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Aim: To estimate the informative value of multislice spiral computed tomography (MSCT) in the diagnosis of myocardial infarction (MI)., Subjects and Methods: The study enrolled 171 patients with acute coronary syndrome (ACS), including 121 patients diagnosed with acute ST-segment elevation MI (STEMI), 19 with non-STEMI, and 31 with unstable angina. A comparison group consisted of 52 patients with stable coronary heart disease (CHD) and a control group comprised 17 patients without CHD. Intravenous contrast-enhanced MSCT was performed using a 64-spiral CT scanner. MSCT was carried out in the patients with ACS on days 3-5 of the onset of a pain attack and in the other patients electively. It was redone in 44 patients with acute MI (AMI) 6 months after a primary examination., Results: Left ventricular (LV) perfusion defect was imaged in 94.3% of the patients with AMI and in 10% of those with unstable angina. LV contrast defects were undetectable in the patients from the stable CHD and control groups. The sensitivity, specificity, prognostic value of a positive result, negative prognostic value of a result, and accuracy of MSCT in the diagnosis of MI were 94.3, 97.1, 97.8, 92.5, and 96.70%, respectively. In the patients with STEMI, myocardial perfusion defect was larger and transmural perfusion defect was more common than in those with non-STEMI. Comparison of the values of myocardial perfusion defect size and myocardial density according to the data of primary and repeat MSCT revealed no statistically significant differences: 2.0 (0.50; 5.45) and 1,8 (0.35; 5.00) cm3 (p = 0.15); 41.7 +/- 10.2 and 46.1 +/- 12.2 HU, respectively (p = 0.07)., Conclusion: Contrast-enhanced MSCT allows visual and quantitative assessments of myocardial perfusion defect in patients with ACS. Myocardial perfusion defect from MSCT data suggests previous MI with a high probability, but does not permit the determination of the duration of the disease.

Objective: To improve the algorithm of pelvic X-ray study to enhance the efficiency of diagnosis of pelvic bone fractures., Subject and Methods: A total of 1.415 patients with pelvic injury were examined. Multi-projection X-ray study (an Apelem radiodiagnostic unit) and multislice spiral computed tomography (an Aquilion-32 multislice spiral scanner (Toshiba, Japan)) were performed., Results and Discussion: An algorithm for X-ray diagnosis of injuries of the pelvis and acetabulum has been elaborated, which will be able to significantly specify fracture detection., Conclusion: In the first diagnostic step in treating pelvic injuries, all patients must undergo multiprojection X-ray study in the anteroposterior and oblique projections, which will be able to reduce the percentage of diagnostic errors from 30 to 5%.

This paper deals with the results of ultrasound (US) and multislice computed tomography (MSCT) in patients with perforated duodenal ulcer in different periods after the onset of the disease, with varying clinical manifestations, and in the postoperative period. A comparative analysis of the results of radiation studies has indicated that X-ray study is a basic technique that defines treatment policy in the early development periods of perforation; US study (USS) reveals a change in the duodenum, fluid and infiltration outside the duodenum. As circumscribed peritonitis progresses, USS allows the diagnosis of abdominal abscesses and infiltrations. Out of the radiation techniques, MSCT is of most importance in the diagnosis of interintestinal abscesses and in the determination of syntopy of purulent cavities.

Comprehensive examination was made in women (mean age 49.6 +/- 7.4 years) with rheumatoid arthritis diagnosed abnormalities of brachiocephalic and coronary arteries in 86% of cases. Duplex scanning of brachiocephalic arteries revealed changes in 82% of the women. 64-section spiral computed tomography established coronary artery abnormalities in 33% of cases. There were isolated changes in the brachiocephalic arteries in 50% of the patients, a concomitant lesion of the brachiocephalic and coronary arteries in 32%, and isolated changes in the coronary arteries in 4%. A direct correlation was found between the index of coronary artery calcification and the intima-media thickness of brachiocephalic arteries.

The paper deals with an algorithm for the radiodiagnosis of pelvic injuries. The examination of victims with pelvic injuries allows one to state that multislice spiral computed tomography (MSCT) can define the type of pelvic ring instability and the nature of fragment displacement, visualize all types of fractures of pelvic bones and cotyloid cavity walls, and reveal intrapelvic hematomas, as well as changes in adjacent soft tissues, sacroiliac joints, intrapelvic vessels and organs. MSCT angiography is a technique that can be successfully used at different stages of diagnosis and as the first imaging method or as a pre-examination one if the diagnosis is established and as a control study. The scope and quality of obtained information are generally sufficient to make a decision on treatment policy.

The paper considers the organizational aspects of radiodiagnosis of polytrauma at the pre- and inpatient stages of care. Radiodiagnosis has been found to be inexpedient at inpatient stage of care. At the inpatient stage of care, there may be two ways to conduct diagnostic studies: 1) to concurrently use traditional X-ray and ultrasound studies and 2) to employ multislice spiral computed tomography as the method of the former stage in severe concomitant injury. Multislice spiral computed tomography has been established to be the method of choice in examining the patients with polytrauma, allowing for early identification of the whole spectrum of injuries in various anatomic regions.