Abstract:

Article presents a review of the scientific literature containing data on the role of ultrasound examination of joints in the diagnosis of rheumatoid arthritis, ultrasound signs of damage of main elements of joints and periarticular tissues, modern semi-quantitative scales for assessing the severity of main pathological changes detected by ultrasound examination of joints and tendons in patients with rheumatoid arthritis.

Aim: was to analyze scientific publications in domestic and world literature on ultrasound examination of joints in rheumatoid arthritis.

Materials and methods: 38 scientific sources of leading domestic and foreign journals were analyzed.

Results: currently, radiography is the gold standard in the diagnosis of rheumatoid arthritis and is widely used to monitor the progression of rheumatoid arthritis. However, it is not sensitive enough to detect changes at early stage of rheumatoid arthritis, since it only allows assessing bone structures that are involved in the pathological process 6-12 months after the onset of first signs of the disease. Ultrasound examination provides new possibilities for early detection of rheumatoid arthritis, since it allows to detect changes at early pre-radiological stage and to prevent the development of significant structural changes leading to early disability of patients.

Conclusion: the use of ultrasound examination of joints in the diagnosis of rheumatoid arthritis accelerates the diagnosis, is used to dynamically assess the course of the disease, evaluate the effectiveness of therapy, and also to predict outcomes. The diagnostic effectiveness of ultrasound examination of joints in rheumatoid arthritis involves the identification of synovitis, tenosynovitis, structural changes in the articular cartilage and bone (erosion), and an assessment of the severity of the inflammatory reaction.

Abstract:

Introduction: one of directions in development of intravascular diagnostic methods is creation of stations or development of methods that allow combining or uniting possibilities of different modalities. This approach makes it possible to overcome limitations inherent in each method of invasive vascular diagnostics, including angiography. This work is devoted to the analysis of possibilities and first results of using the SyncVision station (Philips Volcano), which allows, in various combinations, to carry out joint registration of angiography data, intravascular ultrasound (IVUS) and instantaneous blood flow reserve (iFR) in various combinations - a non-hyperemic version of fractional flow reserve study.

Aim: was to describe possibilities provided by the use of joint recording of data from angiography, IVUS and real-time instantaneous blood flow reserve, the technique for performing these procedures, as well as to analyze the application of these methods in a department with a large volume of intravascular studies.

Material and methods: the first experience in Russian Federation of the clinical use of the SyncVision station, which is an addition to the s5i intravascular ultrasound system (Philips Volcano), is presented. The station allows you to implement five options that expand the operator's ability to analyze study data and develop a treatment strategy directly at the operating table: co-registration of angiography and intravascular ultrasound (IVUS) data; co-registration of angiography data and instantaneous flow reserve (iFR); triple co-registration - angiography, IVUS and iFR; modification of the program for the quantitative calculation of coronary artery stenosis (QCA); real-time image enhancement software for interventional devices.

Results: studies using co-registration with angiography accounted for 21% of all IVUS procedures and 62,4% of iFR procedures. In 67,3% of all studies with angio-IVUS co-registration, the indication for this diagnostic variant was an extended lesion of artery, which required clarification of length of stenotic area, localization of reference segments, and diameter of artery at different levels. In 30 of these patients, triple co-registration was performed. To clarify the hemodynamic significance of lesion with an angiographically indeterminate or borderline picture, co-registration was performed in 13,2% of all cases, to study a bifurcation lesion with a significant difference in the reference segments and angiographically difficult to determine the entry of lateral branch - in 7,3%.

Based on results of triple co-registration, the decision to perform surgical treatment was made in 30 out of 42 patients (71,4%).

Conclusion: joint registration of IVUS data, coronary angiography, and instantaneous flow reserve (iFR) in real time, forms a new diagnostic modality that significantly expands possibilities of intraoperative examination and affects the planning or analysis of intervention results.

Abstract:

Introduction: the importance of intravascular diagnostic methods and the frequency of their use in clinical practice is steadily increasing. However, in the Russian Federation, studies on the analysis of possibilities of intravascular imaging or physiology are sporadic, and statistical data are presented only in very generalized form. This makes it relevant to create a specialized register dedicated to these diagnostic methods.

Aim: was to present the structure, tasks and possibilities of the Russian registry for the use of intravascular imaging and physiology based on results of the first year of its operation.

Material and methods: In total, in 2021, forms were filled out for 2632 studies in 1356 patients.

Studies included all types of intravascular imaging and physiology - intravascular ultrasound, optical coherence tomography, measurement of fractional flow reserve and non-hyperemic indices.

The registry's web-based data platform includes 14 sections and 184 parameters to describe all possible scenarios for applying these methodologies. Data entry is possible both from a stationary computer and from mobile devices, and takes no more than one minute per study. Received material is converted into Excel format for further statistical processing.

Results: 13 departments participated in the register, while the share of the eight most active ones accounted for 97,5% of all entered forms. On average, 1.9 studies per patient were performed, with fluctuations between clinics from 1,6 to 2,9. Studies of the fractional flow reserve accounted for 40% of total data array, intravascular ultrasound - 37%, optical coherence tomography - 23%. Of all studies, 80% were performed on coronary arteries for chronic coronary artery disease, 18% - for acute coronary syndrome, 2% were studies for non-coronary pathology. In 41% of cases, studies were performed at the diagnostic stage, without subsequent surgery. In 89,6% of cases, this was due to the detection of hemodynamically insignificant lesions, mainly by means of physiological assessment. In 72% of cases, the use of intravascular imaging or physiology methods directly influenced the tactics or treatment strategy - from deciding whether to perform surgery or not to choose the optimal size of instruments or additional manipulations to optimize the outcome of the intervention. In the clinics participating in the register, the equipment of all major manufacturers represented on the Russian market was used.

Conclusions: the design of the online registry database is convenient for data entry. Participation in the registry of most departments that actively and systematically use methods of intravascular imaging and physiology ensured the representativeness of obtained data for analysis in interests of both practical medicine and industry, as well as for scientific research in the field of intravascular imaging and physiology. The register has great potential for both quantitative and qualitative improvement.

Abstract:

Aim: was to evaluate the effectiveness of the complex use of MRI and high-resolution ultrasound for the diagnostics of fillers.

Material and methods: in presented case report, the study was carried out using a SOMATOM Aera SIMENS 1.5 Т tomograph in T1, T1 Dixon, T1 Fs, T2, T2 STIR modes, the slice thickness was 3 mm. Ultrasound was performed with a MyLab Alpha, Esaote device, linear sensors with a frequency of 6 - 18 MHz and 10 - 22 MHz were used in B-mode, Color Doppler Imaging mode.

Results: case report demonstrates possibilities of complex use of ultrasound and MRI in patients with atypical ultrasound pattern for hyaluronic acid-based fillers. When choosing treatment tactics, data obtained during the examination, indicating the presence of a filler in soft tissues of the chin that does not correspond to the ultrasound and MRI signs of hyaluronic acid, were taken into account.

Conclusions: complex diagnostics of dermal fillers using high-resolution ultrasound and MRI is indicated for patients with complications of contouring, for differential diagnostics of hyaluronic acid with fillers of non-hyaluronic nature.

Abstract:

Introduction: surgical treatment of an area of accumulation of breast microcalcifications requires the surgeon to choose the optimal method of surgery. For a long time, the gold standard of surgery was the placement of a wire needle under X-ray control and subsequent removal. In our study, we want to demonstrate one of new methods, which is based on the placement of ultrasound marks in the area of accumulation of calcifications at the preoperative stage and further removal under the control of ultrasound device.

Aim: was to make comparative analysis and estimate the effectiveness of preoperative marking with ultrasound-positive (US-positive) marks in patients with non-palpable breast neoplasms.

Material and methods: the study included 165 patients (age 32 - 71 years). Patients were divided into three groups depending on the preoperative marking. The first group: installed ultrasound-positive Gel Mark UltraCor Bard marks in the region of microcalcifications at the outpatient stage.

The second group: marking with a wire needle «DuaLok» Bard immediately before the operation.

The third group: according to results of a repeated preoperative examination, which included: unilateral mammography in two projections with marker, a skin mark was established in the projection of a non-palpable formation.

Results: study showed that when choosing a surgical treatment using ultrasound-positive marks, the risk of detecting tumor cells at edges of the resection decreases, the time of surgery is shortened, and the volume of resection of healthy breast tissue is minimized.

Study proved that marking using ultrasound-positive marks has an advantage over other methods of preoperative marking and can be implemented in medical organizations that are not equipped with x-ray equipment for marking non-palpable breast formations immediately before surgery.

References

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Abstract:

Introduction: article provides a literature review on the role of various imaging methods used in the diagnosis and control of effectiveness of therapy for rheumatoid arthritis.

Aim: to analyze domestic and foreign literature sources reflecting the state of the problem and aspects of radiological diagnosis of rheumatoid arthritis.

Materials and methods: 52 scientific sources of leading domestic and foreign journals were analyzed.

Results: conventional radiography today is the most widely used imaging technique for diagnosing and monitoring of progression of rheumatoid arthritis. However, it is not sensitive enough to detect changes in the early stage of rheumatoid arthritis, since it only allows assessment of bone structures. Establishing the diagnosis of rheumatoid arthritis at the stage of detecting structural abnormalities in joints indicates the presence of functional impairment and disability of patients. At the same time, early diagnosis of rheumatoid arthritis, at the stage of pre-radiological changes, leads to an improved prognosis of the disease and contributes to preservation of working capacity. In this regard, it becomes necessary to introduce into clinical practice sensitive advanced imaging methods aimed at identifying changes that precede the development of structural changes in bone.

Conclusion: the diagnostic effectiveness of radiation research methods in rheumatoid arthritis implies the identification of synovitis, tenosynovitis, early inflammatory changes in the bone, structural changes in the articular cartilage and bone (erosion), assessment of the severity of the inflammatory response.

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Abstract:

Aim: was to analyze domestic and foreign literature sources, reflecting the possibility of applying local ablation methods of focal liver tumors.

Material and methods: article presents an analysis of domestic and foreign 37 publications containing information on the use of methods of local ablation of nodular pathology of liver, deposited in resources of PubMed and information portal eLIBRARY.RU.

Results: most important aspects of performing of methods of chemical, cryo-, microwave, and radiofrequency ablations, used in treatment of local liver tumors were presented.

Conclusion: analysis of various publications on methods of local destruction of tumors does not give a clear answer to the question of which method is preferred, however, article describes each of ablation methods, highlighting positive and negative aspects of their effect on lesions of the liver. The question of the inclusion of minimally invasive methods in schemes of combined and complex antitumor therapy for focal liver lesions also remains open.

Modern approaches and improving techniques of treatment of liver malignancies, expand indications for the use of minimally invasive techniques. Competent selection of patients, selection of the optimal method of local ablation of tumor and subsequent dynamic monitoring of patients reduce the number of relapses, increase the percentage of overall survival of patients and improve their quality of life.

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25.   Lencioni R, de Baere T, Martin RC, at al. Imageguided ablation of malignant liver tumors: recommendations for clinical validation of novel thermal and non-thermal technologies - a western perspective. Liver Cancer. 2015; (4): 208–214.

26.   Mayo SC, Pawlik TM. Thermal ablative therapies for secondary hepatic malignancies. Cancer J. 2010; 16 (2): 111-117.

27.   Scudamore CH, Patterson EJ, Shapiro AM, et al. Liver tumor ablation techniques. J. Invest. Surg. 1997; 4: 157-64.

28.   Brace C. Thermal tumor ablation in clinical use. IEEE Pulse. 2011; (5):28-38.

29.   Iannitti DA, Martin RC, Simon CJ, et al. Hepatic tumor ablation with clustered microwave antennae. The US Phase II trial. HPB (Oxford). 2007; 9(2): 120.

30.   Rossi S, Carbagnati P, Rosa L, et al. Laparoscopic radio frequency thermal ablation for treatment of hepatocelluar carcinoma. Int. J. Clin. Oncol. 2002; 225-235.

31.   Zivin SP, Gaba RC. Technical and practical considerations for device selection in locoregional ablative therapy. Semin. Intervent. Radiol. 2014: 31(2): 212-24.

32.   Mehta A, Oklu R, Sheth RA. Thermal ablative therapies and immune checkpoint modulation: can locoregional approaches effect a systemic response? Gastroenterology Research and Practice. 2016; 9251375: 11.

33.   Sidana A. Cancer immunotherapy using tumor cryoablation. Immunotherapy. 2014; 6(1): 85-93.

34.   Dolgushin BI, Patjutko JuI, Sholohov VN, et al. Radiofrequency thermal ablation of liver tumors. Edited by MI Davydov. Prakticheskaja medicina. 2007; 192 [In Russ].

35.   Fedorov VD, Vishnevskij VA, Kornjak BS, at al. Radiofrequency ablation of malignant tumors of the liver (literature review). Hirurgija. 2003; 10: 77-80 [In Russ].

36.   Machi J, Oishi AJ, Mossing AJ, Furumoto NL, Oishi RH. Hand-assisted laparoscopic ultrasound-guided radiofrequency thermal ablation of liver tumors: a technical report. Surg Laparosc Endosc Percutan Tech. 2002; 12:160–164.

37.   Gilliams AR, Lees WR. CT mapping of the distribution of saline during radiofrequency ablation with perfusion electrodes. Cardiovasc Intervent Radiol. 2005; 476-480.

Abstract

Aim: was to evaluate possibilities of puncture biopsy under ultrasound guidance of parasternal lymph nodes in patients with breast cancer.

Material and methods: study included 34 patients with breast cancer. Criteria for inclusion in the study were: primary breast cancer with a central or medial tumor localization, and patients under observation after previously undergoing surgical treatment. All patients underwent an ultrasound examination of the breast and regional zones, including the parasternal lymphatic collector. All patients underwent biopsy.

Results: in total, 39 parasternal lymph nodes suspicious on secondary lesion were detected, of which 17 (43,5%) lymph nodes had a specific lesion, 22 (56,5%) lymph nodes showed cystological signs of hyperplasia according to results of cytological examination. Parasternal lymph nodes metastases were detected in 16 (47,1%) of 34 patients included in our study. In all cases of specific lesion, lymph nodes were rounded, there was a violation of differentiation of anatomical structures, the absence of a central echo complex, a violation of differentiation and thickening of the cortical layer. In the group of primary patients, 3 (27,3%) patients with metastases in parasternal lymph nodes had distant metastases, remaining 8 (72,7%) patients, due to the lesion of the parasternal lymphatic collector, the stage of the disease were adjusted upwards (stage IIIA).

Conclusion: fine-needle aspiration biopsy under ultrasound-guidance in case of suspected secondary lesion of parasternal lymph nodes, can be successfully used to obtain morphological material with minimal traumatic impact, without the use of anesthesia, which will more adequately assess the state of parasternal lymph nodes at the preoperative stage, correctly set the stage of the disease and prescribe the appropriate treatment.

