Visual and previsual MRI-criteria for early diagnosis of cerebral small vessels disease in middle-aged patients: clinical and neuroimaging correlations

Background. The urgency of cerebral small vessel disease (cSVD) in modern neurology is considered mainly in terms of the development of vascular dementia and early diagnosis of Alzheimer’s disease. Minimal changes in MRI images and indistinct cognitive disorders in SNAMA-type cSVD (sporadic non-amyloid microangiopathy) last for a long time until they manifest as acute cerebrovascular disorders and/or significant mental deficits. However, clinical and neuroimaging criteria for early diagnosis of the disease have not been established yet, and the nature of the correlations between the indicators of neuropsychological and multiparametric MRI studies has not been clarified. Purpose – to develop criteria for early diagnosis of SNAMA cerebrovascular disease in middle-aged patients using neuropsychological studies and high-field multiparametric MRI. Materials and methods. The study enrolled 34 middle-aged patients (52.5 ± 10.8) with hypertension of stage 1–2, stage I–II and cSVD (women – 11 (32.4%), men – 23 (67.6%)). The control group (19 healthy individuals) was identical in age, gender and total duration of education. MRI (3T) was performed in the following modes: T1-2WI, DWI, 3D Brain FLAIR SHC, 3D tra, VEN BOLD, DTI medium iso SENSE. Neuropsychological studies were performed using the MoSA questionnaire evaluating the EIS, VIS, AIS, LIS, MIS, OIS domains. Results and discussion. We developed and introduced a modified scoring system for determining the severity of the burden of cerebral small vessels disease (BcSVDearly) in clinical practice. Among the early visual MRI markers, the expansion of the perivascular spaces was dominated in 27 (79.4%) of participants. A minor increase in Σ BcSVDearly to 6–7 points was found in 10 (29.4%) patients. The age norm (0–4 points) corresponded to the indicators of Σ BcSVDearly 23 out of 34 (67.6%) in the main group. Additional evidence of the disease was obtained by DTI MRI. The most significant decrease in FA was recorded in belt fibers (Δ: up to – 31.4%) and semioval centers (Δ: up to – 33.6%), the largest increase in MD was recorded in hooked bundles (Δ: up to 24.4%); right prefrontal, orbitofrontal and parietal areas (Δ up to 28.0%). According to the MoSA scale, moderate cognitive impairment was detected in 29 of 34 (85.3%) patients with a significant decrease in scores in the domains of EIS, VIS, LIS and AIS (p <0.001). The severity of early clinical manifestations of cSVD (non-amnestic polydomain moderate disorders of attention, speech, visual-spatial and executive cognitive functions) has been found to be moderately / markedly correlated with THMS, MD (positive) and FA (negative).Conclusions. We determined early visual signs of cSVD associated with arterial hypertension: dilated perivascular spaces, hyperintensity of the periventricular deep white matter of the brain, decrease by 9–33.6% of FA coefficient and increase by 20.8% – 28.0% MD. Moderate correlations between neuropsychological and neuroimaging studies have been demonstrated.

Effects of gamma radiation and post-operative cisplatin injection on the incorporation of bone allografts in rats

