Search

Introduction: The process of recording a patient includes a procedure with several separate segments during work that together provide the imaging to be obtained for adequate radiological analysis. Throughout the process, it is possible to experience errors that create artifacts on X-rays which ultimately results in an inadequate recording that is not for valid analysis. Aim: Determine the total number of radiological films that are not for valid analysis. Sort out and analyze errors in radiographs according to the work process. Provide recommendations for improving the quality in the process of recording the patient. Material and methods: A prospective study was conducted at the Radiology Clinic of the Clinical Hospital Center Pristina-Gracanica, for two calendar years. All films that are not for valid analysis were considered. The radiological procedure of patient imaging was broken down into logical segments so that possible errors could be observed. We have summarized the causes of the artifacts in five appropriate groups (errors made by the recording technique, during the acquisition of the image, caused by the object of recording, during the processing of films in an automated machine and improper handling of films). Results: The total amount of used X-ray films is 32600 pieces, of which 242 (0.74%) were errors and artifacts. The most common format of a film with an error or artifact was 30x40 cm. A frequency of errors according to the cause of the occurrence is classified into appropriate groups. The largest number was in a group 1 - 155 (64.04%), in a group 2 - 3 (1.24%), in a group 3 - 13 (5.37%), in a group 4 - 67 (27.69%), and in a group 5 - 4 (1.66%). Conclusion: In the proper systematization of all observed errors and artifacts of X-ray film, it allows us to realise the place of error during the whole process of recording and processing of the film. We hereby wish to propose their elimination and improve the quality of the radiology department.

Introduction: The circle of Willis is the major source of collateral blood flow between the carotid and vertebrobasilar system. Its potential depends on the presence and size of arteries that vary greatly among normal individuals and therefore their adequate observation by a radiologist is necessary. Aim: Determine the type of the circle of Willis and their frequency. Determine the type, frequency and localization of anatomical variants of arteries, as well as their average diameter. Compare these variables according to the age and gender of the examinees. Material and methods: A retrospective study was performed at the Center for Radiology of the Clinical Center Nis during 2017. All subjects underwent CT or MR angiography according to a standard endocranial protocol. The anterior and posterior parts of the circle were specially observed, with an emphasis on the presence or absence of anatomical variants of the arteries, with the measurement of their diameter. The obtained data were classified into variants of the front or rear part of the ring as well as the type of ring according to integrity. The frequency of these variables and their comparison by sex and age were measured. Results: The research included 92 examinees. According to the configuration of the Willis arterial ring, the adult type was the most often represented (71.7%). The most common type in terms of integrity was partially complete. The most common anatomical variants obtained in our work was aplasia of AcoA (27.2%) and aplasia of one or both PCoA (21%). PcoA hypoplasia was occured in women with a frequency of 13.5% while in men it was not present. Conclusion: Adequate understanding of the morphology of the circle of Willis by radiological methods is a good guide for neurosurgical and radiological intervention procedures. In this way, potentially significant neurological complications and the risk of morbidity and mortality could be reduced.

Introduction: The most common causes of renal artery disease are stenosis, as a consequence of atherosclerosis and fibromuscular dysplasia. Computed tomographic (CT) angiography is a non-invasive method, which enables visualization of vascular structures and walls of blood vessels, as well as morphology of the renal parenchyma. Objective: To determine the importance of CT angiography in detecting the cause and degree of renal arterial disease. Methods: A total of 45 patients were included in the cross-sectional study conducted from March 2017 to March 2019 in the KBC DR Dragiša Mišović-Dedinje, Belgrade, Serbia. Criteria for inclusion were suspicion of secondary arterial hypertension, patients in preparation for kidney transplantation and in the follow-up period after transplantation, as well as patients with suspected traumatic lesions. We analyzed the causes of the disease, the morphology of the blood vessel wall, the percentage of stenosis, and the renal parenchyma. Results: The most common causes of renal arterial disease are atherosclerosis, which was found in 33 (73%) patients, renal artery aneurysm was found in 5 (11%) subjects, fibromuscular dysplasia in 4 (8.9%) and trauma in 1 (2) , 3%) of the patient. There were 10 (22.2%) patients with a significant (average 80 ± 14.5%) degree of stenosis. The sensitivity of CT angiography in the detection of atherosclerotic changes in the renal arteries was 87.9%, while the sensitivity of CT angiography in the detection of fibromuscular dysplasia was 75%. A statistically significant correlation was found between atherosclerotic stenosis of the renal arteries and a positive CTA finding (p = 0.0002). Conclusion: CT angiography is an important method of visualization and quantification of pathological changes in the renal arteries.

