Purpose. To moderate computed tomography angiography (CTA) of the heart scanning protocol in children with dilated cardiomyopathy and low left ventricle ejection fraction (LVEF) for optimal visualization of the heart and its major vessels.Materials and methods. We examined 38 patients aged from 9 months to 17 years, undergoing treatment at the cardiology department in the of the Rehabilitation Clinic for Children of the Almazov National Medical Research Centre. Firstly, all patients were performed echocardiography (Echo). Echo data evaluated LVEF. The patients were selected based on the clinical diagnosis, the LVEF index, the patient’s height (or the length of the scan area). 2 groups of patients with DCM (with low LVEF) were formed - younger and older patients; for each group was formed a control group of patients with normal LVEF values. All patients underwent CTA on a 128-sliced computed tomograph Ingenuity Elite (Philips, Netherlands) after a bolus intravenous contrast medium injection.Results. There was revealed a relationship between the start time of the scan and the LVEF, the patient’s height. For patients with low LVEF were created study protocols, where scan start time offset was set as: for the group 1 in the early arterial phase +3c, in the late arterial phase +5c, in the venous phase +15c; for the group 2 in the early arterial phase +5c, in the late arterial phase +5c, in the venous phase +29c.Conclusion. The moderated scanning protocol presents good contrast enhancement by chambers of the heart and its major vessels. It is necessary for an assessment of the anatomy and pathological changes. The identified criteria (LVEF, patient height) should be considered for CTA of the heart in children with dilated cardiomyopathy.

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The gold standard for diagnosing injuries in polytrauma is computed tomography (CT) of the whole body. This method of radiation diagnostics allows to quickly and non-invasively obtain high-resolution images for an accurate assessment of all trauma-related injuries. To date, there are different opinions on the optimal algorithm for conducting and evaluating CT in patients with polytrauma, but a unified standard of research methods for this category of patients has not been developed. This article presents the experience of various domestic and foreign hospitals providing medical care to patients with various types of combined and multiple injuries, as well as describes methodological recommendations for performing and analyzing CT of the whole body in patients with polytrauma, obtained on the basis of our own practical experience. In the article, we also reflected the peculiarities of the interpretation of the resulting traumatic injuries in the native, arterial, venous and delayed phases of scanning; clinical examples of CT studies in patients with polytrauma are given. We noted the particular importance of postprocessing processing of images obtained during CT examination. Here, we recommend performing CT of the whole body in polytrauma with the use of multiphase intravenous bolus contrasting, which allows a more detailed assessment of the changes in internal organs and soft tissues and diagnoses the presence and nature of bleeding. Comprehensive and detailed evaluation of CT images obtained in patients with polytrauma is aimed at helping clinical specialists choose the best treatment method, prioritizing and predicting patient management in each case.