Faculty of Medicine

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    Radiological procedures in diagnosis and preoperative staging of testicular malignant tumors
    (SHMSHM - AAMD, 2008)
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    Gligorievski, Antonio
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    Banev, Sasho
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    PERSISTENT TRIGEMINAL ARTERY - ANATOMICAL FEATURES AND CLINICAL SIGNIFICANCE
    (Macedonian Association of Anatomists and Morphologists, 2023)
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    Persistent trigeminal artery is the most common primitive carotid basilar anastomosis that persists in adulthood. The overall incidence of persistent trigeminal artery is between 0.2 to 0.76%. PTA are known to be associated with a wide range of pathology. The aim of this study was to describe the morphological characteristics of the PTA and to emphasize its clinical significance. We examined radiographs from patients who had CT angiography undertaken for a variety of clinical reasons, performed as a part of their medical treatment at the University Institute for Radiology in Skopje, RN Macedonia. The study population included 234 patients, 130 male and 104 females, mean age 57.8 years. In one patient we found PTA with overall incidence of 0.42%. CTA revealed a left PTA that arise from the internal carotid artery and communicate with the basilar artery between the origin of the anterior inferior cerebellar artery and the superior cerebellar artery. Although anatomically interesting, an awareness of the anatomy and variations of the brain arteries is clinically important for radiologists and surgeons for save performance of procedures, and forensic pathologists since variants may have forensic consequences.
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    RENAL LYMPHANGIECTASIA- AN UNUSUAL MIMICKER OF RENAL HYDRONEPHROSIS
    (Macedonian Association of Anatomists and Morphologists, 2021)
    Tashkova, Zorica
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    Arifi, Njomza
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    Renal lymphangiectasia is a rare malformation of the renal lymphatics. It occurs in both children and adults and can be unilateral or bilateral with no gender predilection. It is a condition characterized by different degrees of dilatation of the lymphatic ducts. Because of the rarity, it can be easily misdiagnosed for other cystic masses, most commonly peripelvic cysts, renal cysts or hydronephrosis. Usually is asymptomatic and incidental finding, but in severe cases can lead to hypertension and renal failure. We report a case of unilateral renal lymphangiectasia in adult male patient with medical history of hydronephrosis and characteristic radiologic CT findings. From imaging methods, we conducted ultrasound (US), contrast enhanced computed tomography (CT) and CT angiography, because they have an important role as diagnostic procedures to recognize renal lymphangiectasia. Kidney cystic lesions revealed on ultrasound and confirmed on CT as hypodense intrarenal multiloculated findings, as well as fluid attenuation collections, not always go in favor of hydronephrosis. Knowledge of the radiological findings associated with renal lymphangiectasia can contribute to better differentiation from other conditions and with the right diagnosis, successful management and treatment can be provided for the patient.
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    Assessment of late gadolinium enhancement in cardiac MRI
    (Macedonian Association of Anatomists, 2021)
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    Aliji, Vjolca
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    Ilievski, Mitko
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    Stojkoski, Aleksandar
    The aim of this study was to evaluate MRI characte ristic s of ischemic and non - is chemic cardiomyopathies with late dadolinium enhancement analysis that can provide differentiation between these two cardiomyopathies. Eligible 96 patients, age range from 26 to 71 years, who showed different and overlapping c linical symptoms, ECG andtransthoracic echocardiography findings that needed further evaluation were included in our study for further evaluation with cardiac MRI. Of the evaluated patients, 47 were females and 49 were males. The examinations were performe d with MRI Scanner 1,5T Siemens Avanto by using 3 channeledSiemens ECG electrodes with retrospective triggering. With the help of PSIR sequence for late gadolinium enhancement evaluation we differentiated ischemic cardiomyopathy from non - ischemic cardiomyo pathy, which is crucial for management of patients with cardiac dysfunction. Of the examined 96 patients, 42 patients were diagnosed with ischemic cardiomyopathy, 51 with non - ischemic cardiomyopathy, and 3 patients had non - conclusive diagnosis. It was foun d that late gadolinium images in the setting of cardiac MRI were capable of detecting myocardial scars and fibrosis. Moreover, they helped in differentiation between ischemic and non - ischemic cardiomyopathieson the basis of myocardial scar enhancement patt ern.