Background. The reconstruction of long bone defects that occur after resection of tumors is a problem that requires constant study. Bone allografts are often used in this scenario. Unfortunately, while they are prepared, allografts partially lose their strength and osteoinductive properties; their survivability in oncological patients is only 40% after 10 years. This is why the search for superior allograft treatment methods and the study of allograft remodeling and incorporation in oncological patients, whose state has been affected by radiation or chemotherapy, is an area of interest. Purpose – study the structure of bone tissue in the distal metaphysis of a rat’s femur after bone allograft implantation (sterilized using gamma radiation or antibiotic saturation) and post-operative intraperitoneal cisplatin injection. Materials and Methods. Experiments were performed on 20 male white rats aged 5–6 months at the beginning of the experiment and weighed 365.8 ± 6.4g. All rats underwent a surgery that created a defect in the distal metaphysis of the femur which was filled with a bone allograft treated with gamma radiation (Control-1 and Experimental-1 groups) or saturated with an antibiotic (Control-2 and Experimental-2 groups). 14 days after allograft implantation, animals from the control groups received an intraperitoneal injection of 2.0–2.4 ml of 0.9% NaCl, while animals from the experimental groups received 2.5mg/kg of cisplatin. Histological analysis and histomorphometry were completed 30 days after the surgery. Results. 30 days after the operation, the smallest relative area of bone tissue (11.79%) was observed in rats from the Experimental-1 group, with gamma radiation treated allografts and post-operative intraperitoneal cisplatin injections. A somewhat higher value was found in the Experimental-2 group (antibiotic saturation + cisplatin) – 31.64%. In the control groups, (intraperitoneal injection 0.9% NaCl), the relative area of bone tissue was 16.7% (Control-1, gamma radiation treatment) and 58.09% (Control-2, antibiotic saturation). The relative area of fibrous tissue was the largest in the Experimental-1 group – 31.55% and the smallest in the Control-2 group – 12.79%. Conclusions. Allograft remodeling occurs along with the formation of bone and fibrous tissue when allografts are used to fill defects in the distal femoral metaphysis of rats, However, the relative percentages of those tissues depend on the allograft sterilization method and the use of cytostatic agents. The largest relative percentage of bone tissue (58.09%) was obtained using an allograft saturated with antibiotics and without the administration of cisplatin. The smallest (11.79%), on the other hand, occurred in gamma radiation treated allografts with cisplatin injected intraperitoneally after the operation

Structural and functional state of Heren carcinoma after local fractional X-irradiation and irradiation combined with meloxicam

Background. One of the most important problems of oncology is the overcoming of therapeutic resistance of tumors, which occurs in particular due to increased levels of the enzyme cyclooxygenase 2 (COX-2). It is known that the growth of COX-2 and the product of its activity, prostaglandin-E2 in cancer, promotes such processes in the body as tumor growth, stimulation of proliferation, induction of cancer stem cells, inhibition of apoptosis, activation of angiogenesis, invasion, metastasis and development of chemoresistance. The use of COX-2 inhibitors, which are nonsteroidal anti-inflammatory drugs (NSAIDs), significantly limits these processes and improves survival and mortality in cancer patients, and in combination with chemotherapeutics eliminates the resistance they cause. Purpose – study of the structural and functional state of Guerin’s carcinoma cells after the combined use of nonsteroidal anti-inflammatory drug meloxicam and local X-irradiation in total doses of 1.0 and 10 Gy. Materials and methods. On 33 rats with inoculated Guerin’s carcinoma, the ultrastructure of tumor cells (TC) was studied using standard methods of electron microscopy 24 hours after the combined use of the meloxicam drug at a dose of 0.2 mg per 1 kg of body weight one day before the first and 2 hours before the second session fractional local X-irradiation in total doses of 1 and 10 Gy (twice daily at 0.5 and 5.0 Gy, respectively. The mitotic index (the number of cells in the state of mitosis per 100 TC,%), the apoptosis index (the number of cells in the state of apoptotic death per 100 TC,%) and the frequency of TC with small nuclei (%). Results. It was found that irradiation of Guerin’s tumor in a total dose of 10 Gy causes disturbances in the ultrastructure associated with damage to the nuclear apparatus of the TC. Pleiomorphism of the nuclei, the appearance of binucleated cells and micronuclei, a significant decrease in mitotic activity and a slight increase in the apoptosis index are observed. Stimulation of the functional activity of macrophages is also noted. Under irradiation in a total dose of 1 Gy, such effects are less pronounced or completely absent, such as, for example, the processes of phagocytosis. The frequency index of TC with small nuclei is equally reliably increased at both radiation doses. The administration of the drug meloxicam leads to a significant decrease in mitotic activity and an increase in the frequency of small cells, while the ultrastructural picture of the tumor remains almost unchanged. With the combined action of the drug and radiation in both doses, violations of the fine structure of the OC are identical to those found during irradiation. At the same time, the mitotic index in the group with the combined effect of the drug and radiation at a dose of 10 Gy is significantly lower than with only irradiation.In addition, at both doses, the frequency of small forms of PC significantly increases in comparison with the indicators of both the intact control group and the corresponding irradiation groups. Only in combination with radiation does meloxicam reliably stimulate apoptosis, while in other groups its index remains at the level of control values. The relationship was confirmed, which was constantly revealed in all experimental groups, between a decrease in the level of the mitotic index and an increase in the frequency of TC with small nuclei in Guerin’s carcinoma. An inverse correlation was found between these indicators (r = 0.80, P = 0.05). Conclusions. The combined action of the drug and irradiation significantly increases the effectiveness of both therapeutic factors due to the property of meloxicam to reliably inhibit proliferative activity and promote post-radiation development of apoptosis in tumor tissue. The presence of a correlation between the mitotic index and the frequency of cells with small nuclei in Guerin’s tumor may indicate the relationship between cell growth and division. Under the combined action of both investigated factors, changes in the tumor ultrastructure are mainly caused by irradiation. The administration of meloxicam increases the efficiency of the combined use of both therapeutic agents due to its ability to reliably inhibit proliferative activity and promote post-radiation development of apoptosis in tumor tissue. The presence of a correlation dependence between the mitotic index and the frequency of cells with small nuclei in Guerin’s tumor may indicate the relationship between the processes of cell growth and division.

