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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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    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.
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    Anatomy and specific variations in nasoethomoid region and their clinical significance
    (Macedonian Association of Anatomists and Morphologists, 2008)
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    Korneti-Pekevska, Kostadina
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    The revolutionary changes in surgical treatment ment of paranasal sinuses in chronic sinusitis in the last twenty years, especially functional endoscopic sinus surgery (FESS), have increased the interest and necessity of clinicians for better understanding of the anatomy of sinonasal cavities and specific variations in this region. This article presents the anatomy and specific variations in the nasoethmoid region, evaluated on CT scans of paranasal sinuses, together with overview of literature. It also gives their clinical significance, for better understanding of sinus pathology, as well as easier diagnostic treatment and preoperative surgical planning in patients with chronic sinusitis.
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    Clinical Effectiveness of Single Lumbar Periradicular Infiltration in Patients with Sciatica
    (Walter de Gruyter GmbH, 2023-07-01)
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    Kostova, Masha
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    Ristikj-Stomnaroska, Daniela
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    Stoshevska, Tatjana Deleva
    Periradicular therapy (PRT) is a minimally invasive radiological procedurein patients with chronic lumbar pain.The aim of the study is to identify clinical and radiological predictive factors for treatment success after a single PRT treatment in patients with sciatica.The study includes a prospective follow-up of 166 patients treated with PRT. The pain intensity is determined according to the VAS scale and the degree of improvement is presented as excellent (over 75%), good (50-70%), moderate (25-49%), and weak (less than 25%). The follow up of the treated patients was done at 2 weeks, 3 and 6 months. In patients with pain duration up to 3 months, the improvement was excellent in n=32 (58.18%) after 2 weeks, after 3 months n=41 (74.55%) and after 6 months n=41 (74.55%). This stands in contrast to patients with pain over 1 year. The percentage of improvement after 6 months, post-intervention, was highest in patients without nerve root compression (86.25±19.2),and the highest improvement after 6 months was in patients with localization of pain at the L4-L5 level (69.69±29.7), the greatest improvement after six months was in patients with extraforaminal hernia (62.82±34.3), and the lowest in patients with central stenosis (40.21±30.7).Our study results suggest that the shorter a pain duration, low-grade root compression, injection level and type of herniation area predictor the more favourable response patients have to transforaminal epidural steroid injection in patients with sciatica.
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    Neuro-Behcet syndrome: presentation of a case
    (2014-10)
    Vjolca Aliji
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    Dejan Daskalov
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    Role of DWI/ADC in evaluation of brain tumor and monitoring treatment response
    (2016-09-22)
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    Vjolca, Aliji
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    Daskalov, Dejan
    DWI consists of a DW image-diffusion trace and ADC map. DW image is a T2-weighted echo planar background image attenuated by the rate of apparent diffusion and with qualitative and quantitative assessment of the ADC map provide distinction of cytotoxic and vasogenic edema. DWI/ADC is used to assess brain tumors, tumor grading by providing information about tumor cellularity- prediction of tu grade. In high grade tumors DWI/ADC evaluate diffuse unenchancing spread and terapeutic response. ADC value of high grade gliomas has been shown to be lower than that of low-grade gliomas. In extra axial meningioma low ADC in atypical vs typical subtypes. Primary neoplasms- peritumoral edema/infiltration = low ADC vs secondary lesions. Lymphoma - high DWI/ low ADC due to its cellularity. DWI/ADC of therapeutic response provide information about post oper margin of surgical resection (ischemia, pyogenic infection-reduction of ADC). Useful in following treatment response and recurrence because cytotoxic chemoradiation reduce cellularity - increase ADC. Radiation necrosis usually showed heterogeneity on DWI images and often included spotty, marked hypointensity (Chiaki Asaoa, et al.AJNR2005). DWI useful in differentiating recurrent neoplasm from radiation necrosis. Material and method: We evaluate 33 cases with brain tumor. 19 of them after operative and/or chemoradiation therapy. All of them underwent on brain MRI enhanced with DWI/ADC, B-value o and 1000s/mm2 on 1,5T SIMENS Avanto. Results: From intraaxial tumor: 4 cases of glioma gr1; 5 gr2; 3 gr3 and 9 gr4; extraaxial 7 from witch 2 atypical and 5 secondary lesions. Follow up on operated gr2 and follow up on oper. and chemoradiated gr3 and 4 with detection of postradiation necrosis, residual tumor and recidiv however transformation in higher grade. Conclusion: Information about tumor type, malignancy grade, and the presence of necrosis is useful to determine the most suitable and effective treatment procedures. Serially obtained diffusion data is useful to document and even predict cellular response to drug or radiation therapy. Today DWI/ADC is necessary tool in CNS examination. DWI practical, useful, requires less imaging time vs other advance techniques but alone insufficient.
