Objective: to determine the association between mechanical dispersion (MD) and the development of ventricular arrhythmias (VA) in patients with coronary artery disease (CAD) after myocardial infarction (MI) using two-dimensional speckle-tracking echocardiography (2D-STE).

Materials and Methods. The study included 80 patients with CAD and post-infarction cardiosclerosis (history of Q-wave left ventricular MI on ECG). Patients were divided into two groups: with ventricular arrhythmias (VA) (n = 58) and without VA (n = 22). The mean age was 61.6 ± 9.7 years. The VA group was further subdivided according to the B. Lown and M. Wolf classification: Class I–II of VA (n = 20) Class III (n = 16) Class IV–V (n = 22).

Results. Standard echocardiographic parameters did not differ significantly between patients with and without VA. Multivariate analysis of variance demonstrated no statistically significant differences in left ventricular global longitudinal strain (GLS) (F = 1.234; p = 0.334). However, patients with class IV–V of VA showed significantly higher MD values (F = 96.149; p < 0.001).A statistically significant moderate positive correlation (Chaddock scale) was found between MD and the number of premature ventricular contractions (PVCs) (r = 0.46; p < 0.001). Each additional PVC was associated with an increase in MD by 0.002 ms. ROC curve analysis for the prediction of VAs by MD demonstrated an area under the curve (AUC) of 0.905 ± 0.033 (95% CI: 0.841–0.969; p < 0.001). The optimal MD cutoff value was 14.95 ms. MD ≥14.95 ms predicted a high risk of ventricular arrhythmias with a sensitivity of 84.5% and specificity of 81.8%.

Conclusions. Mechanical dispersion was significantly higher in patients with ventricular arrhythmias, whereas GLS did not differ between groups. MD ≥14.95 ms was associated with an increased risk of ventricular arrhythmias in patients after MI. These findings highlight the clinical value of 2D speckle-tracking echocardiography with MD assessment for risk stratification of ventricular arrhythmias in CAD patients. 

Objective. To evaluate the role of quantitative ultrasound parameters of atherosclerotic plaque (ASP) as predictors of the development of the primary composite endpoint in patients with carotid atherosclerosis.

Materials and methods. A total of 675 patients with carotid atherosclerosis with no history of transient ischemic attack or ischemic stroke at the time of inclusion in the study were examined; 48.4% were men, with an average age of 66 [61; 72] years. All patients underwent electrocardiography, echocardiography, carotid arteries duplex ultrasound with assessment of the degree of stenosis according to NASCET and maximum wall thickness (MWT) of plaque with subsequent analysis of ASP images in DICOM format. A computer software (own development) was used to calculate the total area of the ASP and segment the image by grayscale ranges (“blood”, “lipids”, “muscle and fibrous components”, and “calcium”). The observation period was 5 years. The primary composite endpoint was the development of an ischemic event in the carotid territory on the affected side or surgical treatment of carotid stenosis. Differences were considered statistically significant at p < 0.05.

Results. During the follow-up period, 85 patients (12%) achieved primary composite endpoint. This event occurred 3 and 10 times more frequently in patients with Gray-Weale ASP types I and II than in those with types III and IV, respectively. Independent predictors in the five-year risk stratification model for event development included the NASCET stenosis grade, MWT, and the plaque image segmentation parameters excluding the “fibrous component”. Patients were divided into three groups: a “high-risk” group for developing primary composite endpoint (the predicted overall five-year risk (OR) was 30% or more) – 136 patients (21%), a “low-risk” group (less than 15% OR) – 405 patients (64%), and a “medium (intermediate) risk" group (from 15% to 30% OR) – 99 patients (15%). The median values of the degree of stenosis according to NASCET and the MWT were 15 [4; 25]% and 2.5 [2.1; 3.1] mm for the low-risk group, 24 [14; 27]% and 3.0 [2.5; 3.6] mm for the average risk group, and 50 [38; 69]% and 4.3 [3.8; 5.5] mm, respectively (p < 0.0001).

Conclusions. The degree of stenosis according to NASCET, MWT and the results of segmentation of the gray-scale image of the ASP by gray-scale ranges are significant independent predictors of the development of primary composite endpoint in asymptomatic patients with carotid atherosclerosis. 

