Section 1. Lectures on X-ray diagnostics of lung diseases
Introduction.
Annotation
Arkhangelsk publishing house SSMU, 2011
A textbook on X-ray diagnostics
Koposova R.A., Zhuravleva L.M.
Published by decision of the publishing council
Arkhangelsk 2011
UDC Reviewers: Doctor of Medical Sciences, Head of the Department of Trauma
BBK of tology SSMU R.P. Matveev, Head of the Department of Hospital Therapy of SSMU, Professor S.I. Martyushov.
Northern State Medical University
Under the general editorship of Professor Valkov M.Yu.
ISBN The textbook provides a detailed description of X-ray diagnostic methods.
The indications and use of X-ray diagnostics in the complex of diagnostic measures for the most common pathologies have been determined. The manual is intended for students of medical faculties, interns, clinical residents and doctors of primary specialization in radiology.
Every year, at the Department of Radiation Diagnostics, Radiation Therapy and Clinical Oncology, students from all faculties of SSMU, interns and clinical residents, take a course in radiation diagnostics and radiation therapy, and receive training to work as a radiologist. In addition, doctors from other specialties in Arkhangelsk, the Arkhangelsk region and related areas undergo primary retraining in the specialty “radiology”.
The training manual was compiled on the initiative of medical students who, unfortunately, have a short training period.
This manual is not a textbook on radiology. It presents selected lectures on the most common and difficult diagnostic issues that future radiologists will encounter in their practical work. The lectures will help radiologists and oncologists in correct and timely diagnosis of diseases, and therefore in their adequate treatment.
Section 1. Lectures on X-ray diagnostics of lung diseases………….
1.1. X-ray diagnosis of acute pneumonia………………………….
1.2. X-ray diagnosis of lung abscesses……………………………...
1.3. X-ray diagnosis of pleurisy…………………………………….
1.4. X-ray diagnosis of chronic lung diseases (chronic bronchitis, emphysema, bronchiectasis).
1.5. X-ray diagnosis of central lung cancer………………….
1.6. X-ray diagnostics of peripheral lung cancer, benign tumors. Differential diagnosis of spherical formations in the lungs……………………………………………………………………
1.7. X-ray diagnosis of pulmonary tuberculosis…………………………..
1.8. X-ray diagnosis of diseases of the mediastinal organs…………..
Section 2. Lectures on X-ray diagnostics of diseases of the heart and large vessels……………………………………………………………………………………………...
2.1. X-ray diagnosis of acquired heart defects…………….
2.2. X-ray diagnosis of congenital heart defects………………
Section 3. Lectures on X-ray diagnostics of diseases of the gastrointestinal tract………………………………………………………………..
3.1. X-ray diagnosis of esophageal cancer……………………………….
3.2. X-ray diagnosis of peptic ulcer……………………………
3.3. X-ray diagnosis of stomach cancer……………………………………
Section 4. Lectures on X-ray diagnostics of kidney diseases…………….
4.1. Methods of X-ray examination of the kidneys and urinary tract……………………………………………………….
4.2. Normal x-ray anatomy of the kidneys……………………………….
4.3. X-ray diagnosis of kidney development anomalies………………………
4.4. X-ray diagnosis of hydronephrosis, urolithiasis, chronic pyelonephritis, paranephritis, kidney tuberculosis, kidney tumors, damage (trauma) to the kidneys, ureters, bladder…………………………………………………………………………………
Section 5. X-ray diagnosis of diseases of bones and joints……………
5.1. X-ray diagnosis of inflammatory diseases of bones and joints (hematogenous osteomyelitis, tuberculosis of bones and joints, syphilis)……………………………………………………………………………….
5.2. X-ray diagnostics of benign and malignant tumors of bones and soft tissues……………………………………………………...
Section 6. Schemes and drawings for lectures and classes on lungs………………..
Section 7. Atlas of radiographs……………………………………………………………………
Section 8. References………………………………………………………
In the monograph by L.S. Rosenstrauch presents a classification of acute pneumonia, presented at the X All-Union Congress of Radiologists and Radiologists in 1977 (classification by R. Hegglinia, supplemented and modified by L.S. Rosenstrauch).
According to this classification, all acute pneumonia is divided into 2 groups: primary and secondary.
Primary pneumonia occurs in previously healthy lungs and is caused by pathogens that have a tropism for lung tissue.
Secondary pneumonia develops due to changes that previously existed in the lungs or other organs and created the conditions for their occurrence.
A. Primary pneumonia.
I. Bacterial.
1. Pneumococcal.
a. lobar pneumonia;
b. bronchopneumonia.
2. Streptococcal and staphylococcal pneumonia.
3. Friedlander pneumonia.
4. Legionnaires' disease (legionellosis).
II. Viral.
1. Acute interstitial pneumonia. Influenza pneumonia.
2. Ornithosis pneumonia.
3. Pneumonia due to adenoviruses.
III. Mycoplasma pneumonia.
IV. Pneumocystis pneumonia.
V. Allergic pneumonia.
VI. Rickettsial pneumonia. Q fever.
VIII. Fungal pneumonia.
B. Secondary pneumonia.
I. Pneumonia due to circulatory disorders in the pulmonary circulation.
1. Stagnant.
2. Hypostatic.
3. Heart attack.
II. Pneumonia due to impaired bronchial obstruction (cancer, adenoma).
III. Aspiration pneumonia.
IV. Pneumonia in diseases of other organs and systems.
1. Pneumonia with purulent diseases.
2. Pneumonia in infectious diseases.
3. Pneumonia due to other primary processes.
V. Traumatic pneumonia.
VI. Postoperative pneumonia.
In clinical practice, we most often have to deal with lobar and focal pneumonia (bronchopneumonia). However, in most cases it is now very difficult to separate these 2 forms of pneumonia. Classic lobar pneumonia is now rare. The widespread use of antibiotics and sulfonamides affected the body's reactivity and bacterial flora, therefore the clinical and radiological picture changed. The role of pneumococcus has decreased, the proportion of staphylococcus, streptococcus, influenza and parainfluenza viruses, mycoplasmas, etc. has increased. Some authors believe that in half of patients pneumonia is caused by atypical agents. The full set of classic clinical signs of pneumonia (fever, cough with sputum, leukocytosis, increased ESR) became less common. Pneumonia with an atypical, sluggish course is becoming increasingly common (Vlasov P.V., 1998).
Lobar pneumonia (lobar, fibrinous, pleuropneumonia)
Known since the time of Hippocrates. In typical cases, the disease is characterized by a rapid, sudden onset, severe course, critical resolution and a certain sequence of pathological changes.
The infection enters the body aerogenously and quickly spreads throughout the lung tissue, affecting a lobe and sometimes the entire lung.
Pathologically, 4 stages of development are distinguished:
Tide stage(hyperemia). The capillaries are dilated and filled with blood, serous fluid with a small amount of red blood cells and leukocytes begins to accumulate in the alveoli.
