Vasilevska V

University Surgery Clinic St. Naum Ohridski, Skopie, Karpoš, Macedonia

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Publications (27)12.72 Total impact


  • No preview · Article · Jan 2015
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    Full-text · Dataset · Mar 2014
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    Violeta Vasilevska · Ulrike Szeimies · Milan Samardziski · Axel St�bler

    Full-text · Chapter · Mar 2012
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    Full-text · Chapter · Feb 2012
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    ABSTRACT: Purpose: To correlate radiologic imaging diagnosis with histopathology in cases with soft tissue musculoskeletal lesions. Before ultrasound (US)-guided core needle biopsy, radiologic imaging diagnosis was done using multimodality imaging. Correlation of histopathologic diagnoses after biopsy and surgical specimen was done.  Method: Prospectively, 100 consecutive patients (53 males, 47 females, median age 51 years) with a musculoskeletal soft tissue mass underwent US, computed tomography (CT) and magnetic resonance (MRI). US-guided core needle biopsy was done in all patients. Fifteen MRI parameters and corresponding parameters on US and CT were evaluated for making a radiologic diagnosis. Multivariate logistic regression analysis was used for imaging parameters predictive for malignancy. Histopathologies after biopsy were correlated with radiologic diagnosis in all patients and with the surgical specimen in 92% of the cases.  Results: There were 70 benign lesions (53 benign tumors and 17 tumor-like lesions) and 30 malignant lesions(26 malignant tumors and 4 metastases). The overall imaging accuracy for benign and malignant tumors was 92%. Nine cases (9%) were false-positive (4 benign tumors, 1 tumor-like lesion and 4metastases) and 2 (2%) were false-negative. The correlation between imaging staging and histopathology was 63.6% for malignant tumors. MRI had the highest diagnostic accuracy (89%) compared with US (78%) and CT (83%). A diagnostic imaging algorithm was created. Histopathology after biopsy correlated in all surgical specimens.  Conclusion: A combination of individual multimodality imaging parameters improved radiologic imaging diagnosis in differentiation between benign and malignant soft tissue musculoskeletal lesions. US-guided core needle biopsy is recommended as the procedure of choice for obtaining representative specimens of soft tissue musculoskeletal tumors for histological examination because of its high diagnostic accuracy and low complication rate.
    Full-text · Article · Jan 2011 · Cancer Imaging
  • V Vasilevska · U Szeimies · E M Ruttner · A Stäbler

    No preview · Article · Aug 2010 · Skeletal Radiology
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    V. Vasilevska · U. Szeimies · E. M. Ruttner · A. Stäbler