Cytomorphological features of papillary thyroid carcinomas with the development of radioiodine-resistance

Background. The problem of diagnosis and treatment of papillary thyroid cancer (PTC) are radioiodine resistant metastases (RIRM). An urgent issue is the possibility of their early prediction and diagnosis based on the detection of cytomorphological features of the PTC and its metastases, which correlate with the development of radioiodine (RI) resistance. Purpose – detection of cytomorphological features of primary PTC and its metastases in patients who subsequently showed resistance to 131I therapy, compared with the control group of patients who achieved a positive effect of 131I therapy. Materials and Methods. A comparative analysis of morphological features in histological conclusions and the study of cytological characteristics in the fine-needle aspiration (FNA) smears of primary PTC and their primary metastases, as well RIRM оf experimental and control groups of patients were conducted. The experimental group consisted of 152 patients who showed resistance to RI therapy, the control group – 161 patients who achieved a positive effect of RI therapy. Statistical processing was done in Statistica 12. Results and discussion. It is shown that the frequency of follicular structures in the material of primary PTC of patients with a positive effect of 131I therapy is significantly higher, and the frequency of necrotic changes is significantly lower than in patients with the development of RIRM (p <0.05 by criterion χ2). The frequency of follicular structures in the histological material and FNA smears of primary metastases of patients with a positive effect of 131I therapy is significantly higher, and oxyphilic changes are significantly lower than in patients with the development of RIRM (p <0.05 by criterion χ2). Oxyphilic changes were observed significantly more often in the RIRM compared with primary metastases of the control group (p = 0.03). It was proved that cystic changes are significantly more common in FNA smears and histological material of RIRM in comparison with primary metastases of experimental and control groups of patients (p <0.05). Conclusions. TThe use of the presence of oxyphilic and cystic changes in the FNA smears and histological material of metastases of the PTC as prognostic factors of RI resistance is proposed. The presence of follicular structures in the materials of primary PTC and metastases can be a prognostic factor of effective RI therapy.

Control of spectral characteristics of the medical accelerator on the basis of comparison of mass weaking coefficients of different materials

