Aim of the study was to assess the value of strain elastography in liver fibrosis staging. 62 patients (19 women and 43 men) aged from 21 up to 74 years old with different liver diseases (chronic hepatitis - 41, liver cirrhosis - 13, steatohepatitis - 7, and primary sclerosing cholangitis - 1) underwent strain elastography (HI VISION Preirus, Hitachi, Japan). Strain elastography data was compared with the liver morphology results. Liver fibrosis index increased significantly according to the METAVIR score: F0-1 (n = 20) - 2.3 (2.0-2.5) (median, 25-75^th percentiles); F2 (n = 14) - 2.7 (2.2-3.1); F3 (n = 12) - 3.2 (2.9-3.4); F4 (n = 16) - 4.4 (3.7-5.0). Correlation coefficient between the METAVIR score and liver fibrosis index was 0.778 (P < 0.0001). According to the ROC-analysis cut-off value of liver fibrosis index for differentiation between the F0-1 and F2-4 was 2.606 (AUC - 0.887). Sensitivity of test «liver fibrosis index >2.606 - F2-4» - 85.7%, specificity - 90.0%. Cut-off value of liver fibrosis index 2.863 (AUC - 0.905) was the optimal for differentiation F0-2 from F3-4. Sensitivity of test “liver fibrosis index >2.863 - F3-4” - 92.9%, specificity - 79.4%. Cut-off value of liver fibrosis index 3.594 (AUC - 0.924) was optimal for differentiation F0-3 from F4. Sensitivity of test “liver fibrosis index >3.594 - F4” - 81.3%, specificity - 91.3%. Strain elastography is a part of ultrasound examination of the liver allowing to differentiate initial and advanced stages of fibrosis.

Retrospective analysis of ultrasound examination was done in 232 patients aged from 22 up to 80 years old. 30 patients formed the first (control) group. 202 patients with focal thyroid lesions formed the second group. Ultrasound examination was done using the Acuson S2000 (Siemens, Germany) (ARFI- elastography). Fine needle aspiration cytology were performed according to the elastography data. Following subgroups were formed according to the morphology results: nodular (colloid) goiter - 80 patients (80 nodules), nodular goiter - 68 (68 nodules), autoimmune thyroiditis - 42 (42 nodules), and thyroid cancer - 12 (12 nodules). Shear wave velocity among the patients of the control group (median - 1.56 m/s, interquartile range - 1.28-1.72 m/s) was significantly different from that of thyroid cancer, nodular goiter, and autoimmune thyroiditis (P < 0.05). Shear wave velocity in patients with thyroid cancer (2.51 m/s, 2.47-2.62 m/s) was significantly different from the patients with nodular goiter and autoimmune thyroiditis (P < 0.05). Shear wave velocity in patients with nodular (colloid) goiter (1.80 m/s, 1.52-2.10 m/s), nodular goiter (1.70 m/s, 1.46-2.04 m/s), and autoimmune thyroiditis (1.90 m/s, 1.66-2.10 m/s) did not differ significantly. Sensitivity of point shear wave elastography in thyroid cancer diagnosis (shear wave speed >2.45 m/s) - 83.3%, specificity - 95.2%, AUC - 0.931.

20 patients (40 testes) aged from 31 up to 85 years old were examined. Inclusion criteria were as follows: presence of both testes; volume of testes more than 10 ml; absence of trauma, torsion, tumours, and infertility; normal B-mode ultrasound image of the testes. Intra- and interobserver reproducibility of the shear wave elastography was assessed. Young’s modulus (kPa) was measured by using two ultrasound systems - Aixplorer (Supersonic Imagine, France) and Aplio 500 (Toshiba, Japan). Two dimensional shear wave elastography demonstrated high intraobserver reproducibility of the Young’s modulus measured in examination of testes. Intraclass correlation coefficient was 0.95 (0.90-0.97) and 0.92 (0.85-0.97). Two dimensional shear wave elastography showed high interobserver reproducibility of the Young’s modulus measured in examination of testes. Intraclass correlation coefficient was 0. 91 (0.82-0.95). Using Applio 500 scanner 2.5-97.5th percentiles of the Young’s modulus in testes parenchyma (n = 40) were 2.8-9.4 kPa, shear wave velocity - 0.96-1.77 m/s; using the Aixplorer scanner - 1.8-3.9 kPa and 0.77-1.14 m/s, respectively. Young’s modulus received by using different ultrasound scanners in patients of the same group showed significant differences (P < 0.0001). Young’s modulus values did not correlate with testicular volume, age of patients, resistive index and pulsatility index in testicular arteries.

