Results of the thyroid ultrasound in 108 patients were analyzed. 28 patients with papillary thyroid cancer (32 nodules) formed the first group, 80 patients with benign lesions (84 nodules) (41 patient with colloid nodules (45 nodules) and 39 patients with follicular adenomas (39 nodules)) - second group. Multiparametric ultrasound was done using Aixplorer scanner (Supersonic Imagine, France). Young’s modulus values in malignant lesions was as follows: Emean median - 63.6 kPa, 2,5-97,5^th percentiles - 16.6-142.2 kPa, and minimal and maximal values - 14.5-149.8 kPa; Emax - 79.2 kPa, 22.9-187.1 kPa, and 22.0-192.1 kPa; stiffness ratio (SWE-ratio) - 3.8, 1.3-9.4, and 0.8-10.2 respectively. There was a significant difference between value of Emean, Emax, and stiffness ratio in malignant and benign lesions (P < 0.000). Sensitivity of the test “Emean >48.3 kPa - thyroid cancer" - 71.9%, specificity - 95.2%, positive predictive value - 85.2%, negative predictive value - 89.9%, and AUC - 0. 886. Sensitivity of the test “Emax >59.6 kPa - thyroid cancer" - 75.0%, specificity - 92.9%, positive predictive value - 80.0%, negative predictive value - 90.7%, and AUC - 0.890. Sensitivity of the test “stiffness ratio >2.74 - thyroid cancer" - 78.1%, specificity - 90.5%, positive predictive value - 75.8%, negative predictive value - 91.9%, and AUC - 0.886. This data can be used as additional criteria of malignancy in patients with thyroid nodules.

Study results of the uterine myoma HIFU-ablation considering nodes localization (anterior or posterior wall) in 109 patients were presented. 179 nodes underwent treatment. 122 (68%) myomas were located at the anterior wall, 57 (32%) - at the posterior wall. Treatment efficacy was assessed by MRI (in 2-4 weeks) and ultrasound (6-7, 12-14, and 24-26 months). There was not any significant difference in application frequency of lens with different focal distance (150 and 180 mm) and treatment duration for myomas located at anterior and posterior walls. There was not any significant difference in volume of ablation between myomas at anterior and posterior walls according to MRI (in 2-4 weeks after HIFU-ablation). There was not any significant difference in volume of reduction between myomas at anterior and posterior walls according to ultrasound (6-7, 12-14, and 24-26 months after HIFU-ablation). The lowest volume of ablation was noticed in myomas with hyperintense characteristics on MRI irrespective of myoma localization (P < 0.05 for both comparisons). Treatment was more successful in myomas with hypointense characteristics on MRI (P < 0.05 for both comparisons). There was not any significant difference in recurrence frequency between myomas at anterior and posterior walls.

The case of congenital diaphragmatic hernia combined with pulmonary sequestration diagnosed on prenatal ultrasound (33 weeks’ gestation) was described. Ultrasound signs were analyzed. Sometimes pulmonary sequestration can play a role of protector, preventing herniation of abdominal organs. Literature review was also presented.

Aim of the study was to assess frequency of visualization and coronary flow parameters registration in the left anterior descending artery during exercise stress echocardiography. 840 patients with coronary heart disease referred to stress echocardiography were included in to study. All patients underwent examination on horizontal bicycle ergometer with left ventricular contractility assessment. Visualization of the left anterior descending artery and assessment of the blood flow spectrum before and during the stress echocardiography were successful in 67% of cases (64-70% - 95% confidence interval). It allowed calculating coronal flow reserve ratio. In case of the left ventricle contractility disorder left anterior descending artery blood flow was registrated in 66% of the cases (95% confidence interval - 61-71%), in patients with negative result of the test - in 74% (95% confidence interval - 70-78%) (P = 0.02). Frequency of the coronary flow visualization during the physical activity did not depend on the sex, age, arterial hypertension, and diabetes mellitus. Significant negative correlation between left anterior descending artery stenosis (coronarography) and coronary flow reserve ratio (ultrasound) was revealed (r_s = -0.40, P < 0.005).