On the 2nd - 3rd day the disease progresses to red liver stage. At this stage, the alveoli are filled with fibrin with a significant admixture of red blood cells. The affected lobe is increased in volume, dense, airless. There are fibrinous deposits on the pleura surrounding the affected lobe. This stage lasts 2–3 days and passes into gray hepatization stage. The lobe is still dense. In the alveoli there is fibrin with an admixture of leukocytes.
On the 7th – 9th day, a crisis occurs in the development of the disease and begins resolution stage. Proteolytic enzymes liquefy fibrin, causing leukocytes to disintegrate. The liquefied exudate is expectorated and absorbed through the lymphatic system.
X-ray picture lobar pneumonia is characteristic and corresponds to pathological changes.
At high tide– increased pulmonary pattern in the affected lobe due to hyperemia. The transparency of the lung is normal or slightly uniformly reduced. The root of the lung on the affected side expands somewhat, its structure becomes less distinct. When the lower lobe is affected, the mobility of the corresponding dome of the diaphragm decreases.
In the red hepatic stage– intense homogeneous darkening, which in localization corresponds to the affected lobe. Darkening with lobar pneumonia differs from lobar atelectasis in that with pneumonia there is no decrease in the volume of the lobe. The lobe is of normal size or even slightly larger. Towards the periphery, the intensity of the shadow increases and the uniformity increases. Against the background of darkening in the medial sections, light stripes of large and medium-caliber bronchi are visible, the lumen of which in lobar pneumonia in most cases remains free (Fleischner’s symptom, Vlasov’s air bronchography symptom).
The root of the lung on the affected side is expanded and becomes non-structural. The adjacent pleura becomes denser. In some cases, there is an effusion in the pleural cavity, which is better identified in the later position.
The median shadow (mediastinum) is not displaced in lobar pneumonia. There are no radiological differences between the stages of red and gray liver. In the process of resolution– gradually, but quite quickly, the intensity of the shadow decreases, it fragments and decreases in size. Inflammatory infiltration resolves from the root to the periphery. The root of the lung may remain expanded and unstructured for a long time. The pulmonary pattern remains enhanced for another 2–3 weeks after clinical recovery. The pleura bordering the lobe is compacted even longer. The pleural reaction is expressed in the form of pleural layers. In 15% of cases there is exudate in the pleural cavity. The liquid is clearly visible on laterograms. Exudate is even better detected by ultrasound (even 10 ml of liquid can be detected).
Sometimes changes in the lungs with lobar pneumonia are bilateral, more often they are not synchronous.
Complete resolution of lobar pneumonia occurs within 3 to 4 weeks. But sometimes, radiographically, perivascular and peribronchial infiltration and delayed restoration of the structure of the lung tissue can be observed within 2 months.
Massive pneumonia is a type of lobar pneumonia. With this pneumonia, unlike ordinary pneumonia, the lumens of the lobar and segmental bronchi are blocked by a fibrin plug. Therefore, in the stage of hepatization, the light stripes of the bronchi are not visible; the shadow is uniform throughout.
In recent years, lobar pneumonia in most cases does not proceed according to the lobar type, but begins with a segmental lesion. If treatment is started early, then the lobe may not be affected. In these cases, all stages of development of pneumonia are determined in 1 - 2 segments - segmental and polysegmental pneumonia.
In other words, lobar pneumonia is not necessarily lobar. With early treatment (from the 1st day of illness), the process sometimes develops within even part of a segment, usually in areas of the lobe adjacent to the interlobar fissure. These are periscissurites. They are characterized by scant physical data, since the inflammatory process lies deep. Previously, they were called central pneumonia. In the diagnosis of “central pneumonia”, the X-ray method is decisive (especially lateral images).
Differential diagnosis of lobar pneumonia is carried out with atelectasis, pulmonary infarction, tuberculous pneumonia.
The outcomes of lobar pneumonia are currently generally favorable. In most cases, pneumonia completely resolves, and the structure of the lungs is restored.
Adverse outcomes:
· suppuration of the infiltrate with the development of abscess pneumonia, sometimes with a breakthrough into the pleural cavity and the formation of pneumothorax;
· transition to a chronic form with the subsequent development of bronchiectasis, cirrhosis, and sometimes carnification. An example of a transition to a chronic form is mid-lobe syndrome.
A few words about carnification. In some cases, during the period of gray hepatization, the leukocyte reaction is weakly expressed, so the resorption of alveolar exudate is delayed. Fibrinous exudate is organized and replaced by connective tissue (carnification). Radiologically, wrinkling of the affected lobe is observed. Hard photographs reveal heterogeneous darkening, the morphological basis of which is made up of areas of uneven fibrosis, alternating with areas of clearing (dystrophic cysts and bronchiectasis).
Complications of lobar pneumonia: pleurisy, less often pericarditis and mediastinitis.
Bronchopneumonia (lobular, catarrhal, focal pneumonia)
Most common. Etiological factors are varied. Like lobar pneumonia, it is a classic form of pneumonia and has been known since ancient times.
Unlike lobar pneumonia, with bronchopneumonia the bronchial wall is initially affected and only secondarily, per continuitatem, the pulmonary parenchyma. Infected sputum is sprayed when coughing, so various parts of the bronchial tree are affected, from where inflammation spreads to the lung tissue (endobronchitis - panbronchitis - pneumonic focus). Since when you cough, air moves through the bronchi at tremendous speed, multiple inflammatory foci quickly appear in various parts of the lungs.
Morphologically, with lobar pneumonia, inflammatory infiltration in a short time occupies a subsegment, segment or lobe, and with bronchopneumonia, the inflammatory focus is limited to a lobule (lobular pneumonia).
Another feature of bronchopneumonia is the occurrence of multiple foci at different times, so the change in morphological stages in them does not occur simultaneously; in some foci there may be a stage of tide, in others - hepatization, in others - resolution.
Exudate in bronchopneumonia is mainly serous, there is no fibrin or very little.
Along with lobular lesions, there may also be smaller lesions - acinar and larger ones - confluent.
The clinical picture of bronchopneumonia is not so typical. The disease begins gradually, often in the form of catarrh of the upper respiratory tract or bronchitis. Then comes weakness, headache, temperature up to 37 - 40 ° C, but rarely reaches 40 ° C. In weakened and elderly people, the temperature may remain normal. In most cases, the condition of patients is less severe.
X-ray picture. Bronchopneumonia is characterized by the presence of bilateral multiple focal shadows. The size, location and number of lesions vary. The size of the lesions is usually 1 - 1.5 cm (lobule), but can be very small - from 2 to 5 mm, sometimes similar to miliary tuberculosis. The contours of the lesions are unclear, the shadow intensity is low.
Focal pneumonia tends to be located in the lower (basal) sections. The apices of the lungs are not affected in most cases. When localized at the apex, they are difficult to distinguish from tuberculosis. Anti-inflammatory treatment for 3-4 weeks allows you to get dynamics and exclude tuberculosis.
With bronchopneumonia, the foci can merge with each other, then they form large infiltrates, occupying one or several segments. In such cases, bronchopneumonia is difficult to distinguish from lobar pneumonia (pseudolobar pneumonia). The affected area usually has a heterogeneous structure. The reason for the heterogeneity is the unevenness of the inflammatory infiltration, the alternation of lobules filled with exudate with areas that retain airiness. Small, low-intensity lesions are not always detected on images.
