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Objectives: This study set out to determine the possibility to differ SARS-СоV-2 viral pneumonia from community acquired pneumonia (CAP) by mean of digital infrared medical thermography. Material, methods: Totally 380 patients were evaluated: with diagnosis 'U07.1COVID-19, virus identified. SARS-CoV-2 pneumonia' (group 1) — 208 pts, with community acquired viral or bacterial pneumonia (group 2) — 172 pts. Thermographic assessment was performed using TBC300-med infrared camera (manufactured by LLC 'STC SILAR', Saint Petersburg, Russia, image format 384 x 288, thermal resolution 30 mK). To store and analyze thermographic images cloud application 'TVision' (LLC 'Dignosys', Russia) was used. Quadrangle in shape regions of interest (ROI) were automatically created on the front and back of the thorax roughly in the projection of the upper lobe (ULP) and the lower lobe (LLP) of the lungs. Mean temperature was measured and thermal gradients- ΔТ° (side-to-side temperature difference) - were calculated between symmetric ROI both on front and back of the thorax. Values obtained were taken as modulus, the greatest value used for analysis. Results: Mean ΔТ° value were significantly higher in SARS-CoV-2 pneumonia compared with CAP group (0,56 ± 0,35 ºC and 0,32 ± 0,14ºC respectively; P < 0,05). The ΔТ° value > 0,51 °C is associated with SARS-CoV-2 pneumonia with sensitivity 71 % and specificity 62,8 %, area under the ROC curve 0.739; P < 0,05). Conclusions. Infrared thermography proved to be a sensitive method for detection of temperature differences between both types of pneumonia and may contribute to preliminary diagnosis.

INTRODUCTION. Currently there are a lot of articles of lung ultrasound (LUS) in COVID-19 both in the diagnosis and in the prognosis of the disease. OBJECTIVE. Evaluation of the relationship between the ultrasound-guided lung lesion index (UIL) with the volume of lung involvement determined by computed tomography (CT) and disease outcomes in patients with COVID-19. MATERIALS AND METHODS. A prospective observational cohort clinical study included 388 patients aged 18–75 years; diagnosed with COVID-19 pneumonia or suspected COVID-19. Lung ultrasound was performed according to the 16-zone “Russian Protocol” within 24 hours after CT scan of the chest organs. RESULTS. The median lung lesion volume on CT was 55 (35; 74) % and UIL was 46 (28; 60) points. UIL had a strong direct correlation of 0.873 (95% CI 0.842; 0.897, p < 0.01) with the change in the volume of lung involvement determined by CT and the inverse with the SpO2/FiO2 index –0.850 (95% CI 0.827; 0.871, p < 0.01). Mortality was 56 patients (14.4 %) (p = 0.018). The optimal cut-off point for ROC analysis in predicting mortality was 55 points and had a sensitivity of 97.6 % and a specificity of 73.9 % with an area under the curve of 0.896 (95% CI 0.861; 0.931). Kaplan–Meier analysis on the entire data set (n = 388) demonstrated a survival rate of 97.6 % in the group with a UIL score less than 55 points and 62 % in the group with a UIL score more than 55 points. Differences between groups were statistically significant (Log Rank test p < 0.001; Breslow test p < 0.001). As a result, multivariate Cox regression analysis, using the stepwise exclusion method, only UIL remained a significant predictor of adverse outcome (p < 0.01). CONCLUSIONS. UIL determined by 16-zone “Russian protocol” correlated with severity of respiratory failure and volume of lung injury and was a predictor of adverse prognosis of disease outcome.

