Moždani udar ili cerebrovaskularni inzult (CVI) je u današnje vrijeme jedan od glavnih uzroka smrtnosti i invaliditeta u svijetu. Veoma značajnu ulogu u dijagnostici CVI-a zauzima magnetna rezonanca (MR), koja se ogleda u mogućnosti klasifikacije i otkrivanju patofiziologije kako bi se pravovremeno i brzo postupilo sa terapijskim tretmanom ukoliko je došlo do pojave CVI-a. Ciljevi: Uporediti kvalitet prikaza CVI-a  između T2 FLAIR i T2 sekvence, utvrditi utjecaj lokalizacije CVI-a na intenzitet signala, utvrditi utjecaj vremena  pojave CVI-a na intenzitet signala. Utvrditi smo kategorije pacijenata kod kojih najčešće nastaje CVI, kao i korelaciju između uputne i definitivne dijagnoze. Metode istraživanja: Istraživanje je dizajnirano kao retrospektivna deskriptivna studija. Rad je realiziran u Kliničkom centru Univerziteta u Sarajevu, na Klinici za radiologiju. U studiju je uključeno 50 pacijenata kod kojih MR nalaz ukazuje na prisustvo CVI-a. Ispitivanje je obavljeno na MRI jedinicama jačine 1.5 i 3.0 T. Rezultati: Od ukupnog broja pacijenata 50 (100%), 32 su muškog pola (64%), a 18 (36%) ženskog pola. CVI je najčešće bio prisutan kod pacijenata muškog pola u grupi od 61-70 godine, dok je kod pacijenata ženskog pola najčešće bio prisutan u grupi od 71-80 godine. 52% pacijenata je imalo jedan od faktora rizika za nastanka CVI-a, HTA je bila prisutna kod 28% pacijenata a DM kod 22% pacijenata. T2 FLAIR sekvenca je imala veće vrijednosti intenziteta signala na lateralnom rubu CVI-a, dok je T2 sekvenca imala veće vrijednosti u centru i prednjem rubu CVI-a.  T2 FLAIR sekvenca je imala veći intenzitet signala na lokacijama: thalamus, mesencephalon, okcipitalno kortikalno subkortikalno i  područje kapsule interne. T2 sekvenca je imala veći intenzitet signala lokacijama: medula oblongata, parieto okcipitalno kortikalno subkortikalno, frontoparietalno paraventrikularno, parietalno kortikalno subkortikalno, frontoparietalno kortikalno subkortikalno, cerebelum i pons. Najčešća uputna  dijagnoza je bila CVI. Zaključak: T2 FLAIR sekvenca je senzitivnija kod prikaza akutnog i subakutnog CVI-a. T2 sekvenca je senzitivnija kod prikaza hroničnog CVI-a, čime radna hipoteza u ovom slučaju nije u potpunosti dokazana.

Contouring, planning and dose calculation in treatment planning systems (TPS) are based on computedtomography (CT) images. Therefore, it is important to have developed, optimized and adapted scanning protocolsfor specific anatomic regions and special radiotherapy modalities such as stereotactic radiosurgery (SRS). The aimof this study was to determine influence of tube voltage, field of view size (FOV) and reconstruction kernels on CTnumbers and the resulting radiotherapy (RT) dose calculation.This study was performed at Clinic of Oncology, Clinical Center University of Sarajevo. Verification electrondensity and CT number values was performed using CIRS Thorax 002LFC phantom, while anthropomorphic CIRS038 phantom for stereotactic end-to-end verification was used for the purpose of dose plan calculation analysis withlarge bore CT simulator Canon Aquillion LB.The significant correlation between the tube voltage and the measuredvalues of CT numbers is significant for all materials (p < 0.05), except for water (p = 0.310). No significantcorrelation between FOV and obtained values of CT numbers was found in any of the evaluated tissue equivalentmaterials. Evaluating the impact of reconstruction kernels on Hounsfield units (HU), significant deviations werefound for the FC62, FC68 and FC07 reconstruction kernels. Also, analyzing the influence of reconstruction kernelson the RT dose calculation, the extreme values are associated with Dmin/D in PTV for kernels FC41 and FC68, wheredeviations from the values obtained using the baseline scanning parameters were -1.3% and -1.9%. For deviation of1 HU in muscle tissue of CIRS 002LFC, the calculated Dmin/D in PTV of CIRS STEEV phantom will reduce by0.79%. Similarly, the reduction of D₉₈ and D₂ would be 6.8 cGy and 3.03 cGy for 1 HU, respectively. Change of thereconstruction kernels caused differences of 0.4% in Dmin/D calculation in clinical target volume (CTV).CT scanning and reconstruction parameters may affect Hounsfield units, which could have an impact on dosecalculations in RT plan. Hence, it is recommended to standardize the scanning protocol used in calibration curvegeneration for TPS. One should avoid use of different tube voltages and kernels, while according to this study, thechange of FOV will have no impact on dose calculations