Objective. To evaluate the ultrasound features of kidney lesions in children with tuberous sclerosis (TS), depending on genetic variant of the disease.

Materials and Methods. This cross-sectional study included children diagnosed with TS. B-mode ultrasound data from the kidneys of 137 children aged 1 month to 18 years were obtained. Of these, 27/137 patients (19.7%) had the pathogenic TSC1 variant, 76/137 (55.5%) had TSC2, 4/137 (2.9%) had TSC2/PKD1, and 30/137 (21.9%) had an unspecified genetic variant (diagnosis was established based on clinical criteria). An analysis of kidney ultrasound features was conducted depending on the genetic variant.

Results. According to ultrasound data, 85.4% (117/137) of patients had kidney lesions - cysts and angiomyolipomas (AML). For patients with pathogenic TSC1 variants, the most common kidney lesion was AML (59.3%), while patients with pathogenic TSC2 variants and TSC2/PKD1 contiguous gene syndrome (TSC2/PKD1-CGS) more often had combined AML and kidney cysts (51.3% and 100%, respectively). Multiple and large AML were most common in patients with pathogenic TSC2 variants, while patients with the TSC2/PKD1-CGS type of disease predominantly had multiple large cysts, which were visible in the first years of life.

Conclusion. Ultrasound is a simple and widely available diagnostic method that allows for timely assessment of kidney in children with TS, including at the diagnosis stage. This may be important for preventing complications such as spontaneous bleeding, aneurysms, and urodynamic disturbances.

The growth and development of the uterus and ovaries in young girls can impact subsequent reproductive function. Ultrasound features of the pelvic organs and  size reference values have been described in detail in older girls, while data for first year of life are extremely limited.

Objective: To assess the size of the uterus, ovaries, and follicles and their growth dynamics in healthy girls during the first 13 months of life based on ultrasound data.

Materials and Methods. Pelvic ultrasound was performed in 342 healthy girls aged 2 days to 13 months using standard techniques and linear multifrequency transducers. Uterine and ovarian volume (cm³) was calculated using the ellipse formula: 0.523 x length x width x thickness (cm).

Results. The uterus was visualized in 100% of the examined girls, both ovaries were visualized in 79%. The median uterine length (including the cervix) was 29 mm (min–max 13–45 mm); ovary length was 13 mm (min–max 8–32 mm). The dynamics of the sizes changes of the uterus and ovaries in girls differed during the first year of life: the volume of the uterus was maximum immediately after birth, by 3 months it decreased by approximately 2 times and remained at this level until the end of the observation period; the volume of the ovaries increased after birth, reaching a maximum at 2 months, after which it decreased by approximately 2 times by 4 months and remained at this level (with minor variations) until the end of the observation period (13 months). The dynamics of changes in the maximum follicle size followed the dynamics of the ovarian volume, but with a smaller amplitude. In each ovary, from 1 to 10 follicles were determined per section (Me – 3). The median maximum follicle size in the right ovary was 5 mm (min–max – 2–16 mm), while in the left ovary it was 4 mm (min–max – 2–19 mm). No differences in the sizes of the uterus, ovaries, or follicles were found between breastfed and formula-fed girls.

Conclusions. Uterine size in girls normally reaches its maximum immediately after birth and decreases significantly by two months of age. Conversely, ovarian and follicular sizes increase significantly by two months of age, decreasing to baseline by four months. This may reflect temporary activation of the hypothalamic-pituitary system after birth. Feeding type does not affect the size of girls' pelvic organs during the first year of life. Reference values for uterine, ovarian, and follicular sizes in healthy girls can be used in clinical practice to differentiate between physiological and pathological conditions.

Objective: to evaluate the potential and limitations of biliary tract ultrasound in children of different age groups and to determine the age-specific values for the diameters of the main biliary tract structures.

Materials and methods: A combined (prospective-retrospective) study of 6,722 children (1 month to 17 years old) with no hepatobiliary pathology. A standardized measurement protocol was performed on expert-class ultrasound scanner with Interobserver reproducibility assessment (ICC, n = 50). Statistical analysis: median, 5th–95th percentiles, and assessment of intergroup differences (Kruskal–Wallis test, p < 0.01).

