Papers by Atanas Hilendarov
World Journal of Biological and Pharmaceutical Research
Introduction: The cystic lesions of the pancreas consists of a range of pathologies which may be ... more Introduction: The cystic lesions of the pancreas consists of a range of pathologies which may be broadly divided into neoplastic, non- neo plastic cysts. Recently new non-neoplastic cystic lesions, called mucinous non-neoplastic cysts (MNCs), have been described. Materials and Methods: The imaging methods (ultrasound and CT) were used as well as invasive imaging methods under image control with a view of the histological verification of the diagnosis. Included cases of pancreatic cystic lesions are described, accidentally detected by ultrasound and CT scan and other diagnostic methods were made for different purpose. Results and Discussion: The finding usually was a cyst in the body of the pancreas, apparently communicating with the pancreatic duct. The Endoscopic Retrograde Cholangiopancreatography and laboratory tests of liver function, serum carcino embryonic antigen (CEA)and carbohydrate antigen C19 -9 were within normal limits. After the distal pancreatectomy in three of the pa...
and Behaviors in Cases with Encapsulated and Unrestricted Liquid Collections into Body Cavities A... more and Behaviors in Cases with Encapsulated and Unrestricted Liquid Collections into Body Cavities AD Hilendarov, AA Georgiev, LG Chervenkov Clin Rev Cases 5 (2), 1-5 The place of US for the diagnosis of clinically suspected abdominal bleeding in trauma patients
World Journal of Advanced Research and Reviews
Introduction: Insulinomas are the most common category of pancreatic endocrine tumors, with an in... more Introduction: Insulinomas are the most common category of pancreatic endocrine tumors, with an incidence of 1-7 cases per million people. Material and Methods: Most are intrapancreatic, benign and solitary. Therefore, they have an excellent prognosis after surgical resection. However, the localization diagnosis of insulinomas still poses a challenge to surgeons and radiologists. Results: We present two cases showing classical appearances on helical CT In these two cases the tumors were occult and could not be found by either abdominal enhanced spiral computed tomography (CT) or ultrasonography. We would like to emphasize the need for performing helical CT whenever the diagnosis is suspected, due to the ability to image the pancreas in the early arterial as well as in the equilibrium phase. Conclusions: We reminded of surgeons that insulinomas represent the most frequently found functioning endocrine tumors .Therefore, they have an excellent prognosis after surgical resection. Howeve...
Общо точки в началото на периодa Total accrued points for the period Общо натрупани точки за пери... more Общо точки в началото на периодa Total accrued points for the period Общо натрупани точки за периода Total redeemed points for the period Общо похарчени точки за периода Total points at the end of the period Общо точки в края на периода
PubMed, 1996
The present study included 97 patients (52 female and 45 male) aged 16-52 years. Conventional ult... more The present study included 97 patients (52 female and 45 male) aged 16-52 years. Conventional ultrasound examination of adrenal glands was made in all cases using a Sonoline SL-2 ultrasound tomograph. The diagnostic results from the examination were compared to the results from the hormonal studies, scintigraphy, computer tomography, angiography, surgery and the histological diagnosis. The diagnostic parameters of the sonographic method were assessed on the basis of the results obtained. The role of the ultrasound tomography in the diagnostics of different adrenal diseases was determined.
Meditsinski Pregled / Medical Review, 2008
European journal of clinical and biomedical sciences, 2021
Purpose: We present our experience in the diagnosis, follow-up and planning therapy of thoracic, ... more Purpose: We present our experience in the diagnosis, follow-up and planning therapy of thoracic, abdominal and retroperitoneal liquid collections in different emergency patients using conventional and interventional ultrasound. Material and Methods: The right and left oblique and poly positionning view was used in 235 patients (159 male and 76 female) for US examination to identify fluids in the thorax and peritoneal or retroperitoneal space. The examination was performed after the clinical survey with patients supine. Positive findings of US were compared with those provided by CT, punctures under US control or surgery. US machine supplied with linear and convex transducers, CT machine, needles and catheters were used. Results: 197 of all 235 US examined patients had fluid collections, confirmed by CT scan, surgery or clinival course. In 156 patients we performed FN diagnostic punctures under US control. There was 155 true-positives, 25 true-negatives, 5 falsepositives and 2 false-negative results. Overall this demonstrated that ultrasonography hamaunt of d a sensitivity of 98.72%, specificity of 83.33% and accuracy of 96.25%. The PPV is 96.87% and the NPV-92.59%. Conclusions: Our experience and literature reports support the opinion that US examination can and should be used as a primary method for diagnosis and follow-up of clinically suspected free and organaised fluids in the thorax, abdomen and retroperitoneum.
