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RESOLUTION OF THE MINISTRY OF HEALTH OF THE REPUBLIC OF BELARUS

of August 23, 2019 No. 87

About approval of the clinical protocol

Based on the paragraph of the seventh of part one of article 1 of the Law of the Republic of Belarus of June 18, 1993 No. 2435-XII "About health care", subitem 8.3 of Item 8 and subitem 9.1 of Item 9 of the Regulations on the Ministry of Health of the Republic of Belarus approved by the resolution of Council of Ministers of the Republic of Belarus of October 28, 2011 No. 1446, the Ministry of Health of the Republic of Belarus DECIDES:

1. Approve the clinical protocol "Radiodiagnosis of Diseases of Brain at Children" it (is applied).

2. This resolution becomes effective after its official publication.

Minister

V. S. Karanik

Approved by the Resolution of the Ministry of Health of the Republic of Belarus of August 23, 2019 , No. 87

Clinical protocol "Radiodiagnosis of Diseases of Brain at Children"

Chapter 1. General provisions

1. This clinical protocol establishes general requirements to radiodiagnosis of diseases of brain (diseases and malformations of the central nervous system) at children in stationary conditions.

2. Requirements of this clinical protocol are obligatory for the legal entities and individual entrepreneurs performing medical activities according to the procedure, established by the legislation.

3. For the purposes of this clinical protocol the main terms and their determinations in the values established by the Law of the Republic of Belarus of June 18, 1993 No. 2435-XII "About health care" and also the following terms and their determinations are used:

neyrosonografiya (further - NSG) - skriniruyushchy method of visualization of structures of brain on the basis of use of high-frequency sound waves before closing of fontanel at children;

magnetic and resonant tomography (further - MRT) - the visualization method applied in radiology for receipt of the detailed image of internal structures on the basis of use of permanent magnetic field;

computer tomography (further - KT) - visualization method on the basis of use of x-ray radiation and its computer processing.

4. The direction of patients with brain diseases for rendering medical care to them in stationary conditions is performed according to Items 6-13 of the Instruction on procedure for the direction of patients for receipt of medical care in the organization of health care approved by the resolution of the Ministry of Health of the Republic of Belarus of November 2, 2005 No. 44.

5. Radiodiagnosis is carried out for refining of the diagnosis and dynamic observation of earlier received pathological results. Frequency rate of inspection is determined by condition of the patient and the importance of the changes revealed by means of neurovisualization methods for correction of treatment and additional inspection.

Chapter 2. Use of NSG as neurovisualization method for diagnosis of diseases of brain at children in stationary conditions

6. NSG is applied as method of radiodiagnosis of diseases of brain at children in stationary conditions of the organizations of health care of district, interdistrict, regional and republican level.

7. NSG is used in case of radiodiagnosis of nosological forms of diseases with the following codes on the International Statistical Classification of the diseases and problems connected with health, the tenth review (further - MKB-10):

P01.0-P01.9 of Defeat of fruit and the newborn caused by pregnancy complications at mother;

P02.0-P02.9 of Defeat of fruit and the newborn caused by complications from placenta, umbilical cord and fetal covers;

P03.0-P03.9 of Defeat of fruit and the newborn caused by other complications of childbirth and rodorazresheniye;

P04.0-P04.9 of Defeat of fruit and the newborn caused by impact of the hazardous substances getting through placenta or breast milk;

The Frustration P05-P08 connected with duration of pregnancy and growth of fruit;

P10-P15 Patrimonial injury;

P52 Intra cranial not traumatic hemorrhage at fruit and the newborn;

P90 of the Spasm of the newborn;

P91 Other violations of the cerebral status of the newborn.

8. NSG perform in the first 5-6 days of life, in 1 month of life, further - on medical indications.

9. Indications to NSG at children of the first year of life:

prematurity;

availability of risk factors of perinatal damage of brain;

neurologic symptomatology of damage of brain;

intra cranial patrimonial injury;

inflammatory diseases of brain (encephalomeningitis, meningitis);

availability of 5 and more stigmata of dizembriogenez;

Cerebral palsy and high risk of its forming.

10. Indications to repeated NSG at children of the first year of life:

lack of positive dynamics or deterioration in condition of the child with availability of risk factors of perinatal damage of brain; neurologic symptomatology of damage of brain; intra cranial patrimonial injury; inflammatory diseases of brain; availability of stigmata of dizembriogenez against the background of the carried-out treatment;

at premature children with extremely low and very low body weight in case of the birth - control of development of intra ventricular hemorrhages, periventrikulyarny hemorrhages, hydrocephaly.

11. The form of the NSG protocol is given in appendix 1.

Chapter 3. Use of MRT as neurovisualization method for diagnosis of diseases of brain at children in stationary conditions

12. MRT is applied as method of radiodiagnosis of diseases of brain at children in stationary conditions of the organizations of health care of interdistrict, regional and republican level.

13. MRT is used in case of radiodiagnosis of nosological forms of diseases with the following codes on MKB-10:

G35-G37 Demiyeliniziruyushchy diseases of the central nervous system;

G40 Epilepsy;

G80.0-G80.9 Cerebral palsy;

G81.0-G81.9 Hemiplegia;

G82.0-G82.5 Paraplegia and tetraplegiya;

G91.0-G91.9 Hydrocephaly;

C71.0-C71.9 Malignant new growth of brain;

D33.0-D33.2 Good-quality new growth of brain;

Having dug up P10.0-P10.9 intra cranial fabrics and hemorrhage owing to patrimonial injury;

P52.0-P52.9 Intra ventricular (not traumatic) hemorrhage;

Q00-Q07 Congenital anomalies (malformations) of nervous system;

Q 28.2 Arteriovenozny malformation of cerebral vessels;

Fakomatoza's Q85.0-Q85.9 which are not classified in other headings.

14. MRT is performed on medical indications in planned procedure.

15. Indications for carrying out MRT:

to children of the first year of life once for disaggregation of the pathological structural changes revealed under NSG;

in case of intra cranial hemorrhages;

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