejection rate (ER max).

Results: To make more objective determining the zones of hypo-, normo-, and hyperkinesis complex approach to the analysis of the obtained findings was used: normalizing of measured REF according to the reference values for each region, a relative parameter of contractile fraction; determining the zones of hypo-, normo-, and hyperkinesis according to REF to the respective ERmax.

Conclusion: The use of complex approach to the analysis of regional contractility disorders in patients after MI allows to make more objective determining hypo-, normo-, hyperkinetic segments of the myocardium.

The ration of hypokinesis zones characterizing disorders of contractile myocardium function and the zones of normo- and hyperkinesis allows to analyze compensation mechanisms providing a definite level of pumping function of the LV after MI.

Key words: radionuclide ventriculography, myocardial infarction, regional contractile function of the myocardium, assessment.


2006, vol 14, # 3, page 252

R. Y. Abdullaev, S. O. Ponamorenko, V.V. Gapchenko

Complex radiodiagnosis of the lumbar spine spinal canal stenosis


Objective: To assess the capabilities of ultrasound study (USS) and other methods of radiation diagnosis in stenosis of lumbar spine.

Material and Methods: Ultrasound study was done in 67 patients aged 21-59 (43 men and 24 women) with osteochondrosis of the lumbar spine revealed by x-ray study, magnetic resonance imaging and computed tomography. The study was done through the transabdominal approach using Aloka SSD-630, Radmir P20, Aplio (Toshiba), Myson (Medison) units in B-mode using convex 3.5 and 2-5 MHz transducers, respectively. Staged axial section from L1-L2 to L5-S1 allowed to obtain the image of the disk and spinal canal (SC) similar to CT. The sagittal size of the SC and its area were measured using planimetry with the account of the state of yellow ligaments, hernial protrusion of the intervertebral disk (IVD). Sagittal scanning was done to reveal vertebra dislocation.

Results: Diminution of the sagittal size at IVD level up to 13 mm, the area < 2.5 cm 2 were considered quantitative criteria of SC stenosis. In inconsiderable stenosis, the area was 2.5-1.7 cm 2, in moderate - 1.7-1.0 cm 2, in considerable < 1.0 cm 2 . Sagittal size < 11 mm was an absolute sign of stenosis. In 17 patients, early signs of disk degenerative process (chondrosis) were revealed, in 19 -protrusion or hernia of the disk without the signs of SC stenosis. In 39 patients, SCS was diagnosed. Comparison of different types of stenosis and methods of diagnosis revealed that MRI demonstrated all of them (100%), USS - 92%, x-ray - 49%. Degenerative stenosis was the most frequent form, i.e. 85% of all stenoses. USS is 7% less effective than MRI and 44% more effective than x-ray study in revealing this pathology. Yellow ligament hypertrophy was diagnosed only using MRI and USS. In the majority of cases (28 patients, 72%), SC stenosis was revealed at L4-L5, L5-S1.

In diagnosis of dysplastic stenosis (all cases, 8% of all stenoses) all radiodiagnosis techniques are of similar diagnostic value. For dysplastic (congenital or constitutional) stenosis USS demonstrated a triangle shape of the SC, reduction of its sagittal and frontal sizes, chiefly the former.

Conclusion: Ultrasound technique is highly informative in visualizing location, direction, size of the hernia in lumbar osteochondrosis and stenosis of spinal canal.

Key words: ultrasound study, radiodiagnosis, stenosis, intervertebral disk, vertebra.

2006, vol 14, # 3, page 257

S. M. mamotuyk, N. I. Pilipenko, Y. O. Nagulin, S. I. Revenkova, N. S. Uzlenkova, V. A. Gusakova, Y. E. Vikman, O. V. Nenuykova, S.V. Rudenko, L. V. Batuyk, I. O. Leonova, O. L. Maslennikova

Experimental investigation of the organism reactions on the influence of gallium ions and x-rays


Objective: To reveal biological effects at combined and separate influence of ionizing radiation and gallium ions on the rats at metabolic, cellular, biophysical levels.

