Renal allograft intraoperative ultrasound was performed in 54 recipients. 33 (61.1%) men and 21 (38.9%) women were examined. Age of the recipients was 1-50 years old, donors - 25-69 years old. Ultrasound was performed during the three stages of the surgery using ultrasound scanner Profocus 2202 (BK Ultrasound, Analogic, USA). The first stage of intraoperative monitoring was the assessment of flow start through the main vessels of the transplanted kidney, the second stage - the study of blood flow after reconstruction of the urinary tract, the third stage - the study of blood flow after surgical intervention. The options considered stabilization of renal blood flow after hemodynamic shock (the start of blood flow through main blood vessels) were discussed. Patients were divided into two groups in accordance with the blood flow state. The first group consisted of patients (n = 25), in which the maximum values of peak systolic blood flow velocity through the main and parenchymal arteries accounted for the second stage of monitoring, then they have stabilized renal hemodynamics, which can be traced to the end of surgery. 29 patients with maximum peak systolic velocities registrated at the third stage of the intraoperative monitoring were included in the second group. Postoperative normalization of renal transplants function has evolved in different ways. Normalization of renal function in all patients of the first group occurred during the first week of the postoperative period, and only in two patients of the second group - to the point of discharge from the hospital. The earlier hemodynamics stabilizes the better renal allograft function is at early postoperative period.

21 patients with diffuse changes of the thyroid and chronic autoimmune thyroiditis diagnosis and 147 patients of control group underwent examination. Ultrasound examination were performed on Aixplorer (Supersonic Imagine, France) scanner with wide band linear probe 4-15 MHz. Emean median in thyroid parenchyma of patients with chronic autoimmune thyroiditis was 16.3 kPa, 2.5-97.5^th percentiles - 5.3-51.1 kPa, minimum-maximum values - 5.2-69.4 kPa, Emax - 21.2, 10.3-80.4, 10.3-83.8 kPa, respectively. All statistical characteristics of Young’s modulus (Emean, Emax, SD) in thyroid parenchyma with diffuse changes were significantly higher in compare with that in control group (P < 0.05). Analysis did not reveal significant correlation between the Young’s modulus (Emean) and thyroid function test results (thyrotropin, thyroxine, thyroperoxidase antibodies) in patients with chronic autoimmune thyroiditis. Test “Emean >13.6 kPa - chronic autoimmune thyroiditis" showed sensitivity 76.2%, specificity 59.9%, and area under the curve (AUC) 0.705. Test “Emax >18.3 KPa - chronic autoimmune thyroiditis" showed sensitivity 85.7%, specificity 55.1%, and area under the curve (AUC) 0.705. These results do not allow using it independently, but allows considering quantitative elastography in multiparametric ultrasound diagnosis of chronic autoimmune thyroiditis.

125 patients (250 testes) were examined with shear wave ultrasound elastography. Testes parenchyma stiffness was assessed. Patient’s age varied from 18 to 85 years old (median - 51 years old). Inclusion criteria were as follows: presence of both testes; absence of any scrotum pathology; absence of trauma, torsion, testes tumours, and infertility; normal ultrasound image of the testes in B-mode. Multiparametric ultrasound (B-mode, color Doppler, pulsed wave Doppler, 2D shear wave elastography) were performed on Aixplorer (Supersonic Imagine, France) scanner with wide band linear probe 4-15 MHz. 2.5-97.5^th percentiles for Emean (medium value of Young’s modulus in region of interest) in normal testis was 1.8-4.4 KPa, for Emax (maximum value of Young’s modulus in region of interest) - 2.5-6.0 KPa; for shear wave velocity - 0.77-1.21 m/s (medium value of shear wave velocity in region of interest) and 0.91-1.41 m/s (maximum value of shear wave velocity in region of interest). There were not significant correlations between the Young’s modulus from one side and testis volume, resistive index in intratesticular artery, and patient’s age from another side.

Testes parenchyma stiffness assessment was performed in patients with limited (less than five microliths) and classic microlithiasis (with five or more microliths on any single view). The study was performed on Aixplorer scanner (SuperSonic Imagine, France) with wideband linear probe (4-15 MHz). Young’s modulus values were assessed with microliths in the ROI and in normal parenchyma. Comparison with the control group was done. Microliths size varied from 0.7 to 2.9 mm (n = 60). Despite of the testis heterogeneity on gray scale ultrasound homogenous staining in the color window was seen during the shear wave elastography with the recommended range of the Young’s modulus (50 kPa). There were significant differences between the Young’s modulus values (Emean and Emax) assessed in microliths area and normal parenchyma. Comparison with the control group showed significant differences for microliths area only. There was not any significant difference of Young’s modulus within the normal parenchyma comparing to the control group. Size of microliths did not correlate with elastography parameters. It is recommended to assess stiffness of testes parenchyma avoiding hyperechoic areas. Multiple hyperechoic structures can affect on quantitative stiffness characteristics.

