Background: Watershed infarction is a distinct subtype of ischemic stroke occurring in the border zones between the terminal vascular territories of major cerebral arteries. Aim: To investigate the clinical and magnetic resonance imaging (MRI) features of watershed infarction. Materials and Methods: This hospital-based prospective cohort study included 200 patients with acute ischemic stroke admitted to the Stroke Unit of the Third State Central Hospital between July 2025 and July 2026. Patients were classified into WI (n=53) and non-watershed infarction (NWI, n=147) groups based on diffusion-weighted imaging (DWI) and cerebral arterial territories. WI was further classified into cortical, internal, and combined subtypes, and their anatomical and morphological features were evaluated on DWI. Stroke etiology was classified using the TOAST criteria and neurological severity using the National Institutes of Health Stroke Scale (NIHSS). Statistical analyses were performed using Stata 14.2 (p<0.05). Result: Of 200 patients, 53 (26.5%) had WI and 147 (73.5%) had NWI. Mean NIHSS scores were lower in the WI than NWI group at admission (4.75±3.32 vs 9.71±5.08) and discharge (2.53±2.73 vs 6.90±4.93; both p<0.001). Among patients with WI, 40 (75.5%) had cortical, 7 (13.2%) internal, and 6 (11.3%) combined WI. Mean NIHSS scores for cortical, internal, and combined WI were 3.30±1.92, 10.14±2.34, and 8.17±2.79 at admission and 1.33±1.14, 7.43±2.57, and 4.83±2.79 at discharge, respectively (both p<0.001). On DWI, the MCA–PCA watershed territory was the most frequent location of cortical WI (47.5%), and 77.5% had a wedge-shaped component. Confluent distribution was observed in 57.1% of internal WI, while cigar-shaped morphology was present in 61.5% of cases with an internal watershed component. Etiology differed among WI subtypes (p=0.030), with all internal WI cases attributed to large-artery atherosclerosis. Conclusion Watershed infarction subtypes differed in clinical severity and etiological distribution, while MRI demonstrated distinct anatomical, distributional, and morphological characteristics of cortical and internal watershed infarctions.

Background: In Mongolia, cervical cancer accounted for 11.9% of all cancers diagnosed in women and 7.3% of cancer-related deaths in 2017, ranking as the third most common cancer among women. The American Society for Radiation Oncology (ASTRO) guidelines recommend concurrent chemo-radiotherapy (CCRT) as a standard and effective treatment for patients with FIGO stage IB3–IVA cervical cancer. Accurate assessment of tumor response following CCRT is essential for evaluating treatment efficacy, identifying residual disease, and estimating the risk of recurrence. Magnetic resonance imaging (MRI) is widely used to assess tumor size, local extent, parametric involvement, and post-treatment morphological changes. In contrast, 18F-FDG PET/CT provides both anatomical and functional information and enables quantitative assessment of tumor metabolic activity using the standardized uptake value (SUV). Aim: To estimate the relationship between treatment response to concurrent chemo-radiotherapy and radiological parameters obtained from MRI and 18F-FDG PET/CT in patients with cervical cancer. Materials and Methods: This retrospective study included 35 patients with histo-pathologically confirmed cervical carcinoma who received concurrent chemo-radiotherapy at the Department of Radiation Oncology, National Cancer Center, between 2024 and 2025. Pelvic MRI examinations were performed using a 1.5-T Siemens MRI system to evaluate tumor dimensions and local tumor characteristics before and after treatment. 18F-FDG PET/CT was performed to assess the metabolic activity of the primary tumor, and the maximum SUV was measured. Tumor response following CCRT was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. The relationships between tumor response, changes in tumor size, and pre-treatment SUV were statistically analyzed. Result: A total of 35 patients aged 32–73 years were included in the study, with a mean age of 51.2±12.6 years. The mean baseline longitudinal tumor diameter measured by MRI was 54.3±15.8 mm. Twenty-eight patients (80.0%) had tumors larger than 4 cm, whereas 7 (20.0%) had tumors smaller than 4 cm. According to the FIGO staging system, 22 patients (62.9%) had stage IIIC1 disease, 7 (20.0%) had stage IIIC2, 3 (8.6%) had stage IIIB, 2 (5.7%) had stage IIB, and 1 (2.9%) had stage IVA disease. Histopathologically, 31 patients (88.6%) had squamous cell carcinoma, 3 (8.6%) had adenocarcinoma, and 1 (2.9%) had clear cell carcinoma. Of the 35 patients, 23 (65.7%) had reached the scheduled post-treatment follow-up time and were evaluable for treatment response according to RECIST 1.1, whereas 12 patients (34.3%) had not yet reached the scheduled time for post-treatment assessment. Among the 23 evaluable patients, 15 (65.2%) achieved a complete response (CR), while 8 (34.8%) achieved a partial response (PR). Following CCRT, the longest tumor diameter measured by MRI decreased by a mean of 94.8% in the CR group and 65.3% in the PR group. The reduction in tumor diameter was significantly greater in the CR group than in the PR group (p=0.0016). The mean baseline primary tumor SUVmax on 18F-FDG PET/CT was 16.0±9.8 in the CR group and 24.3±14.5 in the PR group. Although the baseline SUVmax tended to be lower in the CR group, the difference did not reach statistical significance (Mann–Whitney U test, p=0.059). A higher baseline SUVmax tended to be associated with a smaller reduction in tumor diameter following CCRT. Conclusion CCRT resulted in a significant reduction in primary tumor size in patients with cervical cancer. The reduction in tumor size was significantly greater among patients who achieved a complete response than among those who achieved a partial response. Although pre-treatment 18F-FDG PET/CT findings suggest that MRI-based tumor size assessment combined with metabolic information from 18F-FDG PET/CT may provide complementary information for evaluating treatment response following CCRT.