References

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2.       Федотов Ю.Н., Воробьев С.Л., Черников РА. Тонкоигольная аспирационная биопсия в диагностике заболеваний щитовидной железы. Корреляция между заключением цитолога и гистолога, технические аспекты. Клиническая и экспериментальная тиреоидология. 2009. Т. 5. № 4. С. 28-32.

3.       Бурдюков М.С., Нечипай А.М. Тонкоигольная пункция под контролем эндоскопической ультрасонографии: осложнения и альтернативы. Российский электронный журнал лучевой диагностики. 2013. Т. 3. № 2. С. 26-37.

4.       Марченко М.Г., Трофимов Е.И., Виноградов В.В. Современные методы выявления метастазов рака гортани и гортаноглотки в лимфатические узлы шеи. Российская оториноларингология. 2011. № 1 (50). С. 114-117.

5.       TNM Classification of Malignant Tumours, 7th ed. Sobin L.H., Gospodarowicz M.K., Wittekind Ch., eds. New York: Wiley-Blackwell; 2009.

6.       V. L. Kovalenko, M. F. Musafirov, R. V. Experience of video-assisted thoracoscopic parasternal lymph node dissection in breast cancer. Dal'nevostochnyj medicinskij zhural 2014 g. [In Russ.]

7.       Ujmanov V.A., Nechushkin M.I., Trigolosov A.V.. Petrovskij A.V., Vishnevskaya YA.V., Zajceva A.A. Surgical techniques for morphological assessment of the state of the parasternal lymphatic collector as part of organ-preserving treatment in patients with breast cancer. Vestnik RONTS im. N.N. Blochina RAMN. Tom 23: 3(89), 2012: 29 34. [In Russ.]

8.       McDonald E, Haagensen C.D. In: Diseases of the breast. 2nd ed. Philadelphia: W. B. Saunders; 1971.

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10.     Sinyakov A.G. Videothoracoscopic parasternal lymphadenectomy in the treatment of breast cancer. Mezhdunarodnyj zhurnal prikladnyh i fundamental’nyh issledovanij. №10, 2014. [In Russ.]

Abstract:

Background: expansion of tourism business in countries of South and Southeast Asia, Africa, and South America led to the appearance of rare parasitic diseases in Russia, Europe, and the United Kingdom. In our country, more than 1.3 million patients with various parasitosis are officially registered annually, among which there is an increase in the incidence of intestinal protozoa.

Aim: was to show features of the diagnosis of acute manifestations of necrotic amebic colitis, which simulated severe intoxication with manifestation of clinics of acute surgical disease and intestinal bleeding

Material and methods: using the example of case report of a 70-year-old woman, the possibility of complex diagnostics using abdominal ultrasound, abdominal computed tomography, colonoscopy with biopsy of intestinal ulcers and parasitological research methods is shown. Results: detoxification, anti-inflammatory therapy in a surgical hospital and instrumental examination allowed us to objectively evaluate and conduct targeted therapy avoiding serious complications.

Discussion: primary lesions with acutely occurring both local and general body reactions lead to severe intoxication, which does not allow to exclude acute surgical pathology, and in some cases dictate the need for urgent surgical intervention.

Differential diagnosis of an amoeba with a colon cancer only on the basis of x-ray symptoms is almost impossible. Specific anti-ameba therapy leads to the disappearance of amoeba.

Conclusion: only on the basis of a complex of clinical and epidemiological data, ultrasound, CT, colonoscopy, histological analysis and parasitological methods of research, pathology can be correctly identified. 

References

1.      Bronshtejn A.M., Malyshev N.A., Luchshev V.I. Amebiasis: clinical features, diagnosis, treatment. Klinicheskaya mikrobiologiya i antimikrobnaya himioterapiya. 2001; 3(3): 215-222 [In Russ.].

2.      Gostishchev V.K., Khrupkin V.I., Afanas'ev A.N., Gorbacheva I.V. The complicated intestinal amebiasis in emergency surgery. Xirurgiya. 2009; (5): 4-9 [In Russ.].

3.      Lisicyn K.M., Revskoj A.K. Urgent abdominal surgery for infectious and parasitic diseases. M: Medicina, 1988: 237-271 [In Russ.].

4.      Petridou C, Al-Badri A, Dua A, et al. Learning points from a case of severe amoebic colitis. Infez Med. 2017; 25(3): 281-284. PMID: 28956549

5.      Cook G.C. Parasitic infections of gastrointestinal tract: a worldwide clinical problem. Curr Opin Gastroenterol.1989; 2(Is1): 126-139.

6.      Ozereczkovskaya N.N. Organ pathology in the acute stage of tissue helminthiases: the role of blood and tissue eosinophilia, immunoglobulinemia E, G4 and factors that induce an immune response. Medicinskaya parazitologiya iparazitarny'e bolezni. 2000; (3): 3-8 [In Russ.].

7.      Romanenko N.A. Modern tasks of sanitary parasitology. Medicinskaya parazitologiya i parazitarny'e bolezni. 2001; (4): 25-29 [In Russ.].

8.      Sergiev V.P, Filatov N.N. Infectious diseases at the turn of the century: an awareness of the biological threat. Moskva: Nauka, 2006; 572 s [In Russ.].

9.      Kry'lov M.V. The determinant of parasitic protozoa (human, domestic animals and agricultural plants). Sankt-Peterburg: ZIN, 1996; 602 s [In Russ.].

10.    Eryuxin I.A., Xrupkij V.I. (red.) Experience of medical support of troops in Afghanistan 1979-1989 V. 2: Organization and scope of surgical care for the wounded. Moskva, 2002: 379-386 [In Russ.].

11.    Scherbakov I.T., Leonteva N.I., Chebyshev N.V., i dr. Pathomorphology of colonic mucosa in patients with chronic post-parasitic colitis. Aktual'ny'e voprosy' infekcionnojpatologii. 2014; 95(6): 934- 938 [In Russ.].

12.    Ellyson J.K, Bezmalinovic Z., Parks S.N, Lewis F.R. Necrotizing amebic colitis: a frequently fatal complication. Am J Surg. 1986; 152(1): 21-26. PMID: 3728812.

13.    Shirley DA, Moonah S. Fulminant amebic colitis after corticosteroid therapy: a systematic review. PLoS Negl Trop Dis. 2016; 10(7): e0004879.

14.    Guzeeva T.M. Status the incidence of parasitic diseases in the Russian Federation and tasks in terms of the reorganization of the service. Medicinskaya parazitologiya i parazitarny'e bolezni. 2008; (1): 3-11 [In Russ.].

15.    Weitzel T, Carbera J, Rosas R, et al. Enteric multiplex PCR panels: A new diagnostic tool for amoebic liver abscess? New Microbes New Infect. 2017; 18: 50-53. PMID: 28626584 DOI:10.1016/j.nmni.2017.05.002.

16.    Abbas М.А., Mulligan D.C., Ramzan N.N., et al. Colonic perforation in unsuspected amebic colitis. Dig Dis Sci. 2000; 45(9): 1836-1841. PMID: 11052328.

17.    Sinharay R., Atkin G.K., Mohamid W., Reay-Jones N. Caecal amoebic colitis mimicking a colorectal cance. J Surg Case Rep. 2011; (11): 1. PMID: 24972391 DOI:10.1093/jscr/2011.11.1.

18.    Delabroussea E., Ferreirab F., Badeta N., et al. Coping with the problems of diagnosis of acute colitis. Diagn Intervent Imaging. 2013; 94(7-8): 793—804. PMID: 23751227 DOI:10.1016/j.diii.2013.03.012. 

Abstract:

Despite advances made in the treatment of renal cell carcinoma, kidney cancer still remains a «surgical» disease. Radical surgery is the only cure for this pathology If it is technically impossible to perform a resection of the kidney in situ, it is preferable to use the latter treatment option, since it avoids chronic hemodialysis, the need for kidney transplantation and improve the quality of life. The central and intraparenchymal location of tumors does not allow the organ-preserving operation due to the necessity of resection of segmental vessels, cups and renal pelvis, which prolongs the time of thermal ischemia. Conducting extracorporeal resection of the kidney in conditions of chemo-cold ischemia allows you to expand indications for organ-preserving treatment of patients with localized kidney cancer.

Aim: was to evaluate possibilities of ultrasound monitoring during extracorporeal resection of the kidney with orthotopic nephropexy and replantation of renal vessels at all stages of surgical treatment.

Material and methods: 47 patients (74% of men, 26% of women) with a histologically confirmed diagnosis of kidney cancer were hospitalized for treatment at the period from March 2012 to the present in A.V Vishnevsky National Medical Research Center of Surgery All patients underwent extracorporeal resection of the kidney under conditions of pharmaco-cold ischemia without intersection of the ureter with orthotopic replantation of renal vessels. Ultrasound examination (in B-mode, Color and Energy Doppler Imaging and pulsed Doppler) was performed for all patients in the pre-, intra- and postoperative stages.

Results: the analysis of the ultrasound data obtained during the surgical treatment of patients at its stages allowed us to develop an algorithm for examining patients at stages of extracorporeal resection of the kidney under conditions of pharmaco-cold ischemia without crossing the ureter with orthotopic replantation of the renal vessels, taking into account technical features of surgical intervention

Conclusion: extracorporeal resection of the kidney with orthotopic nephropexy and replantation of renal vessels requires constant dynamic monitoring of the functional state of the renal blood flow Doppler ultrasound, performed according to the developed method, is a highly informative method in the qualitative and quantitative assessment of intrarenal blood flow. Ultrasound monitoring allows you to determine the functional state of the kidneys during the preoperative stage, intraoperatively assess the state of vascular anastomoses and monitor changes in the kidneys and the resectior zone in the postoperative period. 

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5.      Teplov AA, Gritskevich AA, Pianikin SS. Extracorporeal kidney resection in pharmaco-cold ischemia without intersecting the ureter with orthotopic vascular replantation in renal cell carcinoma. Experimental and clinical urology. 2015; 52-62 [In Russ].

6.      Ultrasound diagnosis in abdominal and vascular surgery. Ed. GI. Kuntsevich. - Minsk: Cavalier Publishers, 1999; 256 p [In Russ].

7.      Lelyuk VG, Lelyuk SE. Ultrasound angiology. - M .: Real time, 2003; 322 p [In Russ].

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11.    Hirai T, Ohishi H, Yamada R, Imai Y Hirohashi S, Hirohashi R, Honda N, Uchida H. Usefulness of color Doppler imaging in differential diagnosis of multilocular cystic lesions of the kidney. J. Ultrasound Med. E. 1995; 14(10): 771-776.

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Abstract:

Aim: was to assess the accuracy of the diagnosis of malformations of the fetus at early stages of pregnancy

Materials and methods: 26,404 pregnant women who came to the Republican Center for Screening Mothers and Children on a routine basis in terms of 11 to 20 weeks of pregnancy were examined. Among them, 25,956(98,3%) women were pregnant with a physiological course of pregnancy, 269(1,0%) pregnant women with fetal malformations and 179(0,7%) with pathological pregnancy

Prenatal diagnostics included ultrasound, biochemical, invasive and cytogenetic research methods. Initially, a primary ultrasound study of pregnant women was conducted, with the purpose of measuring fetometric, biometric and dopplerometric parameters. In case of deviation of above mentioned parameters from the norm, a second stage-biochemical screening was carried out. When biochemical parameters changed from normative values, the third stage was carried out - invasive and cytogenetic diagnostics.

Results: based on results of studies, all women were divided into 3 groups. The first group included women with a physiological course of pregnancy - 25,956(98,3%). In the second group of patients (n=269) with single fetal malformations, there were 230(85,5%), with multiple - 39 (14,5%). In the third group of women (n=179), in most cases, a non-developing pregnancy was registered - 99(55,31%), females with uterine fetal death were 69(38,5%), with bladder drift - 11 (6,2%).

Conclusions: every pregnant woman should be examined individually, regardless of age. When carrying out prenatal diagnosis of malformations of the fetus, doctors should use a single algorithm for performing an ultrasound examination. Practitioners should not rely on the age of the pregnant woman; regardless of the age of the pregnant woman, to conduct a more detailed examination for fetal malformations, both 35 years of age and older and younger than 35 years. In order to avoid undeveloped pregnancy, and intrauterine fetal death, as well as early detection of fetal malformations, there is a need for screening in the first trimester of pregnancy Inclusion of the first trimester in the screening program in a timely manner will create risk groups for the birth of children with malformations of the fetus, timely resolve the issue of further introduction of pregnancy, thereby reducing obstetric complications, and also reduce maternal and infant mortality.

References

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3.      Snyders R.J.M., Nicolaides K.K.H. Ultrasound markers of chromosomal defects of the fetus. M .: Vidar. 1997; 13-21 [In Russ].

4.      Medvedev MV, Yudina EV. Retardation of intrauterine development of the fetus. Moscow: RAVUZDPG. 1998; 204 р. [In Russ].

5.      Teratology of human. Ed. G.I. Lazyuk. M .: Medicine. 1991; 315 р. [In Russ].

6.      Ginter EK. Medical genetics. Textbook. M .: Medicine. 2003; 445 р. [In Russ].

7.      Baranov VS, Kuznetsova TV. Cytogenetics of human embryonic development. S-Pb: N-L. 2007; 640 р. [In Russ].

8.      Prenatal diagnosis of congenital malformations in early pregnancy. Ed. M.V. Medvedev M .: RAVUZDPG. Real time. 2000; 160 р. [In Russ].

9.      Medvedev MV, Altynnik NA. About ultrasound evaluation of fetal anatomy in early pregnancy. Prenat. Diagn. 2002; 1(2): 158-159 [In Russ].

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11.    Medvedev MV. Ultrasonic fetometry: reference tables and nomograms. Moscow: Real Tim^ 2002; 80 р. [In Russ].

12.    Esetov MA. Ultrasound diagnosis of congenital malformations of the fetus in early pregnancy. Avtoref....doct. med. scie. Moscow, 2007; 26 р. [In Russ].

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17.    Den Hollander NS, Wessels MW, Niermeijer MF, Los FJ, Wladimiroff JW Early fetal anomaly scanning in a population at. increased risk of abnormalities. Ultrasound Obstet. Gynecol. 2002; 19(4): 570-574.

Abstract:

Aim: was to optimize technics of ultrasound-guided vacuum-aspiration breast biopsy at 3 and 4A categories of BI-RADS scale and subsequent maintenance of patients.

Materials and methods: vacuum-aspiration breast biopsy was performed on 100 female patients aged 23-66 years. Long acting anesthetics were used for anesthesia. After the biopsy no residual tissue was detected.

Results: in 15% of cases (n=15), complications requiring different treatment tactics were revealed. According to histological studies 97% of tumors were benign. 3 patients were diagnosed with breast cancer classified into BI-RADS category 3. For 24% (n=24) of women, long-term results were obtained in 6 months with no signs of relapse.

Conclusions: ultrasound-guided vacuum-aspiration breast biopsy is an effective technics, that doesn't require complex preparation and doesn't take a long time to conduct. With sufficient training of the operator, it is possible to effectively control the completeness of the removal of mass. Using of long acting anesthetics allows ensuring good acceptability of the procedure and providing comfort to patients.