Background. Radiation protection of patients undergoing radiation therapy using linear electron accelerators is based on ensuring the constancy of the equipment parameters set during commissioning. Therefore, studying the possibility of operational assessment of the spectrum characteristics consistency of the generated bremsstrahlung is a priority along with standard dosimetric parameter control procedures. Primarily, this refers to specifying the average measured energy of bremsstrahlung which provides an impartial assessment of the constancy of the whole wave path of the accelerator. However, there is no special diagnostic equipment to determine this parameter. At the same time, the literature data represent a growing interest in the use of CdTe sensors for the analysis of high-energy radiation, including the ones in medical accelerators. Purpose – developing and testing special diagnostic equipment based on semiconductor CdTe sensors, which would implement the assessment of the average measured energy of bremsstrahlung of the medical accelerator 6 MeV via comparing the mass attenuation coefficients in lead and aluminum. Materials and Methods. The paper deals with experimental evaluation of the Varian Clinac 600C linear accelerator (USA) spectrum characteristics carried out at Radiation Oncology Department of State Organization «Grigoriev Institute for Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine» via determining the average measured energy of bremsstrahlung. The assessment of the average measured energy of the bremsstrahlung of the accelerator was performed based on comparing two mass attenuation coefficients of radiation with materials having significantly different atomic numbers, i.e. Al and Pb. The assessment of the mass attenuation coefficients was performed on the basis of measuring the average amplitudes of CdTe signals of the sensor, operating in the pulse mode in conjunction with a 16-bit ADC. Pulses of bremsstrahlung from the linear accelerator were recorded by a peak detector for 10 seconds of measurement by the hardware-software complex at 400 monitor units by CdTe sensor with aluminum and lead absorber. The study was performed at a distance of «source-surface» 100 cm with an area of the irradiation field of 20x20 cm. The spectral energy profile of the generated field of bremsstrahlung was studied. Results. The developed equipment was tested by CdTe sensor, which was created taking into account the energy sensitivity of the sensor itself as well as the spectraltemporal characteristics of the pulsed radiation of the accelerator. The approach dealing with assessing the average measured energy of bremsstrahlung of the linear electron accelerator, based on the dependence of the attenuation of radiation by the absorber layer on the radiation energy, has been experimentally confirmed. The theoretical dependence of the average measured energy of bremsstrahlung of the linear accelerator on the ratio of the mass attenuation coefficients of lead and aluminum has been obtained. The energy range from 0.1 to 6 MeV corresponds to the ratio of mass absorption coefficients of lead to aluminum, varying nonlinearly from 33.8 to 1.639. The average measured energy of the linear accelerator of 0.8 MeV corresponds to a mass coefficient ratio of about 1.23 for these materials. The assessed absolute error (from the set value during commissioning the linear accelerator) of the specified measured average energy of bremsstrahlung is up to 12.5% (0.72 MeV), corresponding to the ratio of mass attenuation coefficients – 1.340. Conclusions. The special diagnostic equipment for recording the spectrum characteristics of the Varian Clinac 600C linear accelerator (USA) based on semiconductor CdTe sensors, which along with 16-bit ADC make it possible to estimate the average measured energy of bremsstrahlung via comparing mass attenuation coefficients in Al and Pb has been substantiated and reduced to practice. The assessment of mass attenuation coefficients is carried out based on measuring the average amplitudes of pulses of СdTe sensors operating in a pulse mode.

Functional visualization in diseases of the joints: current status and prospects (clinical lecture)

Background. Diseases of the musculoskeletal system (MSS), in particular diseases of joints, are a leading factor for reducing the work ability of the population all around the world. The early diagnosis and treatment for them is a high priority task for clinical medicine. Modern nuclear medicine methods can significantly increase the possibilities in differential diagnostics, optimize treatment and improve the prognosis of diseases of the musculoskeletal system (MOP). Purpose – to study and generalize the world experience of application of modern methods of osteoscintigraphy (OSG) for diagnostics of joints diseases, to define possibilities and prospects of various scintigraphic acquisitions for investigation patients with MSS pathology. Materials and methods. Full-text publications in the databases Scopus, Web of Science Core Collection, PubMed (mostly 2015–2021), international standard guidelines for the diagnosis of MSS pathology and monographs for radionuclide examination methods and hybrid imaging technologies in oncology, orthopedics and traumatology. Results. We received the main approaches for radiological diagnostics of pathological changes in joints and the abilities of osteoscintigraphy. We defined the main principles and analyzed the possibilities and advantages of different nuclear medicine protocols: conventional planar examination of the whole body, 3-phase OSG, single-photon emission computed tomography (SPECT) and combined technology with X-ray computed tomography (SPECT/CT). Indications for the use of OSG in various pathological changes of ORA have been determined. We considered different patterns of radiation imaging according to the pathogenesis of various pathological processes – systemic arthritis, diseases of the joints of the spine, upper and lower extremities. The possibilities of different radiological methods for diagnosing and application of different modes of OSG depending on the pathogenesis and localization of lesions were analyzed and compared. Conclusions. Performing 3-phase OSG and tomographic modes (SPECT, SPECT/CT) significantly increases the efficiency of the method for the diagnostics, determination of process activity, staging and prevalence of joint pathology, as well as for monitoring the treatment results. The method detects active metabolic processes at an early stage in the vascular, soft tissue and bone phases and determines the condition of the joints of the whole body without additional radiation exposure.