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder associated with cognitive impairment and structural brain alterations. White matter hyperintensities (WMH) detected on magnetic resonance imaging (MRI) serve as critical neuroimaging markers of cerebral small vessel disease. However, research evaluating the WMH burden in the Mongolian population with T2DM using AI-based automated quantitative methods and comparing these findings with a control group remains limited. This research gap provides the rationale and necessity for the current study. Aim: To evaluate and compare the burden of brain white matter hyperintensities (WMH) in adults with type 2 diabetes mellitus (T2DM) versus a control group. Material and Methods: This analytical cross-sectional, retrospective comparative study included participants aged 40 and older who underwent brain MRI at the Mongolia-Japan Hospital of MNUMS between 2019 and 2025. The T2DM group consisted of patients with a confirmed diagnosis, while the control group included individuals without diabetes or prediabetes. After excluding cases with major structural abnormalities, poor image quality, failed automated processing, or incomplete clinical data, 257 out of an initial 283 participants were included in the final analysis (T2DM: 71, Control: 186). 3D T1-weighted MPRAGE and T2-FLAIR MRI sequences were processed using Neurophet AQUA software (version 3.1) to assess total, deep, and periventricular Fazekas scores. Age- and sex-adjusted ordinal logistic regression analysis was performed using SPSS 25.0, with p<0.05 considered statistically significant. Results: A total of 257 participants (T2DM=71, Control=186) were analyzed. There were significant differences between groups in sex distribution (p=0.046) and age categories (p<0.001). The T2DM group exhibited significantly higher total and deep Fazekas scores compared to the control group (total Fazekas: aOR 10.81, 95% CI 5.20-22.49; deep Fazekas: aOR 8.21, 95% CI 4.32-15.60; both p<0.001). Increasing age was associated with higher total (aOR 1.07, 95% CI 1.03-1.11, p=0.001) and deep (aOR 1.04, 95% CI 1.00-1.08, p=0.037) Fazekas scores. Additionally, female sex was associated with higher total (aOR 1.95, 95% CI 1.04–3.63, p=0.036) and deep (aOR 1.95, 95% CI 1.08–3.51, p=0.026) Fazekas score categories. Conclusion Assessment of WMH burden using AI-based automated quantitative MRI processing revealed that T2DM is significantly associated with higher total and deep Fazekas scores. This association remained significant after adjusting for age and sex. These findings suggest that AI-based MRI processing is a suitable method for the objective, quantitative, and standardized assessment of brain WMH burden associated with T2DM.