Objective: Determination of the importance of computed tomography in the diagnosis of pulmonary infection caused by COVID-19 infection, to compare computed tomography and computed tomography in detecting pathological changes caused by COVID-19 infection, and to prove the sensitivity and specificity of computed tomography. Method: The results of prospective and retrospective studies were used to write this review article, by systematic selection on Internet scientific databases: PubMed, Google Scholar, Crossref. Results: Based on a systematic review of the literature, it was established that chest CR is the first diagnostic method of choice, due to its wide availability. Conclusion: CT is a highly sensitive diagnostic method, and is recommended for more severe stages of the disease and accelerated exacerbation of the disease, in patients with slow regression of radiographic findings and in patients recovering from COVID-19 with impaired lung function.

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.

The purpose of this study was to compare unenhanced MR angiography with contrast-enhanced MR angiography and visualisation of renal arteries with its segment branches using both techniques. We performed renal MRA on 22 patients using a 1.5T MRI unit. For renal MRA, a three dimensional balanced type steady-state free precession (SSFP) sequence (Time-SLIP, Canon) was used with respiratory gating and conventional CE-MRA sequnce (upisati tačan naziv). For analysis, two radiologists independently evaluated the visual quality of the axial images and axial maximum intensity projection images (MIP) of Time SLIP and CE MRA. Visualisation of aorta and main stem of the renal arteries were satisfactory on both techniques, and there was no statistically significant difference. The score of segmental renal artery appeared superior with Time-SLIP and showed a statistically significant difference (P<0.05). Visualisation of segmental renal arteries, interlobar renal arteries and kidneys parenchyma was significantly superiorwith Time-SLIP technique. We compared visualisation of renal arteries and its branches using unenhanced MRA, Time-SLIP, in comparison with contrast-enhanced MRA. Although it is slightly time-consuming and its clinical utility is necessary to further investigate, unenhanced MRA provides superior visualization of peripheral branches even in this study. Further improvement of the technique would make it even more sensitive in detecting small vessel abnormalities and it is promising for clinical use.

Introduction: Fetal Magnetic Resonance Imaging (MRI) is an imaging method for displaying anatomical structures of the fetus without ionizing radiation and it has been in use since the MRI has been used for the analysis of the adult human body. Aim: The aim of our paper is the two-year retrospective analysis of fetal MRI examinations for the purpose of presenting various pathological conditions of the fetuses. Methods: A total of 59 fetal MRI examinations were performed on pregnant women in the time period 2016 to 2018 at the Radiology Clinic at Sarajevo University Clinical Center, on Siemens and Toshiba 1.5 Tesla scanners. All cases were referred by gynecologists who suspected a fetal pathology. The comparison of the fetal age at which the congenital anomalies are usually detected is performed using the univariate analysis of variance and the Student t test, at the 95% level of confidence. Results: Of the total of 59 fetal MRI examinations, 2 fetuses (3,4%) were healthy, while pathology of the head and CNS was found in 26 fetuses (44,2%), thoracic cavity pathology in 5 fetuses (8,5%), abdominal cavity pathology in 18 fetuses (30,6%), pathology of extremities in 2 fetuses (3,4%), spinal cord pathology in one fetus (1,7%), and in 3 fetuses associated anomalies were found (5,1%). The pathology of the uterus and placenta was found in two pregnant women (3,4%). Conclusion: Prenatal MRI provides extremely useful information in cases where the ultrasound examination of the fetus is insufficient due to the size and position of the fetus. MRI is a key tool in deciding whether to continue or stop the further development of the fetus.

Introduction: Accessory renal arteries play a significant role in kidney and abdominal aorta surgery, and renovascular hypertension. In the published literature, the frequency varies considerably, depending on the size of the sample, the method of examination and the ethnic group. Materials and Methods: The aim of this study is to determine the general frequency of accessory renal arteries, their frequency in relation to gender, the origin and the vascularization area, and to determine the differences in left-right and bilateral distribution. Results and Discussion: CT scans of 1357 patients were retrospectively analyzed. Accessory renal arteries were recorded in 35.5% of patients, with a statistically significant difference in male and female incidence (p<0.05) with a ratio of 1.4 : 1. Accessory arteries occur more commonly unilaterally (p<0.05) than bilaterally with a ratio of 4 : 1. Unilateral accessory renal arteries occur at approximately the same frequency at right and left side 1.1 : 1, without statistically significant differences in frequencies (p>0.05). Of the total number of noticed accessory renal arteries 76.7% was originated from abdominal aorta (AA), 23% from renal artery and 0.3% from CIA, with a ratio of 3.3: 1 : 0.0005. Conclusions: The study showed a relatively high frequency of accessory arteries and described their anatomy in detail, which can be of great importance in surgical interventions on abdominal aorta, kidneys, and in case of kidney transplantation.