References

1.     Papathamelis T, Heim S, Lux MP. et al. Minimally Invasive Breast Fibroadenoma Excision Using an Ultrasound-Guided Vacuum-Assisted Biopsy Device. Geburtshilfe und Frauenheilkunde 2017; (2):176-181.

2.     Lakoma A, Kim ES, Minimally invasive surgical management of benign breast lesions. Gland surgery. 2014; (2):142-8.

3.     ACR BI-RADS Atlas® 5th Edition. www.acr.org

4.     Bennett I. C. The Changing Role of Vacuum-assisted Biopsy of the Breast: A New Prototype of Minimally Invasive Breast Surgery. Clinical breast cancer. 2017; (5): 323-325

5.     Seo J, Kim SM, Jang M, et al. Ultrasound-guided cable-free 13-gauge vacuum-assisted biopsy of non-mass breast lesions. Public Library of Science one. 2017; 12 (6)

6.     Jung I, Min JK, Hee J M, et al. Ultrasonography-guided 14-gauge core biopsy of the breast: results of 7 years of experience. Ultrasonography. 2018; (1):55-62

7.     Hui-ping Huo., Wen-bo Wan., Zhi-li Wang., et al. Percutaneous Removal of Benign Breast Lesions with an Ultrasound-guided Vacuum-assisted System: Influence Factors in the Hematoma Formation. Chinese medical sciences journal. 2016; (1):31-36.

8.     Zhang YJ, Wei L, Li J., et al. Status quo and development trend of breast biopsy technology. Gland surgery. 2013; (1):15-24.

9.     Xiao-Fang He, Feng Y Jia-Huai Wen, et al. High Residual Tumor Rate for Early Breast Cancer Patients Receiving Vacuum-assisted Breast Biopsy. Journal of Cancer. 2017; 3: 490-496.

10.   Liu S, Zou JL, Zhou FL., et al. Efficacy of ultrasound-guided vacuum-assisted Mammotome excision for management of benign breast diseases: analysis of 1267 cases. Journal of Southern Medical University. 2017; (8):1121-1125.

11.   Brennan M.E., Turner R.M., Ciatto S., et al. Ductal Carcinoma in Situ at Core-Needle Biopsy: Meta-Analysis of Underestimation and Predictors of Invasive Breast Cancer. Radiology 2011; (1):119-128.

12.   Safioleas PM, Koulicheri D, Michalopoulos N, et al. The value of stereotactic vacuum assisted breast biopsy in the investigation of microcalcifications. A six-year experience with 853 patients. Journal of Balkan Union of Oncology. 2017; (2): 340-346.

Abstract:

The review is devoted to possibilities of ultrasound and functional diagnostic methods in the diagnosis of ischemic stroke of unknown etiology. Main causes of cryptogenic ischemic stroke are highlighted in the article. Advances in high resolution ultrasound of extracranial and intracranial vessels and of the heart, prolonged heart rhythm monitoring are instrumental techniques to identify arterial and cardiac hidden causes of stroke. We reviewed literature, on the basis of available data, designed a diagnostic algorithm for patients with patent foramen ovale (PFO) and risk of embolism from atherosclerotic plaque. 

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4.      Hart R.G., Diener H.C., Coutts S.B., Easton J.D. Embolic strokes of undetermined source: the case for a new clinical construct. Lancet Neurol. 2014;13(4): 429-38.

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6.      Hohnloser S.H., Capucci A., Fain E. et. al. ASSERT Investigators and Committees ASymptomatic atrial fibrillation and Stroke Evaluation in pacemaker patients and the atrial fibrillation Reduction atrial pacing Trial (ASSERT). Am Heart J. 2006; 152(3): 442-447.

7.      Yaghi S., Elkind M.S. Cryptogenic stroke: a diagnostic challenge. Neurol Clin Pract. 2014(4): 386-393.

8.      Favilla C.G., Ingala E., Jara J. et al. Predictors of finding occult atrial fibrillation after cryptogenic stroke. Stroke. 2015(46): 1210-1215.

9.      Miller D.J., Khan M.A., Schultz L.R. et al. Outpatient cardiac telemetry detects a high rate of atrial fibrillation in cryptogenic stroke. J Neurol Sci. 2013(324): 57-61.

10.    Gladstone D.J., Dorian P, Spring M. et al. Atrial premature beats predict atrial fibrillation in cryptogenic stroke: results from the embrace trial. Stroke. 2015; 46: 936-941.

11.    Keach J.W., Bradley S.M., Turakhia M.P, Maddox TM. Early detection of occult atrial fibrillation and stroke prevention. Heart.2015; 101: 1097-102.

12.    Gladstone D.J., Dorian P, Spring M. et al. Atrial premature beats predict atrial fibrillation in cryptogenic stroke: results from the embrace trial. Stroke.2015; 46:936-941.

13.    Brambatti M., Connolly S.J., Gold M.R. et al. Temporal relationship between subclinical atrial fibrillation and embolic events. Circulation.2014; 129: 2094-2099.

14.    Kamel H., O’Neal W.T., Okin PM., et al. Electrocardiographic left atrial abnormality and stroke subtype in atherosclerosis risk in communities study. Ann Neurol.2015; 78(5): 670-678.

15.    Kamel H., Soliman E.Z., Heckbert S.R. et al. P- wave morphology and the risk of incident ischemic stroke in the multi-ethnic study of atherosclerosis. Stroke. 2014; 45:2786-2788.

16.    Sinner M.F, Stepas K.A., Moser C.B. et al. B-type natriuretic peptide and c-reactive protein in the prediction of atrial fibrillation risk: the CHARGE-AF consortium of community-based cohort studies. Europace. 2014; 16: 1426-1433.

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Abstract:

Aim: was to analyze long-term resuts of true lumen reconstruction in complicated aortic dissections type В with help of balloon-expandable stents under intravascular ultrasonic (IVUS) guidance as a preoperative evaluation of anatomy and morphology of lesion.

Materials and methods: 47 patients witn type В aortiс dissections underwent endovascular treatment in our departmert n 20 cases - IVUS was used for irtraoperative anatomy and morphology verification. Complications developed n 16 patients, and true lumen was reconstructed by stent-graft implantation (to cover proximal fenestration) followed by balloon-expandable stents implantation at the level of visceral arteries under IVUS control at every stage. 87,5% of patents were man, mean ago 51 8—16,2 years.

Results: Technical success was 100% True lumen total reconstruction was reached in every case under precise IVUS control. Visceral arteries malperfusion was not observed at hospital period or follow-up. З0-day mortality rate was 6,25% (1 case due to aortic rupture in uncovered part of aorta - 7 days after procedure). All 15 discharged patients survived for 1st year. Mean follow-up period is 3,3±1,6 years. One patient died due to aortobronchial fistula, 1 due to repeated stroke and 1 due to cancer. At CT-scan 2 years after implantation (10 cases) fractures of balloon-expandable stents were observed, without аnу influence on intraluminal size or stenotic lesion. True lumen size stayed stable for 1 year.

Conclusion: true lumen reconstruction under IVUS control seems to be feasible and effective in complicated Type B dissections, even with the use of balloon-expandable stents. The usage of additional intraoperative visualization - intraaortic IVUS is the key point in the development of advanced endovascular methods.

References

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5.      Canaud L., Faure E.M., Ozdemir B.A., Alric P., Thompson M. (2014) Systematic review of outcomes of combined proximal stent-grafting with distal bare stenting for management of aortic dissection. Ann Cardiothorac Surg. 3: 223-233.

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Abstract:

According to current recommendations and orders of the Russian Ministry of Health, in the department of ultrasound diagnostics of the oncological center, it is necessary and lawfully to perform invasive manipulations to obtain a morphological verification of the oncological process. Nevertheless, there are significant gaps in the existing normative acts concerning organizational aspects.

Aim: to conduct an analysis of the organization and results of morphological testing of malignant neoplasms in conditions of separation of ultrasonic diagnostics of the Kursk Regional Clinical Oncology Center.

Materials and methods: 5,114 results of histological and immunohistochemical studies of material obtained with biopsies under ultrasound in the period 2012 - 2016 were analyzed. For the first time we included into department - 2 manipulation rooms, corresponding to sanitary requirements for conducting sterile manipulations. We first install Sonoscape S40 scanners in the manipulation rooms. All invasive examinations were performed by ambulatory and resident patients by ultrasound specialists who have a primary specialization in surgery, gynecology or urology Core biopsy was performed under local anesthesia with semi-automatic needles 14G or 16G; a gun-needle system biopsy was performed using a Bard-Magnum biopsy gun, 18 G needle, and a biopsy attachment to the rectal sensor. The material was preserved in a 10% solution of neutral formalin, labeled and sent to the department of oncomorphology with application of the direction to the intravital pathological anatomical study of the biopsy material. Statistical processing of the data was carried out using the SPSS program «STATISTICS 20.0». Conjugation tables were compiled to determine the relationship between variables. Pearson's x2 was used as the communication criterion, and its asymptomatic two-sided significance was estimated.

Results. During the research, high efficiency of the proposed organizational model is revealed. A statistical relationship is revealed between the informativeness of the material and the physiciar who manipulates and organ-object. Ways of development are offered.

References

1.      Kaprin A.D., Starinskij V.V., Petrova G.V. The state of oncological care for the population of Russia in 2013. M.: FGBU «MNIOI im. PA. Gercena» Minzdrava Rossii. 2014; 235 s [In Russ].

2.      Order of the Ministry of Health of the Russian Federation of 04.07.2017 No. 379n «On Amending the Procedure for the provision of medical care to the population in the field of oncology, approved by Order of the Ministry of Health of the Russian Federation of November15, 2012No.915n»].URL.:http://www.consultant.ru/document/cons_doc_LAW_220809/f891655c8c9f6864b656ef 38dba5a212e7e2b0e6/ (Data obrashhenija 23.10.2017) [In Russ].

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4.      Ponedel'nikova N.V., Korzhenkova G.P, Letjagin VP, Vishnevskaja Ja.V. Choice of the method of verifying the volume of newgrowth of the mammary gland at the preoperative stage. Opuholi zhenskoj reproduktivnoj sistemy. 2011; 1: 41-45 [In Russ].

5.      Nazarenko G.I., Hitrova A.N. Ultrasonic diagnostics of the prostate in modern oncological practice. M.: Izdatel'skij dom Vidar-M. 2012; 288s [In Russ].

6.      About the improvement of the service of radiation diagnosis: the order of the Ministry of Health of the RSFSR of August 2, 1991 № 132. URL.:http:// www.rasudm.org /information/docs.htm (Data obrashhenija 23.10.2017) [In Russ].

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10,    2016. URL.: http://base.garant.ru/12177989/ #ixzz4xU73XzAB (Data obrashhenija 04.11.2017) [In Russ].

9.      Attachment №2 to the order of the Ministry of Health of the Russian Federation of March 24, 2016 N 179n «On the Rules of Pathology and Anatomical Research» (registered by the Ministry of Justice of the Russian Federation on April 14, 2016, registrationN41799). URL.:http://pravo.gov.ru/proxy/ips/?docbody=&nd= 102396069 (Data obrashhenija 04.11.2017) [In Russ].

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Abstract:

The aim of the study was to assess the powers of complex ultrasonography in different stages of endovascular closure of atrial septal defects (ASD). 31 patients 13-56 years old (mean age 23,65 ±5,2 years) with septal defects were included into the study. Ultrasound (US) monitoring performed during the procedure of endovascular closure, and as a follow-up. There were prevalence (35,4%) of the patients with central ASD with rims of 5 mm and more. Abcence of anterio-superior or aortic rim, or its deficiency, noted in 19,2% of cases. Patent foramen ovale (PFO) registered in 25,81% of patients. Incidence of multiple ASDs and ASD in aneurysm occurred to be similar and was as high as 9,67%. In 2 cases of multiple ASDs, and 2 cases of PFO, transseptal puncture was used as an approach to left atrium, for the reason of complex anatomy of the septum. After the closure, transthoracic US showed reliable decrease of the right atrium, right ventricle, and pulmonary artery (PA) size. The majority of patients (64%) showed normalization of PA pressure and left ventricle enlargement in a week after the procedure. Two-dimensional echocardiography (EchoCG) with color Doppler mapping (CDM) is the key method for ASD imaging and assessing its suitability for endovascular closure. Transesophageal EchoCG can help in verification of the ASD anatomy and refinement of the ASD rims. Ultrasound guidance during the procedure of endovascular closure allows optimal positioning of the device, immediate assessment of the homodynamic effects, and timely diagnosis of complications.

Reference

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7.     Пурецкий М.В., Иванов А.С., Тараян М.В.,Балоян Г.М., Плотицин А.А., РодионовА.С., Аксюк М.А., Ревуненков Г.В. Опытиспользования Amplatzer septal occluderдля закрытия дефектов межпредсерднойперегородки. Хирургия. 2008; 2: 10-14.

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10.   Droste D.W., Lakemeier S., Wichter T., Stypmann J., Dittrich R., Ritter M., Moeller M., Freund M., Ringelstein E.B. Optimizing the technique of contrast transcranial Doppler ultrasound in the detection of right-to-left shunts. Stroke. 2002; 33 (9): 2211-2216.

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12.   Augoustides J.G., Weiss S.J., Ochroch A.E., WeinerJ., Mancini J., Savino J.S., Cheung A.T. Analysis of the interatrial septum by transesophageal echocardiography in adult cardiac surgical patients: anatomic variants and correlation with patent foramen ovale. J. Cardiothorac. Vasc. Anesth. 2005; 19 (2): 146-149.

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Abstract:

Results of minimal invasive percutaneus drainage interventions under US-control in 45 children, aged 1-4 years with intraabdominal abscesses of different genesis are presented. Intraabdominal abscesses were identified as subdiaphragmatic (16), intrafilar (22) and pelvic (19). Difference between US-characteristics of intraabdominal abscesses, preoperative planning peculiarities and interventional technologies, that depend on localization of abscesses are presented.

The usage of 3D-echography results data in 13,3% of children increased the value of diagnostics: for optimization of surgical approach, kind and volume of intervention.

Percutaneus drainage intervention under ultrasound control is effective and non-traumatic method of treatment. 

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9.     Vajner Ju.S., Egorov A.B., Vardosanidze V.K. Treatment of abdominal cavity’ abscesses with the help of US-guided mini-invasive interventions. Scientific-practical conference «Transcutaneus and endoscopic interventions in surgery»: abstracts. Moskva. 2010: 48-49 [In Russ].

10.   Shulutko A.M., Nasirov F.N., Natroshvili A.G. Possibilities of US in diagnostics and treatment of abdominal cavity’ abscesses. Scientific-practical conference «Transcutaneus and endoscopic interventions in surgery»: abstracts. Moskva. 2010: 91-92 [In Russ].

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Abstract:

Pancreatic transcutaneous necrosectomy from postnecrotic cavities can be a mini-invasive methods of treatment. Such method leads to fast sanation of lesions and is objectivelly a good monitoring method of control.