Two clinical cases of the aortic dissection (DeBakey III) endovascular treatment with intravascular phased-array probe use are presented. Literature review is given as well. The disease was diagnosed by the aorta, iliac arteries, and lower extremities arteries ultrasound examination, computed tomography, and aortography. Aortic endovascular fenestration under intravascular ultrasound control was performed. Ultrasound investigation was performed using Acuson Sequoia 512 scanner (Siemens, Germany) equipped with the intravascular phased-array probe AcuNav applying B-mode, colour Doppler, and pulsed Doppler. Intravascular ultrasound allowed assessing hemodynamics in the true and false lumen of aorta and its branches during the aortic endovascular fenestration. Intravascular ultrasound allowed showing that endovascular fenestration makes the blood flow speed in the true aortic lumen equal to the false one. In conclusion, intravascular ultrasound allowed assessing hemodynamics before, during, and after the aortic fenestration and estimate fenestration efficacy.

There were examined 24 patients with verified Crohn’s disease and 37patients with verified ulcerative colitis. 30 patients without any clinical and laboratory data of the gastrointestinal diseases were included in to control group. Bowel ultrasound was done without any preparation and contrast enhancement. Sensitivity of the test “bowel wall thickness >2.5 mm - inflammatory bowel disease” - 90.2%, specificity - 100.0%, positive predictive value - 100.0%, negative predictive value - 83.3%, and AUC - 0.957. Sensitivity of the test “doppler signals amount in bowel wall >2 - inflammatory bowel disease” - 93.4%, specificity - 100.0%, positive predictive value - 100.0%, negative predictive value - 88.2%, and AUC - 0.967. Sensitivity of the test “stage 2 according Limberg score - active Crohn’s disease” - 100.0%, specificity - 66.7%, positive predictive value - 90.0%, negative predictive value - 100.0%, and AUC - 0.935. Significant differences in pathological vascularization, ascites, terminal ileum affection, mesentery and (or) omentum inflammatory infiltration, and lymph nodes size were revealed between group of Crohn’s disease and ulcerative colitis (P < 0.05 for all comparisons). Significant differences in pathological vascularization during the activity and remission periods were revealed in all groups; in lymphatic nodes size - in group of ulcerative colitis and combined group of bowel inflammatory disease; in ascites, terminal ileum affection, and mesentery and (or) omentum inflammatory infiltration - in group of Crohn’s disease (P < 0.05 for all comparisons).

Aim of the study was to assess value of ARFI-elastography in differential diagnosis of benign and malignant solid lesions of different localization in children. 121 children aged from 1 up to 216 months (45 children with neuroblastoma, 14 - with hepatoblastoma, 14 - with liver hemangioma, 14 - with nephroblastoma, 7 - with sarcoma of different localization, 15 - with other different benign lesions, 12 - with other different malignant lesions) were examined. All children underwent ARFI-elastography of tumors with stiffness value (median) assessment according to shear wave speed 10 times measurements in the lesion. Values of shear wave speed were calculated for each type of lesions. There was not any significant difference between the stiffness of the liver hemangioma (2.04 m/s (median), 1.74-2.32 m/s (25^th-75^thpercentiles)) and hepatoblastoma (1.85, 1.60-2.27 m/s) (P = 0.37). The same was noticed in the group of patients with ganglioneuroma (1.02, 0.93-1.95 m/s) and neuroblastoma (1.77,1.18-2.14 m/s) (P = 0.28). There was not any significant difference between the group of patients with benign (1.97, 1.20-2.77 m/s) and malignant (1.72, 1.20-2.06 m/s) lesions as well (P = 0.23). The shear wave speed cut-off value for differentiation between benign and malignant lesions was equal to 1.93 m/s with sensitivity - 0.696, specificity - 0.586, AUC - 0.588. It did not allow recommending ARFI-elastography for the daily use.