Results. Significant age differences in the ability to visualize biliary tract structures were revealed. Extrahepatic bile ducts were visualized with high frequency across all age groups (common bile duct (CBD) – 94.8–99.7%, common hepatic duct (CHD) – 78.5–93.5%). Visualization of intrahepatic ducts showed a significant age dependence: visualization of the lobar ducts becomes possible from 1–3 years of age (12.3%) and progressively improves by adolescence (86.2%). The cystic duct remains the least accessible structure for visualization across all age groups (maximum 35.1% in adolescents). Detailed age-specific normative values for the diameters of the main bile ducts were established. Interobserver reproducibility was high for the CBD (ICC = 0.92) and moderate for the CHP (ICC = 0.84).

Conclusions. Our study yielded values for the diameters of extrahepatic bile ducts in children across various age groups.

Objective: To evaluate the potential of multiparametric high-frequency ultrasound (18–24 MHz) for monitoring early changes after photodynamic therapy (PDT) in patients with basal cell carcinoma (BCC).

Materials and Methods. The prospective, single-center study included 31 patients with 51 histologically confirmed basal cell carcinoma lesions. All patients underwent multiparametric ultrasound imaging using an Aplio i800 ultrasound scanner (Canon, Japan) with 18–24 MHz linear transducers before and 24 hours after the PDT session. The protocol included evaluation of the tumor using B-mode, Doppler, and power Doppler mapping, including microcirculation (ADF and SMI) assessment with VI calculation, strain elastography, and fluorescence spectrometry.

Results. Before treatment, all cutaneous lesions were presented as hypoechoic lesions with clear margins, an average thickness of 3.7 ± 1.2 mm, a heterogeneous solid structure, and hypervascularisation (VI 32.4 ± 4.1). 24-hours after PDT, a statistically significant decrease in VI to 4.2 ± 1.8 (p < 0.001) was observed. B-mode revealed an increase in tumor thickness to 4.4 ± 1.3 mm, decreased marginal clarity, and signs of perifocal edema. Fluorescence contrast decreased from 1:4 to 1:1. Elastography did not show significant changes in the early stages.

Conclusion. Multiparametric ultrasound with high-frequency transducers (18–24 MHz) is an informative, noninvasive method for early monitoring of PDT efficacy. The most significant ultrasound feature of treatment response is a significant reduction in intratumoral blood flow, quantified using micro-Doppler techniques. This is due to the primary mechanism of PDT action –photochemical damage to tumor microvasculature and the development of coagulative necrosis. 

The introduction of Doppler ultrasound into clinical practice has enabled the observation of changes in the uterine vasculature after termination of pregnancy. The phenomenon of enhanced myometrial vascularity (EMV) indicates delayed recovery of blood flow parameters and is often associated with retained products of conception (RPOC) in the uterine cavity. However, it shows similar ultrasound features with uterine arteriovenous malformations.

Differential diagnosis of uterine vascular malformations (UVM) from RPOC is important, as this can lead to overtreatment and, on the one hand, to iatrogenic profuse bleeding in the event of an attempted surgical evacuation of the uterine contents when the vascular anomaly is unrecognized. Although angiography is the gold standard for diagnosis, many specialists have favored Doppler ultrasound for detecting UVMs over the past two decades due to its noninvasive nature and usefulness in determining treatment strategies, including the need for uterine artery embolization. To date, differential diagnostics for the physiological and pathological characteristics of myometrial blood flow have not been developed, and signs indicating the likelihood of spontaneous regression or persistence of UVMs with the risk of profuse bleeding have not been established. The clinical significance of UVMs in asymptomatic patients is also unclear.

Mapping the vascular abnormality area using Doppler ultrasound allows for a clear determination of the extent of the process and the prevention of complications when choosing the optimal surgical method.

A standard protocol for breast ultrasound examination is presented. This document consists of a process protocol and a descriptive protocol. The process protocol describes the breast ultrasound examination technique. The descriptive protocol contains a detailed presentation of the breast ultrasound examination results, ending with a conclusion. Current domestic and international diagnostic guidelines (BI-RADS® v2025 Manual) defining indications for breast ultrasound examination are discussed. This standard protocol for breast ultrasound examination is fully consistent with current Russian clinical guidelines and does not contradict international diagnostic guidelines.