Aim: was to demonstrate possibilities of transcutaneous pancreatic necrosectomy after spread anc infected pancreatic necrosis.

Results: one of the most illustrative cases of successful mini-invasive treatment of spread infected pancreatic necrosis using transcutaneous necrosectomy under combined control (ultrasound, X- ray and endoscopy) is presented

Conclusion: the use of mini-invasive surgical techniques such as percutaneous drainage under combined control is possbile for panreatic necroectomy in patients with spread infected pancreatic necrosis (necrotic parapancreatitis).  

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1.    Rossiyskoe obschestvo hirurgov, Assotsiatsiya gepa- topankreatobiliarnyih hirurgov stran SNG, Rossiyskoe obschestvo skoroy meditsinskoy pomoschi. Diagnostika i lechenie ostrogo pankreatita. (Rossiyskie klinic- heskie rekomendatsii) g. Sankt-Peterburg, 2014. (ssyilka:http://xn—9sbdbejx7bdduahou3a5d.xn-- p1ai/stranica-pravlenija/unkr/urgentnaja-abdominalnaja- hirurgija/nacionalnye-klinicheskie-rekomendaci-po-ostromu-pankreatitu.html [In Russ].

2.    KuleznyovaYu. V., MorozO. V., IzrailovR. E., SmirnovE. A., EgorovV. PChreskozhnyievmeshatelstvaprignoyno-nekroticheskih oslozhneniyahpankreonekroza. Annalyi hirurgicheskoy gepatologii. 2015; 2: 90 (ssyilka http://vidar.ru/ Article.asp?an=ASH_2015_2_90) [In Russ].

3.    Ivshin V.G., Ivshin M.V., Malafeev I.V., Yakunin A.Yu., Kremyanskiy M. A., Romanova N. N., Nikitchenko V.V. Originalnyie instrumentyii metodiki chreskozhnogo lecheniya bolnyih pankreonekrozom i rasprostranennyim parapankreatitom. Annalyi hirurgicheskoy pankreatologii. 2014; 19(1): 30-39. [In Russ].

4.    Andreev A. V., Ivshin V. G., Goltsov V. R. Lechenie infitsirovannogo pankreonekroza s pomoschyu miniinvazivnyih vmeshatelstv. Annalyi hirurgicheskoy gepatologii. 2015; 3: 110 (ssyilka http://vidar.ru/Article.asp?an=ASH_2015_ 3_110) [In Russ].

5.    Rogal M.L., Novikov S.V., Gyulasaryan S.G., Kuzmin A.M., Shlyahovskiy I.A., Bayramov R.Sh. Optimizatsiya etapov minimalno invazivnogo chreskozhnogo hirurgicheskogo lecheniya ostrogo pankreatita. Tezisyi s'ezda ROH Rostov- na-Donu. 2015, 1161-1162 [InRuss].

Abstract:

Aim: was to estimate the expediency of one-time sanation of the gallbladder, performed under ultrasound control in patients with acute cholecystitis as a preoperative preparation.

Material and methods. For the period 2007-2016, 1365 sanations of the gallbladder were performed in 1289 patients with acute cholecystitis. In 1284 cases (94.1%), the manipulation was single-staged, performed under local anesthesia by echo-puncture needles, caliber of 17.5 G under ultrasound control by the "free hand" method or using a program of biopsy cursor, percutaneously transhepatic. Access was made through the hepatic parenchyma with a thickness of at least 10 mm. Results. Sanation of the gallbladder was effective in all 1365 cases. Repeated sanitation in a day was necessary in 76 patients. Cholecystectomy within the current hospitalization was performed ir 1132 of (87.8%) 1289 patients, in terms from 1 to 4 days after initial manipulation. The dislocation of the blocking gall-stone from the cervical region of the gallbladder into its lumen was made with a rigid 0.035" gidewire in order to restore cystic duct flow was effective in 122 cases (35.2%). Complications: subcapsular hematomas of the liver in the puncture zone - 4 (0.3%), bilomus of the gallbladder bed - 1 (0.07%), bleeding to the gallbladder lumen - 11 (0.8%) were treated conservatively. There were no lethal outcomes.

Conclusion: one-time sanation of gallbladder allows to decompress safely the gallbladder, to stop pain syndrome, to conduct a full pre-examination and preoperative preparation of patient and perform cholecystectomy in the most comfortable and safe conditions in a delayed or planned order. 

References

1.     Buyanov V.M., Ishutinov V.D., Zinyakova M.V., Titkova I.M. Ultrazvukovaya klassifikatsia ostrogo holetsistita. [Ultrasound classification of acute cholecystitis.] Vserossijskaja konferencija hirurgov: Tezisy dokladov. [Proc. Conf. Surgeons: All-Russian conference of surgeons: Tez. dokl]. Yessentuki. 1994; 51-52 [In Russ].

2.     Takada T., Strasberg S.M., Solomkin J.S., Pitt H.A., Gomi H., Yoshida M., Mayumi T., Miura F., Gouma D.J., Garden O.J., Bьchler M.W., Kiriyama S., Yokoe M., Kimura Y, Tsuyuguchi T., Itoi T., Gabata T., Higuchi R., Okamoto K., Hata J., Murata A., Kusachi S., Windsor J.A., Supe A.N., Lee S., Chen X.P., Yamashita Y, Hirata K., Inui K., Sumiyama Y Tokyo Guidelines Revision Committee. TG13: Updated Tokyo Guidelines for the management of acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci. 2013; 20(1): 1 -7. doi: 10.1007/s00534-012-0566-y. PMID: 23307006.

3.     Yokoe M., Takada T., Strasberg S.M., Solomkin J.S., Mayumi T., Gomi H., Pitt H.A., Garden O.J., Kiriyama S., Hata J., Gabata T., Yoshida M., Miura F., Okamoto K., Tsuyuguchi T., Itoi T., Yamashita Y, Dervenis C., Chan A.C., Lau W.Y, Supe A.N., Belli G., Hilvano S.C., Liau K.H., Kim M.H., Kim S.W., Ker C.G. Tokyo Guidelines Revision Committee. TG13 diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci. 2013; 20(1):35-46. doi: 10.1007/s00534-012-0568-9. PMID: 23340953.

4.     Kimura Y, Takada T., Strasberg S.M., Pitt H.A., Gouma D.J., Garden O.J., Bьchler M.W., Windsor J.A., Mayumi T., Yoshida M., Miura F., Higuchi R., Gabata T., Hata J., Gomi H., Dervenis C., Lau W.Y, Belli G., Kim M.H., Hilvano S.C., Yamashita Y TG13 current terminology, etiology, and epidemiology of acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci. 2013; 20( 1 ):8-23. doi: 10.1007/s00534-012-0564-0. PMID: 23307004.

5.     Mayumi T., Someya K., Ootubo H., Takama T., Kido T., Kamezaki F., Yoshida M., Takada T. Progression of Tokyo Guidelines and Japanese Guidelines for management of acute cholangitis and cholecystitis. J UOEH. 2013; 35(4):249-57. PMID: 24334691.

6.     Briskin B.S., Minasyan A.M., Vasilieva М.А., Barsukov M.G. Chreskozhnaja chrespechenochnaja mikroholecistostomija v lechenii ostrogo holecistita. [Percutaneous transhepatic microcholecystostomy in acute cholecystitis treatment]. Annaly khirurgicheskoy gepatologii. 1996; 1(1):98-107 [In Russ].

7.     Ivanov S. V., Okhotnikov O.

Abstract:

Purpose. Define the role of ultrasound diagnostics in preoperative evaluation, surgical approach, and postsurgical assessment in patients with cystous lesions of pancreas underwent various types of pancreatic distal resection (PDR).

Material and methods. Since 1995 till 2008 in Vishnevsky Institute of Surgery (Moscow) 54 patients with distal cystous lesions of pancreas received a course of treatment. Mean age was 50,6+1,2 years, 37 patients (68.5%) were women. Complex pre- and postoperative ultrasound study was performed in all the cases. Morphologically there were true cysts (2 cases), lymphocysts (1 case), postnecrotic cysts (21 patients), serous cystadenoma (9 cases), mucinous cystadenoma (16 cases), and mucinous cystadenocarcinoma (5 cases).

Results. After laparotomy and abdominal revision the following operations were performed:

1. Spleen-preserving distal pancreatic resection;

2. Distal pancreatic resection with splenectomy.

Pancreatic stump assessment revealed 2 possible complications: external pancreatic fistula and sub. phrenic abscess. Spleen-preserving interventions were shown to associate with fewer complication rate, than those with splenectomy.

Conclusions. The cardinal problem is that the PDR associates with repeatedly high complication rate, and the most common complications are external pancreatic fistulas and subphrenic abscesses. As far as the complication rate has the tendency to decrease in spleen-preserving interventions, it is advisable to avoid splenectomy in cases of benign pancreatic lesions.   

References

1.        Fahy B.N., Frey C.F., Ho H.S. et al. Morbidity, mortality and technical factors of distal pancreatectomy. Am. J. Surg. 2002; 183 (3): 237–241.

2.        Andren-Sandberg A., Wagner M., Tihanyi T. et al. Technical Aspects of Left-Sided Pancreatic Resection for Cancer. Dig. Surg. 1999; 16 (4): 305–312.

3.        Шалимов А.А. Хирургия поджелудочной железы. М.: Медицина. 1964.

4.        Mayo W.J. The Surgery of the Pancreas: I. Injuries to the Pancreas in the Course of Operations on the Stomach. II. Injuries to the Pancreas in the Course of Operations on the Spleen. III. Resection of Half the Pancreas for Tumor. Ann. Surg. 1913; 58 (2): 145–150.

5.        Алимов А.Н., Исаев А.Ф., Сафронов Э.П. и др. Обоснование безопасности органосохраняющего метода лечения разрыва селезенки в хирургии изолированной и сочетанной травмы живота. Хирургия. 2005; 10: 55–60.

6.        Lee S.Y., Goh B.K., Tan Y.M. et al. Spleen-preserving distal pancreatectomy. Singapore Maed. J. 2008; 49 (11): 883–885.

7.        Warshaw A.L. Conservation of the spleen with distal pancreatectomy. Arch. Surg. 1988; 123 (5): 550–553.

8         Буриев И.М., Икрамов Р.З. Дистальная резекция поджелудочной железы. Анналы хирургической гепатологии. 1997; 2: 136–138.

9.        Kimura W., Fuse A., Hirai I., Suto K. Spleen-preserving distal pancreatectomy for intraductal papillary-mucinoustumor. Hepatogastroenterology. 2004; 51 (55): 86–90.

10.      Edwin B., Mala T., Mathisen O. et al. Laparoscopic resection of the pancreas: a feasibility study of the short-term outcome. Surg. Endosc. 2004; 18 (3): 407–411.

11.      Vezakis A., Davides M., Larvin M., McMahon M.J. Laparoscopic surgery combined with preservation of the spleen for distal pancreatic tumors. Surg. Endosc. 1999; 13 (1): 26–29.

Abstract:

Aim: was to provide design and direct clinical outcomes of ORENBURG (Optimal dRug Eluting steNts implantation guided By combination of intravascular Ultrasound and optical coheRence tomoGraphy) - single-center randomized clinical trial.

Materials and methods: 1032 patients were included in this study These patients were treatec with 6 types of drug eluting stents. Patients were randomized not only to the type of implanted stent, but also to the type of guidance of the procedure: intravascular ultrasound (IVUS) - 676 patients, quantitative coronary arteriography (QCA) - 356 patients. Before the procedure was finished, all patients underwent optical coherence tomography (OCT) analysis. Regardless of its results no more adjacent procedures were performed.

Results: we provide characteristics of patients included in this study These characteristics showed an absence of significant differences between two groups of patients (IVUS and QCA groups) and between subgroups of patients, received different types of DES. While analyzing parameters of index procedure, it was emphasized that IVUS group involved a bigger number of patients with left main disease and bifurcation disease, and also a bigger number of stents per lesion, diameter of first stent, total length of used stents, maximal diameter of the postdilatation balloon. Characteristics of Nobori stent (range of sizes) can explain that significantly smaller diameter and length of the first and the second stent implanted, total length of stents per lesion, and maximal diameter of postdilatation balloon were recorded in the Nobori stent subgroup of patients. Besides that, in that subgroup were no patients with left main disease, smaller number of patients with angiographically evident calcifications, but was a bigger number of patients with circumflex artery disease. Immediate effect of the implantation was obtained in 100% of patients. According to the short-term follow-up, 1 patient died due to the myocardial infarction in the region of the untreated artery

Conclusion: angiographic data, and IVUS and OCT results of analyzed patients are going to be published in the next article.  

References 

1.    Mintz G.S. Intracoronary Ultrasound. London and New York: Taylor & Francis. 2005, 408.

2.    Colombo A., Tobis J. Techniques in Coronary Artery Stenting. London: Martin Dunitz. 2000, 422.

3.    Demin V.V. Klinicheskoe rukovodstvo po vnutrisosudistomu ultrazvukovomu skanirovaniyu [Clinical guide to intravascular ultrasound]. Orenburg: Yuzhnyj Ural [South Ural]. 2005; 400.[In Russ].

4.    Demin V.V., Zelenin V.V., Zheludkov A.N. et al. Vnutrisosudistoe ultrazvukovoe skanirovanie pri intervencionnyh vmeshatelstvah na koronarnyh arteriyah: optimalnoe primenenie i kriterii ocenki [Intravascular ultrasound scanning during coronary interventions: optimum application and assessment criteria]. International Journal of Interventional Cardioangiology.2003; 1: 66-72 [In Russ].

5.    Demin V.V., Demin D.V., Dolgov S.A. et al. Sravnenie informativnosti vnutrisosudistogo ultrazvukovogo issledovania I opticheskoj kogerentnoj tomografii vo vremj operacii stentirovanij koronarnyh arterij. [Comparison of intravascular ultrasound and optical coherence tomography informativeness in coronary stenting]. Ultrazvukovye i luchevye diagnostiki v klinicheskoj praktike [Ultrasound and radiology technic in clinical practice]. Ad by Sandrilov V.A., Fisenko E.P., Kulagina T.Yu. Moscow: «Firma STROM». 2012; 12-18 [In Russ].

6.    Demin V.V., Demin D.V., Dolgov S.A. et al. Primemenie vnutrisosudistogo ultrazvukovogo issledovania i opticheskoj kogerentnoj tomografii pri implantacii koronarnyh stentov s lekarstvennym pokrytiem. [Using of intravascular ultrasound and optical coherence tomography in coronary drug-eluting stents implantation]. Oblastnaj bolnitza v sisteme regionalnogo zdravoohranenij. [Regional clinic in regional health care system]. Orenburg: Gazprompechat. 2012; 73-77 [In Russ].

7.    Oemrawsingh P.V., Mintz G.S., Scalij M.J. et al. Intravascular ultrasound guidance improves angiographic and clinical outcome of stent implantation for long coronary artery stenosis: Final results of randomized comparison with angiographic guidance (TULIP Study). Circulation. 2003; 107: 62-67.