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    Anomalous origin of the vertebral artery
    (Macedonian Association of Anatomists and Morphologists, 2010)
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    Aliji, Vjolca
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    The posterior circulation of the brain consists of the vertebrobasilar system and its branches. Vertebral arteries are responsible for about 30% of brain blood supply. The aim of this study was to examine the origin of the vertebral artery and to present the anatomic variations of the vertebral artery origin as well as the percentage of their appearance in the population. Material and methods: The origin of the vertebral artery was investigated in 30 patients; a total of 60 vertebral arteries were examined with CT angiography and DSA by Seldinger technique. Results: Abnormal origin of the vertebral artery was found in one (3.3%) patient. Vertebral artery originated directly from the aortic arch, as a second branch between left subclavian artery and left common carotid artery. Conclusion: Real abnormality of the origin of the vertebral artery is rare; in our series it was found in 3.3% of the cases. The described variations of the vertebral artery origin are not only interesting from the anatomical point of view, but they also find clinical applications in the surgery and diagnostic and therapeutic radiology.
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    Variation in level of entry of the vertebral artery into the transverse foramen
    (Macedonian Association of Anatomists and Morphologists, 2011)
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    Aliji, Vjolca
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    The aim of this study was to analyze the variable level of entrance into the transverse foramen and to point the risks of injury of the vertebral artery during accomplishing surgical procedures. For that purpose we examined 40 patients with CT angiography and analyzed the level of entrance into the transverse foramen. The vertebral artery entered the C6 transverse foramen in 38 (95%) patients. Abnormal level of vertebral artery entrance was observed in two (5%) patients, with entrance into the C4 and C5 transverse foramen. The incidence of abnormal level of entrance into the transverse foramen is relatively high, and this potentially dangerous condition should be detected on preoperative imaging in order to avoid vertebral artery injury.
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    Tortuosity of the vertebral artery
    (Macedonian Association of Anatomists and Morphologists, 2011)
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    Aliji, Vjolca
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    Gjoreski, Aleksandar
    The aim of this study was to analyze the tortuosity of the vertebral artery and to emphasize the clinical importance of tortuosity. The data derived from this study will add important contribution to our anatomical knowledge, but they will also find clinical applications in radiology and surgery. We examined 40 patients with CT angiography and analyzed the tortuosity of the vertebral artery. Of the vessels examined, 22 (55%) followed a relatively straight course from their origin to their entry into the transverse foramen. The other 18 (45%) patients showed some form of tortuosity. Both vertebral arteries showed high incidence of tortuosity. Our study has highlighted the possible role of vertebral artery tortuosity in diagnostic and surgical procedures in order to prevent vertebral artery injury.
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    Endovascular treatment of intracranial aneurysm on anterior circulation
    (Macedonian Association of Anatomists and Morphologists, 2018)
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    Aliji, Vjolca
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    Businovska, Jasna
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    Intracranial aneurysms are abnormal dilations of the intracranial vessels at the weak spot of arterial wall. Rupture of intracranial aneurysm can cause intracerebral hematoma, intraventricular hemorrhage, rarely subdural hematoma. Evaluation of effectiveness of endovascular treatment of intracranial aneurysm as minimal invasive treatment and assessment of result after endovascular treatment for complete occlusion, residual neck or residual aneurysm. The study population included 57 patients referred to the University Clinic of Radiology in Skopje, R. Macedonia for endovascular treatment during the period January 2015 to May 2018. This study included 32 females and 25 males, ranging in age from 25 to 74 years. From total 63 treated IA 33 were ruptured and 30 unruptured, 7 patients was with multiple aneurysm, 5 with 2 and 2 with 3 aneurysms. In this study 34 aneurysms were treated with coiling, 7 aneurysms with stent, 2 aneurysms with flow diverter and complex aneurysms with combined technique, 3 with balloon assisted coiling, 13 with stent assisted coiling and 2 with flow diverter assisted coiling. Two patients with giant aneurysms were treated with occlusion of parent artery after positive balloon occlusive test. Endovascular therapy is a minimally invasive procedure since it’s associated with less risk of bad outcomes, shorter hospital stays and shorter recovery times compared with surgery.