Vertebral artery fenestration is a rare vascular anomaly. It most commonly occurs in extracranial segments of the vertebral artery. This congenital anomaly can occur during the various stages of embryonic development of the vertebral artery. This usually does not have clinical significance, but the possibility of associated anomalies such as saccular aneurysms and arteriovenous malformations should be noted. Awareness of vascular anomalies is key to avoiding iatrogenic injury during endovascular diagnostic and therapeutic interventions. Here, we present incidental findings of vertebral artery fenestration in a 46-year-old woman evidenced by CT angiography of the neck's blood vessells after I .V. contrast medium applications.

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.

Aim To assess hand function and explore the relationship between hand function and neuroimaging findings in children with unilateral spastic cerebral palsy (US CP). Methods Hand function was assessed using Manual Ability Classification System (MACS, I-V). Brain lesions were divided into five groups: brain maldevelopment (MAL), periventricular white matter lesions (PV WM), cortical/subcortical gray matter lesions (C/SC GM), nonspecific and normal findings. Results Of 114 children with US CP (77 boys and 37 girls), 56 were with right-sided and 58 with left-sided involvement. MACS I was found in 49 (42.9%), MACS II in 19 (16.7%), MACS III in 19 (16.7 %), MACS IV in 9 (7.9%) and MACS V in 18 (15.8%) children (p=0.002). Computed tomography (CT) as the only neuroimaging has been done in 18 (15.8%), magnetic resonance imaging (MRI) at 94 (82.5%) children, whereas 2 (1.7%) children had neither CT nor MRI. The CT showed PV WM in eight (44.4%), C/SC GM lesions in 6 (33.3%), and normal findings in 4 (22.2%) children (p=0.709). The MRI showed MAL in 8 ( 8.5%), PV WM in 46 (48.9%), C/SC GM in 28 (29.8%), miscellaneous in 2 (2.1%), and normal finding in 10 (10.7%) children (p=0.0001). Mild hand dysfunction (MACS I and II) was assessed in 68 (59.7%) children, of which 33 had PV WM lesions (p=0.001). Conclusion Mild hand dysfunction in children with US CP has been significantly associated with PV WM lesions. The type of brain lesion may help to identify its timing and predict the level of hand dysfunction.

Multiple sclerosis is a chronic demyelinating disease of the central nervous system, that causes permanent disabilities. Diagnostics of this disease by magnetic resonance requires the appliance of corresponding protocols with the sequences that emphasize demyelinating plaques. Standard sequences T1 and T2 sometimes cannot clearly show demyelinating plaques, and it is necessary to work on perfecting the sequences that emphasize the changes in the brain formed as demyelinating plaques. The aim of the survey: The aim of the survey was to estimate the value of MR sequence with double inversion recovery (DIR) in discovering demyelinating lesions of the brain in multiple sclerosis (MS). Patients and methods of the survey: 22 patients were included in the survey, they were of both genders and different age. The patients were with diagnosed with multiple sclerosis. The patients underwent the scanning on MR apparatus 1.5 T. Comparison of DIR sequence to FLAIR and T2 W sequences were done. Result: DIR sequence proved significantly more MS lesions compared to T2W or FLAIR sequence, including intracortical, juxtacortical and paraventricular zone of the brain. In the infratentorial zone of brain, T2W sequence proved significantly more plaques compared to DIR and FLAIR. Conclusion: DIR sequence compared to T2W and FLAIR sequences discovered more demyelinating lesions in targeted regions that were examined. DIR sequence is a tool that contributes to easier and faster diagnostics of multiple sclerosis, needs to be included into the routine MR protocol of patients with MS, in order to discover more easily intracortical and juxtacortical MS lesions of the brain.

Introduction: Renin-angiotenzin system (RAS) is frequently activated in patients with chronic liver disease. Angiotenzin - II (AT-II), produced by angiotenzin converting enzyme (ACE), has many physiological effects, including an important role in liver fibrogenesis. Combined antiviral therapy with PEG-IFN and ribavirin besides its antiviral effect also leads to a reduction in liver parenchyma fibrosis. Aim of the study: Determining the value of ACE in serum of patients with chronic hepatitis C before and after combined antiviral therapy, as well as the value of ACE activities in sera of the control group. Materials and methods: We studied 50 patients treated at Gastroenterohepatology Department, in the time-period of four years. Value of ACE in serum was determined by Olympus AU 400 device, with application of kit “Infinity TN ACE Liquid Stable Reagent”. HCV RNA levels in sera were measured by real time PCR. HCV RNA test was performed with modular analysis of AMPLICOR and COBAS AMPLICOR HCV MONITOR test v2.0, which has proved infection and was used for quantification of the viruses and monitoring of the patients’ response to therapy. Liver histology was evaluated in accordance with the level of necroinflammation activity and stage of fibrosis. Results: Serum activities of ACE in chronic hepatitis C patients is statistically higher than the values in the control group (p=0.02). Antiviral therapy in chronic hepatitis C patients statistically decreases serum activities of ACE (p= 0.02) and indirectly affects fibrogenesis of the liver parenchyma. Correlation between ACE and ALT activity after the therapy was proved (0.3934). Conclusion: Our findings suggest that the activity of ACE in serum is a good indirect parameter of the liver damage, and could be used as an indirect prognostic factor of the level of liver parenchyma damage. Serum activity of ACE can be used as a parameter for non-invasive assessment of intensity of liver damage.