8.    Gaster A.L., Slothuus Skjoldborg U., Larsen J. et al. Continued improvement of clinical outcome and cost effectiveness following intravascular ultrasound guided PCI: Insights from a prospective, randomized study. Heart. 2003; 89 (9): 1043-1049.

9.    Gil R.J., Pawlowski T., Dudek D. et al. Comparison of angiographically guided direct stenting technique with direct stenting and optimal balloon angioplasty guided with intravascular ultrasound. The multicenter, randomized trial results. Am. HeartJournal. 2007; 154 (4): 669-675.

10.  Frey A.W., Hodgson J.M., Muller C. et al. Ultrasound-guided strategy for provisional stenting with focal balloon combination catheter. Results from the randomized Strategy for Intracoronary ultrasound-guided PTCA and Stenting (SIPS) trial. Circulation. 2000; 102 (20): 2497-2502.

11.  Fitzgerald P.J., Oshima A., Hayase M. et al. Final results of the Can Routine Ultrasound Influence Stent Expansion (CRUISE) study. Circulation. 2000; 102 (5): 523-530.

12.  Sousa A., Abizaid A., Mintz G.S. et al. The influence of intravascular ultrasound guidance on the in-hospital outcomes after stent implantation: results from the Brazilian Society of Interventional Cardiology Registry - CENIC. J. Am. Coll. Cardiol. 2002; 39: 54A.

13.  Russo R.J., Attubato M.J., Davidson C.J. et al. Angiography versus intravascular ultrasound-directed stent placement: final results from AVID. Circulation. 1999; 100: I-234.

14.  Russo R.J., Silva P.D., Teirstein P.S. et al. A Randomized Controlled Trial of Angiography versus Intravascular Ultrasound-Directed Bare-Metal Coronary Stent Placement (The AVID Trial). Cathet Cardiovasc Intervent. 2009; 2: 113-123.

15.  Schiele F., Meneveau N., Vuillemenot A. et al. Impact of intravascular ultrasound guidance in stent deployment on 6-month restenosis rate: a multicenter, randomized study comparing two strategies - with and without intravascular ultrasound guidance. RESIST Study Group. REStenosis after IVUS guided Stenting. J. Am. Coll. Cardiol.1998; 32: 320-328.

Abstract:

Aim: was to identify features of echographic imaging in patients with suspicion on nonocclusive mesenteric blood-flow disorders.

Materials and methods: we analyzed ultrasound data of 50 patients with dynamic ileus (DI). Patients with severe bulging of the transverse colon and the presence of free gas in the abdominal cavity were not included into the research.

All patients underwent ultrasound examination. We evaluated the functional and morphological state of small intestine and colon, celiac trunk and the superior mesenteric artery (SMA). We also examined intraorganic blood flow in walls of small intestine and colon with the determination of the resistance index (RI) and the linear velocity of blood flow.

The ultrasonic data was verified in 34 cases intraoperatively and morphologically, in 12 cases - only morphologically.

Colonoscopy was performed in 4 patients whose ultrasound differential diagnosis between nonocclusive blood-flow disorders in colon walls and pseudomembranous colitis.

Results: in 3 cases nonocclusive blood-flow disorder was not confirmed. Based on endoscopic and bacteriological data we revealed pseudomembranous colitis (PMC). In 1 patient with ultrasound signs of inflammatory changes in walls of the descending colon at colonoscopy revealed necrotizing ulcerative colitis and suspected circulatory problems in the intestinal wall.

It was morphologically identified that 24 patients had nonocclusive blood-flow disorders in walls of the small intestine,10 patients had nonocclusive segmental infarction of small intestine and colon, in 12 patients had nonocclusive segmental infarction of colon.

Conclusion: ultrasound study, conducted in dynamics, in patients with DI, reveals inflammatory and ischemic changes in walls of the small intestine and colon, which provides an abillity to choose the optimal method of treatment of these patients, in some cases predicted for the pathological process.

Absolute symptoms of nonocclusion ischemia of intestine during ultrasound mode in colour doppler imaging (CDI) are: violation of diameter, lack or absence of blood flow in intraorganic walls of the affected intestine while maintaining its mesentery tissue, in a number of patients - bubbles of gas in the intestinal wall.

An indirect sign of circulatory disorders of the small intestine is a complex of ultrasonic signs as an extension of its diameter with liquid contents, wall thickening by submucosal edema, mucosal folds flattening and lack of peristalsis.

An indirect sign of circulatory disorders of the colon during US is identification of a fragment of the colon with thick walls layered structure haustrum smoothness, lack of blood flow in the structure of the wall in the presence of it in the mesentery

When comparing ultrasound, endoscopic and morphological data, in some cases it is possible to make differential diagnosis between nonocclusive intestinal blood-flow disorder and pseudomembranous colitis.

Abstract:

Aim. Was to investigate phase-parameters of renal arteries blood flow in hypertensive patients.

Material and methods. We have examined 173 patients with arterial hypertension, aged 38-78 years, including associated ischemic heart disease or heart stroke in the past. Control group consisted of 27 almost healthy patients aged 39-76 yrs. Acceleration phase index AT/RR, systolic phase index ET/R-R, and flow propagation index RA/R-R (RA is the time from R wave of ECG to the beginning of the systolic flow in the main renal artery at the hilus of kidney) were derived from the Doppler ultrasound.

Results and conclusions. Acceleration phase index in hypertensive patients was higher and systolic phase index was lower than in healthy subjects. Changing in the phase parameters of renal flow depends on associated clinical conditions. The most expressed changes occur in hypertensive patients with old myocardial infarction. Correlations between the phase parameters, the age and the serum lipids were analyzed. Age dependent normal values of the phase indices of renal flow were established. 

References  

1.      Mourad J.J., Girerd X., Boutouyrie P. et al. Opposite Effects of Remodeling and Hypertrophy on Arterial Compliance in Hypertension. Hypertension. 1998; 31: 529-533.

2.      Подзолков В.И., Булатов В.А. Миокард. Нефрон. Взгляд через призму эволюции артериальной гипертензии. Русский медицинский журнал. 2008; 11: 1517-1523.

3.      Riccabona M., Preidler K., Szolar D. et al. Evaluation of renal vascularization using amplitude-coded Doppler ultrasound. Ultraschall Med. 1997; 18(6): 244-248.

4.      Щетинин В.В., Берестень Н.Ф. Кардиосовместимая допплерография. М.: Медицина. 2002; 240.

5.      Макаренко Е.С. Анализ временных показателей кровотока в артериях каротидного бассейна у больных артериальной гипертензией. Вестник рентгенологии и радиологии. 2011;5:21-23.

6.      Макаренко Е.С., Неласов Н.Ю., Поморцев А.В. и др. Возможности комплексной ультрасонографии в оценке структурнофункциональных изменений общих сонных артерий (ОСА) у больных артериальной гипертензией (АГ). Кубанский научный медицинский вестник. 2010; 6(120): 78-84.  

7.      Мельникова Л.В., Бартош Л.Ф. Ранние допплерографические признаки структурнофункциональных изменений почечных артерий у больных с эссенциальной гипертензией. Артериальная гипертензия. 2010; 16 (3): 282-285.

Abstract:

The question about revealing of breast diseases keeps value within many decades. In this connection search of investigation methods which have no damaging action on an organism of young women, has led to development of a radiothermometry microwave method (RTM), based on temperature asymmetry of superficial and deep areas of breast. For definition of diagnostic borders of this method were investigated 619 women aged 30 till 65 years were investigated, including comparison of RTM method with oncoepidemiological testing (a forecast method) and ultrasound (US) diagnostics, known to be wide spread in clinical practice.

Revealing Th 5 temperature asymmetry at young women with breast cancer allows to use this method for screening in risk group. Comparison of RTM and duplex scanning has shown advantages of RTM in revealing initial pathological proliferative displays, raising recognition opportunity of risk zone for 16% at absence of a bloodflow at duplex scanning and for 29% at presence of an individual feeding.
 

References 

1.      Давыдов М.И., Аксель Е.М. Статистика злокачественных новообразований в России и странах СНГ в 2004 г. Вестник РОНЦ. 2006; 17,3 (прил. 1): 132.

2.      Галил-Оглы ГА. Эпителиальные опухоли молочной железы (современная гистологическая классификация ВОЗ, 3 издание, 2003) Клиническая маммология. (Под ред. Харченко В.П., Рожковой Н.И.). Тематический сборник. 1-е издание. - М.: ООО «Фирма Стром», 2005; 7-27.

3.      Веснин С.Г, Каплан М.А., Авакян Р.С. Современная микроволновая радиотермометрия молочных желез. Опухоли женской репродуктивной системы. 2008; 3: 28-36.

4.      Авраменко ГВ. Роль радиотермометрии при хирургическом лечении непальпируемых новообразований молочной железы. Автореф. канд. мед. наук - М., 2009; 23 с.

5.      Бурдина Л.М., Пинхосевич Е.Г., Хайленко В.А. с соавт. Радиотермометрия в алгоритме комплексного обследования молочной железы. Современная онкология. 2006; 6(1): 8-10.

6.      Попов А.Н. Управление скринингом патологии молочных желез на основе компьютерной радиотерометрии. 05.13.01. Автореф. канд. мед. наук. - Воронеж. 2006; 17.

7.      Павлов А.С., Мустафин Ч.К., Вартанян К.Ф. Способ дифференциальной диагностики доброкачественных и злокачественных опухолей молочной железы патент A61B5/01. 2007.10.10. URL: http:/ /www1.fips.ru/wps/wcm/ connect/content_ru/ru.

8.      Смирнова Н.А. Возможности цветной допплерографии в комплексной диагностике заболеваний молочной железы. 14.00.19. Автореф. канд. мед. наук. - М.: МНИИДиХ. 1995; 22 с.'

9.      Yahara T., Koga T., Yoshida S. et al. Relationship Between Microvessel Density and Thermographic Hot Areas in Breast Cancer. Surgery Today. 2003; 33: 243-248.

10.    Gautherie M., Gros C.M. Breast Thermography and Cancer Risk Prediction. Cancer. 1980: 45: 51-56.

11.    Сайт Ассоциации Микроволновой Радиотермометрии. URL: http://www.radiometry.ru.

12.    Joe Abramson Win PEPI (PEPI-for-Windows). URL: http://www.brixtonhealth.com/pepi4windows.html.

Abstract:

In present time coronary angiography remains the "gold standart" in ischemic heart disease diagnostics. The correlation between angiographic or intravascular ultrasound (IVUS) variables and fractional flow reserve (FFR) in patients with intermittent lesion remain unclear. The aim of this article is to demonstrate complimentary use of fractional flow reserve evaluation and intravascular ultrasound for achieving optimal results during PCI.

Abstract:

Aim: was to study features of ultrasonic imaging of local and septic forms of acute hematogenic osteomyelitis (AHO) in children.

Materials and methods: 59 patients with AHO, treated in Children's hospital No. 4 of Tomsk, for the period from 2000 to 2010 - were examined. All patients with suspicion on osteomyelitis (n = 59; 100%) underwent x-ray of defeated area and ultrasonic diagnostics on the Ultrasonix 2,6 with the use of linear sensor of 9-12 MHz. All patients with AHO underwent surgical operation (n=59; 100%).

Results: 47 patients had local form of disease. Each patient had one phase of osteomyelitis. Extramedullary phase, the development of which was due to the disease duration - was prevalencing^^,^. Prevalence of quantity of AHO phases (n=19) over total number of patients with a septic forms of disease (n=12), reflected existence of multiple osteomyelitis in four patients. In each patient with septic form of the AHO we found defeat of several bones in identical or different phases of an inflammation.

Conclusion: obtained results will help the earlier identification of AHO signs and determination of disease phase in patients with local and generalized forms of disease. All that will help to proceed modern sanation of osteomyelitic defeat.

Reference

1.    Abaev Ju.K., Adarchenko A.A., Zafranskaja M.M. Gnojnaja hirurgija detskogo vozrasta. Menjajushhiesja perspektivy [Contaminated surgery of childhood. Changing perspectives.]. Detskaja hirurgija. 2004; 6: 4-7 [In Russ].

2.    Beljaev M.K., Prokopenko Ju.D., Fedorov K.K. K voprosu o vybore lechebnoj taktiki pri metafizarnom osteomielite u detej [The issue of choice of therapeutic tactics in the metaphyseal osteomyelitis in children.]. Detskaja hirurgija. 2007;4:27-29 [In Russ].

3.    Lobanov Ju.A., Cap N.A., Nagornyj E.A. Osnovnye principy diagnostiki i lechenija ostrogo gematogennogo osteomielita u detej [The basic principles of diagnosis and treatment of acute osteomyelitis in children.]. Konsilium 2007 g. Ural'skaja gosudarstvennaja medicinskaja akademija: 56-59 [In Russ].

4.    Zavadovskaja V.D., Polkovnikova S.A., Perova T.B. Vozmozhnosti ul'trazvukovogo issledovanija v diagnostike ostrogo gematogennogo osteomielita u detej [Possibility of ultrasonography in the diagnosis of acute osteomyelitis in children.]. Ul'trazvukovaja i funkcional'naja diagnostika. 2006;4:67-75 [In Russ].

5.    Brjuhanov A.V. MR-tomograficheskaja semiotika zabolevanij kostno-sustavnogo apparata [MR tomographic semiotics of diseases of bone and articular apparatus.]. Materialy Ill regional'noj konferencii 28--30 ijunja 2004 goda. Tomsk. 2004;248-250 [In Russ].

6.    Kotljarov P.M., Sencha A.N., Beljaev D.V. Ul'tra-zvukovaja diagnostika osteomielita [Ultrasound diagnosis of osteomyelitis.]. Ul'trazvukovaja i funkcional'naja diagnostika. 2008;5:110-120 [In Russ].

7.    Tas F., Oguz S., Bulut O. et al. Comparison of the diagnosis of plain radiography ultrasonography and magnetic resonance imaging in early diagnosis of acute osteomyelitis experimentally formed on rabbits. Eur. J. Radiol. 2005; 56 (1): 107-112.

8.    Fitoussi F., Litzelmann E., Ilharreborde B. et al. Hematogenous osteomyelitis of the wrist in children. J. Pediatr. (Orthop. 2007; 27(7): 810-813.

9.    Marochko N.V., Pykov M.I., Zhila N.G. Ul'trazvukovaja semiotika ostrogo gematogennogo osteomielita u detej [Ultrasonic semiotics of acute hematogenic osteomyelitis in children.]. Ul'trazvukovaja i funkcional'naja diagnostika. 2006;4:55-66 [In Russ].

Abstract:

Aim. Was to specify ultrasound diagnostic's possibilities in reasons' detection of lower-limbs (LL) varicose veins (VV) and grades of it s seventy

Materials and methods. We have analyzed ultrasound data of 1376 patients with lover-limb varicose veins. We have used Voluson 730 ultrasound machine (GE) with methods of color and power Doppler and described earlier B-flow technique. This is a highly-effective non-invasive diagnostic method of LL VV reasons, grade severity and expression of valve structure disorders. US allows to specify ocations of pathological veins with valve disorders, distorted blood flow, and that can promote radical treatment and decreases the risk of relapse

Conclusion. Conducted research shows, that visual control in connection with US Doppler is an optimal diagnostic method of this disease. 