97 patients (62 men and 35 women) aged from 38 up to 74 years old (56 ± 8 years) were examined. X-ray coronary angiography was performed in all patients. It was the main inclusion criterion. There were two groups: control group - patients without coronary artery disease (n = 48, 28 men and 20 women), study group - patients with coronary artery disease (n = 49, 34 men and 15 women). The study group was divided into two subgroups: patients with stenosis of left anterior descending artery (35) and right coronary artery (14). All patients underwent Doppler echocardiography and bicycle stress echocardiography. The use of combined technology (Doppler echocardiography and bicycle stress echocardiograph) showed the highest sensitivity (90%) and specificity (94%) and being the most available and safe method of the latent coronary insufficiency diagnosis. The highest reliability of two technologies was shown in diagnosis of left anterior descending coronary artery stenosis because of its more close location to the anterior thoracic wall. The diagnosis of right coronary artery stenosis with two technologies was much less reliable due to the remoteness of posterior wall and vascular anatomy complexity.

Aim of the study was to assess right ventricle function in patients with coronary artery disease in cases with normal and abnormal left ventricle myocardium contractility. 95 patients with verified coronary artery disease aged from 28 up to 79 years old were included into the study. First group consisted of patients without left ventricle myocardium local contractility dysfunction (n = 35), second group - patients with dysfunction of left ventricle myocardium local contractility of the anterior, septal, posterior, and lateral localization (n = 60). Value of tissue Doppler imaging and speckle tracking in patients with right ventricle dysfunction in cases of left ventricle local contractility dysfunction was assessed. Study results showed that longitudinal strain of right ventricle significantly changes only in patients with left ventricle local contractility dysfunction. Decrease of the right ventricle longitudinal strain, acceleration time before the peak of longitudinal strain, and peak of post-systolic shortening occurrence indicate at right ventricle dysfunction. The value of right ventricle lateral wall longitudinal strain assessed by speckle tracking is the most optimal parameter for diagnosis of right ventricle dysfunction in patients with left ventricle local contractility dysfunction.

Aim of the study was to assess Doppler parameters in renal and central retinal arteries in comparison with a common carotid artery intima-media characteristics using color and pulse wave Doppler. These parameters were studied in 100 patients with type 2 diabetes mellitus and in 20 healthy volunteers. Abnormal lamination and solitary hyperechoic elements within the vascular wall were presented as ultrasound features of the diabetic (metabolic) macroangiopathy. Ultrasound hallmarks of the diabetic microangiopathy in patients with type 2 diabetes mellitus were characterized by reduction of the blood flow velocities and increase of peripheral resistance indices in renal and central retinal arteries. Diabetic microangiopathy causes similar changes of the peripheral resistance indices in renal and central retinal arteries. Common carotid artery intima-media thickening is higher than peripheral resistance indices in renal and central retinal arteries increasing. Ultrasound signs of the diabetic macroangiopathy in common carotid artery have prognostic value for diabetic microangiopathy in renal and central retinal arteries.

67 children with suspected acute hematogenous osteomyelitis were examined. Acute hematogenous osteomyelitis was diagnosed after the surgery in 52 (77.6%) cases and septic arthritis in 10 (14.9%). Inflammatory changes were not revealed in 5 (7.5%) cases. All patients were divided into three groups in accordance with their admission to the hospital. The first group included children admitted in the first week of onset (n = 31; 46.3%). Subgroup 1A - children admitted in the first 3 days of onset (n = 16; 23.9%), subgroup 1B - children admitted at 4-7 days of onset (n = 15; 22.4%). Children admitted at 8-14 days formed the second group (n = 24; 35.8%), at 15-21 days - third group (n = 12; 17.9%). Metaepiphyseal zone changes were the main ultrasound signs of the acute hematogenous metaepiphyseal osteomyelitis. They were more distinct at the end of the first week (4-7 days). Ultrasound signs of the acute hematogenous metaepiphyseal osteomyelitis at period 1-3 days were unspecific, and their identification required further follow-up. Synovial fluid presence could be the symptom of the arthritis and osteomyelitis as well. Sensitivity of the ultrasound in acute hematogenous metaepiphyseal osteomyelitis diagnosis during the first three days of the disease was 85.7%, specificity - 88.9%, accuracy - 87.5%; 4-7 days - 100.0, 80.0, and 93.3%, respectively. Sensitivity of the ultrasound at period 8-21 days was 100.0%.

Three cases of the perirenal lymphoma are presented. Tumor was seen as an encompassing lesion above the kidney in all cases. It appeared as a hypoechoic lesion during the ultrasound examination and hyperdense during the computed tomography. Doppler examination revealed vessels in lesion. Computed tomography showed decreased contrast media accumulation within the lesion comparing with the renal parenchyma. Visualization of vessels penetrating the lesion from the renal parenchyma and contrast media accumulation allowed differentiating tumor from the perinephric hematoma, urinoma, and age related changes of perinephric fat. Yarmulke sign term was suggested to describe this symptom.

Clinical case of 19 years old patient with papillary renal cell carcinoma, Fuhrman grade 2, with intratumoral necrosis is presented. Computed tomography was not performed due to the allergic reaction of the patient. Contrast enhanced ultrasound (SonoVue, Bracco) was done. Tumour did not show typical pattern due to the necrosis. It does not allow making a conclusion about presence of a malignant tumor. However, insignificant intake of ultrasound contrast agent in a cavity of cystic tumor and a fragmentary contrast enhancement in arterial phase of the tumor’s capsule were underestimated.