The coronavirus infection (COVID-19) is characterized by a high incidence of pneumonia. Extensive damage, high mortality associated with COVID-19 make the rapid bedside diagnosis and dynamic monitoring of the volume and nature of lung tissue damage a challenge. Lung ultrasound examination can be used as a tool to answer it.The objective: to compare the signs detected by lung computed tomography and ultrasound and to assess the sensitivity and specificity of ultrasound in the diagnosis of pneumonia induced by COVID-19.Subjects and Methods. The observational prospective clinical study included 388 patients aged 18–75 years old; they had a confirmed diagnosis of pneumonia caused by COVID-19 or suspected COVID-19. Lung ultrasound was performed within 24 hours after computed tomography (CT) of the chest organs. During CT, pathological signs, infiltration and consolidation of the lungs were visualized which were documented by lung segments. Lung ultrasound was performed according to the Russian Protocol, ultrasound signs of B-lines and consolidation were also documented based on the projection of lung segments on the chest wall. The distributions of variables was analyzed, described and summarized. The sensitivity and specificity of ultrasound methods were evaluated on the basis of ROC analysis according to CT gold standard.Results. Bilateral involvement was found in 100% of cases. Typical CT signs of pneumonia caused by coronavirus infection were ground-glass opacity of the pulmonary parenchyma, thickened pleura, consolidation, interstitium, reticular induration, and cobblestone appearance. With ultrasound examination of the lungs and pleura, the detected signs corresponded to CT signs. B lines (multifocal, discrete or merging) and consolidation of various volumes of lung tissue were most common during ultrasound. The sign of consolidation was detected less frequently versus infiltration (p < 0.001). The sensitivity of lung ultrasound in the diagnosis of lung lesions was 95.3%, and the specificity was 85.4%, the area under the curve was 0.976 with a confidence interval of 0.961–0.991 (p < 0.001).Conclusion. The use of lung ultrasound during the COVID-19 pandemic makes it possible to identify, assess the volume and nature of lung damage. Lung ultrasound demonstrated accuracy comparable to CT of the chest organs in detecting pneumonia in patients with COVID-19.

INTRODUCTION: Spondyloarthritis (SpA) take one of the leading positions among rheumatic diseases, constituting chronic inflammatory diseases of spinal cord, joints and enthesis. All spondyloarthritis develop as inflammatory lesion of sacroiliac joints (SIJ) — sacroiliitis and proliferation of bone tissues in the joint area and enthesis. Timely and quality visualization of sacroiliitis signs in patients with ankylosing and axial spondyloarthritis by means of radiation diagnostics is one of the main criteria for diagnosis verification at an earlier stage.OBJECTIVE: Review and analysis of the existing foreign and domestic literature for defining the role and place of digital tomosynthesis in methods and techniques of radiation diagnostics regarding axial spondyloarthritis.MATERIALS AND METHODS: A search of scientifiс publications and clinic guidelines in information and analytical systems PudMed (elibrary for 2015–2021) was carries out dedicated to radiation diagnostics of axial spondyloarthritis, including digital tomosynthesis.RESULTS: The review demonstrated wide opportunities and prospects of applying digital tomosynthesis in diagnosis and evaluation of axial spondyloarthritis progression, including the results of applying tomosynthesis with patients, having structural change in sacroiliac joints (SIJ).CONCLUSION: The method opportunity in this direction hasn’t been fully studied and the algorithm of its applying and criteria of patient selection for the research have not been developed.

Aim. To evaluate the results of surgical intervention planning using three-dimensional models based on magnetic resonance imaging in patients with postinfarction left ventricular aneurysms.Material and Methods. Two groups of patients with postinfarction left ventricular aneurysm (PLVA) were included in the study, totaling 41 patients. The first (experimental) group included 17 patients diagnosed with PLVA by magnetic resonance imaging (MRI), and surgical intervention planning was performed using a 3D model of the heart. The control group comprised 24 patients in whom PLVA was diagnosed by echocardiography (TTE) or ventriculography, and surgical intervention planning was performed using traditional two-dimensional slice images.Results. Comparison of full perfusion under cardiopulmonary bypass (CPB) showed statistically significant differences between the groups: this parameter was 60 [56; 68] min in group 1 vs. 71 [61; 84] min in group 2, which was significantly higher (p = 0.043). There were no significant differences in total operation time (280 [265; 320] min in group 1 vs. 263 [248; 283] min in group 2, p = 0.055), overall CPB time (93 [86; 109] min in group 1 vs. 104 [83; 109] min in group 2, p = 0.653), and partial CPB time (31 [26; 39] min in group 1 vs. 27 [21; 32] min in group 2, p = 0.127).Conclusion. The use of 3D models to support surgeons for PLVA correction makes it possible to determine the type of reconstructive surgery, practice the main stages of the upcoming intervention, and reduce the time of full perfusion under CPB during its implementation.

