To reveal the most significant relative parameters (indices) of quantitative transrectal contrast-enhanced ultrasound in the diagnosis of prostate cancer using the results of ultrasound guided targeted prostate biopsy. Material and methods: 75 patients with the suspicion for prostate cancer based on results of digital rectal examination and/or increased level of serum total prostate-specific antigen. One of obligatory inclusion criteria to the study was the presence of hypoechoic foci in the peripheral zone of prostate. A targeted ultrasound guided biopsy of hypoechoic foci pre-selected for the quantitative analysis of contrast enhanced ultrasound performed in all patients, as well as systemic prostate biopsy. According to the morphological data, all foci were divided into two groups: main (prostate cancer) group consisted of 30 lesions and control (non-prostate cancer) one consisted of 45 lesions. For transrectal contrast- enhanced ultrasound was utilized ultrasound diagnostic system Epiq 5 (Philips, Netherlands) with a 4-10 MHz intracavitary probe and ultrasound contrast agent Sonovue (Bracco Swiss SA, Switzerland). With time-intensity curve analysis the following indices (the ratio of the absolute parameter value in the region of interest to the value of same parameter in the reference region) were assessed: WIR (wash-in rate) index, TTP (time to peak) index, PI (peak intensity) index, MTT (mean transit time) index, TPH (time from peak to one half) index, and RT (rise time) index. Results: Significant differences of WIR index (P < 0.0001), PI index (P < 0.0001), TTP index (P = 0.0008), and RT index (P = 0.0248) were obtained between the groups. The test “PI index > 1.174 - prostate cancer” was characterized by sensitivity of 83.3%, specificity of 88.9%, positive predictive value of 83.3%, negative predictive value of 88.9%, and AUC of 0.910. The test “WIR index > 1.432 - prostate cancer" was characterized by sensitivity of 76.7%, specificity of 82.2%, positive predictive value of 74.2%, negative predictive value of 84.1%, and AUC of 0.808. The test “TTP index < 0.936 - prostate cancer" was characterized by sensitivity of 73.3%, specificity of 66.7%, positive predictive value of 59.5%, negative predictive value of 78.9%, and AUC of 0.729. A significant moderate correlation was determined between the Gleason sum and the PI index (r_S = 0.394, P = 0.0311). Conclusions: The use of relative parameters (indices) for quantitative transrectal contrast-enhanced ultrasound can improve the accuracy of targeted biopsies in the diagnosis of prostate cancer. The indices show better diagnostic accuracy than absolute quantitative parameters of quantitative transrectal contrast-enhanced ultrasound.

Objective: To compare conventional endorectal ultrasound and intracavitary contrast-enhanced endorectal ultrasound in the assessment of fistulous tract topography in patients with anal fistula. Material and methods: A total of 49 patients with anal fistula (34 (69.4%) men and 15 (30.6%) women) aged 27-54 years (41.2 ± 13.8 years (M ± σ)) were examined. All patients underwent various surgical procedures. Endorectal ultrasound (conventional and with intracavitary using 1.5% hydrogen peroxide solution) was performed by the same doctor with use of Hi Vision Preirus ultrasound system (Hitachi, Japan) with 5-10 MHz intracavitary linear transducer. Results: Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of endorectal ultrasound with intracavitary using 1.5% hydrogen peroxide solution in purulent cavity detecting are 95.2, 71.4, 95.2, 71.4, and 91.8% versus 76.2, 57.1, 91.4, 28.6, and 73.5%, respectively in conventional endorectal ultrasound. In detection of internal fistula opening and determination of its localization no significant differences were found between two types of endorectal ultrasound (conventional and with intracavitary using 1.5% hydrogen peroxide solution) as well as in determining the type of anal fistula in relation to external sphincter and its relationship with portions of external sphincter (in trans-sphincter fistulas cases) (P > 0.05). However, sensitivity of detection of superficial and deep external sphincter portions involvement during intracavitary contrast-enhanced endorectal ultrasound increased to 100.0% (from 66.7 and 71.4%, respectively). Conclusion: Study results show feasibility of using intracavitary contrast-enhanced endorectal ultrasound in assessing of anal fistula topography in difficult diagnostic cases.