In this study, we aimed to determine the presence and incidence of dehiscence of the tympanic segment of the facial nerve canal using the High Resolution Computed Tomography (HRCT) and to evaluate this variation in relation to gender and age. The retrospective-prospective study was performed at the Clinic for Radiology, University Clinical Center of Sarajevo. After the criteria for participation and non-participation in the study were applied, the study included 295 patients (160 women and 135 men) of ages ranging from 5 to 75, with performed computed tomography (CT) of the temporal bone as a part of a standard procedure due to the suspicion of pathological activity in that area. We divided the subjects into seven age groups. Each group included a ten-year period. The presence of dehiscence of the facial nerve canal was recorded and the obtained results were statistically analyzed. Of the total number of patients included in the study, the dehiscence of the tympanic segment of the facial nerve canal was found in 95 patients (32%). Of 590 temporal bones, there were 118 temporal bones with facial nerve canal dehiscence in the tympanic segment (20%). The dehiscence without stenosis of the oval window was noted in 110 temporal bones (18.6%). The dehiscence with stenosis of the oval window was noted in 8 temporal bones (1.4%). There was no statistically significant difference between age groups (p=0.245, Pearson’s χ2 test). Also, there was no statistically significant difference between males and females (p=0.385, Pearson’s χ2 test). The incidence of dehiscence of the facial nerve canal is high and the tympanic segment is the most frequent site of dehiscence localization. Almost one third of the patients with the suspicion of pathological processes on the temporal bone can have dehiscence of the tympanic segment of the facial nerve canal. HRCT is the best visual imaging technique for the evaluation of the facial nerve course within its osseous canal.

Poster: "ECR 2017 / C-0367 / The Value of Axial Loading in MRI of Lumbar Spine" by: "D. Bulja, E. Avdagic, A. Sehic; Sarajevo/BA"

Poster: "ECR 2013 / C-0912 / Abnormalities of the thoracic veins" by: "D. Bulja, S. Beslic; Sarajevo/BA"

Poster: "ECR 2012 / C-0339 / Magnetic Resonance in Acute Knee Trauma: Correlation of Bone Bruise Location and Rupture of Anterior Cruciate Ligament" by: "S. Hasanovic, B. Hadzihasanovic, L. Milisic, D. Bulja, J. Arslanagic; Sarajevo/BA"

Ultrasound devices and methodologies have been continuously evolving and becoming more important as tools in diagnostic medicine. Recently a new ultrasound diagnostic technique has been developed. Named sonoelastography, the technique enables evaluation of tissue elasticity and is based on differences in stiffness (hardness, compressibility, elasticity) of pathological changes and normal adjacent tissue. Sonoelastography (SE) is also known as Real-time tissue elastography (RTE), Real-time sonoelastography (RTSE), Tissue type imaging (TTI) and Ultrasound Strain Imaging Technology. It has been found useful in many medicine � elds and adopted readily by clinicians of different specialties. It gives more information than conventional ultrasound in evaluation of tumors, liver disease, skeletal muscles, rheumatoid nodules and other pathological changes. This review covers the basics of elastography, its applications, instruments, techniques, the scoring system and the indications for elastography. © 2011 University of Sarajevo Faculty of Health Studies

INTRODUCTION In advanced stage of renal carcinoma especially in right kidney because of proximity of inferior vena cava in most centers preoperative embolization of kidney is performed in purpose of facilitating surgery and reducing pre- and postoperative complications. In certain number of patients with indication for inoperability, complete embolization is performed in order.to prevent complications like bleeding. After intervention, surgical nephrectomy can be performed. In patients with the absolute contraindication for the surgical treatment, embolization represents the treatment of choice. MATERIAL AND METHODS Material for period of 7 years in Elbeck-Schoen Klinik and CCUS is presented in this paper. There were 72 patients, age range 3 to 92 years old, treated with 77 performed embolizations. Embolization was performed with PVA particles in order of achieving capillary embolization, while the principal trunk of renal artery was occluded with one or more coils until complete occlusion occurred. RESULTS Patients were divided in two groups: group A consisted of patients with preoperatively performed embolization, and to patients in group B embolization was performed as form of palliative care. In all patients in group A procedure was a success, and in one patient from group B procedure was needed to be repeated several times. DISCUSSION AND CONCLUSION As it is known from medical history first embolization was performed by Almgard in 1973 with purpose in providing safer surgical treatment to patient. Nowadays, this procedure got its widespread use in interventional radiology. Our experiences indicate successfulness of this procedure in most cases in preoperative management as well as in palliative treatment of patient. Postembolization syndrome occurred in all patients after intervention has been performed, and was successfully treated with symptomatic therapy. More severe complications were sporadic. In conclusion it might be said that embolization of inoperative tumors may increase both survival rate and quality of patients life.