In order to assess the practical efficacy of the S-Detect Thyroid artificial intelligence-based program for automatic detection and analysis of thyroid lesions, the prospective assessment of 84 focal thyroid lesions was carried out. he risk of malignancy was stratified according to the EU-TIRADS at the same time. A fine-needle aspiration biopsy was performed for all detected nodules of EU-TIRADS 3–5 category and a diameter ≥10 mm. Cytological examination was performed using the Bethesda classification. According to the cytology data, all patients were divided into two groups: 73 patients with benign thyroid nodules (Bethesda II) and 11 patients with malignant nodules (Bethesda V). Patients with “uncertain” Bethesda categories “I”, “III”, and “IV” were excluded from the study. The results of the study showed that the use of the S-Detect program based on artificial intelligence allows for differential diagnostics of benign (Bethesda II) and malignant (Bethesda V) thyroid nodules with a sensitivity of 90.9%, specificity of 94.5%, positive and negative predictive value of 71.4% and 98.6%, accuracy of 94%, and AUC 0.941. In our opinion, the best results of all program settings show the S-Detect “High Accuracy” mode, which we recommend for practical use. In some cases, there was disagreement between the S-Detect and the doctor's opinion in characterizing the nodule structure and echogenicity, as well as in determining the presence of macro- and microcalcifications. In our opinion, the use of the S-Detect benign/malignant criteria as indications for needle aspiration biopsy would avoid obviously unnecessary diagnostic interventions in some patients with thyroid nodules classified as EU TIRADS 3–5. However, the S-Detect artificial intelligence program cannot currently fully replace the doctor's intellect, erudition, and experience. 

Objective. To establish ultrasound characteristics of the dynamics of the fetal head descent along the birth canal during the uncomplicated second stage of labor in the occiput anterior and posterior positions.

Materials and methods. The prospective study included 198 women in labor. Spontaneous birth occurred in 180 of them, without the use of augmentation of labor or operative delivery. The remaining 18 women were excluded from the final analysis due to the use of augmentation of labor or operative delivery. The average gestational age was 39 3/7 weeks. The average weight of newborns was 3394 grams; all children were born with an Apgar score of 8 points or more at 5 minutes. All patients in the second stage of labor underwent hourly transperineal ultrasound to assess the angle of progression (AoP) and the delta angle of progression (ΔAoP). According to the AoP values, the following groups were formed: Group 1 - AoP less than 120°, which corresponds to the fetal head station on the parallel plane -1 to -2 cm; Group 2 – AoP 120-144 °, parallel plane 0 to +2; Group 3 – 145–170°, parallel plane from +2 to +5 cm, Group 4 – AoP more than 170°, parallel plane > +5 cm. Statistical analyses were carried out with the use of IBM SPSS Statistics 27 software; the significance of differences between the groups was confirmed by the Long Rank test (p < 0.001) and the Kruskal–Wallis criterion (p < 0.005).

Results. In cases of delivery with occiput anterior position, the time to birth was 177 (177–250) min in group 1, 100 (35–240) min in group 2, 75 (30–170) min in group 3, and 35 (15–75) min in group 4. There was no significant difference in ΔAoP between the groups — 16.6 ± 8.5 (10.1–27.1°). In the cases of delivery with posterior occipital position, no patient in group 1 had spontaneous labor with AoP <120°, while the time to birth was 110 (45–240) min in group 2, 75 (110–170) min in group 3, and 65 (18–110) min in group 4. ΔAoP was 12.5 ± 8.5 (11–15.6°).

Conclusion. The management of labor with dynamic ultrasound control provides the possibility to obtain objective criteria for the normal course of the second stage of labor, to improve the quality and reliability of the information received, to eliminate unnecessary interventions, and to reduce the number of vaginal digital examinations during childbirth, which has a positive effect on perinatal outcomes, reduces the risk of purulent-septic complications in the mothers, and increases the patients comfort during childbirth.

The purpose of this article is a review of literature and our own experience in diagnosing of Müllerian duct anomaly – accessory and cavitated uterine mass (ACUM). The lack of uniform approach to the terminology, classification, methods of diagnosis and treatment makes this anomaly relevant for a multidisciplinary evaluation.