Pulmonary hypertension is a pathophysiological state hemodynamically defined as the increase of the mean pulmonary arterial pressure above 25, or 30 mmHg at rest, measured by catheterization of the right heart. Laboratory findings usually reveals polycythemia, the ECG right ventricle hypertrophy, and x-ray characteristic of diseased branches (echocardiography and biomarkers such as B-type natriuretic peptide (BNP) and N-terminal pro-BNP hormones are potentially helpful tools in identifying PH). Echocardiography can be found the increase of the right atrium and ventricle, right ventricular hypertrophy, abnormal contraction of the interventricular septum, left ventricular diastolic dysfunction and decreased left ventricular size, with reduced volumes of systole and end diastole. Doppler confirming tricuspid regurgitation. Pharmacological therapy would represent a use: Calcium Channel Blockers, Prostacyclin Analogues, Endothelin Receptor Antagonists and Phosphodiesterase-5 Inhibitors. Alpha adrenergic antagonists, endothelial receptor subtype A (Bosentan, Tracller) with treatment of the underlying disease or anticongestive therapy, are recommended. In case of inadequate response to treatment with a specific drug, guidelines recommend the combined use of drugs from the basic three groups, using their synergism.

Introduction: Determination of the overall risk of coronary disease, enables the health professionals for planning the intensity of preventive action. Aim: The aim of this study is that by the results obtained using a modified algorithm with tables adopted by the European Society of Cardiology demonstrate the possibilities for assessment of the risk of coronary heart disease degree, for application to the targeted individual or risk factors groups. Material and methods: The study was conducted as a retrospective, prospective and controlled (included two groups of 200 respondents). Results: By comparing the presence of risk factors according to the representation of groups of diseases, or myocardial infarction, results showed that the European and SCORE table have significantly lower levels of risk factors, or those with sustained myocardial infarction are ranked in groups of low and present risk in relation to our algorithm which patients with myocardial infarction ranked as high and pronounced degree of risk. Results showed that the European and SCORE table significantly reduce the levels of risk or the persons with heart failure have been ranked in the group of low and present risks in relation to our algorithm which patients with coronary insufficiency ranked as pronounced degree of risk. Conclusion: Determination of the overall risk of coronary disease, enables the health professionals for planning the intensity of preventive action. The activities of primary prevention of risk factors, or already resulting disease, may be helpful in assessing the reduction in economic costs in healthcare, both due to lower morbidity, and reducing the total cost of treatment of patients with coronary disease.

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.

BACKGROUND Renal artery aneurysm is very rare and most often incidental finding and we will present it in our case report. CASE REPORT We report a case of 65 years old women who was sent to our hospital Clinic of Radiology. We detected a renal artery aneurysm on the left side on the ultrasound and later we confirmed it on the CTA of the abdominal aorta and its visceral branches. DISCUSSION Renal artery aneurysms can be classified in true anaurysm and pseudoaneurysm. They are more often find at females. They can be fusiform or saccular in appearance and are extraparenchymal in 90% of cases. Most are saccular and noncalcified. CONCLUSION In the case of renal artery aneurysm that we founded we recommended regular Color Doppler ultrasound examinations, consultation from the urologist and CTA control if there is a need.

Poster: "ECR 2012 / C-2008 / Role and possibilities of diagnostic ultrasound in differentiation of acute scrotum causes" by: "S. Kristic, S. Vegar-Zubovic, S. Prevljak, A. Kuskunovic, U. Delic, Z. Licanin; SARAJEVO/BA"

In this paper was examined the occurrence frequently more of one kidney artery of the aortic origin. The examinations were performed on the 213 angiograms of the kidney artery by the method of the unselective renal angiography per Seldinger, in both sexes, of the various life ages. On the analyzed angiograms was the presence of these arteries in 25.82% of cases. They were more often at the right side in 49.09%, than on the left side in 36.36%, while their both side presence was found in 14.55%. Although are these arteries more frequently in male persons, a though the sex cannot be statistically significant the parameter for the determination the frequency of their occurrence. In the relation to the backbone column the level of the exit of this arteries from the aorta is the greatest number of cases between the trunk of the first and third loins vertebra (L1-L3) and all were directed according to the medial edge of the corresponding kidney. According the place of the entrance in the kidney can be differed three types of these arteries: the artery, and upper and low polar artery. On the analyzed angiograms most often were found the hilar and lower polar artery, while the upper polar artery was present in only seven cases of the total number of the analyzed angiograms. We consider that the recognition of the supernumerary arteries of the kidney there is both anatomically and the significance in the surgical and radiological practice and their best identification achieves by the application of the angiographic radiology methods.