Introduction: Glaucoma diagnosis is based on consideration of several factors, such as increased intraocular pressure (IOP), damage to the optical disc, and associated visual field loss. Evaluation of the integrity of the corneal endothelium and monitoring of the corneal thickness is indispensable during the preoperative preparation for phacoemulsification. These data are of great importance for later treatment and monitoring of early and late postoperative complications. Objective: The aim of this study was to determine the central corneal thickness immediately before and after cataract surgery in patients with primary glaucoma (open and closed angle), comparing them with patients who do not have diagnosed glaucoma. Materials and methods: A prospective study covered a total of 159 subjects who performed cataract surgery by the method of phacoemulsification with the implantation of the intraocular lens in the posterior chamber at the Clinic for Eye Diseases at the Clinical Center of Serbia in Belgrade in 2017 and 2018. Pre-operative patients are classified into two groups. The first group with a primary glaucoma consisted of 71 respondents, with an open angle 41 with glaucoma, and a closed angle glaucoma 30. The second group consisted of people who did not have a diagnosed glaucoma, 88 of them. The central corneal thickness was measured using an ultrasound pachymeter. The measurements were made before the operation, 24 hours, 10 and 30 days after the operation, trying to get all done at the same time of day. Results: Between patients without glaucoma (BG), primary open-angle glaucoma (POAG) and primary glaucoma of closed angle (PACG), there is a statistically significant difference in median age (χ2 = 10.102; DF = 2; p = 0, 006). Among the observed groups there were statistically significant differences in the values measured preoperatively (χ2 = 10.265; DF = 2; p = 0.006). Among the observed groups, there was no statistically significant difference in the values measured in the first postoperative day (χ2 = 4.364; DF = 2; p = 0.099), nor in the 10th postoperative day (χ2 = 3.250; DF = 2; p = 0.197); 30 days after surgery (χ2 = 1.427; DF = 2; p = 0.490). In each of the groups individually, the appearance of oedema or a very statistically significant difference in the first and tenth postoperative day. Statistically significant difference was present 30 days after surgery, but far less compared to early postoperative period. Conclusion: Based on the values obtained in this prospective study, we estimate that monitoring of corneal thickness has a mandatory place in the observation of patients after cataract surgery. We found that there is no difference in preoperative measurement only between groups without glaucoma and open angle glaucoma. Measurements performed in the first, tenth, thirtieth day do not differ in groups, but edema restitution in the 30-th day was observed in all observed groups.

Introduction: The presence of malignant altered axillary lymph nodes, and their timely detection is crucial for staging and prognosis of breast cancer. Echotomographic examinations are widely used technique, and represents one of the first tests of diagnostic modalities. Classic B mode, Doppler sonography, and MicroPure testing technique, allow a comprehensive assessment of the detailed morphology and internal structure of the nodes (number, location, size, shape, borders, echogenicity, edema of the surrounding soft-tissue, the presence of microcalcifications), and determination of their nature. Objective: The aim is to determine the role of echotomographic review the morphology, determining the nature and setting guidelines for diagnostic testing algorithm for malignant altered axillary lymph nodes. Materials and methods: This cross-sectional study included 212 echotomographic tested axillary lymph nodes in the Department of Radiological Diagnostics KBC 'Dr Dragisa Mišović-Dedinje' in Belgrade, in the period from February 2016.do March 2017. All patients were examined in the supine position with arms in abduction, and external rotation. The following parameters: shape, size, and homogeneity of the echo-structure, edge, an auxiliary structures such as intranodal necrosis, edema and peripheral vascularization, as well as the presence of microcalcifications, using classical B mode, Doppler sonography and MicroPure technique. For all examinations we used Toshiba device, Aplio XG, 10MHz linear transducer. Results: Of a total of 212 tested nodule, histopathology was also verified 44 malignantly changed (21%), 4 of which the primary (9%) in a patient with Hodgkin's lymphoma, and secondary 40 (91%) in patients with breast cancer. Other nodes 168 (79%) were normal-reactive. The best performance in the echotomographic examinations are the criteria of: the shape (longitudinal cross-ratio