Radiology Case Reports, Mar 1, 2022
The novel coronavirus pandemic outbreak caused extreme public fear, health concerns, and psycholo... more The novel coronavirus pandemic outbreak caused extreme public fear, health concerns, and psychological distress, especially in oncology patients. The presented rare case is of a 40-year-old female with thymoma type B, with rapid progression, due to fear from the COVID-19 pandemic. Biopsy and histological verification of the tumor show a B-type thymoma with a high proliferative index. The fear of infection is causing avoidant behavior and leads to suboptimal therapy in some oncology patients that will have severe consequences. We can conclude that adequate, personalized, and most importantly, active psychological care is necessary and should be implemented for cancer patients. To be prepared for a future lockdown, it may be helpful to urge patients to seek alternative forms of social contact, such as online and mobile communications, to combat depression lockdown effects.
Ultrasound in Medicine and Biology, Aug 1, 2011
Zenodo (CERN European Organization for Nuclear Research), May 30, 2022
Introduction: Insulinomas are the most common category of pancreatic endocrine tumors, with an in... more Introduction: Insulinomas are the most common category of pancreatic endocrine tumors, with an incidence of 1-7 cases per million people. Material and Methods: Most are intrapancreatic, benign and solitary. Therefore, they have an excellent prognosis after surgical resection. However, the localization diagnosis of insulinomas still poses a challenge to surgeons and radiologists. Results: We present two cases showing classical appearances on helical CT In these two cases the tumors were occult and could not be found by either abdominal enhanced spiral computed tomography (CT) or ultrasonography. We would like to emphasize the need for performing helical CT whenever the diagnosis is suspected, due to the ability to image the pancreas in the early arterial as well as in the equilibrium phase. Conclusions: We reminded of surgeons that insulinomas represent the most frequently found functioning endocrine tumors .Therefore, they have an excellent prognosis after surgical resection. However, the localization diagnosis of insulinomas still poses a challenge to surgeons and radiologists.
Book Publisher International (a part of SCIENCEDOMAIN International), Aug 21, 2021
Introduction: Lung cancer is one of the most common causes of mortality worldwide. An increasing ... more Introduction: Lung cancer is one of the most common causes of mortality worldwide. An increasing number of lung and mediastinal lesions are found by MDCT, and histological identification is frequently required to determine the best treatment option for these lesions. At this article we have the aims to describe the invasive procedures of the chest lesions - indications, contraindications, technical aspects, and diagnostic accuracy of the percutaneous lung biopsies. Methods: In patients with lung lesions, fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB) are the methods of choice for collecting tissue specimens.Treatment procedures are frequently based on histology diagnosis. When logistically feasible or when other procedures (such as bronchoscopy with lavage) are equivocal, FNAB biopsy is performed in 85 of the 97 patients in our study, and CNB is performed in 12 of the 97 patients. The needles used were 19-22G disposable needles. Results: FNAB under CT control was conducted on all 76 patients, ages 21 to 79, who had lung lesions with a diameter of 2.0 cm or less. Due to the superficial localisation of the lesions, FNAB under US control is performed in 13 patients. All patients have their tissues samples analysed cytologically and histologically.The diagnostic sensitivity and accuracy, as well as the type of complications that occurred, are calculated. CNB showed a small improvement in overall sensitivity, specificity, and accuracy. Conclusion: Percutaneous FNAB and CNB are the safe procedures for diagnostic evaluation of focal pulmonary lezions. The complications are rare: pneumothorax, pulmonary haemorrhage but some, like air embolism and metastatic seeding are with severe consequences.