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    Pelvic index in examinees of macedonian nationality
    (2013-10-03)
    Janevski, Georgi
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    The aim of this study was to monitor the development of the pelvic parameters during puberty and adolescence in exartiinces of both. Material and methods: The measurements were made according to IBP on 1400 examiinees of Macedonian nationality, dlvided into 14 groups. Pelvic index and ndex of pelvic - Vallo's width were calculated. Results: Pelvic index 18-19.5 (moderate width) was found in female examinees aged 14 10 20 years. In males younger than 17 years pelvic index was smaller than 15.9, which indicates a relatively narrow pelvis. Mean value of pelvic index was found in 15-year-old females Conclusion: The analysis of pelvic Indexes in examinees of Macedonian nationality showed that the width of the pelvis was a sexually connected characteristic. A relatively moderate width of pelvis was found in females older than 14 years, which is a secondary sexual daracteristic policinders skorn: The analysis of per vederate with of pelvis.
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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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    ДЕГЕНЕРАТИВНО ЗАБОЛУВАЊЕ НА ЦЕРВИКАЛНИОТ СЕГМЕНТ ОД ‘РБЕТОТ КАЈ ПАЦИЕНТИ СО ЦЕРВИКОБРАХИЈАЛЕН СИНДРОМ
    (SHMSHM - AAMD, 2020)
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    Janevski, Georgi
    Вовед: Една од главните причини за рефракторна вратна болка е дегенеративното заболување на цервикалниот сегмент од `рбетот. Наша цел е да го прикажеме типот на дегенеративното заболување на цервикалниот сегмент од `рбетот кај овие пациенти. Материјали и методи: Студијата е аналитичка-трансверзална студија во која беа користени МР прегледите на цервикалниот `рбет и податоците од прашалниот дизајниран за оваа студија. Фокусната група се состои од 98 испитаници на возраст од 35-70 год. со рефракторна вратна болка. Резултати: Нашата студија покажа дека кај 77 испитаници постои надув на еден или повеќе интервертебрални дискови додека кај 50 испитаници резултатите од МР на цервикалниот сегмент од ‘рбетот покажаа дека постои протрузија на еден или повеќе интервертебрални дискови. Ваквиот наод незначајно е асоциран и со трауматска повреда на вратот (Chi-square=0,54 df=1 p=0,46). Заклучок: Надув на интервертебрален диск на цервикалниот сегмент од ‘рбетот како патолошка промена е чест кај симптоматските пациенти и се регистрира кај 78,57% од испитаниците. Од друга страна појавата на дискус хернија не е толку честа и се јавува кај нешто повеќе од половина од испитаниците (51,02%).
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    CORRELATION BETWEEN RISK FACTORS FOR ONSET OF DISC HERNIATION AND LOCALIZATION OF THE PATHOLOGIC CHANGE
    (Macedonian Association of Anatomists and Morphologists, 2019)
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    Anastasovski, Mirko
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    Janevski, Georgi
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    Background: Almost 70% of the population suffers from neck pain at some point during a lifetime. Our aim was to show the impact of the risk factors on the incidence of disc herniation and the localization of the pathology. Materials and methods: This was a cross-sectional study in which MRI data of the cervical spine and data from the questionnaire designed for the study were used. The focus group consisted of 98 subjects aged 35-70 years with refractory neck pain. Results: Our study showed that in male subjects 40% of the herniated discs were at level of C3/C4 and C6/C7 respectively, and 47.06% of the herniated discs were at C5/C6 level in female subjects. Sedentary work had a significant impact on the prevalence of cervical disk herniation (Chi-square=16.88; df=3; p=0.00082), most commonly found (46.15%) at C5/C6 level. Conclusion: Disc herniation is most common in the middle cervical spine (C5/6). Significant predictors for the analyzed risk factors of cervical discs herniation are: age, genetic predisposition and work-related daily slouching or straining the neck.