The aim of the study was to determine the capabilities of magnetic resonance morphometry and diffusion tensor imaging in the diagnosis of bilateral spastic forms of cerebral palsy in children. The main groups were 33 children aged from 1 year to 4 years 5 months. with bilateral spastic forms of cerebral palsy, the comparison group – 11 children who did not have movement disorders. The patients underwent magnetic resonance morphometry, diffusion tensor imaging. A comparison was made between the volumes of brain structures and diffusion values between groups. Significant differences (p < 0,05) were found in the volumes of the right lateral, 3rd ventricles, white matter, thalamuses, globus pallidus, putamen, hippocampus. Significant differences (p < 0,05) in diffusion values in the thalamuses and in the posterior limb of internal capsules were also identified. The correlation of the identified changes with the clinic of the disease was demonstrated. The obtained data demonstrate wide possibilities and high diagnostic value in the detection of bilateral spastic forms of cerebral palsy in children.

Backgrоund. Polytrauma is the main reason for incapacitation and death in children of all ages. The appropriate timing of specialized medical care plays a crucial role for the outcomes of the polytrauma. Aim. The aim of the study is to analyze the results of the treatment of musculoskeletal injuries with the use of a decision-making algorithm in pediatric patients with polytrauma. Materials and methods. This is a prospective, observational, controlled, single-center study. The research included 130 children who were divided into two groups. In the main group, the children were provided with specialized medical care by a multidisciplinary team. After stabilization, the patients were transferred to a specialized center for final surgical treatment by minimally invasive fracture osteosynthesis. After the elimination of existing life-threatening conditions and the fitting of skeletal traction, the patients in the control group received surgical treatment only after transferal to a specialized center. Results. In the main group, pain regressed significantly earlier (1.7 0.6 vs 3.2 0.4, p 0.05), and the duration of the postoperative ICU stay was significantly reduced (1.5 0.9 vs 2.4 1.4 days, p 0.05). The optimization of the surgical treatment of injuries facilitated a reduction in the duration of the ICU stay of patients in the main group (5.6 0.3 vs 6.5 0.4 days), in the surgical department (21.5 0.7 vs 25 0.9 days), and the overall hospital stay (up to 27.5 days). Conclusions. This study developed a decision-making algorithm for administering medical care to children with polytrauma based on the principle of stabilization of the condition and early low-trauma surgery in the hours following injury.

The aim of the study was to compare the volumes according to MR morphometry and diffusion values according to diffusion-tensor MRI (DT-MRI) of the corpus callosum in children with spastic diplegia. Methods: the main group consisted of 12 children aged from 1 year 8 months to 4 years 3 months, the comparison group — 5 children with normal motor development, who did not have motor impairments, at the age from 1 year and 3 months up to 3 years 8 months. All patients underwent MR-morphometry, DTI. A comparison was made between the volumes and diffusion values of the corpus callosum between groups. Results: Significant differences were found (p<0,05) in the volume of the genu, splenium and the middle third of the trunk of the corpus callosum. Significant differences (p<0,05) of diffusion values in the middle and posterior third of the trunk of the corpus callosum were also revealed. The data obtained demonstrate the diffuse nature of pathological changes in the corpus callosum in children with spastic diplegia.