Ultrasound elastography was done to 200 children without liver pathology in age from 3 to 18 years (control group) and 32 children with cystic fibrosis in age from 2 to 17 years (study group). Disease in 17 (53.1%) children with cystic fibrosis was regarded as moderate (the first subgroup) and in 15 (46.9%) children - as severe (the second subgroup) (assessment of disease severity was conducted on a scale of Shwachman-Brasfield in the modification of S.P. Rachinsky and N.I. Kapranov). All patients underwent gray-scale liver ultrasound examination, which was supplemented by twodimensional shear wave elastography (Aixplorer, Supersonic Imagine, France) using a broadband convex probe(1-6 MHz). The values of Young modulus were measured 10 times in different segments of the right and left liver lobes with subsequent averaging. In patients with cystic fibrosis only 9 (28.1%) children had Young modulus values not exceeding those in healthy children (as threshold maximum value of Emean in the control group (6.30 kPa) was used). In patients with cystic fibrosis values of Young modulus were significantly higher than in control group (Emean median - 6.50 and 5.00 kPa, interquartile range - 5.62-7.52 and 4.70-5.38 kPa, respectively) (P < 0.001). In the subgroup with moderate cystic fibrosis Young modulus values were significantly lower compared with the subgroup with severe cystic fibrosis (Emean median - 5.90 and 7.30 kPa, interquartile range - 5.20-6.75 and 6.20-10.70 kPa, respectively) (P < 0.002). Ultrasound elastography as the non-invasive technology may be used in multiparametric liver assessment in patients with cystic fibrosis, as well as for this patients follow-up.

Celiac trunk compression by median arcuate ligament of diaphragm is seldom considered as a cause of persistent abdominal pain in children. The article presents two case reports of ultrasound diagnosis of median arcuate ligament syndrome in adolescents 14 and 17 years old. Gray-scale and Doppler (color-coded and pulse wave Doppler) signs of celiac trunk hemodynamically significant stenosis are described. Peak systolic velocity at the site of celiac trunk stenosis was around 300 cm/s in all cases. In addition, in one patient post-stenotic significant changes (peak systolic velocity and resistive index markedly reduction, prolonged systolic acceleration time, typical tardus parvus waveform) in splenic artery were marked. Patients underwent laparoscopic decompression of the celiac trunk. After surgery, peak systolic velocity at the celiac trunk decreased significantly (almost two times). Blood flow in the splenic artery was normalized. Literature review on ultrasound assessment of splanchnic (mesenteric) artery in hemodynamically significant stenosis diagnosis (Doppler criteria at the site of stenosis and in post-stenotic regions) was presented.

The article presents a case of rare anomaly - the omphalomesenteric duct cyst in 6 years old girl with the proximal and distal ductus omphaloentericus parts obliteration and non-obliterated central part. Preoperative ultrasound showed heterogeneous lesion with anechoic (fluid) upper part, located to the right of the bladder. This lesion has been mistaken for acute appendicitis. Intraoperatively, the lesion was regarded as infected urachal cyst. The final diagnosis “infected omphalomesenteric duct cyst” was based in postoperative morphology. A literature review of this rare abnormality preoperative diagnosis is presented. Despite of described anomaly rarity, ultrasound specialists should be cautious in relation to the omphalomesenteric duct cyst as one of acute abdomen causes in children requiring urgent surgical intervention.

34 patients (29-81 years old) with idiopathic left bundle branch block were examined. Mean QRS duration was 153.1 ± 24.5 ms (M ± σ). The control group included 18patients aged from 38 to 80 years old. Echocardiography with left ventricle diastolic function and global longitudinal strain assessment at rest and after exercise stress test were performed to all patients. At rest in the group with idiopathic left bundle branch block, in compare with the control group, lower values of global longitudinal strain (-15.6 ± 3.7 and -18.4 ± 3.1%, P = 0.037) and left ventricle twist (9.08 ± 4.59 and 13.96 ± 4.61°, P = 0.016) were observed, whereas significant differences in diastolic function parameters were absent. After exercise stress test in the group with idiopathic left bundle branch block, compared with the control group, lower values of E_mitr/A_mitr (0.74 ± 0.20 and 0.98 ± 0.30, P = 0.033) and average e’ (9.4 ± 4.0 and 12.7 ± 3.5 cm/s, P = 0.013); longer isovolumteric relaxation time (89.3 ± 19.6 and 67.5 ± 14.2 ms, P = 0.004); lower values of left atrium systolic filling fraction (58.1 ± 5.3 and 64.5 ± 4.5%, P = 0.026); lower values of left ventricle twist (6.82 ± 6.26 and 18.61 ± 6.90, P = 0.000); higher values of pulmonary artery systolic pressure (41.6 ± 8.5 and 32.4 ± 3.8 mm Hg, P = 0.020) were observed. No significant differences were found between two groups in global longitudinal strain after exercise stress test.

Aim of the study was duplex ultrasound diagnostic value evaluation in the diagnosis of vertebral artery dissection at different stages of its development. There were 38 patients (24-55 years old) with extracranial vertebral artery dissection, verified by magnetic resonance imaging. Duplex ultrasound was performed to all of these patients (in the first 3 weeks, in 2, in 3, and after 3 months). 14 (37%) of 38 patients had the bilateral the vertebral artery dissection, and therefore the total number of injured arteries was 52. Most often dissection localized in V1-V2 segments (80%). Vertebral artery dissection led to lumen stenosis in 45 (86%) cases, occlusion - in one (2%) case, double lumen formation - in 6 (12%). The sensitivity of duplex ultrasound in the diagnosis of vertebral artery dissection was 92%. False-negative results were obtained in 4 (8%) cases: 2 cases in the presence of double lumen and 2 cases in the presence of dissection in V3 segment of vertebral artery. Typical ultrasound signs of vertebral artery dissection in acute and subacute stages were: vessel dilating in site of dissection (96%), intramural hematoma (87%) with vessel lumen eccentric narrowing, intimal detachment (71%), and double lumen (12%). Complete artery recanalization was found in 100% of stenotic lesion cases in 92 days (3.1 months) (median) from onset of the disease. Double lumen remained during whole follow up period (2 years). Duplex ultrasound is the valuable method for extracranial vertebral artery dissection diagnosis and can be successfully uses for recanalization follow up.