Background: Pulmonary Embolism (PE) represents a life-threatening medical emergency that, given the serious complications, requires urgent application of anticoagulant therapy. In addition to other factors that are taken into account when choosing a therapy for treatment of PE, the anatomical distribution of thrombi is also considered–whether it is a central, lobar, segmental or subsegmental PE. D-dimer is an intermediate product of degradation of fibrin molecules and its values in the plasma are increased in the case of PE, but also in other diseases. Objective: To determine whether there is a difference in D-dimer values in subjects with different anatomical distribution of PE. Methods: The study included 100 subjects with diagnosed PE by using MSCT and/or V/P SPECT and with measured values of D-dimer. Results: Out of 100 subjects, PE was not diagnosed in 37 subjects, while 63 subjects PE was diagnosed. All subjects with diagnosed PE were divided into 3 groups regarding the anatomical localization of thrombus: lobar, segmental or subsegmental. Average D-dimer values were calculated for all 3 groups. Statistical analysis showed that there was no significant difference in D-dimer values between subjects with different anatomical distribution of PE. Conclusion: There is no significant difference in D-dimer values between subjects with different anatomical distribution od PE–lobar, segmental and subsegmental PE.

Background: MRI techniques of the lumbar spine have not provided data on the effect of gravity on the spine and on the relationship of anatomic structures during its action. Because conventional MRI examinations of the spine are usually performed in the supine position these are often exacerbated by standing upright and are not evident in the supine position the loading conditions differ from those known to cause symptoms in patients with lumbar instability. Axial loading imaging may improve diagnostics in the clinical management of LBP and lead to appropriate treatment decisions. Objective: The aim of this study is to determine the significance of alMRI in detecting the morphologic changes of the lumbar spine caused by axial loading and to compare it with conventional MRI images of the lumbar spine without loading. Methods: The study was conducted as a prospective, descriptive clinical trial. Imaging was performed with a MRI 1.5 T in the head-first supine position. Imaging was performed in two acts: without load and under load. Loading for alMRI was performed with the DynaWell L-Spine device. The onset of loading was 10 minutes before the start of alMRI. The loading continued throughout the imaging procedure. The height of the IV, AP and LL diameters of IV, IV disk surface area, DSCA and width of the IV foraminas before and under load was measured. Results: After evaluating the changes in the height and size of the lumbar disks, the size of the DSCA, and the narrowing of the intervertebral foramina significant differences were found between the images before and after axial loading. Conclusion: alMRI provides information on morphological changes of all segments of the lumbar spine. This data represents significant information that can lead to more accurate and effective treatment of LBP.

Background: The use of resolution recovery (RR) in bone and myocardial perfusion imaging is becoming increasingly popular in nuclear medicine departments. RR produces reconstructed images that show improved spatial resolution and signal-to-noise ratio compared with conventional single-photon emission computed tomography (SPECT) images. Objective: To evaluate the impact of the ordered subset expectation maximization (OSEM) RR modality on preserving noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) for short SPECT acquisition. Methods: This prospective study was conducted on 80 patients. Full SPECT acquisition was performed as a standardized protocol, while reduced acquisition was achieved with the Poisson resampling method. Noise, SNR, and CNR were measured for different reconstruction parameters for the same image levels. The impact of surface area and body mass index was also measured for the same reconstruction parameters. Results: The results show significantly higher SNR and CNR for the Evolution for Bone protocol compared to the other two reconstruction protocols for full and reduced SPECT acquisition. With the shortening of the SPECT acquisition, an increase in the value of noise was recorded. SNR and CNR decreased with the reduction in SPECT acquisition. Conclusion: The Evolution for Bone protocol for all three analyzed acquisition protocols had the lowest noise values. The highest SNR and CNR were recorded in the Evolution for Bone protocol for the three acquisition protocols and SPECT acquisition time can be reduced from 20 to 10 min for bone SPECT.

Experience in managing thromboembolic complications of distal blood vessels during coil embolization in the case of subarachnoid hemorrhage (SAH) is still limited. This is the presentation of the case of a 23-year-old man with a ruptured small aneurysm who experienced thromboembolic occlusion during coil embolization. Mechanical thrombectomy resulted in complete recanalization of the occluded branches without ischemic complications. This case should be used for the use of mechanical thrombectomies as an effective rescue strategy and treatment of distal arteries occlusions of the brain.