References

1.    Алекперова Т.В. Ультразвуковая флебография - опыт применения в современной флебологической практике. Ангиология сегодня. 1999; 9: 2-9.

2.    Зубарев А.Р., Богачев В.Ю., Митьков В.В. Ультразвуковая диагностика заболеваний вен нижних конечностей. М.: Видар, 1999; 100.

3.    Зубарев А.Р. Ультразвуковая диагностика клапанной недостаточности вен нижних конечностей без применения допплеровских методов исследования. Ультразвуковая диагностика. 2000; 1: 47-53.

4.    Котляров П.М., Зубарев Р.П., Асеева И.А. и др. Ультразвуковая диагностика острых венозных тромбозов сосудов системы нижней полой вены. Эхография. 2002; 3 (2): 200-208.

5.    Котляров П.М., Зубарев А.Р., Дудин М.М. и др. УЗ-мониторинг вен нижних конечностей у пациентов с подозрением на острый тромбоз. Ультразвуковая и функциональная диагностика. 2002; 4: 71-76.

6.    Лелюк В.Г., Лелюк С.Э. Ультразвуковая ангиология. М.: Реальное время. 1999; 286.

7.    Henri P., Tranquart F. B-flow ultrasonographic imaging of circulating blood. J. Radiol. 2000; 81 (4): 465-467.

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11.  Zielinski P., Dzieciuchowicz L., Skibansca-Zielinsca M. The value of Duplex Doppler in the assessment varicose vein. Ultras. in medic. and biology. 2000; 26 (2): 82.

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13.  Веденский А.Н. Новый способ коррекции патологического кровотока в венах голени. Вестник хирургии. 1988; 140 (4): 143-144.

Abstract:

Purpose. Was to determine the possibilities of transrectal ultrasound research (TUR) in grayscale-mode with the use of ultrasound angiography in diagnostics of rectitis and in monitoring its treatment in patients with prostate cancet (PC) after radiation therapy.

Materials and methods. The research consists of 62 patients with verified localized prostatic cancer (T13N01M0), which have already obtained conformed radiation therapy (RT) as a radical strategy. To estimate expressive radiation reaction patients were underwent transrectal ultrasound research before, during and after (in 3, 6, 12 months) radiation therapy. During the experiment, using grayscale-mode, the thickness of rectum front wall, its structure and echogenicity, and prostata capsula propria (lat.) tracking were estimated in dynamics. Vascularization of rectum front wall and pararectal cellulose was also analyzed in dynamics. Results of transrectal ultrasound were compared with clinical symptoms during the whole period of supervision, and were registered on the basis of patient’s personal note during and after treatment.

Results. Based on patients complaints we have noticed development of radiation rectitis (radiation therapy after-effect) which can be registered as higher thickness of rectum front wall, changes in its structure, decreasement of echogenicity and increased vascularization. The major part of patients with these changes noticed that such symptoms were therapeutically eliminated during supervision. Such echo-graphic changes won’t appear in case of prostate cancer progression and it can be used as a differential diagnostics between radiation therapy after-effect and prostate cancer growth.

Conclusion. Transrectal ultrasound allows to visualize early radiation rectitis implications in patients with prostatic cancer during radiation theraphy, and can promote the necessary treatment correction and advanced symptomatic therapy. 

References

1.    Орлова Л.П., Зарезаев О.А. Ультразвуковой метод исследования в оценке эффективности лечения больных геморроем. SonoAceInternational (Рус. верс.). 2006; 14: 3–34.

2.    Гранов А.М., Матякин Г.Г., Зубарев А.В. и др. Возможности современных методов лучевой диагностики и лечения рака предстательной железы. Кремл. мед. клин. вест. 2004; 16: 9–12.

3.    Давыдов М.И., Аксель Е.М. Статистика злокачественных новообразований в России и в странах СНГ в 2007 г. Вестник РОНЦ им. Н.Н. Блохина РАМН. 2009; 20 (3 – прил. 1): 8–138.

4.    Канделаки С.М., Гаджиев Г.И., Богомазов Ю.К. и др. Возможности эндоректальной эхографии с контрастным усилением в диагностике свищевой формы парапроктитов. SonoAceInternational (Рус. верс.). 2004; 12: 20–26.

5.    Pescatori M., Regadas F.S.P., Regadas S.M.M. Imaging atlas of the pelvic floor and anorectal diseases. Springer – Verlag Italy. 2008; 4–16, 27–34, 51–61, 73–81, 91–105.

6.    Трапезникова М.Ф., Голдобенко Г.В. Рак предстательной железы. Под ред. Н.Е. Кушлинского, Ю.Н. Соловьева, М.Ф. Трапезниковой. М.: Изд-во РАМН. 2002; 322–328.

7.    Yablon C.M. et al. Complications of prostate cancer treatment. Spectrum of imaging findings. Radiographics. 2004; 24: 181–194.

8.    Hulsmans F.-J.H. et al. Colorectal adenomas. Inflammatory changes that simulate malignancy after laser coagulation evaluation with transrectal US. Rad. 1993; 187: 367–371.

9.    Гранов А.М., Винокуров В.Л. Лучевая терапия в онкогинекологии и онкоурологии. С.-Пб.: ООО «Издательство ФОЛИАНТ». 2002; 178–208.

10.  Hricak H. et al. State of the art. Imaging prostate cancer. А multidisciplinary perspective. Rad. 2007; 243 (1): 28–53.

11.  Moore E.M., Magrino T.J., Johnstone P.A.S. Rectal bleeding after radiation therapy for prostate cancer – endoscopic evaluation. Rad. 2000; 217: 215–218. 

Abstract:

The main part of the research is given to radiodiagnostics of tubercolisis lesion of backbone (traditional x-ray, ultrasound diagnostics, computed tomography, magnetic resonance imaging). We have exmined 452 patients: 40 patients (8,8%) had cervical spine lesions, 185 patients (41%) - thoracic spine lesions, thoracic-lumbar spine - 75 patients (16,8%), lumbar spine - 141 patients (31,1%), lumbar-sacral spine - 11 patients (2,5%). It is especially marked that combination of lungs tuberculosis and spondylitis is higher not only in patients with antibiotic resistant infection but n patients with tuberculosis combined with AIDS.

References 

1.    Митусова Г.М. Лучевая диагностика туберкулезного спондилита у взрослых, осложненного неврологическими расстройствами. Дис. на соиск. к.м.н. С.-Пб. 2002.

2.    Советова Н.А., Савин И.Б., Мальченко О.В. и др. Лучевая диагностика внелегочного туберкулеза. Проблемы туберкулеза. 2006; 11: 7-9.

3.    Руководство по легочному и внелегочному туберкулезу. Под ред. Ю.Н. Левашева и Ю.М. Репина. ЭЛБИ-С.-Пб. 2008; 273-283.

4.    Васильев А.В. Современные проблемы туберкулеза в регионе Северо-Запада России. Проблемы туберкулеза. 1999; 3: 5-7.

5.    Лавров В.Н. Диагностика и лечение больных туберкулезным спондилитом. Проблемы туберкулеза. 2001; 4: 30-32.

6.    Гусева Н.И., Иванов В.М., Потапенко Е.И. и др. Иммунный статус больных активным туберкулезным спондилитом. Проблемы туберкулеза и болезней легких. 2003; 6: 25-28.

7.    Селюкова Н.В. Зонография в диагностике туберкулеза позвоночника на поликлиническом этапе. Проблемы туберкулеза и болезней легких. 2008; 11, 21-23.

8.    Мердина Е.В., Митусова Г.М., Советова Н.А. Ультразвуковая диагностика забрюшинных абсцессов при туберкулезе позвоночника. Проблемы туберкулеза. 2001; 4: 19-21.

9.    Лукьяненок П.И. Магнитно-резонансная томография в диагностике туберкулезного спондилита. Руководство для врачей. 2008.

10.  Щ Советова Н.А., Джанкаева О.Б., Кравцова О.С. и др. Туберкулезный спондилит взрослых в условиях генерализации инфекции и лекарственной резистентности возбудителя. Невский радиологический форум 2-5 апреля 2011 г. С.-Пб.: Научные материалы. 2011; 223-224.

11.  Шилова М.В. Туберкулез в России в 2009 г. М. 2009; 159-161.

Abstract:

Aim: was to evaluate the use of intraoperative ultrasound in examination of patients with liver cancer compared with preoperative diagnostic methods.

Materials and methods: the study involved 650 patients who received surgical treatment for the period 1998-2013 years. During surgical intervention, all patients underwent intraoperative ultrasonography (IOUS) of the liver.

Results: results of preoperative examination methods were compared with intraoperative data, IOUS and histological examination. Sensitivity and accuracy of IOUS is above all methods of preoperative diagnosis, surgical palpation and is 99.7% and 94.9%, respectively Analyzed causes of mistakes of preoperative methods. These related: long time interval before surgical intervention, diameter of formations less then 2 cm, chemotherapy, presence of concomitant cirrhosis, different location of lesions (subcapsular, on the capsular and on the diaphragm of the liver), benign or non-tumorous liver lesions. Changes of operation volume occurred in 38 % cases, 20 % of them - on the base IOUS data.

Conclusions: IOUS provides decisive diagnostic information for the surgeon during the operation which may lead to changes of operation volume, and thus affect outcomes of the disease. Contrast resolution IOUS is actual when oncological operations on the liver are made. Ultrasound professionals should be master of IOUS techniques due to the increasing necessity of its use in clinics dealing with oncological surgery of the liver. 

References

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16.   Lordan J.T., Stenson K.M., Karanjia N.D. The value of intraoperative ultrasound and preoperative imaging, individually and in combination, in liver resection for metastatic colorectal cancer. Ann. R. Coll. Surg. Engl. 2011 Apr; 93(3):246-9.

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Abstract:

Aim: was to evaluate morphological features of lesions in lower limb arteries before percutaneous transluminal angioplasty (PTA) and its arterial complications in patients with critical lower limb ischemia (CLI) combined with diabetes mellitus(DM).

Materials and methods: for the period from September 2010 to June 2013, a prospective single-center study was conducted involving 171 patients with CLI and DM (80(47%) men, mean age 64,1[54-68] years, mean HbA1c 8,3[7,4-9,6]%, mean duration of diabetes 16,5[8-23] years, diabetes type 1/2-18/153) who underwent PTA in 193 lower limbs. Myocardial infarction and brain stroke in anamnesis had 53(31%) and 19(11%) patients, respectively Chronic kidney disease (CKD) 3-4 stages had 40 patients(24%), end-stage renal disease - 16 cases (10%). Diagnosis of CLI was based on recommendation of TASC II. Patency of arteries of lower limbs was evaluated by duplex ultrasound (DU) before PTA and during early follow-up period (30 days). PTA in all patients was considered technically successful in restoring continuous arterial flow to the foot of at least one crural artery without residual stenosis >50%.

Results: stenosis>50% and occlusions of tibial arteries were found in all patients. Peripheral arterial disease 4-6 classes according Graziani L. classification was marked in 180(93%) cases. Extensive tibial arterial calcification was found in 123(64%) cases, in patients with residual stenosis (> 50% remaining diameter) -113 (89%). The mean value of transcutaneous oxygen pressure (tcpO2) before PTA was 14,7(8-25) mmHg, after PTA - 35,2 (31-38) mmHg. After PTA , residual stenosis (>50%) in treated arteries was in 125(79,1%) cases, thrombosis in treated arteries - 9(5,7%), intimal dissection - 18(11,4%), incomplete stent disclosure - 3(1,9%), incomplete capture stent area stenosis - 2(1,3%), dislocation of the stent - 1(0,6%). Repeat PTA in the early follow-up period was performed in 15 patients with clinically significant complications (6%).

Conclusion: CLI in diabetic patients is characterized by having severe morphological lesions of lower limb arteries, infrapopliteal arterial calcification. DU plays important role in evaluation of arterial patency and PTA complications in early follow-up period. The high level of residual stenosis of tibial arteries after PTA is associated with chronic complications of diabetes mellitus, including renal insufficiency Timely reintervention in diabetic patients with clinical significant PTA complications promotes optimal arterial patency and permission of CLI in theese cases. 

Reference

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11.   Adam D.J., Beard J.D., Cleveland T., Bell J., Bradbury A.W., Forbes J.F. et al.; BASIL Trial Participants. Bypass versus Angioplasty in Severelschaemia of the Leg (BASIL): multicentre, randomised controlled trial. Lancet. 2005; 366:1925-34.

12.   Norgen L., Hiatt W.R., Dormandy J.A., Nehler M.R., Harris K.A., Fowkes FGR. Inter-society Consensus for the Management of Peripheral Arterial Disease (TASC II). J. Vasc. Surg. 2007; 45(Suppl S):S5-67.

13.   Hirsch A.T., Haskal Z.J., Hertzer N.R., Bakal C.W., Creager M.A., Halperin J. et al; American Association for Vascular Surgery/Society for Vascular Surgery;Society for Cardiovascular Angiography and Interventions;Society for Vascular Medicine and Biology; Society for Inerventional Radiology; ACC/AHA TASC Force on Practice Guidelines. ACC/AHA Guidelines for the Management of Patients with Peripheral Arterial Disease (lower exteremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA TASC Forc on Practice Guidelines (writing committee to develop guidelines for the management of patients with peripheral arterial disease)-summary of recommendations. Circulation. 2006 113: e463-654,

14.   Dick F., Ricco J.B., Davies A.H.: Chapter VI: Follow-up after Revascularisation. Eur. J. Vasc. Endovasc. Surg. 2011; 42: S75-S90.

15.   Bondarenko O.N., Ajubova N.L., Galstjan G.R., Dedov 1.1. Dooperacionnaja vizualizacija perifericheskih arterij s primeneniem ul'trazvukovogo dupleksnogo skanirovanja u pacientov s saharnym diabetom i kriticheskoj ishemiej nizhnih konechnostej [Preoperative visualization of peripheral arteries with the help of ultrasonic duplex scanning in patients with critical ischemia of lower limbs and diabetes mellitus]. Saharnyj diabet. 2013; 2: 52-61 [In Russ].

16.   Arvela E., Dick F: Surveillance after Distal Revascularization for Critical Limb Ischemia. Scandinavian Journal of Surgery. 2012; 101:119-124. 

17.   Diehm N., Baumgartner I., Jaff M., Do D.D., Minar E., Schmidli J. et al. A call for uniform reporting standards in studies assessing endovascular treatment for chronic ischemia of lower limb arteries. Eur. Heart J. 2007; 28: 798-805.

Abstract:

Current indications for transcatheter aortic valve replacement (TAVR) are limited for inoperable and high risk patients only. Meanwhile, TAVR may be successfully performed in young patients with low risk and with high technical and functional results according to short- and long-term follow-up.