It was said above that there is another variant of bronchopneumonia, when the foci are very small - 4 - 5 mm and even 2 - 3 mm (miliary bronchopneumonia). Large- and medium-focal confluent pneumonia may resemble , metastases of malignant tumors.
Unlike tuberculosis and tumors, bronchopneumonia is characterized by rapid dynamics of the process, negative tuberculin tests, and the absence of damage to other organs. But if the study is one-time, then diagnosis is difficult. With bronchopneumonia, the pulmonary pattern is enhanced throughout the entire length of the lungs (hyperemia). The roots are expanded, not structural. As a rule, a pleural reaction is noted; there may also be exudative pleurisy.
Bronchopneumonia is characterized by rapid dynamics of the X-ray picture. Within 5–6 days it changes significantly, and after 8–10 days the lesions often resolve.
Bronchopneumonia (focal pneumonia), with a certain similarity in the clinical and radiological picture, is in fact a collective concept; with a variety of etiological factors, focal pneumonia has different courses and outcomes. But in general, the outcomes and complications of bronchopneumonia are the same as with lobar pneumonia.
It should be noted that often, due to the summation of foci of inflammation with air areas, a subtraction effect (subtraction) occurs. The shadows of inflammatory foci become low-intensity and may even completely disappear from view. This especially happens in patients with emphysema. This explains the frequent discrepancies between auscultatory data and X-ray data.
The X-ray picture of numerous viral pneumonias is characterized primarily by an increase in the pulmonary pattern due to edema and inflammation of the peribronchial and perivascular tissue. In this case, the pattern maintains a radial direction - from the roots of the lungs to the periphery. A similar picture can be observed with increased blood filling of the lungs. These processes can be distinguished using the Valsalva maneuver.
When straining after a deep breath with the glottis closed, excess blood from the pulmonary vessels is “squeezed out” and the pulmonary pattern is normalized. If the reason for the strengthening of the pattern is the infiltration of interstitial tissue, as in viral pneumonia, then the pulmonary pattern remains excessive even at the height of the Valsalva maneuver.
Following the infiltration of peribronchial and perivascular tissue, swelling and inflammation of the interstitial tissue surrounding the lobules and acini occur, which leads to deformation of the pulmonary pattern, acquiring a cellular character. After 2–4 days, the picture of interstitial pneumonia is often accompanied by infiltration of the pulmonary parenchyma. Along with focal changes, more extensive darkening can sometimes be observed, usually in shape and distribution not corresponding to the lobes and segments of the lungs.
These darkenings without anatomical boundaries are characterized by a peripheral location, most often in the middle and lower zones, and differ from similar darkenings in their low intensity, especially in the initial stages of development.
As infiltration intensifies and darkening increases, their intensity increases and approaches normal. According to N. Schinz et al. (1973), the occurrence of dark spots in viral pneumonia corresponds to stage III of the disease: stage I - tracheobronchitic, stage II - peribronchitic, stage III - pneumonic.
Against the background of an enhanced and deformed pulmonary pattern, multiple infiltrates are visible
in both lungs, without clear anatomical boundaries.
The course of viral pneumonia in most cases is quite long - 3 - 6 weeks, sometimes more. First, pneumonic foci resolve; the pulmonary pattern returns to normal later. The disintegration of pneumonic foci in viral pneumonia is rare, usually with the accumulation of bacterial flora. If the course of the process is favorable, after the elimination of all manifestations of viral pneumonia, the x-ray picture can completely normalize. However, in some cases there is a transition to chronic pneumonia.
"Differential X-ray diagnostics
diseases of the respiratory system and mediastinum",
L.S.Rozenshtrauch, M.G.Winner
Bronchopneumonia: clinical and radiological pictures
Clinical picture. The onset of the disease often cannot be accurately determined, because it develops against the background of bronchitis or acute catarrh of the upper respiratory tract. However, in young people the disease can begin acutely and even with chills (M.Yu. Lyanda, M.F. Ryabov). Much less frequently, patients report pain in the chest or under the shoulder blade, general weakness, headache, and shortness of breath, which is more often observed in older people. Body temperature usually rises. In this case, a rise to 37–38° is often observed, more often to 39° and even 40°, rarely above 40°. Fever of remitting or intermittent type predominates. In cases where bronchopneumonia develops against the background of a disease accompanied by fever, the previous temperature curve undergoes some changes (height, character). In elderly and weakened patients, bronchopneumonia occurs at normal or subfebrile temperature.
During an objective examination of the patient, attention is drawn to some hyperemia or cyanosis (in old people) of the skin of the face, lips, and sometimes shortness of breath. The respiratory rate reaches 25–30 per minute.
Physical examination reveals various changes in individual patients depending on the location (superficial, deep) and size of the inflammatory focus. Centrally or even superficially located, but small lesions do not cause changes in vocal tremor of percussion sound. Increased vocal tremors, dullness of percussion sound, as well as the manifestation of bronchial or vesicobronchial breathing are possible only with bronchopneumonia that spreads to large areas of the lung tissue. Along with this, there are areas where breathing is weakened or completely absent (areas of pulmonary atelectasis). If the process of bronchopneumonia takes on a confluent character, spreading to an entire lobe or a significant part of it, then physical research methods reveal changes similar to those of lobar pneumonia.
The most constant symptom of bronchopneumonia is moist rales, which are heard in a limited area over the lesion and, most importantly, are sonorous. This makes it possible to differentiate bronchopneumonia in the case of inflammation localized in the lower parts of the lungs from congestion in the lungs. Along with sonorous moist rales over a considerable distance or in more or less limited areas, scattered, dry and moist rales can be heard, indicating concomitant bronchitis or bronchiolitis. Due to the relatively limited possibilities for identifying inflammatory foci in bronchopneumonia using physical methods, the role of x-ray examination is increasing. However, the absence of visible changes in the lungs during fluoroscopy (especially in one position) does not provide grounds for categorically denying the presence of bronchopneumonia. Changes in bronchopneumonia can be observed not only in the alveoli, but also in the interstitial tissue of the lungs, where they manifest themselves, in particular, in the form of infiltration along the vascular-bronchial bundles. Bronchopneumonia of this localization can only be recognized radiographically. X-ray examination (in sagittal positions) also reveals small-focal hilar and paravertebral pneumonia, the determination of which by physical methods of examination is completely inaccessible.
On the part of the cardiovascular system, disturbances similar to those with lobar pneumonia may be observed: tachycardia, expansion of the borders of the heart in diameter, muffling of the first sound at the apex, changes in cardiac output, peripheral vascular resistance, especially in cases similar to lobar pneumonia in clinical course (confluent forms extending to the lobe of the lung or a significant part of it, etc.). In the blood with bronchopneumonia, leukocytosis is usually observed, but less pronounced than with lobar pneumonia (10,000 - 15,000 in 1 mm3) , with some, sometimes vaguely expressed shift to the left. Often, bronchopneumonia occurs with a normal content of leukocytes in the peripheral blood (according to M.Yu. Lyanda, 44.8%). ROE is usually accelerated, but less than with lobar P. When examining urine in patients with bronchopneumonia, a small amount of protein is sometimes detected (up to 0.5°/01), which is regarded as “febrile albuminuria” (A.M. Damir). After the temperature normalizes, albuminuria usually disappears.
