The article presents standards for performing and reporting of transabdominal prostate ultrasound in adults. The document consists of ultrasound protocol, which describes the methodology of ultrasound examination performing, and ultrasound report, describing the examination results with final conclusion. The ultrasound protocol and ultrasound report comply with current national and international guidelines.

Objective: to determine the value of using cardiothoracic ratio (CTR) as a second criterion, along with the peak systolic velocity in the middle cerebral artery (PSV-MCA) for a more accurate diagnosis of moderate-severe fetal anemia. Material and methods: fetal CTR was measured in two groups of pregnant women with normal pregnancy (group 1, n = 368) and anemic fetuses (group 2, n = 20). These groups made up a training sample. To test the diagnostic algorithm, a comparison group was formed (group 3, n = 61). The results were analyzed by the scikit-learn Machine learning in Python. Results: CTR increases with gestation and differs in groups of normal fetuses (group 1) and moderate-severe anemic fetuses (group 2) (P < 0.01). A logistic regression analysis was performed, a discriminant function was obtained, and a model was constructed. That allows the selection of fetuses with mode rate-severe anemia with an error value of 0,5%. For the diagnosis of moderate-severe fetal anemia, it is necessary to evaluate the PSV-MCA, and if the upper boundary of the 95% confidence interval is exceeded, to evaluate the CTR (two criteria). A comparative ROC analysis of the author’s approach and the G. Mary’s et al. (2000) approach (one criterion - PSV-MCA) was carried out. For the analysis, a test sample (group 3) was used, which did not participate in the evaluation of the model. The author’s approach is characterized by sensitivity 93.3%, specificity 100.0%, positive predictive value 100.0%, negative predictive value 97.9%, false positive fraction 0.0%, false negative fraction 6.7%, AUC (area under the curve) 0.966; the G. Mary’s et al. (2000) approach - 100.0%, 84.8%, 68.2%, 100.0%, 15.2%, 0.0%, 0.920, accordingly. Conclusion: the proposed diagnostic method of moderate-severe fetal anemia with a low level of false positive results makes it possible to avoid unjustified interventions, which is especially important in early pregnancy due to high risk of complications.

Objective: to evaluate the role of initial systolic rotation (ISR) of left ventricle (LV) in twist and untwist modulation in unstable angina (UA) and myocardial infarction (MI). Material and methods: 145 patients were examined and divided into three groups, the first of which included 30 patients with UA, the second - 62 patients with anterior MI, the third - 53 patients with inferior MI. Transthoracic echocardiography was performed in all patients with the use of Affiniti 70 (Philips, Netherlands) with aCMQ (automatic cardiac movement quantitative analysis) software. The maximal systolic peaks of segmental longitudinal and circular strain and global longitudinal and circular strain (GLS and GCS), systolic and diastolic rotation, twist and untwist of the left ventricle were assessed. The evaluation of basal and apical ISR based on curves of basal and apical LV rotation. Results: the twist and untwist of LV is predominantly influenced by the magnitude of circular strain of LV apical segments. A positive wave of basal ISR was obtained with higher frequency (44.1%) than a negative wave (31.7%) (P < 0.05). The presence of ISR of left ventricle basal segments is associated with greater basal systolic rotation and lesser LV twist (hereinafter: M ± SD, minimal - maximal values) (-3.0 ± 2.0 °, -8.4-1.2 ° and 7.5 ± 3.5 °, -1.0-16.4 °, respectively) than in the absence of the ISR wave (-4.5 ± 1.9 °, -12.1-0.1 °, P < 0.0001 and 9.1 ± 4.1 °, 0.5-21.5 °, P < 0.05, respectively). In all patients GLS values were significantly lower in the presence of basal ISR than in absence of it (-12.1 ± 3.4%, -18.2--3.0% and -10.7 ± 3,5%, -17.2--2.8%, respectively, P < 0.05). Significant GCS/GLS ratio decrease was obtained in the presence of ISR in comparison with its absence (1.71 ± 0.46, 0.67-3.70 and 1.92 ± 0.59, 0.96-4.10, respectively, P < 0.05). In UA and MI, a decrease in the systolic circular strain magnitude of basal segments <20% (modulus) in the presence of a basal ISR wave is combined with a decrease of the twisting index <1.0 °/cm (P < 0.05). In UA and MI, a decrease in the systolic circular strain magnitude of basal segments <20% (modulus) in the presence of a basal ISR wave is combined with a decrease in the untwisting index <0.35 °/cm (P < 0.05). Conclusions: the occurrence of basal ISR wave is higher in inferior MI than in anterior MI (P < 0.05). The presence of basal ISR wave is associated with lower values of LV twist in patients with UA and MI (P < 0.05), and modulate the effect of LV basal segment circular contraction on the value of the twisting and untwisting indices.

Non-compact cardiomyopathy is a rare heterogeneous disease, which is based on a violation of the structure of the myocardium. This article presents a clinical case of a 23-year-old patient, diagnosed biventricular non-compact cardiomyopathy, Brugada-like electrocardiographic pattern. Transthoracic echocardiography revealed two-layer structure of the left ventricular (LV) myocardium with a predominance of the non-compact layer over the compact one in the middle and apical segments of the anterior and inferior walls of LV. In the color Doppler imaging, contrasting of intertrabecular lacunae was visualized. More than 3 trabeculae were visualized at the end of diastole. The non-compact layer contracted synchronously with the compact. There were signs of moderate LV systolic dysfunction (LV outflow-tract velocity-time-integral - 13 cm), LV global longitudinal strain ≤14%, LV diastolic dysfunction (E/A - 2.4, DT - 77 мс). According to the contrast-enhanced cardiac magnetic resonance imaging (MRI), a significant increase in the trabecularity of the myocardium of the anterior, lateral, and inferior LV walls in the middle and apical segments in the diastolic phase (10 out of 17 segments) was determined with the ratio of non-compact and compact layers of the myocardium in the diastolic phase - 2.5-4.0, in the systole phase - 1.2. In addition, cardiac MRI showed images with increased trabeculation in the right ventricular apex. The cardiac MRI findings were regarded as biventricular non-compact cardiomyopathy. Resting ECG revealed sinus arrhythmia with a heart rate of 58-71 beats/min, incomplete right bundle branch block, signs of LV and left atrium hypertrophy, and the coved configuration of the ST segment with >2 mm elevation in leads V1-V3. Whole-exome sequencing was performed. Two rare heterozygote variants in the MYH7 (с.2679G>A, p.Ala893=) and FLNC (c.6629C>A, p.Ser2210Tyr) were identified. The article also presents a brief review.

The article is a pictorial review on the value of the assessment of mechanical dissynchrony in echocardiography. Special attention is paid to the prognostic value analysis of the mechanical dispersion of peak longitudinal strain of the left ventricle by speckle-tracking echocardiography in various diseases and pathological conditions. The values of this parameter in control groups and in various diseases and pathological conditions are presented.