These guidelines may have been translated, from the originals published by ISUOG, by recognized experts in the field and have been independently verified by reviewers with a relevant first language. Although all reasonable endeavors have been made to ensure that no fundamental meaning has been changed the process of translation may naturally result in small variations in words or terminology and so ISUOG makes no claim that translated guidelines can be considered to be an exact copy of the original and accepts no liability for the consequence of any variations. The guidelines are only officially approved by the ISUOG in their English published form.

Objective: To determine cut-off values for left atrial function parameters at rest and during physical exercise that are specific to patients with atrial fibrillation (AF).

Materials and Methods. The prospective single-center study with screening tests of 300 patients was carried out; 297 of them were included in the final analysis. The main cohort of patients was divided into three groups: patients with sinus rhythm without a history of AF, a group with paroxysmal/persistent AF, and patients with permanent AF. Stress echocardiography was performed in all patients according to the ABCDE protocol with additional assessment of left atrial volume index and left atrial strain (reservoir phase) at rest and peak exercise.

Results. The left atrial function assessment was successful in 99% (95% CI 98–100%) of patients. The group with sinus rhythm included 240 patients (Group 1), with paroxysmal/persistent AF (PAF) – 38 patients (Group 2), with permanent AF (PermAF) – 19 patients (Group 3). The threshold values of the parameters were determined: left atrial volume and function and LV diastolic function at rest and during exercise, which reliably distinguished the group of patients with sinus rhythm from patients with paroxysmal/persistent AF (Groups 1 and 2, respectively). The best parameters for classifying belonging to the PAF group were the volume and contractility of the LA. Moreover, the quantitative parameter of LA strain classified these groups of patients significantly better during physical exercise (accuracy – 74%, sensitivity – 89%, specificity – 49%) than at rest (accuracy – 64%, sensitivity – 74%, specificity – 51%), with p < 0.004.

Conclusions. The obtained threshold values of the left atrial function and volume, as well as E/e' at rest and during physical exercise, provide more accurate differentiation of patients with dyspnea/chest discomfort into groups with and without paroxysmal/persistent AF. The most accurate parameter is the left atrial strain during the exercise stress test.

The article presents a pictorial literature review on ultrasound evaluation of arteriovenous fistula for hemodialysis in patients with end-stage renal failure. Native arteriovenous fistula (AVF) is considered the “gold standard” of vascular access. Nowadays ultrasound is the first-line imaging modality of management of patients receiving hemodialysis treatment at all stages. The article highlights the role of ultrasound in preoperative assessment when planning the AVF creation, assessing the maturation of vascular access, as well as early detection of its dysfunction. The main complications of arteriovenous fistulas are presented, and examples of their diagnosis using the ultrasound are given.

A standard protocol for superficial lymph node (LN) ultrasound is presented. The document consists of a technological (1) and descriptive (2) protocols. The technological protocol describes the technique of superficial LN ultrasound. The descriptive protocol contains a detailed report of the results of superficial LN ultrasound, which ends with a conclusion. Modern domestic and foreign clinical and diagnostic recommendations that determine the indications for superficial LN ultrasound are analyzed.

The presented standard protocol for superficial LN ultrasound fully complies with current Russian clinical recommendations and does not contradict foreign clinical and diagnostic recommendations.

Transthoracic echocardiography has become an important tool in the diagnosis of not only cardiovascular diseases but also other pathologies. With the technological progress, echocardiography has become a widely used modality by doctors of various specialties, which increases its value in clinical practice. Despite this, there are still problems with the organization and standardization of examinations, which can negatively affect the quality of diagnostics. Existing disadvantages of the regulatory documents governing echocardiography lead to uncertainty in the time standards of the examination. The desire to reduce the time allocated for the echocardiography can worsen the quality of the examination and increase the staff fatigue. The need to record multimedia data emphasizes the importance of access to archives for re-analysis and quality control. However, the volume of data can be significant, which requires the creation of centralized data repositories. Digitalization of examination processes, including the formation of electronic reports, also faces some difficulties associated with the compatibility of electronic databases and their correct display, which requires further improvement of medical information systems.