[Radiologic localization of pancreatic insulinoma]. / Luchevye metody vyiavleniia lokalizatsii insulinom podzheludochnoi zhelezy.

Thirty-one patients with insulinoma of the pancreas verified during operation were examined. The localization of the tumor was detected by ultrasonic examination in 9.7%, by X-ray computed tomography in 38.9%, by angiographic study in 32.1%, and by endoscopic retrograde pancreatocholangiography in 11.1% of cases. Complex use of the methods allowed the localization of the tumor to be determined in 48.4% of cases. The smallest diameter of insulinoma diagnosed during ultrasonic examination and endoscopic retrograde pancreatocholangiography was 1.5 cm, X-ray computed tomography and angiography demonstrated tumors measuring 1.0 cm in diameter. The diagnostic efficacy of the methods increases when the tumor is located in the body and tail of the pancreas. The examination scheme for patients with suspected insulinoma must include ultrasonic study and X-ray computed tomography; when their results are negative angiography must be resorted to.

[Radiologic diagnosis of non-Hodgkin's lymphoma in abdominal and retroperitoneal sites]. / Luchevaia diagnostika nekhodzhkinskikh limfom abdominal'noi i retroperitoneal'noi lokalizatsii.

A total of 112 patients with non-Hodgkin's lymphomas of abdominal and retroperitoneal localization were examined by the ultrasonic and x-ray methods, in 83 of them x-ray computer-aided tomography was used. Angiographic examinations and puncture biopsy monitored by US or x-ray CAT were carried out if indicated. The authors discuss the problems of ultrasonic and x-ray semeiotics of the lymphomatous involvement of the lymph nodes, spleen, gastrointestinal tract. They claim that USE, permitting the specification of further plan of examination of each patient, and x-ray examination as a method to assess the gastrointestinal status are the optimal methods for the primary diagnosis of non-Hodgkin's lymphomas. US data may prompt further application of x-ray CAT, whose results will supplement the US findings. Angiographic examinations should be carried out only in the most difficult diagnostic situations, bearing in mind the invasive nature of the method and its high price.

[The current diagnostic aspects of abdominal aortic aneurysms]. / Sovremennye aspekty diagnostiki anevrizm briushnoi aorty.

Based on diagnostic data in 35 patients with abdominal aortic aneurysm, which were obtained during ultrasonic scan echography, X-ray computed tomography and radioopaque angiography, and on their comparison with intraoperative findings, a diagnostic algorithm for examinations has been developed, which enables errors in the diagnosis to be excluded. The major diagnostic technique for abdominal aortic aneurysms has been found to be X-ray computed tomography which provided no errors in the assessment of the extent of aneurysms and the presence of their complicating components in all 35 patients. In high aneurysms of the abdominal aorta and suspected stenoses in the visceral, renal, and iliac arteries, X-ray computed tomography should be supplemented by radioopaque angiography to clarify the status of aortic branches.

[Radiologic methods in the diagnosis of diseases of the spleen]. / Luchevye metody v diagnostike zabolevanii selezenki'

Ultrasonic and computer-aided tomographic examinations of 2457 patients with suspected diseases of the abdominal cavity organs have revealed splenic involvement in 48. The sensitivity of ultrasonic technique for the detection of splenic diseases has made up 70.8%, that of computer-aided tomography--95.8%. Invasive interventions monitored by these two methods were carried out in 26 patients; in 10 of these transcutaneous puncture drainage was carried out for cysts (2), hematoma (1), and abscesses of the spleen (7). In one patient with multiple abscesses of the spleen the drainage was found insufficient for complete cure and he had to be subjected to splenectomy, in the rest cases surgery did not have to be resorted to. Therefore, ultrasonic and computer-aided tomographic examinations of the spleen, used together with various invasive interventions, result not only in correct diagnosis and differential diagnosis of this organ's disease, but permit various therapeutic measures and help achieve cure without laparotomy.

[Ultrasonic diagnosis of non-Hodgkin's lymphoma]. / Ul'trazvukovaia diagnostika nekhodzhkinskikh limfom.