The duration of bronchopneumonia varies and depends on the condition of the body and the virulence of the microbes that caused the disease.
Complications of bronchopneumonia due to the use of antibiotics and sulfonamides have become significantly less common than during the antibiotic period. According to V.P. Dyachenko and A.A. Stupnitsky, in the period 1952–1957. complications with focal P. were observed in 25 out of 353 patients (pleurisy - in 25 patients, lung abscess - in 6). According to V.I. Struchkov (1958), suppurative processes in the lungs during bronchopneumonia were observed in 1.2% (relative to the number of patients studied), while in the period 1941–1945. they were observed in 4.75% (M.F. Ryabov). Complications such as lung gangrene and purulent pleurisy have disappeared; Exudative serous pleurisy is also observed much less frequently.
Diagnosis and differential diagnosis. Small lesions, especially deep ones, often cannot be recognized using physical examination methods. In patients with emphysema, even larger pneumonic foci are often not detected by percussion and auscultation. Bronchopneumonia is difficult to recognize in debilitated patients, in people with nutritional dystrophy, severe heart disease, which is due to their frequent and shallow breathing, as well as in some cases, congestion in the lungs. It is difficult to recognize bronchopneumonia in patients with myocardial infarction, especially in the first period of the disease, when, due to the forced position, their examination is sharply complicated. In these cases, general clinical observation of the patient (cough, the nature of the temperature curve, blood changes, etc.), as well as x-ray examination, is of great help.
As a result of the widespread use of antibiotics and sulfonamides, the typical, cyclical course of lobar pneumonia with severe symptomatology has become rare, which makes the differential diagnosis between lobar pneumonia and bronchopneumonia difficult. An acute onset with chills, stabbing pain in the side, more severe intoxication, rusty coloration of sputum, lobar or partially lobar spread of the process, high leukocytosis - all this speaks in favor of lobar pneumonia. In addition, the course of the inflammatory process as a whole with lobar pneumonia is much more pronounced.
X-ray examination helps significantly in identifying bronchopneumonia in capillary bronchitis.
Protracted forms of bronchopneumonia are differentiated from pulmonary tuberculosis on the basis of multiple studies of sputum (culture), the results of infection of animals (for tuberculosis - a guinea pig), as well as repeated radiography data.
X-ray picture. X-ray examination for bronchopneumonia is sometimes crucial for diagnosis, especially when recognizing the so-called. atypical forms of pneumonia (viral, influenza, acute interstitial, staphylococcal, etc.), the clinical course and symptoms of which in the vast majority of cases are not sufficiently characteristic. At the same time, one should not overestimate in other cases very scanty or even negative radiological data in limited small-focal bronchopneumonia, in which clinical symptomatology may be more conclusive. Numerous bronchopneumonia, different in their etiology and pathogenesis, often give completely similar radiological semiotics. Only some of them, such as staphylococcal pneumonia, have known specific radiological features.
With severe bronchopneumonia, the x-ray picture is usually quite convincing. The focal nature of the lesion is clearly evident. In some cases, foci of inflammatory infiltration involve groups of pulmonary lobules (lobular pneumonia), in others they are limited to damage to several nearby acini (acinous pneumonia). On a radiograph, lesions of acinar pneumonia usually range in size from 1 to 3 mm in diameter, with lobular they reach 10–15 mm . In both cases, there are multiple foci of inflammation, although their number can vary significantly. Often the lesions merge into larger spotted shadows, which, in turn, can turn into a continuous lobar darkening (pseudolobar pneumonia). With a dense arrangement of inflammatory foci, their apparent merging into larger shadows can arise as a consequence of the projection summation of focal shadows located at different depths. Unlike tuberculous focal lesions, foci of bronchopneumonia are more often localized in the lower and middle parts of the pulmonary fields. Sometimes radiologically it is possible to identify the predominant perioronchial localization of focal shadows, which is an indication of the pathogenetic connection of pneumonia with damage to the bronchial tree.
In focal lobular pneumonia, the lesions rarely have any regular geometric shape, which is explained mainly by the true and projection fusion of individual lesions, which have vague outlines and a relatively low shadow density. Through the shadow of even a large lesion, a pulmonary pattern can be easily traced, noticeably enhanced and excessive both due to vascular hyperemia and due to peribronchial inflammatory infiltration and edema. In contrast to the inflammatory infiltrate, with lobar pneumonia or tuberculosis, light stripes of the lumens of the bronchi cannot be traced (A.E. Prozorov). The reaction from the interstitial tissue can be expressed to a greater or lesser extent, but is always an almost indispensable component of the X-ray picture of bronchopneumonia. The reaction from the roots of the lungs, depending on the volume of pulmonary lesions, the nature of the pathogen, and the general phenomena of intoxication, is expressed differently in individual cases.
Dynamic radiological observations show that bronchopneumonic foci can sometimes completely disappear after 3–5 days, leaving behind only an enhanced heavy pulmonary pattern. But sometimes the x-ray picture becomes very persistent. New focal shadows may appear, sometimes in another lung (vagus pneumonia). With long-term radiographic changes, the process, as a rule, turns into a chronic form of focal pneumosclerosis with the development of bronchiectasis. Repeated X-ray monitoring is also necessary for the early detection of complications of bronchopneumonia such as exudative pleurisy and abscess formation.
With small focal (acinous) bronchopneumonia, individual focal shadows do not differ in appearance from foci with hematogenous tuberculous dissemination. Small focal bronchopneumonia is supported by the known limited nature of the lesion, usually in the lower and middle parts of the lungs, while with tuberculosis a universal lesion is observed. A small number of delicate small pneumonic lesions can sometimes be difficult to distinguish even on radiographs and go unnoticed during transillumination. The only indication of the presence of P. in such cases may be the strengthening and redundancy of the bronchovascular pulmonary pattern and the expansion of the shadows of the roots. With a large number of small focal shadows, even with fluoroscopy, a noticeable decrease in the transparency of the pulmonary field in the affected area is observed. The radiograph reveals a fairly dense seeding of foci, behind which the pulmonary pattern may become invisible.
Bronchopneumonia, in addition to lobular and small focal ones, can also manifest itself in the form of segmental and even lobar lesions. The extensive continuous pathological shadows that arise in this case, according to most authors, never reach the intensity of the shadow that is characteristic of lobar pneumonia. The latter is also distinguished by the presence of light stripes of the bronchi that retain their airiness, as well as the almost constant limitation of the pneumonic process by extensive, but one pathological darkening. Multiple pneumonic foci and bilateral lung damage occur with bronchopneumonia immeasurably more often than with lobar pneumonia. (G.R. Rubinstein).