Introduction: Among the female population, breast cancer is the most commonly diagnosed cancer in the world, and nearly half of women population with breast cancer develop metastatic disease during their lifetime. Breast cancer most often metastazises to the lungs, liver, bones, brain and lymph nodes. 18F-FDG PET/CT can detect metastases that are not visible in other imaging modalities, and with the newly discovered lesions, decision about adequate treatment option can be evaluated. Material and methods: The examination was conducted as a retrospective descriptive study in May and June of 2019 at the Clinic for Nuclear Medicine and Endocrinology of the University Clinical Center in Sarajevo. It included 100 female patients with the age structure of 33-79 years. The patient's reference diagnosis is breast cancer, with a suspected finding of metastatic activity. A comparison of the sensitivity and specificity of the breast imaging between PET/CT, CT and bone scintigraphy was performed. Results: PET/CT revealed significantly more positive findings on metastatic activity than other diagnostic imaging modalities, with Mann-Whitney test value of p = 0.01014. In the diagnosis of lungs and liver lesions, PET/CT sensitivity and specificity are 92.59% and 85.37%, respectively, while the statistical parameters for CT are 77.78% for sensitivity and 90.24% for specificity. The PET/CT sensitivity and specificity for bone lesions are 93.55% and 88.89%, respectively, compared to 78.57% and 100% for bone scintigraphy. Conclusion: Hybrid imaging technique, which integrates PET and CT imaging methods, has considerable advantages over other diagnostic methods in the detection of distant metastases, and based on obtained results, PET/CT may be method of choice in evaluation of metastatic activity in breast cancer.

The clinical appliance of perfusion is being continuously developed and it is closely related to technology development. The role of perfusion neuroimaging in the management of acute stroke has been to prove reduced regional blood flow and to give the contribution in the identification of ischemic areas, respectively the regions of hypoperfusion that can be treated by thrombolytic and/or endovascular recanalization therapy. There are two main approaches to the measurement of cerebral perfusion by magnetic resonance. The aim of this article is to compare different measuring approaches of MR perfusion neuroimaging.

Poster: "ECR 2017 / B-0160 / Role of lung ultrasound in the evaluation of pneumonia in children" by: "I. Sefic-Pasic, A. Džananovic, A. Pasic, S. Vegar Zubovic; SARAJEVO/BA"

© 2016 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. A1 Point‐of‐care ultrasound examination of cervical spine in emergency department Yahya Acar, Onur Tezel, Necati Salman Department of Emergency medicine, Etimesgut Military Hospital, Ankara, Turkey Correspondence: Onur Tezel, e‐mail: yahyaacar@gmail.com Critical Ultrasound Journal 2016, 8(Suppl 1):A1

Introduction: Chronic kidney disease (CKD) represents a serious public health problem due to the increase in incidence and prevalence of this disease worldwide. Given the significant morbidity and mortality from cardiovascular disease (CVD) in the population of patients with CKD, and the fact that dyslipidemia itself is a risk factor for CVD, increases the importance of lipid metabolism study in patients with CKD. Goal: Evaluate the lipid status of patients with chronic kidney disease. Material and methods: A one-year prospective study included 150 adult patients who were in various stages of chronic renal failure (stage I to IV). Estimate of creatinine clearance was performed using Cockroft-Goult formula. The classification of patients according to stages of chronic renal insufficiency was performed in accordance with the criteria of Kidney Disease Outcomes Quality Initiative (K/DOQI). Results: Of the total number of patients (N=150) there was 71 males and 79 females. The mean age of patients was 55.43 years. Average values of serum cholesterol were highest in patients with stage II renal disease and the lowest in patients classified as stage IV (5.76±1.60 mmol/L vs. 5.07±1.88 mmol/L). Analysis of the average value of triglycerides in blood show a slight increase through the stages of CKD in a manner that patients classified into stage I have low serum triglyceride levels (1.73±1.17 mmol/L (range 0.61 to 5.5 mmol/L), and patients classified in stage III the highest value 2.13±1.11 mmol/L (range 0.62 to 4.66 mmol/L). Conclusion: Average cholesterol levels does not statistically significantly change with progression of chronic renal disease. There is an almost linear increase in average triglyceride levels in chronic renal disease. Triglyceride levels in serum begins to increase in the early stage of chronic renal disease and reach the peak in stage IV.