54 patients underwent TAVR, 7 (12,9%) of them were younger than 65. Cause for endovascular procedure was the presence of oncological process in liver/autoimmune hepatitis/liver cirrhosis/severe bronchial asthma/atherosclerotic lesion of major vessels/severe diabetes mellitus. In 3 cases additional visualization method (intracardiac ultrasound examination) was necessary. All patients underwent implantation of CoreValve.

Technical success was 100%. Function of valves was satisfactory. Light near-valve regurgitation was found in 6 cases, valve regurgitation class II was found in 1 case with decrease to class I after treatment.

Intracardiac ultrasound examination is useful to attend successful results in this group of patients. 

References

1.     2012 ACCF/AATS/SCAi/STS Expert Consensus Document on Transcatheter Aortic Valve Replacement. JACC. 2012; 59: 1200-1254.

2.     Lemos PA, Lee CH, Degertekin M, et al. Early outcome after sirolimus-eluting stent implantation in patients with acute coronary syndromes: insights from the Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) registry. JACC. 2003; 41: 2093-2099.

3.     Ong A.T., Serruys P.W., Aoki J., et al. The unrestricted use of paclitaxel versus sirolimus-eluting stents for coronary artery disease in an unselected population: one-year results of the Taxus-Stent Evaluated at RotterdamCardiologyHospital (T-SEARCH) registry. JACC. 2005; 45: 1135-1141.

4.     Hoye A., Tanabe K., Lemos P.A., et al. Significant reduction in restenosis after the use of sirolimus-eluting stents in the treatment of chronic total occlusions. JACC. 2004; 43: 1954-1958.

5.     Rao S.V., Shaw R.E., Brindis R.G., Klein L.W., Weintraub W.S., Peterson E.D. On- versus off-label use of drug-eluting coronary stents in clinical practice (report from the American College of Cardiology National Cardiovascular Data Registry [NCDR]). Am. J. Cardiol. 2006; 97: 1478 -1481.

6.     Beohar N., Davidson C.J., Kip K.E., et al. Outcomes and complications associated with off-label and untested use of drug-eluting stents. JAMA. 2007; 297: 1992-2000.

7.     Grines C.L. Off-label use of drug-eluting stents putting it in perspective. JACC. 2008; 51: 615-617.

8.     Piazza N., Otten A., Schultz C., et al. Adherence to patient selection criteria in patients undergoing transcatheter aortic valve implantation with the 18F CoreValve ReValvingTM System: results from a single center study. Heart. 2010; 96: 19-26.

9.     Eltchaninoff H., Prat A., Gilard M., et al. Transcatheter aortic valve implantation: earlyresults of the FRANCE (FRench Aortic National CoreValve and Edwards) registry. Eur. Heart J. 2011; 32:19-197.

10.   Zahn R., GerckensU., Grube E., et al. Transcatheter aortic valve implantation: first results from a multi-centre real-world registry. Eur. Heart J. 2011; 3:198-204.

11.   Rodes-Cabau J., Webb J.G., Cheung A., et al. Transcatheter aortic valve implantation for the treatment of severe symptomatic aortic stenosis in patients at very high or prohibitive surgical risk: acute and late outcomes of the multicenter Canadian experience. JACC. 2010; 55:1080-1090.

12.   Tamburino C., Capodanno D., Ramondo A., et al. incidence and predictors of early and late mortality after transcatheter aortic valve implantation in 663 patients with severe aortic stenosis. Circulation. 2011; 123: 299-308.

13.   Webb J.G., Altwegg L., Boone R.H., et al. Transcatheter aortic valve implantation: impact on clinical and valve-related outcomes. Circulation. 2009; 119: 3009-3016.

14.   Piazza N., Grube E., Gerckens U., et al. Procedural and 30-day outcomes following transcatheter aortic valve implantation using the third generation (18 Fr) corevalve revalving system: results from the multicentre, expanded evaluation registry 1-year following CE mark approval. EuroIntervention. 2008; 4: 242-249.

15.   Leon M.B., Smith C.R., Mack M., et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N. Engl. J. Med. 2010; 363: 1597-1607.

16.   Smith C.R., Leon M.B., Mack M.J., et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N. Engl. J. Med. 2011; 364: 2187-2198.

17.   Lee D.H., Buth K.J., Martin B.J., et al. Frail patients are at increased risk for mortality and prolonged institutional care after cardiac surgery. Circulation. 2010; 121: 973-978.

18.   Roques F., Nashef S.A., Michel P., et al. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients. Eur. J. Cardiothorac. Surg. 1999; 15: 816-822.

19.   Lange R., Bleiziffer S., Mazzitelli D., et al. improvements in Transcatheter Aortic Valve implantation Outcomes in Lower Surgical Risk Patients. JACC. 2012; 59: 280-287 

Abstract:

In order to check the efficiency of pharmacological prophylaxis of venous thromboembolism in 500 patients with multiple injuries we weekly performed ultrasonography of lower limb veins from 3-5 days after the accident date. Patients were divided into two groups. There were 186 patients with prophylaxis with LMWH in the first group, other group included 314 patients which took single antiplatelet therapy. Thrombosis occured in 29 (15.6%) cases in the first group. In 19 (61.2%) limbs thrombosis defeated the common femoral vein and it was floating in 67.7% of cases. In the second group thrombosis was found in 165 (52.5%) patients. Mural (46%) and occlusive (35.3%) changes from the proximal border, not reaching the common femoral vein - (62%) were dominating.

It was found that during fraxiparine treatment venous complications were 3.3 times less likely than with antiplatelet agents, however, 3.6 times increased the proportion of floating embologenic thrombosis. However, in these patients, the spread of the pathological process in the proximal direction noted in 2 times less, and the beginning of recanalization 1-2 weeks earlier and more effective restoration of the lumen.

References

1.     Van Hensbroek P.B., Haverlag R., Ponsen K.J. et al., Prevention of thrombosis in traumatology. Ned. Tijdschr. Geneeskd.2007; 4(151): 234-239.

2.     Lippi G., Franchini M. Pathogenesis of venous thromboembolism: when the cup runneth over. Semin Thromb Hemost. 2008; 8(34):747-761.

3.     Baeshko A.A. Risk i profilaktika venoznykh tromboembolicheskikh oslozhnenii v khirurgii [Risk and prophylaxis of venous thromboembolic complications in surgery] Khirurgiya. 2001; 4: 61-67 [In Russ].

4.     Anderson F.A., Spencer F.A. Risk factors for venous thromboembolism. Circulation. 2003;107: 33-38.

5.     Geerts W.H., Jay R.M., Code K.I. et al. A comparison of low-dose heparin with low-molecular-weight heparin as prophylaxis against venous thromboembolism after major trauma. N. Engl. J. Med. 1996; 335: 701-707.

6.     Lazarenko V.A., Mishustin V.N. Pulmonary artery thromboembolism in patients with trauma. Angiol. Sosud. Khir. 2005; 11(4): 101-104.

7.     Geerts W.H., Pineo G.F., Heit J.A. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004; 126(3): 338-400.

8.     Giannadakis K., Leppek R., Gotzen L. et al. Thromboembolism complication in multiple trauma patients: an underestimated problem? Results of a clinical observational study of 50 patients. Chirurg. 2001;72:100-107.

9.     Knudson M.M., Lewis F.R., Clinton A. et al. Prevention of venous thromboembolism in trauma patients. J. Trauma. 1994; 37:11-15.

10.   Rogers F.B. Venous thromboembolism in trauma patients: a review. Surgery. 2001;130:74-78.

11.   Kearon, C. Natural history of venous thromboembolism. Circulation. 2003;107(1):22-30.

12.    Robinson D.M., Wellington K. Fondaparinux sodium: a review of its use in the treatment of acute venous thromboembolism. Am. J. Cardiovasc. Drugs. 2005; 5: 335-346.

13.    Shchelokov A.L., Zubritskii V.F., Nikolaev K.N i dr. Kombinirovannaya venoznykh tromboembolicheskikh oslozhnenii u postradavshikh s perelomami proksimal'nogo otdela bedrennoi kosti [Combined prophylaxis of venous tromboembolic complications in patients with fracture of proximal part of femur]. Vestniktravmatologiii ortopedii. 2007;1:16-21 [In Russ].

14.    Asamov R.E., Tulyakov R.P., Muminov Sh.M. i dr. Bessimptomnye flebotrombozy nasledstvennaya trombofiliya u bol'nykh so skeletnoi travmoi [Asymptomatic phlebothrombosis and hereditary thrombophilia in patients with skeletal trauma]. Angiologiya i sosudistaya khirurgiya. 2008; 3:73-76 [In Russ].

15.    Kruger K., Wildberger J., Haage P. et al. Diagnostic imaging of venous disease: Part I: methods in the diagnosis of veins and thrombosis. Radiologe. 2008; 48 (10): 977-992.

16.    Tomkowski W.Z., Davidson B.L., Wisniewska J. et al. Accuracy of compression ultrasound in screening for deep venous thrombosis in acutely ill medical patients. Thromb. Haemost. 2007; 97(2):191-194.

17.    Savel'ev V.S. Venoznye trombozy i tromboemboliya legochnoi arterii (venoznye tromboembolicheskie oslozhneniya): Metod. rekomendatsii. V.S.Savel'ev [Venous trombosis and pulmonary embolism (venous tromboembolic complications )]. M., 2007: 20 s [In Russ].

18.    Balakhonova T.V. Sovremennye instrumental'nye metody diagnostiki tromboza: ul'trazvukovoe dupleksnoe skanirovanie. Profilaktika tromboembolicheskikh oslozhnenii v travmatologii i ortopedii [Modern instrumental diagnostics of trombosis: ultrasonic duplex scanning. Prophylaxis of thromboembolic complications in traumatology and orthopedics.]: materialy gor. simp., Moskva. 2003; 12-17 [In Russ].

19.    Utverzhdenie otraslevogo standarta vedeniya bol'nykh. Profilaktika tromboembolii legochnoi arterii pri khirurgicheskikh i inykh invazivnykh vmeshatel'stvakh: Prikaz Ministerstva zdravookhraneniya Rossiiskoi Federatsii №233 ot 09.06.2003 [Approval of medical treatment standarts. Prophylaxis of pulmonary embolism in surgical and other interventions: order of Ministry of Health of the Russian Federation №233 since 09.06.2003] [In Russ]. 

Abstract:

Aim: was to investigate characteristics of ultrasound image of hydatidiform mole (HM).

Materials and methods: analyzed 15 cases of this type of gestational trophoblastic tumor, which was confirmed morphologically. Transvaginal ultrasound examination was carried out in the B-mode, using the technique of color and power Doppler.

Results: it was marked out 2 ultrasound types of the tumor node in case of HM: cellular and solid-cystic. We have seen that the structure depends on the nature of the tumor vasculature.

Conclusion: determination of nodes localization and vascular lacunae in it allows to identify the danger of massive bleeding. 

References

1.     Genest D.R., Berkowitz R.S., Fisher R.A. et al. Gestational trophoblastic disease . WHO Classification of Tumours. Pathology and Genetics of Tumours of the the Breast and Femal Genital Organs / Eds. F.A.Tavassolli, P.Devilee. Lyon: IARC, 2003; 250-254.

2.     John R. Lurain, Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. American Journal of Obstet. & Gynecol., 2010; 203(6): 531-539.

3.     Green C.L., Angtuaco TL, Shah HR, Parmley TH. Gestational trophoblastic disease: a spectrum of radiologic diagnosis. Radiographics. 1996; 16(6):1371-84.

4.     Kim Seung Hyup. Radiology Illustrated: Gynecologic Imaging 2nd ed. Springer-Verlag, New-York, 2012; 354.

5.     Wagner B.J., Woodward P.J., Dickey G.E. Gestational trophoblastic disease: radiologic-pathologic correlation. RadioGraphics. 1996; 16: 131-148.

6.     Mazur Michael Т., Kurman Robert J. Diagnosis of Endometrial Biopsies and Curettings: A Practical Approach., 2nd ed.. Springer. 2005; 67-99.

7.     Stern Jeffrey L. Trophoblastic Disease. Women's Cancer information center, Web site www.cancer.org от 26/9/2012.

8.     Meshherjakova L.A. Standartnoe lechenie trofoblasticheskoj bolezni [Standart treatment of trophoblastic disease] Prakticheskaja onkologija. 2008; 9(3): 160-170 [In Russ].

9.     Meshherjakova L.A. Zlokachestvennye trofoblasticheskie opuholi: sovremennaja diagnostika, lechenie i prognoz [Malignant trophoblastic tumors: modern diagnostics, treatment and prognosis] Dis.d-ra med. nauk. M.,2005 [In Russ].

10.   Cip N.P., Vorob'eva L.V. Hirurgicheskij metod v lechenii trofoblasticheskih opuholej [Surgical method in treatment of trophoblastic tumors]. Prakticheskaja onkologija. 2008; 9 (3): 179-185 [In Russ].

11.   Tasci Y., Dilbaz S., Secilmis O. et al. Routine histopathologic analysis of product of conception following first trimester spontaneous miscarriages. J. Obstet. Gynaecol. Res. 2005; 31(6) : 579-582.

12.   Callen Peter W., Saunders W.B. Ultrasonography in obstetrics and gynecology, 1994;621.

13.   Tatarchuk T.F., Sol'skij Ja.P. Jendokrinnaja ginekologija [Endocrinological gynecology]. Kiev: Zapovgg, 2003; 244 [In Russ].

14.   Mazur Michael Т., Kurman Robert J. Diagnosis of Endometrial Biopsies and Curettings: A Practical Approach., 2nd ed.. Springer, 2005; 67-99.

15.   Zhou Q., Lei XY, Xie Q., Cardoza J.D. Sonographic and Doppler imaging in the diagnosis and treatment of gestational trophoblastic disease: a 12-year experience. J. Ultrasound Med. 2005; 24(1):15-24.

16.   Kurjak A., Chervenak A. Fran. Donald School Textbook of Ultrasound in Obstetrics & Gynecology, 3rd Edition. Jaypee Brothers Medical Publishers, 2011; 158.

17.   Chekalova M.A. Ul'trazvukovaja diagnostika zlokachestvennyh opuholej tela matki [Ultrasound diagnostics of malignant uterus tumor]: Dis.d-ra med. nauk. M., 2,1998 [In Russ]. 

Abstract:

The article describes main epidemiological, clinical and morphological diagnostic features of a rare form of breast tumor - hamartoma. Current scientific data accompany results of own seven-year research. Diagnostic features (qualitative elastography) of breast hamartoma are described for the first time ever. Authors draw attention to morphological diversity of the breast hamartoma, which leads to complex radiological semiotics. 

References

1.     Malignant diseases in Russia in 2011 (morbidity and mortality). Edited by V.I. Chissov. V.V. Starinsky, G.V. Petrova. M.: FSBI «P.A. Herzen MSROI of the Ministry of Health and Social Development of the Russia», 2013; 289.

2.     Tavassoli F.A., Devilee P. (Eds.): World Health Organization classification of Tumours. pathology and genetics of tumours of the breast and female genital organs. IARC Press: Lyon. 2003; 103.

