Pashoska, Milkica

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Pashoska, Milkica

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Pashoska, Milkica

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MRI features of sacrococcygeal teratoma in neonates
(Department of Anaesthesia and Reanimation, Faculty of Medicine, “Ss. Cyril and Methodius” University in Skopje, R.N.Macedonia, 2022-12-03)
Ognenoska B
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Stevkovski J
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Jovanovska Z
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Kamcheva M
Magnetic resonance is a crucial imaging modality in evaluation and classification of lower lumbar region masses, in our case sacrococcygeal teratoma (SCT). Sacrococcygeal teratoma is the commonest congenital tumor in fetuses and neonates. Sacrococcygeal teratomas are derived from all three germinal layers and arise from the ventral surface of the coccyx. The American Academy of Pediatrics’ Surgical Section (APPSS) classification helps in grading the extent of sacrococcygeal teratomas in four different types. The SCTs appear on MRI as hetero-signal, tumor-like masses of varying extent containing soft tissue, fat or liquid components. Treatment and further management depend profoundly on the type of SCT which is based on the exact MRI findings
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Large Ovarian Cyst Presenting as Weight Gain in an Adolescent Girl: A Case Report
(SHMSHM - AAMD, 2022)
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Jovanovska, Zlatica
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Kamcheva, Marta
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Dukovska, Marija
Ovarian cysts are a common finding in female adolescents presenting with macrocysts that occupy the entire pelvis or abdomen. Ovarian cysts can be asymptomatic and found accidentally or be manifested as a painful syndrome in which one of the first clinical signs is the feeling of abdominal fullness or progressive enlargement of the abdomen. The frequency of which ovarian cyst are present in adolescent young females has raised and is in the range from 3,8% to 30,9%. Peak ovarian cyst frequency was at age of 15 years with a rate of 31.3%.1 We report an unusual case of a large ovarian cyst in a 12-year-old girl without previous medical information of illness. The cyst was asymptomatic until it became large enough and manifested as weight gain and progressive abdominal distension over the course of a few months and was an accidental finding on an abdominal CT. Because of the progressive pain and discomfort of the patient, CT and MR imaging were performed. The radiographic features of the cyst together with the further management and treatment are discussed below.
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Pulmonary manifestation of sarcoidosis detected on high resolution computed tomography
(Macedonian Association of Anatomists, 2023)
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Sarcoidosis is a multisystemic disease of unknown etiology that mostly affects the lung parenchyma with interstitial and granulomatous changes of varying intensity and expression depending on the stage of the disease. In addition to the parenchyma and interstitium, the mediastinal lymph nodes are also very often affected. To analyze the distribution and characteristics of interstitial lung lesions and the involvement of mediastinal lymph nodes in pulmonary sarcoidosis by the method of high-resolution computed tomography.15patients diagnosed with pulmonary sarcoidosis were included in the study. Computed tomography with high resolution was made on 128 slice CT scanner PHILIPS INCISIVE, using 1 mm thin-slice thickness and high spatial frequencies algorithm for image reconstruction. Lymph nodes are classified as hilar and mediastinal with a maximum diameter of short axis of more than 10 mm taken as their enlargement. Pulmonary changes are classified as nodules, reticular opacities, fibrous lesions, ground glass opacities and consolidations. The predominant distribution of lesions in the upper and middle zones of the lungs compared to the lower zones was noted. The disease is graded in 5 stages with the Scadding classification. 15cases of patients diagnosed with sarcoidosis were analyzed all of whom are women in the age group of 30-60 years old. Two patients are in stage I and three are in III stage of the disease, 6patients are in stage II of sarcoidosis and 4 are in stage IV of the disease. Dry cough as a symptom predominates in all patients, while dyspnea is graded according to the mMRC scale. Mediastinal lymphadenopathy with and without calcifications was present in 11patients. The type of lung changes as well as their distribution are presented in graphs. HRCT is the method of choice in the evaluation of pathological changes in pulmonary sarcoidosis. It very precisely shows us the characteristic appearance of nodules and lesions, their distribution and atypical changes and helps us in grading the disease and its treatment.