    Preview · Article · Jun 2010 · Skeletal Radiology

  • No preview · Article · Aug 2009

  • No preview · Article · Aug 2009 · Ultrasound in Medicine & Biology
  • Violeta Vasilevska · Ulrike Szeimies · Axel Stäbler
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    ABSTRACT: The purpose of this retrospective study was to assess the frequency of magnetic resonance imaging (MRI) signs of iliotibial band friction (ITBF) in patients with advanced medial compartment knee osteoarthritis. Proton density-weighted (PDw) fat-saturated (fatsat) MR images (1.5 T, slice thickness (SL) 2.5-3 mm, eight-channel phased array coil) of 128 patients with isolated advanced osteoarthritis of the medial knee compartment and complete or subtotal (>80%) loss of cartilage were evaluated. There were 41 men and 87 women. Mean age was 63 years, range 34-89 years. The control group consisted of 94 patients with medial meniscus degeneration without cartilage loss (56 men and 38 women, mean age 50 years, range 16-89 years). MRI signs of ITBF were evaluated in both groups [poorly defined abnormalities of signal intensity and localized fluid collection lateral, distal or proximal to the lateral epicondyle; signal intensity abnormalities superficial to or deep by the iliotibial band (ITB)]. Transverse images were evaluated separately. Consensus evaluation using all imaging planes was performed. Of 128 patients with osteoarthritis, 95 had moderate or advanced MRI signs of ITBF (74.2%). Eighty-nine patients (69.5%) had advanced degeneration of the meniscus. In the control group, 26 of 94 patients had only moderate MRI signs of ITBF. There was a statistically significant difference between both groups for the presence of MR signs of ITBF (P <or= 0.01). MRI signs of ITBF were frequently present in patients with severe medial compartment osteoarthritis of the knee. Joint space narrowing with varus knee deformity may be a cause of ITBF.
    No preview · Article · May 2009 · Skeletal Radiology
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    ABSTRACT: In this retrospective clinical study, 6 cases of osteosarcoma of the bone have been analyzed. Five patients were with parosteal osteosarcoma and one with periosteal osteosarcoma. The study was performed at the Clinic for Orthopaedic Surgery in Skopje, Macedonia, from 1995 to 2005. This tumor represents 1.5% of all primary bone tumors treated at the Clinic in the 11 year period. The age of the 6 patients (2 female and 4 male) ranged from 8 to 39 years (average 23.8). The history analysis of the patients showed misinterpreted diagnosis in 50% of the cases, with 83.3% rate of local recurrence, 33.3% of metastases and 33.3% of mortality. Follow-up varied from 11 months to 9 years (average 4.5). The clinical and histopathological findings (identical with those reviewed in the literature) confirmed occurrence of two biologically different types of parosteal osteosarcoma: predominant type is originally "benign" but has a definite malignant potential, causing metastases after long symptom-free interval. The other type is highly malignant from the beginning. More radical surgery is recommended for the latter category of tumors, followed by chemotherapy. Compartmental, radical "en bloc" resection, followed by regular review of the patients, is recommended for the former (Tab. 1, Fig. 3, Ref. 20). Full Text (Free, PDF) www.bmj.sk.
    Full-text · Article · Feb 2009 · Bratislavske lekarske listy
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    ABSTRACT: Abstract: In this retrospective clinical study, 6 cases of osteosarcoma of the bone have been analyzed. Five patients were with parosteal osteosarcoma and one with periosteal osteosarcoma. The study was performed at the Clinic for Orthopaedic Surgery in Skopje, Macedonia, from 1995 to 2005. This tumor represents 1.5 % of all primary bone tumors treated at the Clinic in the 11 year period. The age of the 6 patients (2 female and 4 male) ranged from 8 to 39 years (average 23. 8). The history analysis of the patients showed misinterpreted diagnosis in 50 % of the cases, with 83.3 % rate of local recurrence, 33.3 % of metastases and 33.3 % of mortality. Follow-up varied from 11 months to 9 years (average 4.5). The clinical and histopathological findings (identical with those reviewed in the literature) confirmed occurrence of two biologically different types of parosteal osteosarcoma: predominant type is originally “benign” but has a definite malignant potential, causing metastases after long symptom-free interval. The other type is highly malignant from the beginning. More radical surgery is recommended for the latter category of tumors, followed by chemotherapy. Compartmental, radical “en bloc” resection, followed by regular review of the patients, is recommended for the former (Tab. 1, Fig. 3, Ref. 20). Full Text (Free, PDF) www.bmj.sk. Key words: parosteal osteosarcoma.
    Full-text · Article · Jan 2009 · Bratislavske lekarske listy