3.     Prym P. Pseudoadenome, Adenome and Mastome der weinblichen Brustdruse uber die Entstehung umschriebener adenomahnlicher Herde in die Mamma und uber die Nachahmung des Brustdrusengewebes durch echte Adenome und Fibroadenome. Beitr. Pathol. Anat. Pathol. 1928; 81: 221.

4.     Arrigoni M.G., Dockerty M.B., Judd E.S. The identification and treatment of mammary hamartoma. Surg. Gynecol. Obstet. 1971; 133: 577-582.

5.     Ruiz-Tovar J., Reguero-Callejas M.E., Arano-Bermejo J.I. et al. Mammary hamartoma. Cir. Esp. 2006; 79 (3): 186-188.

6.     Lee W.F., Sheen-Chen S.M., Chi S.Y. et al. Hamartoma of the breast: an underrecognized disease? Tumori. 2008; 94 (1): 114-115.

7.     Farrokh D., Hashemi J., Ansaripour E. Breast hamartoma: Mammographic findings. Iran J. Radiol. 2011; 8 (4): 285-260.

8.     Mizuta N., Sakaguchi K., Mizuta M. et al. Myoid hamartoma of the breast that proved difficult to diagnose: a case report. World J. Surg. Oncol. 2012; 10 (12): URL: http:www.wjso.com/content/10/1/12.

9.     Ravakhah K., Javadi N., Simms R. Hamartoma of the breast in a man: first case report. Breast J. 2001; 7 (4): 266-268.

10.   Harigopal M., Mudrovich S.A., Hoda S.A., Rosen P.P. Secondary tumors in mammary adenolipomas: a report of 2 unusual cases. Arch. Pathol. Lab. Med. 2003; 127 (3): e151-e154.

11.   Murugesan J.R., Joglekar S., Valerio D. et al. Myoid hamartoma of the breast: case report and review of the literature. Clin. Breast Cancer. 2006; 7: 345-346.

12.   Ko M.-S., Jung W.S., Cha E.S., Choi H.J. A rare case of recurrent myoid hamartoma mimicking malignancy: imaging appearances. Korean J. Radiol. 2010; 11 (6): 683-686.

13.   Kajo K., Zubor P., Danko J. Myoid (muscular) hamartoma of the breast: case report and review of the literature. Breast care. 2010; 5: 331-334.

14.   Ayva S.K., Ozturk F.K., Obut H. Adenohibernoma: a rare breast tumor. Int. J. Surg. Pathol. 2012; 20 (3): 280-283.

15.   Nasit J.G., Parikh B., Trivedi P., Shah M. Myoid (muscular) hamartoma of the breast with chondroid metaplasia. Indian J. Pathol. Microbiol. 2012; 55: 121-122.

Abstract:

Acute severe pancreatitis remains one of the actual issue in urgent surgery Forecast of the disease is dependant on spread of purulent necrotic process in pancreas and retroperitoneal tissues. Therefore diagnosis of purulent complications becomes extremely important.

The aim of the study was to demonstrate and evaluate features of ultrasonography in diagnosis and treatment strategy definition of purulent necrotic complications of acute severe pancreatitis.

Materials and methods. The study included 115 patients with acute destructive pancreatitis aged of 21-81 years The major part of them (50%) were persons at most able-bodied (working) aged 32-59 years. All patients underwent ultrasound diagnostics for determination the spread of pathology and detection of complications of the disease.

Ultrasound scanning was carried out as follows:

1. inspection of pancreatic parenchyma;

2. inspection of cellular tissues;

3. detection of free liquid in the abdominal cavity;

4. evaluation of the abdomen and kidneys;

5. inspection of the pleural cavity

Results. Examination of the parenchyma revealed that the pancreas was often inlarged, had a fuzzy, uneven contours and heterogeneous structure. However, it should be noted that in some cases, the pancreas was normal size and structure. Infected necrosis, acute liquid accumulation and/or free liquid in the abdominal cavity had occurred in 100% of cases in various combinations during examination of cellular tissues. Regarding the abdominal organs following complications were revealed: obstructive jaundice - in 5(4.3%) cases; portal vein thrombosis - in 1 (0.9%) case; splenic abscess - in 1 (0.9%) case. The presence of liquid in the pleural cavity was determined by leaves dissociation of the parietal and visceral pleura. The volume of the liquid was determined according standard classification.

Conclusion. Ultrasound scanning allows to determine the presence and extent of local complications arising at the stage of purulent necrotic complications of acute severe pancreatitis and general complications as a result of systemic pathological effect on the body of the disease.

References

1.     Охотников О.И. Перкутанная диапевтика в неотложной абдоминальной хирургии органов панкреато-билиарной зоны. Автореф. ... дис. докт. мед. наук. Воронеж. 1998; 39 с.

2.     Echenique A.M., Sleeman D., Yrizarry J. et al. Percutaneous catheter-directed debridement of infected pancreatic necrosis in 20 patients. J. Vase. Interv. Radiol. 1998; 9: 565-571.

3.     Затевахин И.И., Цициашвили М.Ш., Будурова М.Д. Комплексное ультразвуковое исследование при остром панкреатите. Анналы хирургии. 1999; 3: 36-42.

4.     Scaglione M., Casciani E., Pinto A. et al. Imaging Assessment of Acute Pancreatitis. Semin Ultrasound CT MRI. 2008; 29:322-340.

5.     Багненко С.Ф., Курыгин А.А., Синенченко ГИ. Хирургическая панкреатология. Санкт-Петербург: Речь. 2009; 608 с.

6.     Loser C., Folsch U.R. Acute pancreatitis: medical and endoscopic treatment. Pancreatic disease. State of the art and future aspects of research. 1998; 12: 66-78.

7.     Martines-Noguera A., Mohtserat E., Torruba S. etal. Ultrasound of the pancreas: update and controversies. Eur. Radiol. 2001; 11: 1594-1606.

8.     Mortele KJ, Girshman J, Szejnfeld D, et al. CT-guided percutaneous catheter drainage of acute necrotizing pancreatitis: clinical experience and observations in patients with sterile and infected necrosis. AJR Am. J. Roentgenol. 2009; 192(1): 110-116.

9.     Kumar P., Mukhopadhyay S., Sandhu M. et al. Ultrasonography computed tomography and percutaneous intervention in acute pancreatitis: A serial study. Austral. Radiology. 1995; 39(2): 145-152.

10.   Balthazar E.J., Freeny P.C., van Sonnenberg E. Imaging and intervention in acute pancreatitis. Radiology. 1994; 193: 297-306.

11.   Mortele K.J., Wiesner W., Intriere L. et al. Modified CT severity index for evaluating acute pancreatitis: improved correlation with patient outcome. Am. J. Roentgenol. 2004; 183(5): 1261-1265.

12.   Bharwani N., Patel S., Prabhudesai S. et al. Acute pancreatitis: The role of imaging in diagnosis and management. Clinical Radiology.2011; 66: 164-175.

13.   De Waele J.J., Delrue L., Hoste E.A. et al. Extrapancreatic inflammation on abdominal computed tomography as an early predictor of disease severity in acute pancreatitis: evaluation of a new scoring system. SourcePancreas. 2007; 34 (2): 185-190.

14.   Биссет Р., Хан А. Дифференциальный диагноз при абдоминальном ультразвуковом исследовании. Пер. с англ. под ред. С.И. Пиманова. М.: Медицинская литература. 2001; 272 с.

15.   Бенсман В.М. Облегченные способы статистического анализа в клинической медицине. Краснодар: Издательство КГМА. 2002; 30 с.

16.   Кармазановский ГГ, Степанова Ю.А. Классификация острого панкреатита - современное состояние проблемы и нерешенные вопросы. Медицинская визуализация. 2011; 4: 133-137.

17.   Сидорова Ю.В., Шабунин А.В., Араблинский А.В., Шиков Д.В., Бедин В.В., Лукин А.Ю. Острый панкреатит: некоторые вопросы диагностики и лечения. Диагностическая и интервенционная радиология. 2011; 5(2): 15-26. 

Abstract:

Case report indicates the usefulness of ultrasound for diagnostics of inorganic retroperitoneal tumor. It is necessary to use interventional methods under ultrasound control, because it gives an opportunity to clarify histological structure of tumor before surgical operation. 

References

1.     Klimenkov A.A., Gubina G.I. Neorgannye zabrjushinnye opuholi: osnovnye principy diagnostiki i hirurgicheskoj taktiki [Inorganic retroperitoneal tumor: basic diagnostic and surgical tactics]. Prakticheskaja onkologija. 2004; 4: 285-289 [In Russ].

2.     Babajan L.A. Neorgannye zabrjushinnye opuholi. Izbrannye lekcii po klinicheskoj onkologii [Inorganic retroperitoneal tumors. Elected lectures on clinical oncology] M.,2000; 420-436 [In Russ].

3.     Shhetinin V.V., Shejh Zh.V., Pachgin I.V., Kurzanceva O.O. Neorgannye mezenhimal'nye opuholi zabrjushinnogo prostranstva: osobennosti izobrazhenija i priznaki zlokachestvennosti. [Inorganic mesenchymal tumors or retroperitoneal space: features of imaging and signs of malignancy] Radiologija-praktika. 2004; 3:34-41 [In Russ].

4.     Vlasov P.V., Kotljarov P.M. Kompleksnaja luchevaja diagnostika zabrjushinnyh opuholej i opuholevidnyh sostojanij. [Complex beam diagnostics of retroperitoneal tumors and new-growth conditions.] Vestnik rentgenoogii i radiologii. 1998; 3: 30-40 [In Russ]

5.     Kilkenny J.W. IIIrd, Bland K.I., Copeland E.M. Retroperitoneal sarcoma: the Universitty Florida experience. J. Amer. Coll. Surg. 1996; 329-339.

6.     Singer S., Corson J.M., Demetri G.D., et al. Prognostic factors predictive of survival for truncal and retroperitoneal softtissue sarcoma. Ann. Surg. 1995; 185-195.

7.     Herman K., Kusy T. Retroperitoneal sarcoma - the continued for surgery and oncology. Surg. Oncol. 1998; 7(1-2): 77-81.

8.     Gvarishvili M.A. Ul'trazvukovoe issledovanie v diagnostike neorgannyh opuholej brjushnoj polosti i zabrjushinnogo prostranstva. [Ultrasound diagnostics of inorganic tumors of abdominal cavity and retroperitoneal space.] Diss. cand. med.nauk. M., 2010; 15-18. [In Russ].

Abstract:

Aim: was to determine the possibility of ultrasound in the diagnosis of hepatocellular carcinoma (HCC).

Materials and methods: the study involved 140 patients who underwent surgical treatment for the period 1998-2013 years. HCC was confirmed in 127 patients, 12 patients had benign tumors, such as hepatocellular adenoma, focal nodular hyperplasia.

Results: ultrasound features of hepatocellular carcinoma were studied. To determine the informativeness, results were compared with preoperative methods of examination, intraoperative ultrasound (IOUS) and histological examination with surgical evaluation and histologic data. Number of tumor nodules, determined by ultrasound confirmed in 74% of cases with HCC and 83,3% for benign diseases. Dimensions, which were measured by ultrasound, were confirmed in majority cases (81,1%) with HCC and 100% of cases with benign tumors. Sensitivity and specificity of ultrasound were 99,2% and 25%, CT - 96,9% and 28,6%, MRI - 100% and 33,3% respectively Aspiration biopsy showed the most balanced performance: sensitivity - 94,9%, specificity 45,4%. Lack of true negative results during angiography, IOUS and surgical evaluation did not gave possibilities to calculate the specificity and predictive value of a negative result. Sensitivity of IOUS and surgical evaluation were 98,8% and 97,6%, respectively Of all tumor markers used in the diagnostic process, none of all showed any significant sensitivity, but they were characterized by high specificity and positive predictive method predictability

Conclusions: US strategy in the diagnosis of HCC is to identify neoplasm, conducting navigation during fine-needle aspiration biopsy, specifying diagnostics during surgery. Results showed highly informative diagnostic value of ultrasound at all stages of the examination and treatment of patients with HCC. 

References

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16.   Cryu S.W., Bok G.H., Jang J.Y, et al. Clinically useful diagnostic tool of contrast enhanced ultrasonography for focal liver masses: comparison to computed tomography and magnetic resonance imaging. Gut Liver. 2014 May;8(3):292-7.

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20.   Tumanova U.N., Karmazanovskij G.G., Schegolev A.I. Sravnitel'naja kompjuterno-tomograficheskaja harakteristika densitometricheskih pokazatelej gepatocelljuljarnogo raka i ochagovoj uzlovoj giperplazii pecheni [Comparative computed tomography characteristics of densitometric indications of hepatocellular carcinoma and focal nodular hyperplasia of liver] .Diagnosticheskaja i intervencionnaja radiologija. 2013; 7(3): 25-35 [In Russ].

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Abstract:

Aim: was to evaluate possibilities of using of ultrasound classification of subcutaneous rupture of the Achilles tendon (AT) for hospital clinical practice.

Materials and methods: we examined 11 patients (9 men and 2 women). Clinical and X-ray examinations were done. Ultrasound examination was done by the standard method; modern sonographic classification of the rupture of AT was done with functional probe

Results: clinical signs of subcutaneous rupture of AT were obtained in each patient. According to sonographic classification, complete AT rupture was found in 27,2% patients (3 of 11), incomplete rupture was found in 72,8% (8 of 11). Tendinosis signs were found in 37,5% patients (3 of 8) with incomplete rupture.

Conclusions: obtained data prove the effectiveness of ultrasound method of diagnosis of subcutaneous rupture of AT, in detection various variants of its trauma. It is important for optimization of treatment strategy. 

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Abstract:

Aim: was to estimate ultrasound signs of placental insufficiency in women whose pregnancy was the result of extracorporeal fertilization (ECF) and embryo replanting.

Materials and methods: the study involved 84 women who became pregnant as a result of ECF and replanting embryos. Terms of pregnancy were 18-40 weeks. Age of women was from 24 to 46 years. Ultrasound examination was performed by standard methods recommended for pregnant women, with an estimation of basic fetal metric parameters and their compliance with the term of pregnancy, the heart rate of the fetus, the degree of maturity of the placenta, thickness, location and sonographic features of the placenta (calcifications, cysts, heart attacks, expand the intervillous space varying degrees of severity) the quantity and quality of amniotic fluid.

Results: during ultrasound of women whose pregnancy was the result of ECF and embryos replanting, in 38 (35.6%) patients pathological changes in the placenta were diagnosed. It is evident in discrepancy of placenta maturity for a full-term pregnancy The combination of 3 or more of features identified during the ultrasound examination may indicate the development of placental insufficiency in women after ECF. Ultrasound features include: the degree of maturity mismatch placenta given gestational age; the thickness of the placenta; violation of utero-placental or fetus-placental blood flow; fetal growth retardation; amount of water.

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26.   Radzinskij V. E

Percutaneous ethanol injection therapy under ultrasound guidance as a treatment of secondary hyperparathyroidism