12 patients aged from 33 up to 67 years old with uterine endometrial stromal sarcoma were included into the study. Low-grade endometrial stromal sarcoma was diagnosed in 9 from 12 (75.0%) patients. Metastases of different localization were revealed in 6 from 9 (66.7%) patients. High-grade endometrial stromal sarcoma was diagnosed in 3 from 12 (25.0%) patients; recurrence of the disease was revealed in 2 from 3 (66.7%) patients owing the non-radical treatment. Typical ultrasound signs of endometrial stromal sarcoma were hypoechoic lesion in uterine cavity, unclear boundary with myometrium.

Aim of the study was to assess the papillary muscles contractility in terms of strain and strain rate among patients with coronary artery disease according to the mitral regurgitation grading. Examination was done to 55 patients with IIIb type of ischemic mitral regurgitation according to A. Carpentier. Speckle tracking echocardiography was performed using Vivid 7 Dimension (GE Healthcare, USA) ultrasound system. Strain, strain rate, time to peak strain and strain rate of anterolateral and posteromedial papillary muscles in systole were assessed. There was no any strain of posteromedial papillary muscle in 22.5% of patients with II and III type of ischemic mitral regurgitation. There was no any strain of anterolateral papillary muscle in 13.0% of patients with III type of ischemic mitral regurgitation. There was a correlation between the posteromedial papillary muscle strain and mitral valve geometry in IIIb type of ischemic mitral regurgitation (mitral annular diameter (r = 0.44, P = 0.03), coaptation depth (r = 0.46, P = 0.02), and mitral valve tenting area (r = 0.74, P = 0.0002)). Papillary muscles strain did not depend on left ventricle local contractility disorders in segments, which are adjacent to the muscles.

Aim of the study was to assess the cardiac biomechanic changes after the primary anterior ST-segment elevation myocardial infarction according to the 2D speckle tracking echocardiography. 35patients with acute Q-wave myocardial infarction were admitted within the 24 hours from the disease onset. Echocardiography including 2D speckle tracking was performed on 3^rd (T1), 7^th (T2), and 14^th (T3) day and in 6 months (T4) after the myocardial infarction using Vivid E9 (GE Healthcare, USA) ultrasound system. Patients were divided into two groups: with left ventricular remodeling (14 people) and without it (20 people). Emergency reperfusion therapy was performed in all patients, in 25 (71%) cases within the first 6 hours. Strain decrease identified cardiac function recovery in early postinfarction period. The improvement of global longitudinal strain occurred already to the point T2, while the changes in rotation data in these terms were not observed. Despite the fact that apical rotation and peak S apical rotation rate were in normal range, peak S apical rotation rate increased significantly to the 14^th day (T3). Peak S apical rotation rate and peak S basal rotation rate decreased significantly by the 6 months (T4) of follow-up period. By that time end-systolic volume, end-diastolic volume, and stroke index significantly increased. In patients with left ventricular remodeling at 6-month follow-up period decrease of left ventricle ejection fraction and global longitudinal strain were noticed, indicating the deterioration of systolic function.

Results of liver blood flow assessment using the transesophageal echocardiography at cardiac reconstructive surgeries with cardiopulmonary bypass are presented. 66 patients aged from 35 up to 71 years old were examined. There was not any evidence of liver failure according to the laboratory examination before the surgery. According to the cardiopulmonary bypass duration, all patients were divided into 3 groups: 20 (30%) patients - less than 80 min duration, 24 (36.4%) - 80-110 min, 22 (33.3%) - 110 min and more. Blood flow parameters in the right hepatic vein, right portal vein, and right hepatic artery before the sternotomy, 10 min before switching off cardiopulmonary bypass machine, and after switching off cardiopulmonary bypass machine were assessed. Blood flow was also assessed during the transabdominal examination in early postoperative period (in 9 hours after the surgery). There was not any correlation between the blood flow velocities in hepatic vessels during cardiopulmonary bypass and laboratory characteristics at postoperative period. K-coefficient was introduced to demonstrate the ratio between the sum of input average velocity values and output average velocity value during the cardiopulmonary bypass. Significant correlation was revealed between the K-coefficient and laboratory data of liver congestion at early postoperative period (r = 0.789, P = 0.00012). ROC-analysis determined the cut-off value for K-coefficient equal to 3.5 with sensitivity 95%, specificity 82%, AUC 0.94. K-coefficient equal to 3.5 or more can help to predict the liver failure in early postoperative period in patients undergoing cardiac surgery.

Literature review presents modern approach in oral and oropharyngeal squamous cell cancer diagnosis. Particular attention is paid to ultrasound value assessment. Transcutaneous submandibular, transoral, and transcutaneous buccal ultrasound approaches are described. Regional anatomy characteristics affecting on diagnostic accuracy of those approaches are discussed. Criteria of tumour extension to adjacent organs and tissues are given.