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Correlation between CMR and chest CT in assessment of constrictive pericarditis.
(2023-10-11)
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Ilievski, Mitko
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Description of Clinical Presentation A 35-year-old adult presented to the cardiology department with shortness of breath, coughing, and fatigue. He had a history of recurrent colds with high fever, but their recent cold led to worsening symptoms. Tests revealed atrial fibrillation with a heart rate of 150 bpm, enlarged atria, and reduced systolic function. Laboratory results showed thrombocytopenia, elevated GGT, and high bilirubin, with no elevated Troponin levels. CMR showed systemic volume overload, with passive liver congestion and left pleural effusion, no pericardial effusion, but thickening with dimensions of 4,6mm. SSFP sequences showed left and right ventricle hypokinesia with impaired diastolic filling, severe diastolic septal bounce and abnormal contour of left lateral wall which was akinetic. The T2-STIR sequence showed hypersignal intensity in the basal anterolateral and inferolateral segments, distributed within the subepicardial and mid-wall regions. Additionally, focal pericardial involvement was observed in these segments, along with two central hypo signal lesions that showed identical signal characteristics across all sequences. On delayed enhancement PSIR sequences, there was increased signal intensity in the specific areas on the T2-STIR sequence, suggesting gadolinium accumulation and in the mid and apical inferior and inferolateral segments with subepicardial distribution. There was pericardial enhancement dominantly at the basal ventricular segments, along with focal pericardial enhancement at the left apex also featuring a central hypo signal lesion. The patient underwent a native chest CT examination, revealing circumferential thickening of the pericardium with linear diffuse calcifications. This finding was correlated with the MRI results, indicating a state of subacute to chronic inflammatory/fibrotic constrictive pericarditis with constriction throughout the entire heart with concomitant myocarditis changes dominantly at the left lateral wall. Diagnostic Techniques and Their Most Important Findings Cardiac MRI is a valuable tool for diagnosis of pericardial constriction where the ventricles may appear compressed or have a "square root sign" appearance, reflecting impaired ventricular filling during diastole. T1 and T2 mapping, can provide insights into the tissue characteristics of the pericardium and myocardium. These techniques can help differentiate between pericardial and myocardial involvement and assess the degree of fibrosis. Cardiac MRI can assess respirophasic variation in ventricular filling, which is a hallmark feature of pericardial constriction. During inspiration, there may be an exaggerated increase in ventricular filling due to reduced compliance of the constricted pericardium. Learning Points from this Case Pericardial constriction, characterized by impaired diastolic filling due to thickened, fibrotic, and/or calcified pericardium, can be a diagnostic challenge, often requiring the use of multiple imaging modalities which within this case with the correlation between TTE, CMR and CT scan a noninvasive diagnosis can be made.
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Role of gadolinium enhanced MRI and DWI in diagnosis of renal abscess in children
(Balkan Society of Radiology, 2019-10-17)
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INTRODUCTION: Renal abscess is a localized collection of infected fluid in kidneys. It develops as a complication of focal pyelonephritis or hematogenous infection, when inflammation may occasionally result in liquefactive necrosis and abscess formation. MRI is increasingly important pediatric imaging modality because of great spatial resolution and sparing patients from potential risks of ionizing radiation exposure, especially children and adolescents PURPOSE: The purpose of this article is to present a case report of 10 years old child with renal abscess, diagnosed by MRI. MATERIALS AND METHODS: We present a 10 years old female with symptoms of fever, left flank pain, dysuria, vomiting and fatigue 5 days before examination. Blood tests shows leukocytosis and bacteria and leukocytes were present in urine. CT and US was performed previously, but were inconclusive. MR was used to confirm the diagnosis. 1.5 Siemens Avanto scanner was used with whole body MRI coil exploited. Standard MRI abdominal examination involved T1 and T2 weighted pulse sequences, Fat Sat technique, DWI and SPC 3D sequence and post Gadolinium T1 sequences. RESULTS: MRI confirmed a renal abscess formation in upper pole of left kidney, especially DWI and postcontrast T1 sequence. DW and corresponding ADC map show that the lesion has restricted diffusion with thin walled post Ga enhancement. Lesion has drained in perirenal space and collecting system. CONCLUSION: MRI is increasingly important pediatric imaging modality because of great spatial resolution and sparing patients from potential risks of ionizing radiation exposure, especially children and adolescents.