Introduction. The identification of early edematous changes using MRI and the assessment of the nature of their distribution among the muscles is important for the diagnosis of dysferlinopathy and the differentiation of hereditary muscular dystrophies from inflammatory myopathies. Purpose of the study: to assess the capabilities of STIR and T2 MSME methods in the diagnosis of early edematous changes in the muscles of patients with LGMDR2. Materials and methods: We examined 20 patients with clinical manifestations of dysferlinopathy, with an average age of 35 (24; 44) years. Magnetic resonance imaging of the muscles of the pelvic girdle and lower extremities was performed by 20 patients and a control group equivalent in sex and age.Results. The T2 MSME (ms) method based on the calculation of relaxation time has the highest diagnostic accuracy in detecting early edematous changes in muscles. The sensitivity of the STIR method was 56%, and the specificity was 100%. Conclusion. Dysferlinopathy is characterized by diffuse edema of the least affected muscles. STIR is optimal for differential diagnosis of myopathies characterized by edematous changes. Whereas, for the assessment of minimal edematous changes, T2 MSME is the most acceptable.

Aim. To evaluate the capabilities of CT and MRI in the assessment of resectable and potentially resectable pancreatic tumors.Materials and methods. From 2015 to 2020 CT and MRI examination of the abdomen was performed in 220 patients with pancreatic ductal adenocarcinoma. The average age of the patients was 54.6 ± 9.9 years. 198 (90%) patients had a tumor of the pancreas head, 22 (10%) patients had a tumor of the body or tail of the organ. 110 (50%) people were recognized as inoperable. The results of examination of 88 (40%) patients were subjected to in-depth analysis.Results. Eighty eight patients were assessed for tumor resectability. In 36 (40.9%) cases, the neoplasm was recognized as resectable, and the standard resection was performed. In 52 (59.1%) cases, the tumor was determined as borderline resectable; extended gastropancreatoduodenal resection was performed.The usefulness of CT was shown in assessing the features of the variable vascular anatomy of the hepatopancreatobiliary area, determining the nature of the involvement of key vessels in the pathological process and lesions of the pancreas as a whole. The importance of using multiphase CT scanning is demonstrated and emphasized. The advantages of the MRI are indicated, including examples of the effective use of diffusion-weighted images.Conclusion. Multiphase MDCT and MRI with dynamic contrast enhancement are the leading methods of radiological diagnosis of malignant tumors of the pancreas and effectively complement each other.

Introduction. In the literature, the insufficient attention is paid to preoperative planning of access to adrenal masses using modern computed tomographic navigation capabilities. The purpose. To demonstrate the possibilities of designing a safe access for adrenalectomy with the appliation of three-dimensional printed models based on the integral assessment of preoperative computed tomographic data.Materials and methods. The possibilities of preoperative design of access for adrenalectomy were studied in 362 patients with adrenal tumors, for whom computed tomography was performed on an Aquillion 64 (Toshiba, Japan).Results. Reliable anthropometric (BMI, body shape) and CT criteria for designing surgical access to the right and left NP were determined. Three patients with a borderline number of risk criteria for the development of vascular complications associated with technical difficulties of adrenalectomy (for the right AP, ≥4, for the left AP, ≥3) underwent CT-segmentation of images followed by the creation of three-dimensional plates — a model of the AP tumor with adjacent organs and vessels.Conclusion. Preoperative computed tomographic access design, taking into account the criteria of the risk of complications and the application of three-dimensional printed models, make it possible to reasonably use endoscopic and open adrenalectomy options, significantly improving the immediate results of patient treatment.

Purpose. Assessing the possibilities of quantitative MRI in the diagnosis and monitoring of the course of rhabdomyolysis of various etiologies. Materials and methods. The results of MRI performed by 80 patients with clinical manifestations of rhabdomyolysis were analyzed. The diagnosis of rhabdomyolysis was confirmed by measuring the level of myoglobin (more than 70 μg/l) and CPK (more than 1000 IU/l) in the absence of laboratory and instrumental signs of myocardial damage. Scanning was carried out using T1, T2, STIR protocols, as well as the developed pulse sequences for calculating the relaxation times T1, T2 and T2*. Patients underwent MR examination at least 3 times during the course of the disease. Results. In 48 cases was detected a hyperintensive signal from muscle tissue on the T2 and STIR protocols. In 25 cases were identified MR signs of rhabdomyolysis, 16 of which were confirmed by laboratory methods and or biopsy of the affected muscle. One patient with a blood myoglobin level (577 ng/ml) showed no pathological changes in MR images. Thus, in the analyzed group, the sensitivity and specificity were 94% and 71%. Quantification protocols obtained relaxation times for the affected muscle tissue. The ROC analysis method determined cutoff thresholds for rhabdomyolysis: T1 greater than 1152 ms, T2 greater than 63 ms and T2* greater than 48 ms with sensitivity and specificity, respectively: 94% and 73%, 94% and 84%, 88% and 85%. Dynamic changes in the relaxation time during the recovery of patients had correlation relationships of high and medium strength with the main laboratory markers of rhabdomyolysis. The highest values of the correlation coefficient were found between T2 and the activity of CPK, ALS, and AST (rs = 0.805, 0.813, and 0.803; p