Small focal, lobular, segmental and lobar lesions of the lungs can be observed in the X-ray picture both in bacterial bronchopneumonia (pneumococcal, streptococcal and staphylococcal pneumonia, typhoid pneumonia, etc.), and in viral ones, as well as, for example, in pneumonia due to Q fever . Sometimes a patient, especially with dynamic X-ray observation, may experience combinations of individual specified X-ray morphological forms (for example, the simultaneous presence of lobular foci and segmental opacities), as well as the transition of one form to another (more often the fusion of lobular bronchopneumonic foci into segmental and lobar infiltration). The variety of X-ray morphological manifestations of the pneumonic process, their pronounced dynamism and the multiplicity of lesions are apparently explained by the hematogenous origin of some pneumonias. From this point of view, their classification into the group of bronchopneumonia is largely arbitrary.
The X-ray picture of primary influenza pneumonia (viral influenza pneumonia) can be extremely diverse. Hirsch points out that during a particular epidemic, a very specific localization of pneumonia may predominate; however, more often, in his opinion, they are localized in the lower parts of the lungs, above the diaphragm. According to V.A. Dyachenko, influenza pneumonia is characterized by the early appearance of pathological darkening, often on the second day from the onset of the disease, and most importantly, the almost natural location of the focus of inflammatory infiltration along the edge of the pulmonary lobe (marginal or periscissural pneumonia). The inflammatory process is often segmental in nature. All this allows the author to consider influenza pneumonia as typical, in contrast to a significant part of researchers who classify all viral pneumonia, including influenza pneumonia, into the group of so-called atypical pneumonia. According to A.E. Prozorov, with viral P. broncholobular focal forms, segmental, lobar and occasionally disseminated with a pronounced interstitial component in the form of mainly perivascular changes, can be observed. The latter type, according to the author, is associated with the hematogenous origin of pneumonic lesions. Most researchers emphasize the almost obligatory involvement of interstitial connective tissue in the inflammatory process during influenza pneumonia. It is in this regard that on radiographs, sometimes even with the rapid disappearance of the pathological focus of darkening, an enhanced stringy pattern or “mesh” pattern remains in its place for a relatively long time.
In case of viral, in particular influenza pneumonia, a moderate reaction from the pulmonary roots can be considered quite characteristic and should be taken into account in the x-ray picture. With influenza pneumonia, a vaguely defined “path” may also be observed connecting the expanded root with the area of pneumonic darkening. According to A.E. Prozorov, influenza pneumonia is prone to abscess formation. Small pleurisy may often be observed.
With Q fever, lobular, segmental and lobar pneumonic foci are radiologically determined. The darkening can be very gentle, cloud-like, but can also reach medium intensity. More often, the lesions are located away from the root, the shadow of which is usually normal. Migration of pneumonic foci is rarely observed. Reversal usually occurs within 2–5 weeks.
Septic metastatic pneumonia usually gives a fairly bright radiological picture. The shadows of pneumonic foci are, as a rule, multiple and visible in both pulmonary fields, which is typical for their hematogenous occurrence. There is no preferred localization of lesions along the pulmonary lobes. Usually several pneumonic foci immediately appear, to which new ones can quickly join. With septic pneumonia, both small-focal disseminations and larger foci of darkening, up to segmental and lobar, occur. Multiple large foci of septic pneumonia in the X-ray picture may resemble metastases of malignant tumors. Individual pneumonic foci often give quite intense and well-defined round shadows. In another projection, such a shadow turns into an irregular or triangular one with the apex facing the root (segmental lesion). The most typical feature of these pneumonias is the tendency to abscess formation. The cavities of multiple abscesses are quickly cleared of necrotic masses, the walls of the cavities look thin, without the wide rim of perifocal inflammation characteristic of a regular pulmonary abscess. The amount of purulent content in abscesses is small, and fluid levels are located only in the lower parts of the cavities or are not visible at all. With the often favorable course of septic pneumonia, a rapid, within a few days, reverse development of cavities can occur with their transformation into foci of pneumosclerosis or thin-walled pulmonary cysts.
A peculiar x-ray picture can be observed with staphylococcal septic pneumonia, which, according to Hirsch, accounts for about 10% of all primary pneumonia and sometimes joins pneumonia of a different etiology. Staphylococcal pneumonia is observed both in adults and in early childhood. Characterized by a general severe course and rapid variability of the x-ray picture, expressed in the formation of multiple large foci of darkening, merging with each other and then forming multiple abscesses and purulent exudate in the pleural cavity. In children with a favorable course, the formation of thin-walled cystic cavities is subsequently observed.
A special form is represented by septic interstitial pneumonia (V.I. Yakovleva), in which focal compactions of the lung tissue itself are either completely absent or quantitatively negligible. X-ray changes in the lungs are expressed only in the appearance of excessive radial heaviness emanating from the roots and a pronounced mesh pattern in the peripheral parts. The X-ray picture is not very characteristic and can only be taken into account when comparing it with clinical data. Typhoid pneumonia is characterized by radiologically significant persistence of focal changes (according to T.V. Rosenthal, up to 2 months after the onset of typhoid fever). With these pneumonias, mainly small-focal and lobular disseminations are observed, which are not prone to abscess formation.
The prognosis for bronchopneumonia depends on the previous general condition of the patient, the state of his cardiovascular system and is closely related to the nature of the underlying disease. The dependence of the outcomes of bronchopneumonia on the age of the patients was noted. Thus, as age increases, the course of the disease lengthens, later the clinical and radiological pictures normalize, and recurrent diseases are more often observed.
The prognosis of bronchopneumonia is especially serious (even death) in the elderly, in people with diseases of the cardiovascular system with symptoms of circulatory failure, in patients with a pronounced violation of general nutrition (nutritional dystrophy, vitamin deficiencies), as well as in diseases accompanied by cachexia.
The main morphological substrate of which is inflammatory exudate in the respiratory parts of the lungs.
The modern possibilities of its drug treatment from the standpoint of evidence-based medicine are covered in detail, including the use of topical therapy methods, basic treatment agents, pulse therapy options, as well as the possibility of intensifying treatment using biological agents.
1 835 R
The book analyzes the modern capabilities of neuroimaging research methods (positron emission and functional magnetic resonance imaging, voxel morphometry, diffusion tensor imaging and magnetic resonance spectroscopy) in the diagnosis of depressive disorders. The issues of monitoring the effectiveness of treatment for depression and the pathogenetic aspects of the phenomenon of pharmacoresistance are considered.
1 490 R
Desk atlas of botulinum therapist. Ultrasound control of botulinum toxin injections: a textbook for neurologists, neurosurgeons, rehabilitation specialists, specialists in the field of movement disorders and botulinum therapy
2 630 R
Particular emphasis is placed on analyzing the logic of sequential analysis and the use of additional ultrasound techniques (CD, ED, 3D, elastography and elastometry modes) in addition to the standard gray-scale examination of mammary tissue. The need for a multiparametric approach to ultrasound assessment of the condition of the glands is substantiated. The use of the BI-RADS system in the final summary assessment of the risks of malignancy of breast tumors is shown
3 190 R
The presented document contains many specific provisions that are of great importance both for the general development of radiological diagnosis of prostate cancer and for the practical work of an MRI doctor. In addition to the system itself for stratifying patients according to the likelihood of having clinically significant prostate cancer, the manual contains many specific recommendations regarding the technical aspects of scanning, interpretation of the images obtained, and the procedure for recording the results. A glossary of key terms used in the PI-RADS system is provided at the end of the document.