Material and Methods: The experiments were performed on 75 mature mongrel white male rats in which the changes of hematological (leukocytes, erythrocytes, thrombocytes), biochemical (AlT, AsT, alkaline phosphatase, total protein and total bilirubin) and biophysical (erythrocyte shape index, rate of acid erythrocyte hemolysis) parameters were analyzed after intravenous injection of GaCl 3 at a dose of 20, 64, 200 mg/kg and fractionated x-ray exposure at a total dose of 1 Gy (Eef=100 keV) on days 3, 7, 21.

Results: It was established that gallium ions caused the changes in the organism manifesting by the changes in the amount of formed elements, bilirubin, alkaline phosphatase, liver enzymes in the blood and death of the animals from blood coagulation at high GaCl 3 doses. Specific effect of ions was demonstrated by induced erythrocyte aggregation in vitro and disturbances of membrane properties in vivo. An additional effect of radiation did not change the revealed characteristics.

Conclusion: Administration of substances containing gallium ions can cause the changes in homeostasis and requires control of the coagulation state, in particular.

Key words: gallium ion toxicity, x-ray exposure, biochemical changes, hematological changes, disturbances of erythrocyte membrane properties.

2006, vol 14, # 3, page 264

R. I. Kratenko

Influence of ionizing radiation and 12-crown-4 on L-arginine-dependent synthesis of nitrogen oxide and NO-synthase activity


Objective: To investigate L-argininic synthesis of nitrogen oxide and NO-synthase activity of warm-blooded animal organism under the influence of 12-crown-4 and ionizing radiation at the conditions of subacute toxycologic experiment.

Material and Methods: Meth-hemoglobin concentration was determined by the aid of spectrophotometer. Arginine and citrulline contents determination was performed by ion-exchange chromatography. Nitrogen oxide content evaluation was carried out by the coloured reaction with Gryss reagent. Adenylate and guanylate cyclase systems state and activity were determined by radioligand method taking into account the levels of adenylate cyclase, guanylate cyclase, cyclic adenosine monophosphate (cAMP), cyclic guanosine monophosphate (cGMP), phosphodiesterase, and intensity of 45 Ca 2+ absorbtion by membrane fractions. Microsomal oxidation state was evaluated by respiratory and enzymic activities, cytochrome b5 and P-450 contents.

Results: Under the influence of 12-crown-4 and ionizing radiation, blood meth-hemoglobin level was increased compared with the control magnitudes. The action of both factors resulted in the statistically reliable elevation of citrulline, and diminution of arginine blood plasma contents. This might be connected with the activation of substrate oxidation process and conversion of the substrate to L-citrulline. The investigation of nitrite and nitrogen oxide (IV) contents established their level agmentation in comparison with the controls. The action of 12-crown-4 and ionizing radiation decreased adenylate cyclase activity and cAMP contents increasing guanylate cyclase and phosphodiesterase activities. Simultaneously, both factors influence led to the cGMP and 45 Ca 2+ accumulation in hepatocytes which may point out at the stimulation of guanylate cyclase mediatory mechanism by nitrogen oxide (II). Both factors activated O-demethylase, cytochrome P 4 50, NADPH and NADH-cytochrome c-reductase activity, microsomal endogenic respiration and lipid peroxidation not influencing cytochrome b5 activity.

Conclusions: The influence of ionizing radiation and 12-crown-4 may be considered as modulatory at the respect of nitrogen oxide production and NO-synthase activity which is connected with the functional activity of monooxigenase system. Similar character of the alterations caused by ionized radiation and 12-crown-4 suggests the presence of radiomimetic properties of the latter.

Key words: crown-ethers, ionizing radiation, meth-hemoglobin, L-arginine, L-citrulline, adenylate cyclase, guanylate cyclase, cyclic nucleotides, phosphodiesterase, micrisomal monoxigenase system.

