Use of CR in the detection of present gastric cancer: diagnostic aspects

The authors describe the state-of-the-art of gastric cancer detection in detail and show the current principles of its radiodiagnosis. They provide a detailed explanation for that radiodiagnosis should be urgently returned into gastroenterology as an equal with endoscopy, which is based on the existing tendency for the major morphological types of gastric cancer to appear. The present-day capacities of radiodiagnosis of gastric cancer are mainly based on the introduction of the digital technologies into traditional radiology, which will replace the analog imaging principle in the foreseeable future. The authors present their data of examining 300 gastric cancer cases diagnosed by the CR system and later verified by a morphological study of resected gastric specimens. They emphasize that intraparietally growing gastric cancer is frequently inaccessible for endoscopy long, which determines the need for two basic procedures (radiodiagnosis and endoscopy) coexisting on a par for the detection of gastric cancer. They are sure that computed radiology (CR) will be the most acceptable way of changing traditional radiology to the digital imaging principle in primary, municipal health care in the near future.     

Magnetic resonance imaging in the diagnosis of gastric cancer: X-ray versus MRI anatomic findings

The paper assesses the present-day role of MRI in the diagnosis of gastric cancer. The authors consider the major prerequisites for the main aim of their study to be: 1) a dramatic incidence of diffuse (endophytic) gastric carcinoma, which requires significant correction of today's approaches to its diagnosis and 2) a rather biased and, in the authors' opinion, present-day mainly negative attitude towards MRI of the stomach as a diagnostic method for its tumor lesions. By applying the X-ray-MRI anatomic principle to the comparative study of MRI findings in 50 patients with predominantly gastric intramural carcinoma and in 25 patients without gastric tumors (controls), the authors present their methods for gastric MRI, the MRI semiotics of gastric cancer by concurrently touching upon a variety of problems that characterize the potentialities of MRI of the stomach in the diagnosis of its tumor lesions, including their differential diagnosis. As a result, the authors highly appreciate gastric MRI and consider this method to be included into the diagnostic algorithm of radiation techniques used in the diagnosis of gastric cancer, which should occupy its definite diagnostic place.     

A standardized x-ray examination in the diagnosis of tumors of the large intestine]

High morbidity and mortality rates because of large intestinal carcinoma and a clear-cut tendency to the growth of these rates have prompted the authors to undertake this study. When new methods of radiodiagnosis appeared, traditional and highly informative methods, Ba enema among them, seemed to be forgotten. The authors suggest a program of standard examinations of the large intestine, based on simultaneous double-contrast technique, that permits an essential improvement of the diagnostic and economic efficacy of this one of the most prevalent methods of x-ray examinations. The suggested technique was used in examinations of 4120 patients with suspected tumors of the large intestine.     

Cancer of the upper stomach: current problems of its diagnosis

Data on 1248 cases of stomaches radically operated on for cancer at the surgical departments of the Moscow Regional Research Clinical Institute in 1971 to 2000 were used to study a number of problems associated with cancer of the upper stomach, by regarding the present-day role of radiation diagnosis as of paramount importance. The following radiation diagnostic techniques were assessed. Among them there were traditional X-ray studies (in each case), the new radiation diagnostic techniques: ultrasound study and computed tomography (CT) (750 studies), magnetic resonance imaging (MRI) (120 studies). The potentialities of radiation diagnosis and endoscopy performed in all cases are compared. A specially developed procedure for exploring endophytic forms of gastric cancer was employed in the morphological studies of the material. The incidence of cancer of the upper stomach and its association with the esophagus are presented; some aspects of the morphogenesis of cancer of this site are discussed. The relationship of its clinical symptoms and its radiation image has been studied. In the authors' opinion, the past two decades' rise in the incidence of proximal gastric cancer is one of the main problems in diagnosing gastric cancer that continues holding its stand in the general structure of cancer morbidity. The tendency for diffuse and mixed forms to increase in the morphogenesis of gastric cancer provides evidence that radiation techniques should be actively used in its diagnosis. It is necessary to apply classical double-contrasting X-ray study and endoscopy on equal grounds as basic diagnostic methods at early stages. Only their concord use may change the poor situation associated with the diagnosis of cancer at this site. CT and MRI as additional techniques may substantially provide more required diagnostic information. This is first and foremost associated with difficulties in gastric endoscopic study when esophageal cancer is apparently proved.     

The problem of instability of perception and interpretation of x-ray images of spheroidal lung formations

Sixteen radiologists analyzed twice 44 sets of x-ray films of verified spheroidal lung formations (SLF), copied the images through a transparent film. High instability of image-bearing and speech perception of all x-ray signs of SLF was revealed. It greatly influenced diagnostic effectiveness in informative uncertainty of images. The author substantiated methodological approaches to further work at increasing the effectiveness of radiodiagnosis of this pathology.     