1 490 R
The paper describes the examination methodology, normal anatomy and semiotics of changes in the sacroiliac joints and spinal column according to radiography, CT and MRI in patients with ankylosing spondylitis. Criteria for assessing the stages of sacroiliitis according to radiography and CT are presented. Distinctions are made between reliable and probable sacroiliitis according to radiological research methods.
1 990 R
A solid work, created on the basis of the authors’ extensive experience and deep knowledge in the field of MRI diagnostics, which uses an original way of presenting the material. Magnetic resonance imaging images were obtained on an MRI scanner with a magnetic field induction of 3 Tesla and are distinguished by clarity and a high degree of detail. All tomograms are accompanied by semi-schematic color illustrations, made personally by the authors, with color coding of anatomical structures, and at the bottom of each page there is a diagram indicating the direction and side of the body. The illustrations strictly fit into a certain concept, reflect only the musculoskeletal structures under consideration, significantly facilitate the use of the atlas and, of course, are its advantage.
3 490 R
These guidelines summarize scientific data and personal professional experience in organizing an x-ray service, and describe methods of radiation diagnostics. Methods for studying human organs and systems with normal anatomy, embryogenesis, x-ray anatomy, as well as x-ray semiotics of various pathological conditions in adults and children are covered.
1 690 R
A description of the latest angiosurgical technology for treating the most common urological disease - adenoma and prostate cancer using X-ray endovascular embolization of the prostatic arteries is presented.
990 R
A feature of this textbook is a comprehensive consideration of the x-ray picture of diseases and pathological conditions of the esophagus in the context of their structural foundations - the pathomorphological substrate of the diagnostic picture.
1 990 R
The book presents the main currently existing methods of preoperative and intraoperative visualization of the parathyroid glands, indicates the advantages and disadvantages of each of them, and analyzes the causes of possible errors in interpreting the results of the study. A certain place is given to the clinical signs of hyperparathyroidism.
1 790 R
Methods of surgical techniques and minimally invasive technologies of liver surgery are considered based on the achievements of modern foreign and domestic specialists. Most of the issues covered concern the oncological aspects of the treatment of patients with tumor lesions of the liver. The principles and stages of performing open and laparoscopic resections are outlined in detail, the most pressing issues of liver transplantation are presented, and the stages and techniques of minimally invasive interventions are covered in detail.
3 590 R
The theoretical foundations and practical approaches to the diagnosis and treatment of rare diffuse parenchymal lung diseases are outlined. The publication contains more than 630 drawings - microphotographs of histological preparations, CT sections; images obtained by confocal laser endomicroscopy of the distal airways (alveoscopy).
2 790 R
1 690 R
CT has advantages and should be used as a primary method in several situations: in patients from intensive care units (shorter examination time, more monitoring capabilities), in severely debilitated patients (shorter examination time, less motion artifacts), in patients with suspected , bone destruction and bone erosions
4 790 R
This Guide to Helical and Multislice Computed Tomography, which provides detailed CT anatomy necessary for proper diagnostic image evaluation, highlights new or improved CT applications such as cardiac CT and CT angiography.
3 890 R
Contains descriptions of medicinal products on the Russian pharmaceutical market and the “Parapharmaceuticals” section, which includes dietary supplements, medical products, medical nutrition and medicinal cosmetics. Information pages of manufacturing companies contain contact information, a list of drugs, their classification and other information.
2 399 R
1 399 R
This book will be useful not only to radiologists and medical students, but also to doctors of other specialties. It does not replace standard textbooks, but is designed as a practical reference guide for a concise overview of various pathologies.
2 099 R
The manual covers the problems of diagnosis and treatment of almost all diseases and injuries of the shoulder joint and shoulder girdle. The book is intended for orthopedic traumatologists, surgeons, rheumatologists, as well as radiology specialists.
2 290 R
In your hands is a book that answers the questions healthcare professionals face as they strive to provide thorough, rational, and effective medical advice.
2 390 R
Contains more than 1000 radiographs and illustrations with detailed comments, focusing on the main signs of the disease. It is recognized as a comprehensive publication providing professional information to radiologists.
4 475 R
Brief but comprehensive descriptions of diseases of the genitourinary system are accompanied by a series of carefully selected images (more than 1600), allowing you to get acquainted with both the characteristic signs and the pitfalls of modern imaging in urology.
4 490 R
Methods for examining the mammary glands: self-examination, questionnaires, electrical impedance tomomammography, radiothermometry, as well as traditional methods of clinical examination. The features of dose-free radiological digital technologies - ultrasound computed tomography (USCT), magnetic resonance imaging (MRI), laser tomo-mammography - are considered.
1 190 R
A brief guide to key issues in diagnosing diseases of internal organs. All sections are presented in the form of visual material - brief structural logical diagrams (algorithms). The content of the book is subject to a single scheme, which greatly facilitates the ability to quickly work with the book and quickly search for a symptom or syndrome.
539 R
A variety of radiation semiotics for apostematous pyelonephritis, carbuncle and kidney abscess are shown in detail, and various modern treatment methods are presented with the dynamics of inflammatory changes in the kidney parenchyma.
1 190 R
Achalasia of the pharyngoesophageal junction (upper esophageal sphincter). The surgical anatomy of the pharyngoesophageal junction, the physiology and pathology of the act of swallowing, types of dysphagia, and their differential diagnosis are presented.
1 190 R
The effectiveness of conservative drug treatment and the possibility of using extracorporeal shock wave therapy are substantiated. Traditional surgical procedures are described, as well as alternative microsurgical and endovascular interventions.
1 390 R
The main approaches to the X-ray diagnosis of lung diseases in newborns are outlined, the development and normal anatomy of the lungs, the methods of X-ray examination are presented, the features of the interpretation of X-ray images of the chest and the X-ray semiotics of lung diseases in the youngest patients are discussed. The book contains more than 200 illustrations - drawings and radiographs of the chest and abdominal organs.
2 190 R
Each chapter of the guideline now includes a detailed list of prognostic factors, divided into groups necessary for staging, recommended for use in clinical practice, and promising. Criteria for evaluating statistical models and predictor scales are proposed. For some tumor sites, including prostate, breast, and colon cancer, predictive models for clinical use were selected based on these criteria. 12 new staging systems were presented, including HPV-associated oropharyngeal cancer, bone tumors, soft tissue sarcomas of various locations
2 990 R
A modern compact format for presenting complex material, including imaging features, research protocols, sections on pathology and clinical manifestations. Brief but comprehensive descriptions of diseases of the genitourinary system are accompanied by a series of carefully selected images (more than 1600), allowing you to get acquainted with both the characteristic signs and the pitfalls of modern imaging in urology.