Objective: To determine of borderline ovarian tumors ultrasound features based on own research data and literature review. Material and methods: Ultrasound examination was performed in 21 patients, aged from 25 to 58 years old (mean age 48 years) with 22 borderline ovarian tumors. Postoperative histological examination revealed unilateral serous borderline ovarian tumors in 11 patients, unilateral mucinous borderline ovarian tumors in 9, and bilateral borderline ovarian tumors (mucinous on the right and serous on the left) in 1. All tumors (n = 22) were divided into two groups: 12 serous borderline ovarian tumors to the first group and 10 mucinous borderline ovarian tumors to the second group. Results: Unilocular (with no inclusions) and solid types are uncommon for borderline ovarian tumors. For serous borderline ovarian tumors, unilocular-solid type is more typical (P <0.05 when compared with mucinous borderline ovarian tumors). For mucinous borderline ovarian tumors, multilocular or multilocular-solid types is more typical (P < 0.05 when compared with serous borderline ovarian tumors). In 4 out of 10 (40%) cases of mucinous borderline ovarian tumors, hyperechoic suspension was revealed as inner content of loculi, which is difficult to differentiate from a solid component. In some cases of mucinous borderline ovarian tumors, a honeycomb (1 case) or multilocular (3 cases) types of solid part were found (there were no cases of these types in the group of serous borderline ovarian tumors). The ascites is uncommon for borderline ovarian tumors. The majority (21 out of 22 (95%)) of borderline ovarian tumors showed minimal or moderate blood flow (type 2 or 3 according to the IOTA terminology); with no significant differences between serous and mucinous borderline ovarian tumors. Median of Vmax of intratumoral arterial blood flow in borderline ovarian tumors was 10.2 cm/s, minimum - maximum values - 4.2-15.2 cm/s, RI - 0.48, 0.31-0.55, respectively. Conclusion: The correct diagnosis with using ultrasound examination was estimated in 14 out of 22 (64%) cases of borderline ovarian tumors (serous borderline ovarian tumors in 6 out of 12 (50%) cases, mucinous borderline ovarian tumors in 8 out of 10 (80%) cases). The correct diagnosis of nonbenign ovarian tumors was estimated in 20 out of 22 (91%) cases (serous borderline ovarian tumors in 11 out of 12 (92%) cases, mucinous borderline ovarian tumors in 9 out of 10 (90%) cases).

A rare case of a calcified fibrin sheath, fixed in the vein lumen, in a 4.5-year-old child with acute lymphoblastic leukemia, which was visualizing for several months after central venous catheter removal, is presented in the article. The fibrin sheath on the catheter was first detect in a patient during the routine brachiocephalic veins ultrasound in the period of a course of specific therapy. A hyperechoic tubular mass with a posterior acoustic shadow in the lumen of internal jugular vein imaged after catheter removal. Position, size, and shape of calcified fibrin sheath was not change during the next 16 months of follow-up. There were no signs of thrombosis, infection or embolism in the child. Fibrin sheaths formation on central venous catheter is the physiological response to the presence of a foreign body. Usually, it is asymptomatic, but it can lead to catheter dysfunction and rare to life-threatening complications after catheter removal: pulmonary embolism, sepsis, and heart walls and valves injury. On various imaging modalities (ultrasound, X-ray, and computed tomography) calcified fibrin sheaths can mimic catheter fragments left in the vein. To avoid misdiagnosis the thorough revision and length measurement of the catheter during its removal, assessment of the catheter contours, and additional masses in its projection on radiological and ultrasound examinations are necessary.

Objective: To assess the left ventricular mechanics during postnatal ontogenesis in preterm children with very low and extremely low birth weight. Material and methods: 88 children aged from one to five years old, born extremely prematurely with very low and extremely low body weight (the main group), were examined. The control group consisted of 46 healthy children of the same age, born full-term. Left ventricular mechanics was studied by evaluating left ventricular rotation at level of basal segment, papillary muscle, and apex and left ventricular twist using two-dimensional speckle-tracking echocardiography. Results: There are four types of left ventricular twist both in healthy full-term children and in children born extremelypremature. The distribution of left ventricular twist types in main and control group was different. The first type (adult type) of left ventricular twist was detected in 46.59% of children born with extreme prematurity and in 67.39% of healthy full-term children. There were no significant differences in incidence of children’s types of left ventricular twist (second and third types) between the groups (11.36 and 15.91% vs 13.04 and 15.22%, respectively). Incidence of the fourth type of left ventricular twist (negative apical rotation) was significantly higher in infants born extremely prematurely in comparison to full-term infants (26.14% vs 4.37%; P = 0.01). There were no differences in incidence of different types of left ventricular twist according to gender among children born extremely premature. The significant correlations between left ventricular twist types and birth weight (r = 0.53; P = 0.003) were found among children born with extreme prematurity aged from one to three years old.

Echocardiography is the method of choice for non-invasive diagnosis of left ventricular diastolic dysfunction, despite the complexity of interpretation in a number of patients, especially with normal transmitral blood flow. Modern technologies, such as speckle tracking echocardiography, allow us to supplement the analysis of diastolic function of the left ventricle with an assessment of global longitudinal strain of the left atrium. Global longitudinal strain of the left atrium reflects the distensibility of the chamber and can be a highly effective index of left atrial dysfunction and an early marker of left ventricular diastolic dysfunction. This review presents an analysis of data from clinical studies on the value of left atrial longitudinal strain in patients with left ventricular diastolic dysfunction.

The article presents a report on the last annual course on behalf of ISUOG and RASUDM “Ultrasound diagnosis in maternal-fetal medicine", which held online for the first time because of the COVID-19 pandemic. The analysis of the traditional questionnaire showed followed results: only 57.8% of the respondents would prefer the offline format in the “peacetime", and 42.2% of respondents would prefer the online communication. However, in a pandemic time, a predictable majority (92.6%) of respondents chose the online format, and only 7.4%o voted for traditional offline meeting.