Contrast-enhanced ultrasound (bolus intravenous injection of 1.2 ml of SonoVue (Bracco Swiss SA, Switzerland) followed with 5 ml saline flush) was performed in 57patients aged 25-72 years old with focal liver lesions (34 benign lesions and 23 malignant). All patients underwent contrast-enhanced liver computed tomography. In 34 (11 + 23) of 57 cases, a morphological evaluation was performed after a targeted biopsy or autopsy. The studies utilized DC-8 scanner (Mindray, China) with a 3-5 MHz convex transducer, in specialized Contrast mode with a low mechanical index (0.08-0.12). The quantitative analysis was performed in post-processing mode with built in ContrastQA software. Cine-loop from the moment of the introduction of the ultrasound contrast agent up to complete washout of ultrasound contrast agent from the lesion or up 300 s in the cases of absence of wash out was analysed. Quantitative parameters of CEUS (1) arrival time (AT), 2) ascending slope (AS) or slope of wash in (SWI), 3) time to the peak intensity (TPI) or time to peak (TTP), 4) peak intensity (PI), 5) half of descending time (DT/2), 6) descending slope (DS)) were analysed. The following parameters were proposed for the differential diagnosis of malignant lesions: DT/2 ≤ 147.970 s (sensitivity - 100.0%, specificity - 93.1%, AUC - 0.997), DS ≤ -0.060 dB/s (sensitivity - 95.7%, specificity - 96.6%, AUC - 0.996). For the differential diagnosis of liver metastases were proposed DT/2 ≤ 82.340 s (sensitivity - 100.0%, specificity - 100.0%, AUC - 1.000), DS < -0.090 dB/s (sensitivity - 94.7%, specificity - 100.0%, AUC - 0.992). For haemangiomas in the group of benign lesions TPI ≥ 32.620 s (sensitivity - 97.5%, specificity - 100.0%, AUC - 0.998), AS ≤ 0.670 dB/s (sensitivity - 77.5%, specificity - 100.0%, AUC - 0.934). For focal nodular hyperplasia in the group of benign lesions PI ≥ 36.280 dB (sensitivity - 81.80%, specificity - 87.50%, AUC - 0.895). Quantitative analysis of contrast-enhanced ultrasound based diagnostic algorithm was suggested for differential diagnosis of different types focal liver lesions.

262 children were investigated: 200 healthy children aged 3 to 18 years (control group) and 62 - with chronic liver diseases aged 2 to 17 years (main group). The main group included patients with the following pathology: cryptogenic hepatitis - 13, autoimmune hepatitis - 4, liver cirrhosis - 3, cytomegaloviral hepatitis - 2, storage diseases - 2, liver fibrosis - 2, primary sclerosing cholangitis - 2, viral hepatitis C - 1, herpes viral hepatitis - 1, cystic fibrosis - 32. Routine liver ultrasound and two-dimensional shear wave elastography were performed with the use of Aixplorer system (Supersonic Imagine, France, 1-6 MHz convex transducer) in all patients. The values of Young modulus were significantly higher in the main group than in the control group (median Emean were 6.85 and 5.00 kPa, interquartile range - 5.85-8.20 and 4.70-5.38 kPa, respectively) (P < 0.001). Shear wave elastography can be considered as a new promising modality for early diagnosis of liver fibrosis in children.

A retrospective analysis of the results of the examination and surgical treatment of 50 patients (women - 17, men - 33) aged 53-69 with 60-99% stenosis of the internal carotid arteries was carried out. All patients underwent unilateral carotid endarterectomy followed by a histological evaluation of the removed atherosclerotic plaque. Duplex ultrasound of brachiocephalic arteries and contrastenhanced ultrasound (Acuson S2000, Siemens, Germany) with SonoVue as an ultrasound contrast agent were performed in all patients. The following parameters of time-intensity curve were evaluated: peak intensity (Peak), peak intensity averaged over the area of the plaque (Peak%), time to peak intensity (Tp or TTP), area under the curve (AUC), and mean transit time (MTT). Four degrees of neoangiogenesis (0-3) were assigned after histological examination. The strong correlation of neoangiogenesis was detected with Peak, a moderate correlation - with Peak% and AUC, and a weak correlation - with MTT (P < 0.05). There were no correlations of the atherosclerotic plaque size (area) with the contrast enhancement parameters and neoangiogenesis degree. Statistically significant differences of Peak%, Peak, AUC, and MTT were obtained between 1^st and 2^nd degrees of neoangiogenesis (P < 0.005) and between 1^st and 3^rd degrees of neoangiogenesis (P < 0.001). Significant differences between 2^nd and 3^rd degrees of neoangiogenesis occurred only for two parameters: Peak and AUC (P < 0.05). With the use of ROC-analysis the diagnostic signs for 2^nd and 3^rd degrees of neoangiogenesis differentiation were revealed. The sensitivity of Peak (cut-off value 11.6 IU) in determining of 2^nd degree of neoangiogenesis was 88.9%, specificity - 76.5%, and area under the curve - 0.907; AUC (cut-off value 59%s) - 88.9%, 82.4%, and 0.887, respectively. The sensitivity of Peak (cut-off value 23.5 IU) in determining of 3^rd degree of neoangiogenesis was 63.6%, specificity - 94.4%, and area under the curve - 0.826; AUC (cutoff value 95%s) - 72.7%, 77.8%, and 0.742, respectively. The use of ultrasound contrast agents augments the capabilities of ultrasound in the diagnosis of atherosclerotic plaques with a high risk of embolization due to the detection of neovascularization.

Umbilical cord rupture is a rare condition, associated with a high risk of fetal neurological complications and death. Complications are usually acute conditions, occur during antenatal or intranatal period and require urgent delivery for fetal death prevention. Three cases of antenatal ultrasound detection of umbilical cord rupture were presented. The histological changes of umbilical cord (linear rupture, vessel wall inflammatory changes) were found in all cases that confirmed the results of the preoperative ultrasound examination and the presence of concomitant intrauterine infection. After analysis of own data and literature review the criteria for an umbilical cord rupture suspicion were identified.