Рresents the possibilities of various visualization methods for assessing heart fat depot in patients with cardiovascular disease, as well as the effect of adipose tissue on myocardial function. The prospects of using the heart fat depot as a therapeutic target are considered on the example of the successful use of various groups of antidiabetic drugs, in particular glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors. Thus, it has been established that an ectopic fat depot makes a certain contribution to atherogenesis due to its effect on lipid metabolism, participation in the formation of a chronic inflammatory reaction of low intensity, potentiation of endothelial dysfunction, and activation of a coagulant shift. In addition, local organ dysfunctions, such as increased intrarenal pressure, mitochondrial disorders, increased lipogenesis, the formation of insulin resistance and lipotoxicity additionally create prerequisites for an increase in cardiovascular risk. Defines diagnostic and useful methods that not only quantitatively, but also qualitatively describe the relationship of fat depot and potential comorbid pathology. The effect of reducing cardiovascular risk, consisting in reducing the amount of epicardial adipose tissue in the studied, was observed when taking the preparation of the biguanide group, as well as its combination with drugs - analogues of glucagon-like peptide 1 and dipeptidyl peptidase-4 inhibitor. A similar effect was also observed in the case of the use of type 2 sodium-glucose cotransporter-2 inhibitors.

In the literature, insufficient attention is paid to the preoperative planning of the approach to adrenal glands using the modern capabilities of computed tomography (CT) navigation. The aim of the work was to demonstrate the possibilities of designing safe access for adrenalectomy using three-dimensional printed models based on preoperative CT data. The possibilities of preoperative access design for edrenalectomy were studied in 362 adrenal tumor patients who underwent CT imaging on Aquillion 64 (Toshiba, Japan), followed by post-processor image processing, construction of multi-plane and 3D reconstructions. All patients were divided into retrospective (n=157) and prospective (n=205) groups. In 3 clinical cases, preoperative access design was supplemented by the creation of a three-dimensional printed model of the adrenal gland with a tumor using the Slicer 4.10.1 software. Reliable anthropometric (body mass index, body shape) and CT-criteria for designing surgical access to the left and right adrenals were determined: diameter of formation; tumor syntopy in relation to the walls of the inferior vena cava; the length of the central adrenal vein and the place where it flows into the inferior vena cava; the location of the tumor relative to the inferior vein of the right lobe of the liver, as well as relative to the gate of the right kidney; location near the aortic-renal vascular triangle, gate of the left kidney and spleen vessels. Three patients with a borderline number of risk criteria for the development of vascular complications associated with the technical difficulties of adrenalectomy (for right adrenals≥4, for left adrenals≥3) underwent CT-segmentation of images with the subsequent creation of three-dimensional plates - a model of an NP tumor with neighboring organs and vessels. Preoperative CT design of the approach, taking into account the risk criteria for complications and the use of 3-D printed models, can reasonably apply endoscopic and open options for adrenalectomy, significantly improving the immediate results of treatment of patients.