Multimodality imaging and clinical significance of isolated congenital absence of the pericardium

Background. Congenital absence of the pericardium is a rare anomaly characterized by variable and non-specific clinical manifestations. The prevalence of this pathology in the population is approximately 0.0001 – 0.044% and it is almost three times more common in men. However, the real prevalence, including asymptomatic and undiagnosed cases, may be higher. Purpose – highlighting the echocardiographic and tomographic signs of isolated congenital absence of the pericardium. Materials and methods. A 42-year-old patient M. Echocardiography did not permit to obtain standard echo images via typical echocardiographic approaches due to poor acoustic window. Magnetic resonance imaging and computed tomography of the heart revealed marked left heart rotation and confirmed the most common variant of congenital absence of the pericardium, that is complete left-sided absence pericardial agenesis. Results. The presented case illustrates the non-specificity of clinical symptoms in patients with congenital absence of the pericardium. The electrocardiogram of the patient showed right axis deviation, right bundle branch block, poor R wave progression in the precordial leads. Chest X-ray in the anterior-posterior projection typically shows a pronounced displacement of cardiac silhouette to the left without deviation of the trachea, elongated left border of the heart and inability to delineate the right border, indicating left heart rotation. Echocardiography revealed an unusual orientation of the heart in the chest, i.e. the displacement of the heart (particularly, of the apical segments) to the left and backwards. In cases when the pericardium is absent on the right and on both sides, the right ventricle can indeed be enlarged, sometimes there is a paradoxical motion of the interventricular septum, severe tricuspid regurgitation as well as the swinging motion of the cardiac apex. Magnetic resonance imaging and computed tomography of the heart enable detection of the displacement of the heart to the left half of the chest with cardiac apex directed backwards, the interposition of lung tissue between the ascending aorta and the pulmonary artery trunk. Conclusions. Congenital absence of the pericardium is a rare pathology and thus it can be challenging in terms of diagnosis, while sometimes it remains undiagnosed. The combination of echocardiography with magnetic resonance imaging and/or computed tomography allows to accurately diagnose congenital absence of the pericardium and assess the risks associated with it. Most patients with complete unilateral or bilateral congenital absence of the pericardium have a favorable prognosis and do not require treatment.

Assessing the influence of special treatment of differentiated thyroid cancer on the urinary system long-term effects