Analyzes the results of ultrasonic examinations of 111 patients with various forms of non-Hodgkin's lymphomas. Reviews ultrasonic semeiotics of non-Hodgkin's lymphadenopathy of the abdominal cavity and retroperitoneal space and of extranodal variants of lymphoma course (with involvement of the spleen and stomach). Suggests the most safe method for precision diagnostic aspiration biopsy of the spleen monitored by ultrasound. The author considers ultrasonic examination to be a valuable method for the diagnosis of non-Hodgkin's lymphomas; it is economic, rapid, safe, permits a simultaneous assessment of the status of many organs and systems. The results of ultrasonic examinations should be assessed in complex with the results of other diagnostic methods. Ultrasonic examination should be considered as a method of choice for monitoring patients with diagnosed non-Hodgkin's lymphoma.

[A complex x-ray endoscopic study in complicated cholelithiasis]. / Kompleksnoe rentgenoéndoskopicheskoe issledovanie pri oslozhennoi zhelchnokamennoi bolezni.

Recurrent or residual choledocholithiasis was diagnosed in 202 patients with a history of cholecystectomy, in 148 cases this condition was combined with papillostenosis. Transfistula extraction of the concrements and endoscopic papillosphyncterotomy helped achieve cure of 186 (92%) patients without relaparotomy. The authors discuss the role of roentgenology in such combined x-ray and endoscopic diapedetic examinations and emphasize its role in identification of the diagnostic details that are so important for the choice of the optimal treatment strategy. They come to a conclusion that the results of treatment of complicated cholelithiasis by 'minor surgery' means depend not only on the manipulations and skills of the surgeon endoscopist, but on the full-value employment of roentgenology as well.

[Ultrasonography and computed tomography in the detection of overlooked gauze surgical dressings]. / Ul'trazvukovoe issledovanie i komp'iuternaia tomografiia v obnaruzhenii "zabytykh" marlevykh khirurgicheskikh materialov.

USI and CT were performed in 14 patients with textile foreign bodies left in the abdominal cavity and retroperitoneal space during operation on the biliary tracts (6 cases), kidneys (4 cases), pancreas (2), stomach (1), and during appendectomy (1). A decisive sign in USI that enabled one to detect gauze foreign bodies, was a stable echogenic zone corresponding to a proximal body contour with a solid acoustic shadow behind. Extra-organic localization of these changes contributed to making diagnosis. A certain amount of fluid could be seen around a foreign body during an exudative reaction. In CT, diagnosis was based on the detection of a formation with a capsule containing calcinates and air masses.

[The ultrasonic diagnosis of textilomas]. / Ul'trazvukovaia diagnostika tekstil'nykh inorodnykh tel.

The article analyses ultrasonic symptomatology of textile foreign bodies which were left in the abdominal cavity and retroperitoneal space during surgical interventions in 10 cases. An intensive distal acoustic shadow behind a space-occupying echogenic structure in the main sign of a foreign body. Two variants of the echotomographic picture are distinguished. It is shown that the picture depends on the degree of the exudative reaction. The authors claim ultrasonic examination to be an effective method for detecting foreign bodies and determining their exact localization.

[Ultrasonics in the diagnosis of stomach tumors]. / Ul'trazvukovoe issledovanie v diagnostike opukholei zheludka.

Proceeding from analysis of over 2000 ultrasound investigations (USI) the role of this method in the diagnosis of stomach tumors was defined (employed during routine investigation of the abdominal cavity and as a procedure with liquid filling of the stomach cavity). Ultrasound semiotics of a neoplastic process of the stomach was described. USI can be used for screening and specification. Various methodological approaches were proposed with regard to purposes to be achieved. Routine methods (x-ray and endoscopy) were shown to remain the chief methods. USI can be used in doubtful cases or for obtaining detailed information. The most valuable are its potentialities in showing details of intraparietal changes in endophytic stomach carcinomas which are difficult for diagnosis.

[Possibilities of computerized tomography in the diagnosis of gastric tumors]. / Vozmozhnosti komp'iuternoi tomografii v diagnostike opukholei zheludka.