4 299 R
Neoplasms of the lungs, respiratory tract, mediastinum (including the thymus and esophagus), heart, great vessels, pleura and chest wall are described in detail. Particularly noteworthy are the sections devoted to a detailed overview of all forms of lung cancer and lymphomas of the chest, as well as an assessment of the prevalence of malignant tumors and the effectiveness of therapy.
4 390 R
A comprehensive guide to the radiological diagnosis of diseases of the esophagus, stomach, intestines and mesentery, including congenital anomalies, functional disorders, vascular diseases, benign and malignant tumors and inflammatory conditions.
3 990 R
More than 600 drawings. Each drawing accurately depicts the anatomy and location of critical structures, allowing the reader to quickly assess the potential extent of the malignancy.
2 499 R
Classifications of tumors of the esophagus and esophagogastric junction, stomach, lung, appendix, biliary tract, skin and prostate. Several new classifications are also provided for staging malignant melanoma of the mucous organs of the upper respiratory tract and digestive tract, stromal tumors of the gastrointestinal tract, carcinoid of the stomach, small intestine and colon, cholangiocarcinoma of the intrahepatic bile ducts, Merkel cell carcinoma, uterine sarcoma, cortical tumors adrenal gland
2 599 R
Ultrasound, echohysterography, MSCT, MRI, PET/CT. Vagina and vulva. Anatomy of the vagina and vulva. Congenital disorders. Vaginal atresia. Overgrown hymen. Vaginal septum. Benign neoplasms. Leiomyoma of the vagina. Hemangioma of the vulva. Vaginal paraganglioma. Malignant neoplasms. Vaginal cancer. Leiomyosarcoma of the vagina.
4 290 R
Taz. Ultrasound examination: technology and anatomy. Hysterosalpingography. Infusion sonohysterography. Computed tomography: research technology and anatomy. Magnetic resonance imaging: research technology and anatomy. Positron emission tomography/computed tomography: research technology and imaging features
4 290 R
Classification of malignant tumors - modern international standards for describing and determining the stages of malignant tumors. Contains updated organ-specific classifications for staging, prognosis and treatment of malignant tumors. Organized by anatomical region, the guide provides classifications for carcinomas of the head and neck, thyroid, esophagus, stomach, anal, lung, pleura, skin, ovary, prostate, penis and adrenal cortex, as well as neuroendocrine tumors and bone sarcomas. and soft tissues.
1 790 R
The book is intended for both beginning ultrasound diagnostic doctors and experienced specialists. The technology of ultrasound mammography in the differential diagnosis of inflammatory diseases, benign and malignant neoplasms, including the use of echo contrast agents, is described, and ways of integrating ultrasound results with the international BI-RADS system are determined.
2 290 R
The questions of the structure and topography of the organs of the digestive system are presented in detail. Necessary terms are given in accordance with the International Anatomical Nomenclature (2003). Particular attention is paid to those aspects of the morphology of the digestive system organs that are necessary for further successful development of clinical disciplines.
727 R
Unique material on endoscopic diagnosis and surgical treatment of nasal liquorrhea, applied aspects of the anatomy of the nasal cavity and paranasal sinuses, the physiology of the educational system and the circulation of cerebrospinal fluid are presented. The features of surgical treatment of forms of the disease of various origins are described in an accessible form.
1 310 R
519 R
Information about the clinical application of the method and its diagnostic capabilities is presented. Much attention is paid to the endosonographic semiotics of diseases of the esophagus, mediastinum, tracheobronchial tree, stomach, biliary tract, pancreas, small and large intestine in normal conditions and in various diseases.
3 200 R
It may be useful for diagnosing contraindications to treatment using manual medicine methods, and for comparing changes in the spine before and after treatment. The systemic model makes it possible to purposefully treat a patient using manual medicine methods together with doctors of other specialties.
1 600 R
The guide contains up-to-date and up-to-date information on the diagnosis and treatment of major breast diseases. It covers the main aspects of mammology. A guide reflecting a consensus position on current issues of modern diagnosis and treatment of breast diseases.
3 199 R
Modern ideas about magnetic resonance imaging of the liver. At the beginning of the book, the basics of the method are briefly outlined, the main pulse sequences used in studying the liver, and the principles of contrasting the organ with both traditional and hepatospecific contrast agents are described. Each section on specific liver diseases and conditions concludes with a series of representative images arranged in accordance with the proposed study protocol.
2 940 R
Ultrasound, MRI, PET/CT. Uterus. Introduction and overview of the anatomy of the uterus. Age-related changes. Endometrial atrophy. Congenital disorders. Anomalies in the development of the Müllerian ducts. Hypoplasia/agenesis of the uterus. Unicornuate uterus. Double uterus (uterus didelphys). Bicornuate uterus. Intrauterine septum. Saddle uterus. Abnormalities of uterine development associated with exposure to diethylstilbestrol. Congenital uterine cysts. Inflammation/infection
3 390 R
A detailed description of the categories assigned as a result of a comprehensive radiological examination will simplify the implementation of the classification into the routine practice of specialists involved in assessing the condition of the mammary glands.
2 099 R
The terminology and classification of degenerative diseases of the spine are outlined. The radiation semiotics of degenerative diseases of the spine is described, which presents data from traditional radiography, CT and MRI.
1 276 R
The textbook describes in detail the anatomy of the esophagus and the technique of x-ray examination, and discusses issues of x-ray diagnosis of diseases and pathological conditions of the esophagus. Almost all known forms of pathological changes in the esophagus are included: from gastroesophageal reflux disease and esophageal cancer to esophagopathy in various extra-esophageal diseases.
1 890 R
Risk factors for endometrial cancer. Diagnosis of uterine cancer. Screening for endometrial cancer. Iliopelvic lymph node dissection. Radiation and drug therapy for uterine cancer. Adjuvant therapy for uterine cancer.
1 499 R
The manual outlines recommendations for performing computed tomographic coronary angiography for coronary heart disease. Indications for the study, features of the technique and analysis of the results are considered. CT semiotics of atherosclerotic lesions of the coronary arteries is described.
820 R
The guide presents the normal anatomy of the brain and spine using MRI and CT scans. MRI images of the brain are reflected in three mutually perpendicular planes.
1 879 R
The features of performing cardiac MRI in children of different age groups are discussed in detail. MRI scans of the normal anatomy of the heart and mediastinum in infants are presented. Atlas on the clinical use of magnetic resonance imaging for diagnosing the anatomy of congenital heart defects in children.
1 484 R
The book is a practical guide to the diagnosis and treatment of benign tumors and tumor-like bone diseases in children. It presents detailed clinical and radiomorphological characteristics of benign tumors and tumor-like bone diseases in children.
3 500 R
The normal radial anatomy of the elbow joint is described according to X-ray, CT and MRI data. Description of radiation semiotics of the most common diseases and injuries of the elbow joint, which presents data from X-ray examination, CT and MRI. Recommendations on the tactics of radiological examination are given, and differential diagnosis is given.