World journal of research and review, Oct 5, 2016
Purpose : The present study assess factors affecting the success of US and CT-guided liver biopsy... more Purpose : The present study assess factors affecting the success of US and CT-guided liver biopsy of focal lesions on the basis of experience when cytopathologic examination results were available.Methods and Materials: 175 liver biopsies and punctures in 175 patients(120 male and 55 female) were performed under US or CT control. Lesions ranged in diameter from 9mm to 25 mm. We utilized US guidence in 103(66.02%) cases and CT guidence in 53(33.97%) cases. Ultrasound equipment supplied with 3.5 and 7 MHz linear and convex transducers, MDCT machine and biopsy needles were used. The on-site cytologic evaluation guided the radiologist to continue to another biopsy pass and avoid a nondiagnostic biopsy result. Results: During a 4-year period we performed FN liver biopsies or punctures in 175 patients (120 males and 55 females) with small (9-25mm) liver lesions. The CT guidance was utilized for biopsy of deep, small liver masses of ultrasonographically non visible and subdiaphragmatically located lesions. Interventional procedures under imaging control of small focal liver lesions had a sensitivity of 97.76 %, specificity of 80.48 % and accuracy of 93.71 %. The PPV (positive predictive value) is 94.24 % and the NPV (negative predictivе value)-91.66%. Conclusion: Interventional procedures under imaging (US and CT) control of the small focal liver lesions is a highly reliable, safe, inexpensive invasive procedure with great diagnostic value in suspected HCC less than 2 cm in diameter, liver metastases, as well as all benign tumors without typical findings on either dynamic multi-detector CT or CEUS.
Purpose of this presentation is to describe etiology and pathophysiology of pneumomediastinum, pn... more Purpose of this presentation is to describe etiology and pathophysiology of pneumomediastinum, pneumothorax and subcutaneous emphysema, and illustrate the imaging fittures. Materials and Methods: For a period of 5 years (2012-2017), 124 traumatic patients have undergone, examined and proved through an emergency department of the University Hospital. In each of these studies, at least two imaging methods were performed to allow even minimal injuries. Results and discussion: All of these patients have undergone, examined and proved through an Emergency and Diagnostic Imaging departments of the University Hospital. The obtained results were-in 37 patients' pneumothorax, 64-pneumomediastinum, 23 subcutaneous emphysemas. Spontaneous pneumothorax/SP/, occurs in 24 patients without underlying pulmonary disease. Conclusion: Therefore, it is possible to find amount of gas in mediastinum, pleural cavity and subcutaneous tissues in many different cases; as demonstrated, these conditions could be concurrent or isolated. Radiologist must know these conditions and, most of all, recognize the degree of severity and the onset of complications.
World journal of research and review, Apr 1, 2017
International journal of applied research, May 1, 2017
Folia Medica, 2011
the clinical, radiologic, and pathologic features of cystic pancreatic lesions are well known, an... more the clinical, radiologic, and pathologic features of cystic pancreatic lesions are well known, and yet preoperative diagnosis is often difficult to make. aim: to present the role of ultrasound study in conventional and interventional diagnostics of cystic pancreatic neoplasms. Patients and methOds: 65 patients (17 men, 48 women) with cystic pancreatic lesions were examined by ultrasound and computer tomography and investigated using a number of diagnostic interventional procedures over three years. we used siemens-Adara ultrasound system, Ge Sytec 3000i CT equipment and a set of biopsy needles and catheters. Results: We performed ultrasound studies for all 65 patients to determine the structural characteristics of the cystic lesions. Lesions varied in size from 15 to 130 mm in diameter. In 50 patients we used Us control to perform the invasive procedures for cytological and histological examination. In 9 cases the invasive procedures were repeated. In 15 cases we preferred to use CT guidance. We were able to detect 46 pseudo cysts, 9 mucinous neoplasms, 6 serous cystadenomas, 3 intraductal papillary mucinous neoplasms and 2 lymphoepithelial cysts. cOnclusiOns: ultrasound tomography is an imaging method of sufficient informative value with respect to the structural characteristics of cystic pancreatic neoplasms. Us-guided invasive manipulations of cystic pancreatic lesions are easy to perform, quick and effective diagnostic methods. In some cases punctures and biopsies under Ct control appear to be the imaging modality of choice.
Ultrasound in Medicine and Biology, 2017
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Papers by Atanas Hilendarov