Examination results of 100 patients (41 male, 59 female) with chronic diffuse liver diseases were retrospectively analyzed. Chronic hepatitis C was found in 34 patients, chronic hepatitis B - in 7, chronic hepatitis G - in 1, autoimmune hepatitis - in 4, primary biliary liver cirrhosis - in 15, and chronic hepatitis of unknown etiology - in 39. The age of patients ranged from 18 to 77 years. All patients underwent shear wave elastography using Aixplorer scanner (SuperSonic Imagine, France). Average values of liver parenchyma stiffness (Emean), obtained in a series of 5 measurements in each patient, were assessed. Elastography data were compared with morphological findings (liver biopsy). According to morphological results, the patients were divided into 4 groups: F0-F1 Metavir stage - 31 patients, F2 - 9 patients, F3 - 15 patients, F4 - 45 patients. Young modulus values in groups F0-F1, F2, F3, and F4 were 5.4 (4.8-7.2), 8.5 (8.3-8.9), 13.5 (10.1-14.8), and 22.0 (18.2-28.5) kPa correspondingly. The differences between all groups were significant (P < 0.05). Strong correlation between liver stiffness (Young modulus) and morphological fibrosis stage (Metavir score) was noted (Spearman’s rank correlation coefficient - 0.81, P < 0.1 х 10⁶). The sensitivity, specificity, and AUC of test “Emean ≥7.50 kPa - ≥F2 Metavir stage” were 97.1%, 77,4%, and 0.915; test “Emean ≥13.25 kPa - ≥F3” - 88.3%, 92.5%, and 0.932; test “Emean ≥14,90 kPa - F4” - 95.6%, 89.1%, and 0.930.

Ultrasound examination of axillary lymph nodes in 71 women aged 25 to 76 years with histologically confirmed breast cancer was performed. All patients had suspicion for metastases to the axillary lymph nodes. All women were examined using ultrasound system Aplio 500 (Toshiba, Japan) with linear transducer 7-18 MHz. The first group of patients consisted of 33 women with confirmed metastatic lymph nodes, the second group - 38 patients with hyperplasia of lymphoid reticular tissue. Significant difference (P < 0.001) in Young’s modulus values between metastatic (median - 94.0 kPa, 2.5-97.5^th percentiles - 14.0-150.0 kPa) and benign (median - 18.3 kPa, 2.5-97.5^th percentiles - 6.2-66.4 kPa) axillary lymph nodes was revealed. Stiffness assessment was highly effective for metastatic axillary lymph nodes diagnosis (AUC - 0.920). The best diagnostic efficiency in breast cancer metastatic axillary lymph nodes detection was achieved at the cut-off value of Young’s modulus equal to 26.1 kPa (shear wave speed - 2.95 m/s) (sensitivity - 85%, specificity - 82%).

Strain elastography was done to 69 reproductive age women with suspected ectopic pregnancy. Final diagnoses were: ectopic pregnancy (n = 30), complicated uterine pregnancy (n = 18), abnormal uterine bleeding in the reproductive years (n = 21). Control group consisted of healthy volunteers, examined in the second phase of menstrual cycle (n = 10). Strain elastography was done using Logiq E9 (GE Healthcare, USA) with transvaginal approach. Qualitative and semiquantitative (elasticity index) myometrium and endometrium elasticity data and fallopian tubes qualitative elasticity data were evaluated. In all examined patients endometrium stiffness was always lower in compare with myometrium (ratio of uterus and endometrium elasticity indices in all cases was >1.0). Normal fallopian tube (n = 14) were coded as an elastic structure in green with fragments of yellow and red. Fallopian tubes with scares (n = 5) also were coded as elastic in green, but hard fragments additionally appeared in blue. In case of tubal pregnancy 4 types of fallopian tube elastographic patterns were found. These types were corresponding to laparoscopic data. In case of progressive early tubal pregnancy (n = 3) gestational sac 4-5 mm in diameter was coded in blue; other parts of tube were coded as elastic. When tubal pregnancy was interrupted with hematoma formation, uterine tubes were coded as hard structures in blue with fragments of light blue and two rims at periphery of tube - inner light blue and outer green (n = 20). In case of complete tubal abortion (n = 6) fallopian tubes were elastic throughout.

240 women of reproductive age (18-43 years old) with histologically confirmed chronic endometritis and reproductive dysfunction were examined. Women were treated with standard rehabilitative therapy (the first group, n = 108), and the same therapy, combined with peloid therapy (the second group, n = 132) (Karachi lake, Novosibirsk region). The groups were comparable for age, disease duration, parity, gynecologic and somatic anamnesis. The control group, consisted of 30 healthy volunteers of similar age (24-36 years old), was examined before IVF/ICSI because of male factor infertility. Results of ultrasound examination in proliferative phase of menstrual cycle were scored qualitatively. Results of uterus vessels pulsed wave Doppler were also evaluated. In patients of both groups before treatment the total score was 4 or more. After treatment in the first group only one of 8 ultrasound signs of the scoring - non-linear endometrial midline - was detected significantly less frequently (P = 0.01). In the second group there was a significant positive dynamics of the 4 scoring signs: endometrium thickness <6 mm (not earlier than the 12^th day of menstrual cycle) (P = 0.007), non-linear endometrial midline (P = 0.007), non-uniform endometrial echogenicity (P = 0.02), irregular endometrial-myometrial junction (P = 0.04). After treatment in both groups resistance index and systolic/diastolic ratio significantly decreased (P < 0.05). In patients of the second group after treatment systolic/diastolic ratio was significantly lower compared with the first group (P = 0.026) and was not significantly different from the control group (P = 0.590). Inclusion of peloids in therapy of chronic endometritis creates the conditions for successful rehabilitation of patients with chronic endometritis.

The aim of the study was to assess the value of ultrasound examination in differential diagnosis of peritoneal involvement in ovarian cancer and tuberculosis. The study included 36 patients aged from 29 to 80 years. In all patients at primary ultrasound investigation peritoneal involvement and fluid in abdominal cavity were identified. Later, in 15 (41.7%) patients peritoneal tuberculosis and in 21 (58.3%) - peritoneal carcinomatosis in ovarian cancer with normal size ovaries were verified. Ovarian cancer in normal size ovaries was characterized by following ultrasound signs: 1) peritoneal dissemination with solid (usually) or solid-cystic structure; 2) pelvic peritoneum and/or abdominal cavity peritoneum involvement; 3) greater omentum involvement; 4) metastatic lymphatic nodes in mesentery of colon are extremely rare and can be detected in retroperitoneal space. Peritoneal tuberculosis is characterized by following ultrasound signs: 1) multiple clusters of cystic masses with thin walls, accumulating in sloping areas of abdomen and pelvis; 2) absence of greater omentum involvement; 3) multiple lymph nodes up to 21 mm in size, usually visualized in ileocecal area in combination with bowel wall changes and local peritoneum thickening.

Aortic regurgitation usually is associated with insufficiency of aorta semilunar valves, which is considered as valvular heart disease. Unlike other heart valves, there is still no consensus about the possible presence of physiological regurgitation in the aortic valve in the literature. Unfortunately there are no generally accepted echocardiographic criteria for the trace (trivial) aortic regurgitation. The article presents a critical literature review of the prevalence, terminology, and evaluation criteria for trace (trivial) aortic regurgitation in healthy individuals. Possible pitfalls and mistakes in echocardiographic assessment of trace (trivial) aortic regurgitation are discussed.