Introduction: Radiological diagnostics is the dominant diagnostic discipline in medicine. The level of technical equipment of radiological departments directly affects many aspects of importance for the diagnosis of a large number of pathological conditions and, therefore, the progress in the treatment of patients. Aim: The research analyzes the existing situation in radiological cabinets on the territory of AP Kosovo and Metohija. Particularly important elements will be analyzed for the functioning of the radiology service. An analysis of the obtained results gives recommendations in order to improve radiological diagnostics. Methods: A survey was conducted to obtain relevant data. A questionnaire consisting of segments containing basic elements for determining patients' accessibility criteria, equipping the cabinet with equipment and employing professional staff was designed. This formulated questionnaire was sent to radiological departments in health institutions on the territory of AP of Kosovo and Metohija, which are part of the Ministry of Health of the Republic of Serbia. Results: The highest percentage of radiological equipment is represented in KBC Kos. Mitrovica and KBC Pristina-Gračanica, a total of 54%. The percentage of medical staff is at KBC Kos Mitrovica radiologist 50%, work technician 36%. This is followed by KBC Prishtina-Gračanica with 25% radiologists and 27% of radiological therapists. Conclusion: The basics of radiological diagnosis are conventional x-ray techniques. Tertiary health care does not adequately possess radiological high-tech modes of computerized tomography and magnetic resonance. Staff training is required in order to re-establish existing knowledge and skills development that are followed by the continuous professional development of technology applied in radiological practice.

CT diagnosis of peritoneal space is a complex part of the scan and it is difficult to introduce on axial sectionsbecause it is normal in a curved plane. The presence of 'blurred' or 'misty' mesentery, is the most common sign of the presence of pathological processes in the peritoneal cavity. Normal subperitoneal fat is low attenuation measurements, and any increase in the attenuation of these structures (from -60 to 0 HU) diagnostic is important. The aim of this study was to evaluate the role computerized tomography in the exploration and visualization of pathological changes in the mesentery. The study of prevalence on 28 patients was performed CT examination of the abdomen and pelvis within the Department of Radiological Diagnostics KBC 'Dr Dragisa Mišović-Dedinje' in Belgrade. We used a standard protocol recording the abdomen, based on testing by dynamic protocol by Rossi. All recording were performed at 16-slice scanner. In 18 of total 28 people (64%), saw the changes on mesentery, which were inflamantory origin, of which changes according to the type of 'misty' mesentery were recorded in 6 people with pancreatitis (33%), in 4 people with appendicitis (22%) in 7 persons with diverticulitis (39%), while in one there was panniculitis with pseudocapsule in the form of fat ring (6%). In the two people (7%), there was a 'misty' mesentery as a result of thrombosis of the superior mesenteric vein, while the 2 persons (7%), mesentery was altered as a result of hemorrhagic ischemia of the small intestine. One person (4%) had pathologically altered due to the mesentery of the small intestine primary tumors (carcinoid), and in 5 people (18%) were present as a result of adhesion sequelae after surgical intervention and radiation therapy. The sensitivity of CT diagnostics for obtaining positive results in people who have an inflammatory changed mesentery was 90% and specificity of the method was 87.5%, positive predictive value 94.7% and negative predictive value of 77.8% and a diagnostic accuracy 89. 3%. Based on the high values of sensitivity and specificity of the test examination in this study section, CT diagnosis of peritoneal space is required place in the diagnostic algorithm. Thanks to the multidetector scanners has been extended exploration peritoneal space, but despite the large contribution of software solutions, meticulousness in the review, as well as a high level of knowledge are essential assumptions to work, a review of these areas is always a diagnostic challenge.

The term 'acute myocardial infarction ' is used when there is evidence of myocardial necrosis in a situation when the clinical picture suggests myocardial ischemia. Average per year in the world of acute myocardial infarction fall ill 6 million people, lethality occur in over 25% of cases. Identification of the most important epidemiological characteristics of myocardial infarction in the Serbian areas of Kosovo and Metohija. In paper we used an epidemiological cross sectional study (cross -sectional). During the period of 2004-2011 in Kosovo and Metohija (Serbian areas) reported a total of 421 patients with acute myocardial infarction . The ratio of male patients compared to the number of female patients is 2,69:1 . The largest number of patients (92) and the highest non-standardized incidence rate of acute myocardial infarction (59.13/100000 population) are registered in 2008th year. Incidence of acute myocardial infarction showed a statistically significant correlation with patients ' age and gender (chi-square=21.39 , df=1 , p