Background. Differentiated thyroid cancer (DTC) is the most common endocrine tumour. Its prevalence varies from 1.0% to 2.2% of all malignant neoplasms. The standard strategy of special treatment of DTC consists of surgery, radionuclide therapy and hormone therapy being sequentially applied. Theoretically, each component of the treatment process can cause adverse somatic consequences in future, the study of which can help to prevent and correct them. Purpose – to evaluate possible long-term effects of the treatment of differentiated thyroid cancer in the form of the urinary system (US) pathologies on the basis of follow-up data of long-term observation using sophisticated information technologies. Materials and methods. The study was based on follow-up data of 157 individuals who were undergoing combination treatment of DTC at the Institute clinic from 1993 to 2015, received it in full and underwent regular screening examinations after treatment. The database created for the study contained, as much as possible, digitized arrays of follow-up data of paper case-records on the disease and its consequences in patients with a follow-up period exceeding 1 year after special treatment. The number of logical records of long-term consequences in the generated database was 463 units – one record for one type of long-term consequences of each of 157 patients. Statistical processing of data was carried out in two ways: comparing the incidence of US pathologies before treatment and at a long time after special treatment and identifying factors of statistically significant influence on the occurrence of US pathologies among the treatment peculiarities. WizWhy packages (Data Mining category) and the general purpose software package STATISTICA were used to make hypotheses and test them. Results and discussion. The analysis of the available references has shown that there is only a limited number of papers dealing with the US status of DTC patients. However, a comprehensive analysis of the long-term consequences of treatment of DTC patients revealed a statistically significant increase of US disease cases within the period of 3.75 – 4.8 years after special treatment. It was shown that the total number of US pathologies was 2.04 times higher in comparison with US incidence before the oncet of special treatment. These differences did not depend on age: the median for age of patients before treatment was 51 years, after treatment – 50 years. Additionally, it has been found that patients with or without episodes of postoperative hypothyroidism decompensation with a dose of L-thyroxine not exceeding 2.5 μg/kg need special attention due to the occurrence of urolithiasis. The obtained dependences are quite predictable, since, firstly, it is known that thyroid hormones affect kidney development and physiology, and secondly, the major percent of 131I in radioiodine therapy is excreted with the urine and deposited in the bladder, that can result in a radio-induced carcinogenic effect. Conclusions. Special treatment of DTC increases US pathologies more than twice. The term of post-treatment pathologies is 2.5 (3.75 – 4.8) years. Patients who have episodes of postoperative hypothyroidism during hormone therapy with a dose of L-thyroxine not exceeding 2.5 μg / kg represent the high-risk group.

Non-immune fetal hydrops in late pregnancу: antenatal ultrasound monitoring and pregnancy outcomes in a series of 14 cases

Background. Fetal hydrops is the accumulation of extracellular fluid in two or more fetal cavities, often in combination with subcutaneous edema. An isolated accumulation of fluid only in the abdominal, pleural, or pericardial cavities is described as ascites, pleural effusion (hydrothorax), pericardial effusion (hydropericardium). Features of the pathogenesis of non-immune hydrops fetalis (NIHF) are the follow: high hydrophilicity of fetal tissues, obstruction of the lymphatic vessels, impaired lymph return, congestive heart failure, obstruction of venous return, changes in fetal venous pressure. All these factors lead to the release of fluid from cells and tissues into the «third» spaces – the abdominal, thoracic, pericardial cavities, as well as the subcutaneous space. The oncotic pressure of fetal plasma proteins is not of great importance in the formation of the fetal circulating blood volume. Currently, all the links in the pathogenesis of hydrops fetalis syndrome with various etiological factors are not fully known. The prevalence of NIHF is unknown because it is difficult to collect relevant data; many cases of the disease are not diagnosed until intrauterine fetal death or may spontaneously resolve during the prenatal period. Currently, up to 90% of all cases of fetal dropsy are attributed to NIHF. Purpose – acquaintance of the medical community with the diagnosis and treatment of non-immune hydrops as well as the analysis of clinical features, ultrasound monitoring and perinatal outcomes of 14 cases of non-immune fetal hydrops onset in a second half of pregnancy. Materials and methods. The material for the study were publications and results of clinical trials found in the databases Scopus, Web of Science Core Collection and PubMed for the period 2009–2020 and the analytic report of the own series of 14 cases of non-immune hydrops fetalis (NIHF) of various origins. During the period of 2005–2020 under the supervision in the Ultrasound Department of Kharkiv regional hospital with regional perinatal center there were 14 pregnant women with NIHF diagnosed in a second half of pregnancy. Clinical features are described, ultrasound images and Doppler monitoring are given, perinatal / postnatal results are studied. Results and discussion. The analysis of clinical features, ultrasound monitoring and pregnancy outcomes of 14 cases of non-immune fetal hydrops developed in the second half of pregnancy in presented series was carried out. 6/14 fetuses had structural anatomical defects (lung sequestration, СDH, myasthenia gravis, megacystis and hydronephrosis, epidermolysis bullosa, meconium peritonitis, intestinal atresia). Mortality rate (including perinatal and infant losses) was as high as 9/14 cases (64.2%): 3 of antenatal, 4 of neonatal, 2 of infant death). Surgical treatment was performed on 2 newborns. 5 newborns had apparently a favorable clinical postnatal outcome. In 2 cases, spontaneous resolution with complete regression of hydrops was observed (parvovirus-B19 and idiopathic NIHF). Complete recovery of fetus (spontaneous regression of hydrops without any deterioration and pathological consequences) was observed in 1 case. Conclusions. Antenatal ultrasound monitoring of fetus with NIHF is based on the assessment of PSV CMA, ductus venous, umbilical vein, atrioventricular flow. According to the results of the study, it was revealed that the cardiovascular profile of the fetus with NIHF is disturbed earlier, and the placental profile and arterial Doppler-later. Normal umbilical artery Doppler do not exclude the possibility of an adverse outcome, including intrauterine fetal demise. Extended Doppler monitoring is essential at NIHF. All neonates with NIHF in an antenatal anamnesis require postnatal follow-up.