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    ABSTRACT: A crucial and important factor for successful treatment of burns is the early covering of the burned area with skin substitutes. The covering of the burn requires material that restores the epidermal function and integrates itself into the process of healing. Biological dressings are the golden standard for the temporary covering of burns. All biological skin substitutes are susceptible to early graft reaction and the only exception is the amnion membrane. The importance of the amnion membrane as a biological dressing for burns amounts to: a barrier to bacterial colonization, hastens the epithelisation, and control of water loss. Amnioplasty is a method of application of amnion membrane on the recipient site. In this comparative study, 60 patients with dermal and sub-dermal burns were included. Research was made on an examination group of 30 patients with burns where the method of amnioplasty was applied, and for this amnion membrane conserved in 76% alcohol was used. The control group was made up of 30 patients with burns treated conventionally, and standard methods for the local treatment of burns were applied: exposition, occlusive dressing and initial excision with skin grafting. Pathohistological and microbiological analyses of the bioptical material were made. The degree of the burns was determined through a pathohistological analysis of the bioptical material taken the third day, and in some of the subjects where re-epithelialization was determined on the seventh day, the further re-epithelialization was observed clinically. Pathohistological examination enabled discrimination between bacterial colonization and the invasive bacterial infection. Furthermore, the type of bacterial colonization and infection was determined, which was confirmed with microbiological analysis. The analysis of the results from the microbiological and pathohistological researches of the bioptical material according to the bacterial colonization and infection showed that, although between the examined and the control group there was no statistically important difference, the value of p = 0.067 is close to the statistically important value of p < 0.05. The results of the pathohistological examination of the bioptical material taken the seventh day and analysed according to the re-epithelialization showed that there was a significant difference between the two groups of p < 0.035. It should be mentioned that, although according to the microbiological examinations of the bioptical material a statistically significant difference was not achieved, clinical significance was achieved. The obtained significance of p < 0.035 compared to the re-epithelialization in both groups approved the application of the method of amnioplasty. The histological analysis of the bioptical material not only determines the degree of the burns specifically, but facilitates the choice of method for further treatment, observes the speed of the re-epithelialization and plays an important part in the correct diagnosis and the early start of the specific therapy, important in preventing sepsis. The application of amnion membrane as a biological dressing speeds the re-epithelialization and prevents invasive bacterial infection. Pathohistological examination of the burns is recommended to be established as a standard method in clinical practice.
    Full-text · Article · Jul 2008 · Prilozi / Makedonska akademija na naukite i umetnostite, Oddelenie za biološki i medicinski nauki = Contributions / Macedonian Academy of Sciences and Arts, Section of Biological and Medical Sciences
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    Violeta Vasilevska · Urlike Szeimies · Axel Staebler
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    ABSTRACT: Background. The purpose was to evaluate the enlargement of the Baker cyst and the significance of medial compartment knee osteoarthritis. Patients and methods. In a period of two years we evaluated 66 patients with MRI signs of the Baker cyst and medial compartment knee osteoarthritis (median age 56 years, age range 34-84 years, 23 males and 43 females). One group was with MRI signs of the large Baker cyst and the other one with the small Baker cyst. Following graded criteria for medial compartment were used: cartilage thickness, meniscus degeneration, bone marrow oedema, effusion. Lateral compartment was normal. Results. In the group with the large Baker cyst, 26/31 cases (84%) had medial compartment cartilage loss. Eighteen from them had associated 3dh degree meniscal degeneration. Five/31 (16%) cases had only medial meniscus involvement. In the second group, 17/35 (48%) cases had cartilage loss, with 3dh degree meniscal degeneration was 14 (82%). In 18/35 (52%) cases only meniscus degeneration was present, 67% had 1st degree of meniscus degeneration. There was a statistically significant difference in the group with the distended Baker cyst between different degrees of medial meniscus degeneration. Conclusion. The size of the Baker cyst, as a soft tissue tumour, is strongly correlated with degenerative changes of the cartilage and with the degree of meniscus degeneration on the medial compartment of the knee joint.
    Preview · Article · Jun 2008 · Radiology and Oncology