1 250 R
The normal radiation anatomy of the hip joint is described according to X-ray, CT and MRI data. The book is devoted to the description of radiation semiotics of the most common diseases and injuries of the hip joint. Recommendations on the tactics of radiological examination are given, and differential diagnosis is given. Issues of etiology, pathogenesis, morphology and clinical manifestations of diseases and injuries are considered.
1 340 R
Radiation anatomy of the ankle and foot according to X-ray, CT and MRI. Radiation semiotics of the most common injuries of the ankle and foot, which presents data from X-ray examination, CT and MRI. Recommendations on the tactics of radiological examination are given, and differential diagnosis is given.
1 340 R
Radiation semiotics of the most common diseases of the ankle and foot, it presents data from X-ray examination, CT and MRI. Recommendations on the tactics of radiological examination are given, and differential diagnosis is given. Issues of etiology, pathogenesis, morphology and clinical manifestations of diseases are considered.
1 240 R
The manual outlines the normal radial anatomy of the shoulder joint based on X-ray, CT, MRI, and ultrasound. Radiation semiotics of the most common diseases and injuries of the shoulder joint. They present data from X-ray studies, CT, MRI and ultrasound. Recommendations on the tactics of radiological examination are given, and differential diagnosis is given.
1 492 R
The manual outlines the normal radiographic anatomy of the knee as determined by X-ray, CT, and MRI. Radiation semiotics of the most common injuries of the knee joint, which presents data from X-ray examination, CT and MRI. Recommendations on the tactics of radiological examination are given, and differential diagnosis is given.
1 325 R
Radiation semiotics of the most common diseases of the knee joint. Data from X-ray examination, CT and MRI are presented. Recommendations on the tactics of radiation examination, differential diagnosis is provided. Issues of etiology, pathogenesis, morphology and clinical manifestations of diseases are considered.
1 240 R
The issues of normal and ultrasound anatomy of the mammary glands at various stages of a woman’s life are considered. Not only the fundamental sections of ultrasound mammography are presented (anatomy, benign and malignant tumors, inflammatory diseases of the mammary glands).
3 590 R
Over 1,000 drawings, diagnostic charts, high-quality x-rays, CT scans, and ultrasound images.
3 450 R
The tests are intended for the certification exam for the title of radiologist. They can also be used for certification examinations for assignment of a qualification category.
850 R
Standard layouts and various options often found in the practice of a radiologist and x-ray technician are presented. The original structure of the atlas, including an x-ray image and explanatory diagrams and drawings, greatly facilitates the understanding of the material presented. The same goal is furthered by the additional use of a second color.
1 420 R
General issues of physiological reorganization of bones at different ages; it is shown how these processes change when osteotuberculous inflammation occurs, and, most importantly, how bones change when bone-articular specific inflammation subsides and is completely eliminated.
Review of the most important diseases and pathological conditions with a brief description of their etiology, pathogenesis and clinical manifestations, treatment tactics and prognosis. Each section presents in detail visualization methods of instrumental diagnostics (X-ray, ultrasound, CT, MRI, etc.)
2 190 R
Each section presents in detail visualization methods of instrumental diagnostics (X-ray, ultrasound, CT, MRI, etc.), the necessary projections and modes for diagnosing a particular pathology of the lungs and mediastinum, cardiovascular system, neck, gastrointestinal tract , genitourinary tract, musculoskeletal system, central nervous system
1 990 R
Each section presents in detail visualization methods of instrumental diagnostics (X-ray, ultrasound, CT, MRI) of the brain, spinal canal, chest, arteriovenous fistula of the dura mater of the spinal cord, abdominal cavity, kidney, limb.
1 730 R
1 900 R
Technical aspects of selected imaging techniques are presented. Methods for diagnosing the most important diseases of the heart and great vessels.
3 440 R
Dedicated to a description of the radiation semiotics of various changes in the spine and spinal cord that occur during trauma, which presents data from traditional radiography, CT and MRI. Recommendations on the tactics of radiological examination are given, and differential diagnosis is given. Issues of etiology, pathogenesis, morphology and clinical manifestations of diseases are considered.
1 130 R
Each section presents in detail visualization methods of instrumental diagnostics (X-ray, ultrasound, CT, MRI, etc.), the necessary projections and modes for diagnosing a particular pathology, radiological symptoms, differential diagnosis.
1 970 R
The atlas is illustrated with photographic reproductions of radiographs in typical projections. Contains information from normal and topographic anatomy, illustrated with diagrams and accompanied by a description of x-ray placement.
3 750 R
Normal values for x-ray examinations are presented, the doctor’s approach to the analysis of x-rays is systematized, and templates for conclusions are proposed. The book is clearly structured, equipped with illustrations indicating the main measurements necessary to make the correct conclusion and diagnosis.
This book presents typical clinical situations that we analyzed during our work at the Institute of Surgery named after. A.V. Vishnevsky. All of them are from our usual practical work. The presented material covers surgical diseases of the abdominal cavity and retroperitoneal space outside of acute or emergency conditions.
990 R
Modern data on the anatomy and x-ray picture of developmental anomalies of the spine and skull base. Modern classifications, X-ray patterns and clinical manifestations of developmental anomalies of the spine and skull base, available for routine X-ray examination, are covered.
740 R
A publication devoted to the ultrasound assessment of a number of diagnostically significant neuroimaging phenomena in major extrapyramidal diseases: idiopathic and atypical parkinsonism, essential tremor, dystonia, hereditary neurodegenerations manifested by movement disorders.
1 940 R
Normal radiographic anatomy necessary for interpretation of conventional radiography is provided.
1 460 R
Reflects the capabilities of methods in the diagnosis of TBI, vascular diseases and brain tumors. The CT and MRI semiotics of these diseases are described, the advantages and disadvantages of the methods in diagnosing the pathology in question are shown. The basics of differential diagnosis are presented. The book contains more than 150 illustrations.
2 090 R
Each section presents in detail visualization methods of instrumental diagnostics (X-ray, ultrasound, CT, MRI, etc.), the necessary projections and modes for diagnosing a particular pathology, radiological symptoms, and differential diagnosis.
1 800 R
Radiation research methods using ultrasound, fluoroscopy of the stomach and duodenum, instrumental research methods using gastroduodenoscopy and histological examination of the material are described. The clinical and radiological characteristics of the stomach and duodenum in patients with gastritis, gastroduodenitis, duodenitis, and peptic ulcer during treatment are presented.
Normal radiation anatomy of the larynx, the main clinical manifestations, radiological and ultrasound symptoms of malignant lesions in this area are presented. The key errors in image interpretation and diagnostic tactics that arise among practitioners using various radiation methods for the differential diagnosis of neoplastic processes of the larynx are described.
950 R
Normal X-ray anatomy, stages of development and formation of the skeleton, the most common variants of the norm, a list and systematization of the most common sources of errors in the interpretation of radiographs are considered.
RUB 1,250
in a practical aspect, the issues of ultrasound diagnosis of pleural effusions are presented
1 390 R
