Introduction:The study of the possibilities of perfusion computed tomography (PCT) in determining the nature of focal lung formations in the absence of morphological verification, doubtfulness of the data of native CT — the actual problem of thoracic radiology.The aim of the studywas to Refine the methodology and capabilities of PCT in determining the nature of formations of the lungs.Material and methods of research:The data of PCT of 29 patients with benign and malignant changes in the lungs on 128 slice computed tomography with data processing at the workstation were analyzed.Conclusion:Low-dose scanning Protocol for lung PCT allows to obtain reliable data on the angiogenesis of focal lung formations. Upon receipt of the perfusion map, the ROI is placed on the area of the highest blood flow. With sufficient PCT data on the nature and prevalence of lung disease from CT with contrast enhancement may refuse. Average PS, TTP are the main and leading factors in determining the nature of the lesion in the lungs. Qualitative and quantitative analysis of PCT data allows to speak reliably about the nature of foci in the lungs.
Background. Diagnostic imaging of retroperitoneal neoplasms that arise within the retroperitoneal space but outside the major organs in this space is challenging due to the presence of large spaces filled with fatty tissue that allows the tumor to develop asymptomatically for a long time. In addition, these tumors are rare, and radiological semiotics and clinical manifestations can be nonspecific.Case presentation. We present the rare clinical case of a 53-year-old patient with a large retroperitoneal mass detected by contrast-enhanced computed tomography. Additional imaging diagnostic procedures as well as histological findings helped to make a definitive diagnosis: extraorganic retroperitoneal leiomyosarcoma arising from the muscular wall of the splenic vein.Conclusion. The retrospective analysis of CT data showed that the tumor-induced marginal defect in the contrasted splenic vein may indicate the tumor arising from the muscular wall of the vessel. The final diagnosis was made on the basis of a morphological study.
The paper describes a clinical case of pancreaticoduodenectomy for pancreatic ductal adenocarcinoma with superior mesenteric vein resection without its reconstruction. This is the first case study of the kind found in Russian-language literature. In total, 16 such clinical observations have been described in the relevant world literature to date. A 74-year-old female patient was diagnosed with ductal adenocarcinoma of the pancreatic head 1.1 × 1.1 cm in size adjacent to the superior mesenteric vein. After four courses of ineffective neoadjuvant therapy, the tumor completely obliterated the superior mesenteric vein. The control multislice spiral computed tomography (MSCT) showed that the tumor was complete with the formation of a distinct collateral between the superior mesenteric and the inferior mesenteric veins. The patient underwent pancreatoduodenal resection with resection of the involved vein segment without vascular reconstruction. The histopathological diagnosis was pT1cN1M0R0. The patient was discharged on the next day after the operation.
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