Errors and difficulties in the x-ray diagnosis of osteogenic sarcoma of the long tubular bones

In some cases radiodiagnosis of osteogenic sarcoma is associated with some difficulties resulting from a variety of its x-ray picture. The main factor that influences the x-ray manifestations of osteogenic sarcoma, is a neoplastic bone formation which reflects the morphological essence of this tumor. Other signs depend on a tumor site in one or another anatomical part of the tubular bone, on rates and type ot tumor growth. In some cases the combination of these signs ensures reliable diagnosis. However, along side with typical forms of osteogenic sarcoma there are also other ones which do not fit into the classical concept of this tumor type resulting in diagnostic difficulties and errors.     

Potentialities of ultrasound study in diagnosis of endophytic carcinoma of stomach

The data of studies of 45 patients with gastric cancer are used to consider the potentialities of ultrasonography (USG) in the diagnosis of its endophytic forms. Its use in the diagnosis of "small" gastric carcinomas is evaluated. The USG semiotics of endophytic tumors of the stomach, including its "small" and early forms, is presented. The place of USG in the diagnostic algorithmic of gastric cancer is specified. In the authors' opinion, gastric USG along with traditional X-ray and endoscopic studies should take an appropriate place as it is beneficial in solving a great deal of differential diagnostic problems associated with the intramural spread of tumors.     

Current X-ray diagnosis of stomach cancer (comparison of radiologic and morphological methods of investigation)

By using the principles of wide comparisons of the data of radiation diagnosis (routine X-ray study, ultrasonography (USG), CT, MRI) with the morphological findings of resected gastric specimens from patients with endophytic gastric cancer (EGC) (n = 85), the authors propose some points in the problem associated with its diagnosis. They believe that by taking into account the fact that there is an obvious growth of endophytic parietally growing gastric cancer with the concurrent reduction in its intestinal forms, it is necessary to restore current radiation to its leading place, along with endoscopy, in detecting the cancer. The authors makes a highly positive assessment of USG, CT, MRI in addition to routine X-ray study and endoscopy particularly in those cases when difficulties emerge in histological verification of the existing signs of parietally growing cancer. The paper makes indications for USG, CT, MRI concrete. The authors also show how to stage gastric cancer.     

Roentgen diagnostics with the emphasis on it's traditional roentgenological method is a major sourse to improve gastric cancer diagnosis

The main idea of the article is presentation of todays problem of gastric cancer diagnosis. Authors, supported by long-term experience of gastric cancer diagnostics, demonstrate the necessity of the return of traditional roentgenological method for it's diagnostics, along with endoscopic technique. In the first place it is determined by the increase of sclerotic and mixed forms. In the second place, it is associated by the change of gastric cancer primary localizations, supporting the need of active use of roentgen diagnostics for it's diagnosis. One of the important parts of the article consists of the author's attempt to change general opinion about insignificancy role of traditional roentgenological method for diagnosis of gastric cancer. Authors demonstrate modern techniques of traditional stomach roentgenology and firstly, it's digital development with CR-systems for the improvement of diagnosis of the intramural forms of carcinomas. In the initial stages it is obligatory to engage classical roentgenology with double contrast study and endoscopy as main equally important methods. The unfavourable situaition in the diagnosis of gastric cancer can be changed only with conjoint use of these two approaches. It is chiefly depends with the difficulties of endoscopic study of diffuse (endophytic) forms of gastric carcinoma. Authors separately underline the necessity of including specialists in roentgen diagnostics in the national project of modernization of roentgenological equipment in medical institutions.     

Computed tomography in the diagnosis of endophytic cancer of the stomach

The authors discuss the potentialities of CT in the diagnosis of endophytic stomach cancer. They proposed a method for CT of the stomach based on a pneumatic study of its lumen via a nasogastric probe with graded inflation and repeated CT imaging. The major CT-semiotics of endophytic stomach cancer were obtained. This method should be employed in combination with the existing routine methods of stomach cancer diagnosis, and its efficacy is in direct relation to the quality of preliminary routine x-ray and endoscopic investigations.     

Radiodiagnosis of kidney diseases in a municipal hospital]

Ultrasonic (US) examinations of the urinary tract of 2384 patients have revealed pathologic shifts in 725 cases; x-ray examinations had to be carried out in 632 of these to specify the diagnosis. X-Ray and US-based radiodiagnosis of a wide spectrum of renal diseases, carried out at a common municipal hospital, promotes a better diagnosis. Employment of US examinations as a screening method helps recognize renal hypoplasia, cystic diseases, and an acute inflammatory process, renal carbuncle, fairly well. The diagnosis of other renal abnormalities, urolithiasis, hydronephrotic transformations, tumors and injuries still has to be specified by routine x-ray methods.     

Computed tomography in the x-ray diagnosis of pneumonia

Experience in the use of CT in combined radiodiagnosis of pneumonia was analysed. It has been concluded that CT objectively reflects morphological inflammatory pulmonary changes and permits their all-round assessment over time. The diagnosis of pneumonia in CT is based on classical x-ray symptoms. As compared to survey radiography CT reveals symptoms of pneumonia to the full at earlier stages. CT is an important additional method of investigation of inflammatory pulmonary diseases, but it should not be used separately without survey radiography. In a majority of cases when CT is performed there is no need in x-ray tomography.     