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Двоен канален систем
(2016-09-22)
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Јошева Ј
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Primary cavitating tuberculosis in an 8-month-old infant
(European Society of Paediatric Radiology, 2023)
Ognenoska, Biljana
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COMPARATIVE ANALYSIS OF ULTRASOUND AND MAGNETIC RESONANCE IMAGING FOR THE EARLY DETECTION OF CRYPTORCHIDISM IN CHILDREN AND ITS CORRELATION WITH ORCHIDOPEXY FINDINGS
(Macedonian Association of Anatomists and Morphologists, 2024-05-02)
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Objective: This study aimed to investigate the diagnostic accuracy of ultrasound (US) and magnetic resonance imaging (MRI) in detecting cryptorchidism in pediatric patients and to compare these imaging modalities with classic orchidopexy findings. Materials and Methods: Conducted between 2018 and 2019 at the PHI University Institute of Radiology - Skopje in collaboration with the PHI Clinic for Children's Surgery at the Mother Teresa University Clinical Centre - Skopje, this cross-sectional study included pediatric patients up to 14 years old with suspected cryptorchidism. B-mode ultrasound and MRI, including DW-MRI sequences, were employed for localization of undescended testes. These imaging findings were compared with those obtained from classic orchidopexy, serving as the gold standard. Results: A total of 41 male pediatric patients (≤14 years old) with suspected cryptorchidism were enrolled, with a mean age of 6.76±3.74 years. MRI demonstrated superior detection and visualization of undescended testes compared to ultrasound. Specifically, MRI significantly improved the preoperative diagnostic accuracy, especially in localizing non-palpable undescended testes, when compared to ultrasound. Conclusion: The findings suggest that MRI is more effective than ultrasound in detecting undescended testes in pediatric patients. Furthermore, MRI enhances the preoperative diagnostic accuracy, particularly in localizing non-palpable undescended testes, thereby potentially serving as a recommended imaging modality for this purpose.
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THE ROLE OF HIGH RESOLUTION CT IN THE DETECTION AND DIFFERENTIATION OF PULMONARY CHANGES BETWEEN UIP AND NSIP PNEUMONIA
(Macedonian Association of Anatomists, 2023-12)
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Introduction: High-resolution computed tomography (HRCT) has a central role in the diagnosis of interstitial lung diseases, particularly in differentiation between UIP and NSIP pattern. Aim of the study: To analyze the distribution and characteristic radiological findings of interstitial lung changes with HRCT in UIP and NSIP pattern and to show the efficacy of this method in distinguishing these two entities. Material and methods: High-resolution computed tomography was performed on a 128-slice PHILIPS INCISIVE CT scanner, using 1 mm slices and a special reconstruction algorithm. A total of 37 patients at the University Clinic for Pulmonology and Allergology-Skopje were examined with UIP and NSIP pattern. Results: Of the total number of patients, 23 showed a UIP pattern on HRCT, 15 of them were men, and 8 were women with a predominant age over 60 years and most were smokers. Out of 14 patients with NSIP pattern, 11 are women and 3 are men. Half of them are under the age of 60, where the smoking status is significantly lower compared to UIP patients. Conclusion: This article demonstrates HRCT finding and its distribution in UIP pattern associated with idiopathic pulmonary fibrosis and NSIP pattern commonly present in connective tissue diseases. These two entities clearly differ in their specific radiological signs, which is very significant in the therapy and prognosis of interstitial lung diseases. Key words: UIP pattern, NSIP pattern, HRCT, interstitial lung diseases
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Incidental Breast Lesions detected on computed thorax tomography
(Macedonian Association of Radiologists, 2023-11)
Andonov, Gorazd
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Dungevski, Gjorgi
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Pashoska, Milkica

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