On basis of experience in computed tomography (CT) of the stomach in 76 individuals, in 44 of whom gastric tumors were diagnosed, the possibilities of this method in the recognition of this pathological condition are discussed. The authors discuss in detail their own method of CT of the stomach, which combines elements of the classical gastroroentgenology and the specific features of CT characteristic of it as an independent method. The method is based on fractional contrasting of the gastric lumen by introducing air through a nasogastric catheter. It practically excludes the possibility of diagnostic errors associated with visualization of "pseudothickenings" of the gastric wall, and thus removes the main limiting factor of using CT in the diagnosis of gastric tumors. Appraising quite highly the CT potential in neoplastic diseases of the stomach, the authors emphasize that the method must be used in complex with the existing traditional means of examination of the stomach.

[Radiological diagnosis of tumors of the adrenal glands]. / Luchevaia diagnostika opukholei nadpochechnikov.

Radiation methods were used for examining 176 patients with hormonal-active tumors and 12 patients with hormonal-nonactive tumors. The correct diagnosis of tumor of the adrenals was established with the help of oxysuprarenography in 51.9%. Ultrasonic examination was used in 78.8% and roentgen computed tomography--in 93.5%. Differential diagnostics of the Itsenko--Cushing disease and Cushing syndrome, due to corticosteroma is possible on the basis of the whole complex of findings of USI, RCT and venography with determination of the level of cortisol, aldosterone, catecholamine in blood flowing from the adrenals.

[Computed tomography in the diagnosis of endophytic cancer of the stomach]. / Komp'iuternaia tomografiia v diagnostike éndofitnogo raka zheludka.

The authors discuss the potentialities of CT in the diagnosis of endophytic stomach cancer. They proposed a method for CT of the stomach based on a pneumatic study of its lumen via a nasogastric probe with graded inflation and repeated CT imaging. The major CT-semiotics of endophytic stomach cancer were obtained. This method should be employed in combination with the existing routine methods of stomach cancer diagnosis, and its efficacy is in direct relation to the quality of preliminary routine x-ray and endoscopic investigations.

[Ultrasonic diagnosis of ureterocele]. / Ul'trazvukovaia diagnostika ureterotsele.

Diagnostic ultrasonic investigation has found many applications in routine urologic practices. The use of ultrasound for the investigation of 19 patients with ureterocele is reported. High diagnostic value, simplicity and noninvasiveness of echographic diagnosis of this congenital malformation of distal ureteral portions and related complications are pointed out. Its advantages over conventional means of ureterocele diagnosis, such as excretory urography and cystoscopy, are demonstrated, while their shortcomings are avoided. Echography is particularly effective in cases of impaired renal activity, doubled upper urinary tract and segmentary ureterohydronephrosis. Ultrasound makes it possible to choose the type of surgical intervention, and exclude angiography from the diagnostic complex in some cases. Follow-up echographic examination after surgery for ureterocele provides adequate information on treatment results.

[Ultrasonic study of the bile ducts in patients after cholecystectomy]. / Ul'trazvukovoe issledovanie zhelchnykh putei u bol'nykh, perenesshikh kholetsistéktomiiu.

Ultrasonic examination (USE) of the bile tract was conducted in 287 patients with removed gallbladder. The choleretic test based on comparative appraisal of the lumen of the bile ducts before and after medication with pharmacological agents stimulating bile secretion was performed in 167 cases to increase the USE efficacy. USE allowed choledocholithiasis to be diagnosed in 24 of 30 patients and obstruction of the bile ducts in 60 of 67 patients. The sensitivity of USE in pneumobilia detection was appraised highly. Preference was given to radiological methods of examination of patients with external biliary fistulae and drains in the common biliary duct in comparison with USE. The authors believe USE to be the optimal means for primary diagnosis of biliary pathology in persons with removed gallbladder, which can be undertaken in out-patient conditions and which reduces the need for conducting invasive radio-endoscopic examination (endoscopic retrograde cholangiography) in such patients.