Background: Chest radiography is a fundamental imaging modality used to diagnose acute and chronic pulmonary diseases. It is relatively inexpensive, rapid, and can be performed at the bedside. Pulmonary abnormalities identified on chest radiographs are generally classified into two main categories: diffuse and focal. Depending on lesion size and image quality, abnormalities can be detected with an estimated accuracy of 70–85%. However, radiologists may overlook findings due to several factors, including heavy workloads, emergency conditions, and the presence of small focal lesions measuring less than 1 cm. Previous studies evaluating the application of artificial intelligence (AI) to chest radiographs for detecting lung cancer, COVID-19, and pneumonia have reported that the sensitivity of diagnostic interpretations improves from 88% to 95% when radiologists and AI work together. Aim: To evaluate selected thoracic abnormalities on chest radiographs using artificial intelligence and compare the results with radiologists’ interpretations. Materials and Methods: This retrospective study was conducted in the Department of Radiology at the Mongolia–Japan Hospital of the Mongolian National University of Medical Sciences. A total of 845 chest radiographs obtained between September 10 and September 30, 2022, were reviewed. After applying the exclusion criteria, 721 chest radiographs were included. The interpretations provided by four radiologists were compared with the results generated by an AI system. Results: A total of 721 posteroanterior chest radiographs were included in the study, comprising 377 images from male patients and 344 from female patients. By age group, the images included 24 from patients aged 10–19 years, 114 from those aged 20–29 years, 150 from those aged 30–39 years, 147 from those aged 40–49 years, 97 from those aged 50–59 years, 96 from those aged 60–69 years, 58 from those aged 70–79 years, and 37 from those aged 80–89 years. Radiologists identified abnormalities in 331 (46%) radiographs and reported no abnormalities in 390 (54%). In comparison, the AI system classified 392 (54%) radiographs as abnormal and 329 (46%) as normal. Using the radiologists’ interpretations as the reference standard, the AI system demonstrated a specificity of 95.8% and a sensitivity of 89% for detecting abnormalities on chest radiographs. Conclusion The AI system demonstrated high sensitivity and specificity in detecting abnormalities on chest radiographs, suggesting its potential utility in clinical practice. Its application may be particularly beneficial in supporting the interpretation of chest radiographs used for preventive screening and early detection of pulmonary abnormalities.

Background: The Global Cortical Atrophy (GCA) scale is widely used for visual assessment of cortical atrophy on MRI but is subject to interobserver variability. Automated brain volumetry provides objective measurements; however, its association with visual atrophy grading remains understudied in Mongolia. Aim: To assess the association and agreement between radiology report–based atrophy grades and AI-derived whole-brain volume, and to compare brain volumes in adults with and without type 2 diabetes mellitus (T2DM). Materials and Methods: This retrospective, single-center study included 367 adults aged ≥40 years (T2DM, n=144; controls, n=223). Intracranial volume–adjusted whole-brain volumes were obtained from 3D T1-weighted MRI using Neurophet AQUA v3.1. Atrophy severity recorded in routine radiology reports was coded from 0 to 3. Welch’s ANOVA assessed differences across grades, and ROC analysis evaluated discrimination between adjacent grades. Classification agreement was assessed using stratified five-fold cross-validation and Cohen’s κ. Age- and sex-adjusted ANCOVA compared brain volumes between groups. Results: Mean whole-brain volume decreased across atrophy grades 0–3 (1122.12, 1068.50, 1034.76, and 968.33 mL; Welch’s F(3, 60.04)=207.30; P<0.001). ROC AUCs for adjacent grades were 0.892, 0.897, and 1.000, with corresponding thresholds of 1099.86, 1056.17, and 995.57 mL. Five-fold cross-validation yielded 78.7% exact agreement (289/367), unweighted κ=0.684, and quadratic-weighted κ=0.856. Adjusted whole-brain volume was 11.98 mL lower in T2DM than in controls (95% CI, −22.67 to −1.30; P=0.028), whereas the overall association between T2DM and atrophy grade was not statistically significant (P=0.059). Conclusion Higher report-based atrophy grades were associated with lower whole-brain volumes, with strong quadratic-weighted agreement between volumetric and report-based classifications. Adults with T2DM had lower adjusted brain volumes than controls. Automated volumetry may complement radiologists’ assessments by providing objective quantitative information.