Relationship between maxillary sinuses’ shapes and their contacts with upper jaw teeth roots according to computer tomography

Background. Rhinosinusitis, affecting both maxillary and other sinuses, is a multidisciplinary issue which otolaryngologists, dentists, neurologists and ophthalmologists are constantly dealing with. There is a remarkable diagnostic value of anthropometric indicators of maxillary sinuses of people of different genders, using CT scan images of mature age patients. Purpose – establish a relationship between the shape of the maxillary sinuses and possible contacts of the tooth roots of the maxillary dental arch in healthy mature men and women. Materials and methods. The study was performed based on the results of 102 CBCT with normal maxillary sinuses variations in adults in the frontal and sagittal plane. The examinations were performed on Point 3D Combi 500 cone-beam tomograph. The paper belongs to the «description of case series» category whis is a type of study recognized by evidence based medicine and does not claim statistical significance of the results. Results and discussion. When examining the computer tomograms of men and women in the study group, it has been found out how the shape of the maxillary sinuses (MS) affects the contact of the tooth roots with the cortical plate and the mucous membrane of the maxillary sinuses. Six main shapes of the MS are defined: trapezoidal, square, round, oval, rectangular and triangular. In the frontal plane of CBCT, the most frequent contact with the MS cortical plate is observed in the triangular and rectangular shape of the MS, that is: in the MS rectangular shape it is in contact with the 15th, 25th tooth root in 13 people (56.5% of cases) and in the triangular shape – with the 15th, 25th tooth root in 17 people (56.5% of cases). Analyzing CBCT in the sagittal plane, the most frequent contact with the cortical plate of the left MS is observed in the MS triangular shape, namely – the sinus is in contact with the 25th tooth root in 38 people (59.4% of cases). In the sagittal plane of CBCT, the contact with the tooth roots was rarely observed in the MS square and round shape. In the MS square shape, the 13th and 14th tooth roots do not come into contact with its cortical plate, and, with the mucous membrane, there is no contact of all the roots of the teeth except the 16th, in 1 person only. Conclusions. The results of the study have made it possible to trace a number of patterns of influence of the maxillary sinus shape on the tooth roots contacting it. The contact of the MS cortical plate is most often observed with 16th and 26th tooth roots, while the MS mucous membrane – with 17th and 27th tooth roots of the upper jaw. It was found that in any shape of sinus in the frontal plane, no contact of the 13th, 23rd and 24th tooth roots of the maxillary dental arch with the mucous membrane of the maxillary sinus was detected. In the CBCT frontal plane, it has been found that the most frequent contact with the MS cortical plate is observed in triangular, trapezoidal and rectangular form of the MS, and the rarest one – in oval, square and round form of MS. The study has established that in the sagittal plane of CBCT the most frequent contact with the MS cortical plate is observed in the MS triangular shape, and the rarest – in the round one.