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    ABSTRACT: The purpose of this retrospective study was to assess the different imaging presentation of musculoskeletal soft tissue vascular lesions. We evaluated imaging findings of 28 patients, with musculoskeletal soft tissue vascular anomalies, in a two-years period. Sixteen (57%) were male and 12 (43%) female, with mean age of 28 years (range 2-60 years). Radiography and ultrasonography was done in all patients. CT and MRI were done in 10 cases, angiography in 3 cases. The lesions were characterized according to echogenicity, density and signal intensity. They were classified as hemangiomas and vascular malformations. Histological examination proved 24/28 hemangiomas. Superficial were localized 13/24 (54%), and deep intramuscular, localization was found in 11/24 (46%). Capillary hemangiomas were 14/24 cases (58%), and cavernous 10/24 (42%)cases. Lower extremity and thorax localization appeared the same in 6 (25%) cases, on head were localized in 10 (42%), and upper extremity was involved in 2 (8%) cases. Four of 28 were imaging diagnosed vascular malformations, one of them was histologicaly confirm after surgery. Two had high-flow, one was low-flow malformation, and one was lymphatic malformation. All vascular malformations were localized on lower extremity. Soft-tissue musculoskeletal vascular anomalies have a variable imaging appearance. Ultrasonography, CT and radiography are valuable imaging methods and give valuable information for preoperative distinguishing of hemangiomas and vascular malformations. MRI provided superior delineation and differentiation of musculoskeletal anomalies in respect to other soft tissue tumors.
    No preview · Article · Jan 2008 · Rentgenologiya i Radiologiya
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    ABSTRACT: Hydatid disease has a worldwide distribution and causes health problems in endemic countries. Musculoskeletal hydatid disease may be a difficult differential diagnosis. The aim of this retrospective study is to present some different imaging features of musculoskeletal hydatid disease. We evaluated imaging findings of 15 patients with musculoskeletal hydatid disease over a 15-year period. Ten (67%) were men and 5 (33%) women, ages ranging between 12 and 69 years. All underwent radiographic evaluation. CT was done in 9 patients and MRI in 3 patients with soft tissue involvement. All underwent surgery, followed by histological examination. Bone involvement occurred in 11 patients and soft-tissue involvement in 4 patients respectively. Bone lesions in the spine were found in 4 (36%), in the pelvis 2 (18%), in the proximal femur 2 (18%), in the tibia 2 (18%) and 1 (9%) in the first metatarsal. On plain film we identified three different patterns of presentation of bone HD, defined as "typical" osteolytic lesion (33%), "tumour-like" features (41.6%) and lesions resembling infection (25%). Soft-tissue hydatidosis was localized on the distal part of the thigh, paravertebral and deltoid muscle. MR imaging showed a cystic mass, containing multiple vesicles, and in one of them the pathognomonic for hydatid disease, the "water lily" sign, was present. We present three cases of primary musculoskeletal hydatid disease localized on metatarsal bone, proximal femur and deltoid muscle. Musculoskeletal hydatid disease, presenting with a variety of patterns, may resemble a tumour or an inflammatory process. Because of the rare presentation of the disease it should be kept in mind in the diagnostic work-up of musculoskeletal tumours.
    Full-text · Article · Jan 2008 · Prilozi / Makedonska akademija na naukite i umetnostite, Oddelenie za biološki i medicinski nauki = Contributions / Macedonian Academy of Sciences and Arts, Section of Biological and Medical Sciences
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    ABSTRACT: We present the case of an 8-year-old boy with pain in the distal part of the right thigh that occurred after a ball injury, without haematoma or oedema. The plain film showed exostosis of the distal part of the right femur. In another institution the "exostosis-like" formation was surgically removed and the histological finding was an aggressive type of chondroblastoma. A few months later, on the site of the surgical intervention, a significantly enlarged painful solid mass appeared. Radiography showed a large dense mass at the level of distal femoral metadiaphysis with tumour matrix mineralization, and Codman's sign. Computed tomography showed a large soft tissue mass, which arose from the surface of the underlying cortical bone and signs of high-grade malignancy. CT is a valuable method in predicting high-grade malignancy. Arteriography was also done. After operative treatment - seq. Campanacci, histology showed high-grade surface osteosarcoma of chondroblastic type. Pre- and post-operative chemotherapy was carried out. The boy died 2 years after diagnosis because of recurrent disease. High-grade surface osteosarcoma has the worst prognosis, compared with other surface osteosarcomas. Therefore, timely diagnosis is indispensable.
    Full-text · Article · Jan 2008 · Prilozi / Makedonska akademija na naukite i umetnostite, Oddelenie za biološki i medicinski nauki = Contributions / Macedonian Academy of Sciences and Arts, Section of Biological and Medical Sciences

  • No preview · Article · Jan 2004

  • No preview · Article · Jan 2004 · Makedonski medicinski pregled. Revue médicale macedonienne

  • No preview · Article · Jan 2003 · ANZ Journal of Surgery