X-ray and ultrasonic diagnosis of noninflammatory benign diseases of the gallbladder]

The author analyzes the results of x-ray (cholecystography) and ultrasonic examinations carried out in patients with noninflammatory benign diseases of the gallbladder (71 with cholesterosis and 28 with adenomyomatosis). X-ray and ultrasonic symptoms of these conditions are presented and the diagnostic potentialities of both methods in the detection of such diseases assessed. The author considers ultrasonic scanning the method of choice for the diagnosis of any forms of gallbladder cholesterosis, whereas an x-ray examination appears to be informative only in a polypous form of the disease. X-ray contrast examination is preferable for the recognition of gallbladder adenomyomatosis, for it presents a clear-cut pattern characteristic of each form of this condition, whereas ultrasonic symptoms of such involvement are nonspecific.     

Study of the "continuous cell antigen" and the human gastric mucosa]

The antigen common for continuous epithelial cell lines and gastric mucosa of humans described earlier was studied. This antigen was revealed in one more cell line, namely in that prepared from human mammary carcinoma MDA-MB-231, noncontaminated with HeLa cells. The antigen described can be detected in the exophytely growing adenocarcinomas of the stomach and in the mucosa of the carcinoma affected stomach at a distance of 10--12 cm from the site of affection; no such antigen was revealed in the endophytely growing carcinoma of the stomach and in mucosa areas surrounding gastric ulcer. The antigen is not a glycoprotein since glycoprotein fractions obtained by means of 1.2 M perchloric acid from the normal stomach mucosa homogenate and the E 16b extract were inactive in immunodiffusion with a sensitive serum. The electrophoretic mobility of the antigen was similar to that of globulin alpha1-beta2. This antigen is of interest since its detection or absence would possibly aid in determination of the initial type of cells from which development of carcinoma occurred, and in more precise recognition of the histological form of carcinoma of the stomach.     

X-ray diagnosis of injuries to the posterior part of the pelvic ring in children]

Proceeding from morphoroentgenological investigation of 48 isolated pelvic specimens from dead children, a new method for radiodiagnosis of fractures of lateral sacral masses (LSM) and rupture of sacroiliac joints (SIJ), based on quantitative assessment of pelvic ring deformity has been developed. Limitations of the method were established. The introduction of this roentgenometric method into clinical practice for diagnosis of injury of the posterior pelvic semiring permitted an increase in x-ray detection of LSM fractures 10-fold and SIJ ruptures 2.5-fold.     

Ultrasonics in the diagnosis of stomach tumors]

Proceeding from analysis of over 2000 ultrasound investigations (USI) the role of this method in the diagnosis of stomach tumors was defined (employed during routine investigation of the abdominal cavity and as a procedure with liquid filling of the stomach cavity). Ultrasound semiotics of a neoplastic process of the stomach was described. USI can be used for screening and specification. Various methodological approaches were proposed with regard to purposes to be achieved. Routine methods (x-ray and endoscopy) were shown to remain the chief methods. USI can be used in doubtful cases or for obtaining detailed information. The most valuable are its potentialities in showing details of intraparietal changes in endophytic stomach carcinomas which are difficult for diagnosis.     

Experimental and clinical rationale for the choice of optimal methods of x-ray diagnosis of kidney diseases

Limits of potentialities of methods of radiodiagnosis of renal diseases were studied by way of experimental simulation of organs with various pathomorphological changes (urolithiasis, kidney tumors and tuberculosis). Special attention was paid to the detection of pathomorphological elements which were characteristic for the initial forms of disease. Photofilm and thermoluminescent dosimetry were used to study radiation-hygienic characteristics of radiation methods of kidney investigation. Recommendations for establishing diagnosis were worked out in suspected urolithiasis, kidney tumors and tuberculosis. The thickness of a studied object played an important role in the detectability of minor and low contrast details. An objective method of the control over the quality of roentgenocontrast images was proposed.     

Value of magnetic resonance imaging in the diagnosis of complicated forms of the diabetic foot

Magnetic resonance imaging was performed in 98 patients to estimate the capabilities of radiodiagnosis in the study of complicated forms of the diabetic foot. This diagnostic technique can visualize foot changes with a high degree of validity.     

The many faces of basal cell carcinoma

Basal cell carcinoma is the most easily cured carcinoma, but because of the many forms it can take, and because it grows so slowly, it can be misdiagnosed or neglected. The author discusses its more common forms and etiologic considerations.     

Gastric magnetic resonance study (methods,semiotics)

The paper shows the potentialities of gastric study by magnetic resonance imaging (MRI). The methodic aspects of gastric study have been worked out. The MRI-semiotics of the unchanged and tumor-affected wall of the stomach and techniques in examining patients with gastric cancer of various sites are described. Using the developed procedure, MRI was performed in 199 patients, including 154 patients with gastric pathology and 45 control individuals who had no altered gastric wall. Great emphasis is placed on the role of MRI in the diagnosis of endophytic (diffuse) gastric cancer that is of priority value in its morphological structure. MRI was found to play a role in the diagnosis of the spread of a tumorous process both along the walls of the stomach and to its adjacent anatomic structures.