2006, vol 14, # 3, page 268

L. I. Stepanova, S. V. Hignayk, A. V. Klepko, L. V. Babich, N. V. Didenko, V. M. Voycickiy

The evaluation of lipid synthesis in small intestine mucosa enterocytes at radiation exposure


Objective: To evaluate lipid synthesis basing on the findings of labeled acetate annexation to lipid fractions of the apical membrane (AM) of small intestine enterocytes 24, 48, 72 hours after the exposure to ionizing radiation at a dose range of 0.1-6.0 Gy.

Material and Methods: The study was done on the specimens of small intestine apical membrane enterocytes of the rats which were administered 2-14 C-acetate at a dose of 0.3 mCi per 1 kg of the body weight prior to decapitation. Lipids and cholesterol obtained from the membranes specimens were separated using thin-layer chromatography into separate spots which were cut out. Their activity was determined in toluol scintillation fluid ЖС -107. The amount of labeled acetate in the specimens was calculated taking into consideration the known standard radioactivity.

Results: The analysis of the obtained findings of 2-14 C-acetate intensity annexation to total lipid, phospholipid and cholesterol fraction suggests their biosynthesis activation with the increase of exposure dose. The value of 2-14 C-acetate annexation to lipid fractions of enterocyte apical membrane approaches to the control values with the prolongation of the term after the exposure.

Conclusion: The revealed activation of 2-14 C-acetate annexation to various fractions of lipids after single exposure at a dose of 1.0 to 6.0 Gy suggests reparation processes in enterocyte apical membrane of the small intestine of rats after the exposure.

Key words: ionizing radiation, apical membrane, lipids.


2006, vol 14, # 3, page 272

V. A. Zinchenko, L. I. Chashina

Acquired resistance of tumor cells


Objective: To study the mechanisms of forming tumor cell resistance to ionizing radiation.

Material and Methods: To simulate the process of radio-resistance (RR), RR strains, variants of Guerin's carcibnoma and Pliss lymphosarcoma, cultures of transformed fibroblasts L 929 were obtained.

Results: The characteristic cytological characteristics, which allow to assess RR state specificity, were investigated after repeated exposure of the RR strain to a dose of 12 Gy. This increased polymorphism of the cells, their nuclei, membrane structures.

The obtained artificial RR variants of the tumors differed from their classical ancestors in the character of the growth, morphology and metabolism. Intrapopulation heterogenicity of the cells and changes in RR tumors generations increased with the stage of RR formation. The analysis of cytological and biochemical characteristics of RR obtained by the cells in vitro, in vivo and on transplanted tumors, allowed to distinguish 17 main characteristic signs of RR. Five of them most typical and stable (based on the developed algorithm) are recommended to use as objective laboratory criteria of tumor cells RR.

Conclusion: The obtained RR strains differed from the wild ones in the character of their growth, morphology and metabolism. RR development results from two interrelated processes, i.e. selection of the most RR portion of the cellular population and formation of new features during adaptive reactions due to cellular stress caused by ionizing radiation.

Key words: ionizing radiation, tumor cells, radioresistance, in vitro and in vivo cell culture, morphological changes.

2006, vol 14, # 3, page 277

V. G. Knigavko, E. B. Radzishevskay, N.S. Ponomarenko

On some problems of interpreting the phenomena of sublethal and potentially lethal radiation lesions in cellular DNA


Objective: To suggest and substantiate the hypotheses allowing new interpreting of the phenomena of existence of sublethal and potentially lethal lesions in the exposed cells.

Material and Methods: Mathematical simulation was used to substantiate the hypotheses.

Results: New hypotheses were suggested, the results of the calculation following from the created mathematical models are reported.

Conclusion: A new interpreting of sublethal lesions as well as a new mechanism of forming irreparable component of potentially lethal lesions are suggested. Mathematical expressions for evaluation of dependence of maximal cell survival in suboptimal conditions of radiation dose were obtained.

Key words: sublethal and potentially lethal radiation lesion, DNA.

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