Background: The aim of this study was to investigate the diameters of the bony nasolacrimal canal by computed tomography in normal adult Mongolian population and the effect of gender and age on the nasolacrimal canal diameter. Methods: Using standart tomographic images, we measured the diameters, angle between the bony canal and nasal floor and length of the bony nasolacrimal duct in 150 patients without nasolacrimal duct disease. Results: The anterioposterior diameter of the bony nasolacrimal canal was 6.49± 1.06mm, transverse diameter was 4.56±0.9mm, angle between the bony canal and nasal floor was 69.6±8.1o. No significant difference in anterioposterior diameter and transverse diameter in gender. The angle between the bony canal and nasal floor was significantly greater in male. Conclusions This study may contribute to the establishment of a detailed anatomical and morphometric baseline of the bony nasolacrimal canal and provide useful information for the planning of interventions for nasolacrimal duct obstruction

Background: Pneumonia is one of the leading causes of morbidity and mortality in children around the world. Annually, it’s estimated about total of 120 million cases of pneumonia occur in children under the age of five around the world and about 2 million of them end in mortality. In 2017, respiratory diseases constituted 31.3% of all diseases in children under the age of five in Ulaanbaatar city. 268 cases of respiratory diseases occur in every 1000 children, making it the leading disease in children of that age group. Sonographic examination has several advantages including lack of radiation, accessibility, portable (can easily bring it next to the patient’s bed), cost effective, and can be used repeatedly on the patients. To our knowledge, currently in Mongolia, there are no published research materials on sonographic examination in children with pneumonia. Given, the lack of study, increased rate of pneumonia and advantages of ultrasonographic, the present study was performed to detect lung ultrasound sign of pneumonia and determine the specificity and sensitivity of lung ultrasound and X-ray. Methods: The study used cross-sectional studies of analytical study. 379 inpatient children aged between 1 month to 14 years old who are in the children’s hospital of Bayangol district between 1st of September 2019 to 1st of December 2019 participated in the study. Procedures included collection of questionnaires from the parents or the guardians, random collection of data from the patients’ history, and assessment of results from ultrasound and X-ray examination. The study used Stata software to analyze the statistics. Results: 56% or 210 cases showed decreased echogenicity in the ultrasound examination. Incorporated B line sign (р=0.001),, decreased echogenicity in the consolidation (р=0.001), and presence air positive bronchus (р=0.001), are shown to the major sign of pneumonia in ultrasound examination. Conclusions In pneumonia, following signs are present in lung ultrasound: Unilateral B-lines, consolidation, hypoechoic, irregular shaped consolidation, positive air bronchogramm sign in lung. From the results of our research, we discovered diagnosis sensitivity of pneumonia in ultrasound is 85%, specificity of pneumonia in ultrasound is 87%, sensitivity of pneumonia in Х ray is 78%, specificity of pneumonia in Х ray is 84%.

Background. There are at least 650 million people and one out or every 10 people worldwide has a disability. In Mongolia, around 128.000 people with disabilities and 12.000 are wheelchair users. Disabilities affect people in different ways. Causing trouble to their economy, their social life, mental and daily self care.The people with disabilities in Mongolia have much difficulties for their daily activities, have limited possibilities to be included in a health and social services equally and the status to become isolated from the society of them and their families are the invariable problem for them.Goal. To study and evaluate the daily embarrassments and problems of the disabled people and the standard medical environment for them.Results. The 55.8% were male and 4.2% were female of the participants in the survey 88.4% of them answered that they can use their wheelchairs in even land and square only. The 76.4% of the participants do not use public transportation and there is no road for the wheelchair users, no ramp is planned for the citizens with wheelchairs in service centers and organizations and so these are the facing problems for the disabled citizens in Mongolia.It demonstrates that the standard for the disabled citizens is not considered in the medical environmental standards seemingly from no ramp is planned for the citizens with wheelchairs in 92% of the hospitals, no elevator for the citizens with wheelchairs in 91% of the hospitals, 88% of the hospitals have not equipped their toilets with the equipments for the disabled citizens, and 91 % of the hospitals have not planned a room for the disabled citizens for the hospitals included in the surveys.Conclusions:1. Wheelchair users mostly dependent for daily and creative activities. Also they have limited social opportunities because there is no appropriate environment.2. Hospitals involved in the research showed that disabled people have limited health services, hospital environmental standard is not appropriate for them and 1,2 and 3 level of hospitals must setup infrastructure for the disabled people.