Aim: to determine the possibilities of modern multislice computed tomography in the preoperative planning of a rational variant of surgical access to the adrenal gland with a tumor. Materials and methods: the results of the examination and treatment of 1196 patients with surgical diseases of the adrenal glands (AG) were studied. The virtual-figurative design of a rational variant of surgical access to AG with a tumor was carried out in 362 patients after evaluating the features of their topographic-anatomical location according to CT-scan. The criterion for the inclusion of patients in the study was the ability to perform after 2013 multislice computed tomography (MSCT) with intravenous contrast on the modern installation Aquillion 64 (Toshiba, Japan) and subsequent post-processing of images with the construction of multiplane and 3D reconstructions. Results: studying the features of the topographic-anatomical location of AGs with a tumor using MSCT allowed us to form a virtual-figurative perception of their syntopy in 362 patients and to design options for access to perform adrenalectomy (AE): retroperitoneoscopic (n = 303), laparoscopic (n = 25), thoracophrenotomy ( n = 30), thoracophrenolaparotomic (n = 5). 363 surgical interventions were performed for 362 patients. A single-sided retroperitoneoscopic AE for pheochromocytoma was performed in 1 patient. Reliable CT criteria were determined that affect the duration and safety of the above-mentioned accesses performed by AEs. It has been established that when designing access to the right AG, it is necessary to consider: the diameter of the neoplasm; the location of the AG with a tumor relative to the inferior vena cava and the lower right hepatic vein; contact with vessels in the gate of the kidney, as well as the presence of additional central veins AG. The determining factors in planning access to the left AG are: neoplasm diameter, contact with vessels in the gate of the kidney and splenic vessels, location in the aorto-renal vascular triangle. It was established that retroperitoneoscopic AE, performed in 83.7% of patients with AG tumors with a diameter of ≤ 8 cm, is an operation of choice. Laparoscopic access remains relevant only when the right-sided localization of an AG tumor with a diameter of up to 8 cm and planning simultaneous surgical interventions on the abdominal organs in individuals of a brachymorphic physique (8.3%). Open approaches are shown in benign lesions of the AG more than 8 cm in diameter, generalized forms of adrenocortical cancer (ACC) (T3-4N0-2M0-1), malignant paragangliomas with signs of invasion or distant metastasis (n = 9.7%). Conclusions: multispiral computed tomography allows, before the operation, to carry out adequate planning of the safest surgical access for adrenalectomy, avoiding the development of intra- and postoperative complications, minimizing operative trauma, shortening the operating time, and speeding up the medical and social rehabilitation of patients.

Surgical treatment remains the only way to primary prevention of intracranial hemorrhage in patients with cerebral aneurysms. The implementation of such interventions is associated with the risk of the development of secondary cerebral circulation disorders. The effect of ischemic damage to cerebral structures on the state of mental functions and the quality of life of patients is currently not well understood. The interrelation of the formation of foci of cerebral infarction according to magnetic resonance imaging and the dynamics of the state of cognitive functions of patients undergoing surgery for unruptured cerebral aneurysms is considered. It has been established that «fresh» foci of ischemic damage are formed in a third of patients. Among patients operated on with intravascular access, brain infarction zones are formed in half of the patients. Endovascular interventions under balloon assistance are associated with a high risk of asymptomatic ischemic complications. When comparing the results of neuropsychological examination in patients with diagnosed foci of cerebral infarction and the group where the ischemic complications were absent, no significant differences were found. According to the neuropsychological examination, the results before and after the operation did not differ significantly in patients with infarction foci. Thus, after surgery for unruptured aneurysms, local foci of cerebral infarction are often detected. In most cases, these changes are not associated with the deterioration of the higher mental functions of patients and are asymptomatic.

Introduction. Rhabdomyolysis is destruction syndrome of striated skeletal muscle characterized by myalgia, an increase of creatine phosphokinase level (CPK), serum myoglobin and myoglobulinuria. This review presents the analysis of five cases of acute postexercise rhabdomyolysis happened to militaries, complicated by pigmentary nephropathy with the description of clinical and laboratory studies, magnetic resonance imaging (MRI), electroneuromyographic and morphological features. The purpose of the study is the clinical assessment of MRI for the diagnosis of postexercise rhabdomyolysis.Results. A comparative assessment demonstrated that in the presented clinical cases in the muscle groups with minimal edematous changes, an increase in the MR signal was observed at T2-WISPAIR, as well as in diffusion-weighted images (factor b — 0, 500, 1000), at the same time on all other pulse sequences (including STIR) changes in signal intensity were not detected. Conclusion. There was shown that in mild cases of rhabdomyolysis, the regression of MR manifestations corresponds to a decrease in laboratory parameters of CPK and myoglobin, whereas in severe forms of rhabdomyolysis, the regression of MR manifestations is significantly slowed down relative to laboratory indicators, and in the place of necrosis areas, the foci of degeneration form (hyperintensive on T1 and T2-WI, hypo-intensive on T1-WI-SPIR and T2-WI-SPAIR). Morphologically confirmed the fact of pronounced hemorrhage in the compartment syndrome due to postload rhabdomyolysis (hyperintensive sites on T1-WI and T1-WI-SPIR, iso-, hypointensive on T2-WI, T2-WI-SPAIR).

