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Will the detected lung foci in patients with a burdened oncological history (breast cancer) always be metastatic? In response to the question posed, we present a clinical case of pulmonary sarcoidosis mimicking the metastatic lesion of metaplastic breast cancer. And we remind of the need for a differential diagnosis, despite the oncological history of a patient and radiation diagnostics data.

A rare case of jejunal lipoma complicated by intestinal intussusception in a 71-year-old man is presented. Abdominal computed tomography revealed intestinal intussusception caused by the jejunal wall lipoma, allowed to timely make a diagnosis and perform surgical treatment.

Superior mesenteric artery syndrome, first reported by Karl Freiger von Rokitansky, is a rare disorder associated with the compression of the horizontal part of the duodenum between the mesenteric artery and the abdominal aorta. A rare clinical observation of the development of the superior mesenteric artery syndrome in a 19-year-old patient is presented to raise the awareness of doctors about this syndrome and the need for early diagnosis and treatment to prevent complications.

The jejunal diverticulosis is rare and accounts for approximately 0.5–1 % of the general population. Diagnosis of the pathology is difficult even in the presence of symptomatic complications (perforation, abscess, peritonitis, sepsis, intestinal obstruction and bleeding), therefore, it is often overlooked or delayed, which requires high awareness and vigilance of physicians. Emergency surgical interventions are performed due to the lack of clear clinical symptoms and reliable radiological data in an average of 25 % of patients with complications of diverticulosis. In the presented case, multislice computed tomography (MSCT) with intravenous contrasting revealed multiple diverticula of the jejunum with reactively altered walls, infiltration of the adjacent cellular tissue and small gas inclusions, indicating diverticulum microperforation. Esophagogastroduodenoscopy (EGD) was performed which confirmed the jejunum bleeding, and was followed by laparotomy which confirmed multiple jejunal diverticula with microperforation and bleeding. Thus, timely MSCT in combination with EGD allowed to avoid complications of jejunal diverticulitis.

The paper presents two clinical cases of patients with giant renal angiomyolipomas (AML), in one of whom its course was complicated by intratumoral hemorrhage. It describes key diagnostic criteria for computed tomography (CT), as well as the distinctive features of other neoplasms that should undergo a differential diagnosis. The similar clinical presentations and morphological characteristics of different renal neoplasms can cause certain diagnostic difficulties; however, the carefully collected historical data and distinctive criteria allow AML to be identified. Due to its high sensitivity and specificity, abdominal contrast-enhanced CT is an effective imaging technique in the detection and differential diagnosis of giant renal AML.

Gastric neuroendocrine tumors commonly called carcinoids arise from enterochromaffin cells of the stomach and are rare. Recently, their incidence has increased, which may be due to the improvement of diagnostic and therapeutic capabilities. The article describes a rare clinical case of gastric carcinoid 23 years after surgical removal of gastric cardia cancer.

The early and complete diagnosis of lung carcinoid tumors is of great interest in clinical oncology, since this is the basis for the possibility of using options for organ-sparing surgical treatment. According to the 2015 WHO classification, carcinoids belong to the group of neuroendocrine tumors and are divided into two types: a typical carcinoid and an atypical one. Based on the data available in the literature, there are from 0.2 to 2 cases per 100,000 population. The paper considers the possibilities of radiation studies in the early diagnosis of this tumor, as well as those of determining the tactics, type, and scope of surgical treatment.

Computed tomography for coronavirus infection (COVID-19) is effective not only in making a diagnosis, but also in timely and accurately detecting some complications of this disease in different organs and systems. The paper shows various complications of coronavirus infection that a radiologist may face in practice, which develop both in the natural course and due to therapy for COVID-19, including hemorrhagic and thrombotic events in coagulopathy, pneumothorax, and pneumomediastinum as a result of the direct cytotoxic effect of SARS-CoV-2 on pneumocytes, and barotrauma during mechanical ventilation, as well as pathological fractures due to osteoporosis, including steroid osteoporosis that has developed during therapy with glucocorticosteroids. It considers the main causes and pathogenesis of various complications of coronavirus infection.

Objective: to evaluate the role and place of MRI lung screening in the detection of pneumonia and patient routing.Material and methods. 500 MRI tests were performed in the period from November 1, 2020 to December 15, 2020 on the basis of more than 20 diagnostic centers of the federal MRI-Expert network. Two groups were identified. In Group 1 (control, n = 50) MRI studies were compared with CT studies in a single time interval of 0–2 days; 25 patients had a positive PCR test for SARS-CoV-2 and 25 patients were conditionally healthy. In Group 2 (effective, n = 450) mediastinal MRI was performed with lung screening on Philips 1.5 T and Siemens 1.5 T devices. The statistical analysis of the medical data base was performed.Results. During the study, mandatory and additional MRI scanning programs were identified: for Philips 1.5 T tomograph, the mandatory programs are sSSh_fb: tra and cor; THRIVE: tra (inhale/exhale); for Siemens 1.5 T – T2_BLADE: cor, tra, sag. When comparing the visual data of the control group (n = 25) with a positive PCR test in a single time interval of 0–2 days, the fact of detecting MR changes coincided with CT changes in 76% of cases (n = 19). The group of patients were examined by only one method – MRI-screening of the lungs (n = 475), pathological changes in the lungs were detected in 44% (n = 209). Localizations of the pathological changes were as follows: bilateral changes – 70.3% (n = 147), right-side changes – 19.6% (n = 41), left-side changes – 10% (n = 21); lower parts 26.8% (n = 26), average departments – 10% (n = 21), the upper divisions – 14.8% (n = 31), mid-lower 29.6% (n = 62), total – 18.6% (n = 39). The ranges of the area of lesion of the pulmonary parenchyma on MRI were graded according to MRI criteria into 4 groups (< 25%, 25 – 50%, 50 – 75%, > 75%). The collective radiation dose decrease was calculated for a group of patients (n = 450), which averaged 2.025 man-Sv for 1.5 months, of which 0.077 man-Sv were control studies.Conclusion. Based on the results obtained, the analyses of the possibilities of the MRI method in displaying pulmonary changes was performed. The method of MRI screening of the lungs is recognized as a possible alternative to computed tomography for dynamic monitoring in conditions of a shortage of CT records or the inability to perform it, and as a tool to reduce the collective effective dose of radiation to the population.

The biceps muscle located between the shoulder and ulnar articulations is attached to the bone structures with a tendon, so in case of traumatic impact, the damage may be both in the proximal and distal parts. Most tendon ruptures occur in the proximal biceps, less often distally, in the area of radial tuberosity. The anamnesis and examination data play an important role in the diagnosis of ruptures. But the instrumental diagnostics is used for complete verification of the diagnosis and exclusion of complications or other diseases. The most reliable and comprehensive information is provided by the method of magnetic resonance imaging (MRI). The article presents analysis of MRI results in a patient with a complete distal biceps tendon rupture with the tendon pulled upward and the muscle retracted. The MRI study could make a correct clear diagnosis, which allowed the patient to immediately contact a specialized professional and to receive qualified assistance in time. Thus, it is shown that high-field MRI makes it possible to solve the problems of identifying the pathological processes and determining their severity with high accuracy.

Multiple primary colon cancer is an urgent medical problem of our time, which is associated with a steady increment in the incidence of the above disease and with the high complexity of its diagnosis. According to the literary sources, the incidence of this form of cancer of the colon has recently amounted to as much as 17% among all multiple primary neoplasms and this organ is a very common site. The paper describes a clinical case confirming the need for a thorough diagnosis of multiple primary colon cancer, by applying radiation techniques to further define treatment policies.