Introduction: In adults the diagnosis of acute pyelonephritis and glomerulonephritis is primarily based on clinical and laboratory-biochemical testing. In patients where the clinical picture atypical, even if a person does not respond to therapy resorts to radiographic examination. Echotomographic examination is unavoidable in the diagnostic algorithm. Objective: The aim of this study was to establish the individual echotomographic parameters, as well as to determine their diagnostic power in patients with acute infections (pyelonephritis and glomerulonephritis), and comparing them with the appropriate reference tests. Materials and methods: We performed a cross sectional study in the period from October 2014. until May 2015. It included 50 patients with acute inflammation of the kidney which was made echotomographic examination of the abdomen and pelvis, within the Department of Radiological Diagnostics KBC 'Dragisa Mišović-Dedinje' in Belgrade. The echotomographic examination of the kidneys included testing of numerous parameters that could indicate the existence of an acute inflammation of the kidney. For the gold standard, we take the findings obtained by CT (computed tomography) imaging of the abdomen and pelvis, as well as histopathological findings obtained by fine needle bio-psy. Results: At 50 patients with acute inflammation of the upper urinary tract, 41 patients (82%) had acute pyelonephritis, and 9 (18%) had acute glomerulonephritis. In 70% of patients with acute pyelonephritis (29 people) were present enlargement of the kidney where the test sensitivity was 79.3% and specificity of 91.7%. The accuracy of the method was 82.9% when the monitored parameters: loss of central echo complex and cortico-medullary differentiation. The sensitivity of the test in which the observed thickening of the pelvic and ureteric wall was 65% and specificity of 90%. The analysis of the presence of calculus in renal parenchyma leads to the values of sensitivity test of 54.8% and specificity of 80%. Hypoechoic focus in the renal parenchyma, enlargement of the kidneys and loss corticomedullar limits are parameters who with great sensitivity and specificity suggest acute glomerulonephritis. Conclusion: On the basis of high values of sensitivity and specificity of the test survey estimates that ultrasound has a required place in the following diagnostics algorithm. The use of echotomography that offer the possibility of high resolutive views, as well as the wide availability and good reproducibility of the method, the low cost of inspection, in favor of the first exploration ultrasound examination. Multidetector CT scan and fine needle biopsy remains the method of choice for the definitive diagnosis.

In the diagnostic algorithm, abdominal ultrasound is not the method of choice in detecting malignancies of the colon. However, in practice, with unclear clinical symptoms and without hemoccult test, abdominal ultrasound is often the first step in the diagnosis. Our experience indicates that abdominal ultrasound, as the first diagnostic method, gives good results in the detection of colon tumor mutation. The aim of this study was to evaluate the role of echotomography, as the first diagnostic method in detecting colon cancer. During the past six months, in the Department of Diagnostic Radiology University Hospital 'Dr Dragisa Mišović' in 14 patients were detected tumors the colon. In 11 patients, abdominal ultrasound was first applied diagnostic method. All patients made a Hemoccult test, CT of the abdomen and pelvis and endoscopy with biopsy. The histopathological findings corresponded to adenocarcinoma. Ultrasound diagnosis is performed on the camera brand Toshiba. Echotomographicaly in 11 of the 14 patients it was observed a thickening of the colon wall, with suspected characters infiltration of the wall. Solid mass, hypo-heteroehogenog looks were observed in 11 patients, vague form of the intestinal lumen in 9 patients, the jagged edges of a suspected infiltration in 6 patients, the air trapped in the tumor (pseudotumor) weight in 6 patients, pathologically altered regional lymph nodes were observed in 3 patient, and the presence of the distal scattering diseases, in the form of secondary deposits in the liver, in 4 patient. Tumor mass greater than 5 cm was observed in 8 patients. Sensitivity of this performed echotomographic diagnosis was 78.6%, specificity 83.3%, positive predictive value 68.7%, negative predictive value of 89.3%, while the accuracy of the diagnosis made was 81.8%. Echotomography as the first diagnostic step, contributing to establishing the final diagnosis. It is important in evaluation of diagnostical and therapeutical cost-benefit, with shorter diagnostic treatment, which leads to endoscopy, and in the clinical assessment of the ex­tent of the underlying disease, considering insufficient availability of CT examinations in our conditions.