The possibilities of functional magnetic resonance imaging in the diagnosis of opioid dependence syndrome are considered. It is known that opioid addiction is one of the leading problems of modern narcology. Despite the fact that the number of researches of the neurobiological effects of opioids is increasing every year, the pathogenetic effects of dependence on this narcotic substance are still not fully understood. Functional magnetic resonance imaging rest allows one to assess the functional connectivity of the remote from each other parts of the brain and makes a great contribution to understanding the mechanisms of development of addictive disorders in general. In patients with opioid dependence, an analysis was made of the neural network of the passive mode of the brain (default mode network). This resting network is associated with the processes of control and thinking, including emotional and cognitive components, and consists of medial frontal regions, posterior cingulate sections, precuneus, lower parietal and temporal divisions. It was found that, in comparison with the control group, in all patients suffering from opioid dependence, weakened functional connections of all structures of the cerebro-spinal cord system (p0,05). In this case, changes in the medial prefrontal cortex and precuneus are more pronounced in patients who are in the state of opioid intoxication, and in the parietal-temporal regions in patients who are in a state of remission up to 1 month. The correlation of cortical structures responsible for the «behavior control» system (orbitofrontal cortex, prefrontal cortex) with subcortical structures responsible for emotions in the limbic system was also evaluated. In comparison with the control group, in patients with early remission, weakened functional connections between cortical structures and left contiguous nucleus, almond-shaped body from two sides. In patients in a state of intoxication in addition to these changes, the functional relationship between the orbital frontal cortex and the shell on the left has been weakened. The weakening of functional links in the network of the passive mode of the brain in the groups of drug addicts suggests that they have violated the processes of control, thinking and making the right decision. The resulting functional changes can form the basis for creating biomarker maps for patients suffering from opioid dependence, which can be used to guide and evaluate the treatment of this pathology.

The possibility of using multiplanar reformations oriented on the axis of heart in diagnosing the common arterial trunk with X-ray computed tomography is substantiated. Examination data of 140 patients aged 1-19 days of life, 3030-3890 g body weight with conotruncal congenital heart diseases was analyzed, and common arterial trunk was detected in 7 patients (4 - boys, 3 - girls). In 5 (72%) patients, it developed mainly from the morphological right ventricle, 1 (14%) - completely from the morphologically right ventricle, and 1 more (14%) - evenly located above the ventricles. In four (57%) cases, the trunk valve had three leaflets, in two (28,5%) cases - two, in one (14,5%) case - four. All the patients had mitral-semilunar fibrous prolongation, intraventricular septal defects, doubled coronary arteries system, and the pulmonary arteries had their origin from ascendant part of common trunk. Pulmonary arteries had also their own common trunk in 4 (57%) cases, separate estuary in 3 (43%) cases. Aortic arc abnormalities included dextral aortic arc (2 cases), discontinuity of aortic arc (1 case), discontinuity of fourth aortic arc with persistence of fifth left aortic arc (2 cases). In general, computed tomographic angiocardiography heart-axis-oriented multiplanar reformations permit full and correct assessment of heart and main vessels, which is important for surgical treatment planning in congenital heart diseases.

The authors determined the efficacy of main methods of MR-imaging and their part in differentiated diagnostics of focal liver lesions. There were examined 256 patients and 414 liver lesions were analyzed. It was shown that the efficacy of conventional research without application of contrast medium was very limited (efficacy of mathematical model 58%). The data obtained during dynamic contrast enchancement (efficacy of the model 67%) were the basis for differentiated diagnostics for majority of nosological forms. The investigation using hepatotropic contrast medium had the greatest possibilities (efficacy of the model 80%). MR-diffusion is the effective procedure for visualization of focal liver lesions, but its possibilities in differentiated diagnostics is limited.

The aim of the study was to examine the possibilities of ultrasound examination in the diagnosis of olecranon bursitis and tumor for treatment planning. The study included 47 patients with a preliminary diagnosis: «olecranon bursitis». 22 of them were diagnosed with serous bursitis, 17 - with purulent and three - with chronic bursitis; one patient showed swelling and increasing volume of soft tissue (contusion); four patients - lipoma. Ultrasound signs and differential diagnostic criteria of different variants bursitis, tumors were identified for treatment planning.

We report a patient with recurrent glioblastoma in eloquent brain area. Stereotactic fluorescence biospectroscopy and stereotactic photodynamic therapy of tumor in opercular area of the left frontal lobe under neurophysiological monitoring were carried out. Literature data on this issue were analyzed.В статье рассмотрен клинический случай лечения пациентки с рецидивом глиобластомы функционально значимой зоны головного мозга. Применена методика стереотаксической флуоресцентной биоспектроскопии и стереотаксической фотодинамической терапии очага в оперкулярной зоне левой лобной доли в условиях нейрофизиологического мониторинга функционально значимых зон головного мозга. Представлен обзор публикаций по данной теме.