Aim: to assess the correlation between ultrasound findings and outcomes of minimally invasive surgical treatment in patients with benign breast masses.

Materials and Methods. The study included 61 patients with benign breast masses treated by vacuum-assisted excision (VAE) with complete lesion removal. A total of 70 breasts underwent intervention, with 105 masses excised. The patients ranged in age from 20 to 75 years (mean age, 38.7 years). All patients underwent multiparametric breast ultrasonography before surgery and at long-term follow-up, at least 6 months after the procedure. At the same postoperative time points, patients completed a questionnaire assessing their subjective well-being and satisfaction with the treatment outcome.  The preoperative and follow-up ultrasound findings were compared with the questionnaire data and subjected to statistical analysis.

Results. According to the ultrasound  BI-RADS classification, with the highest category assigned to each breast, the distribution was as follows: category II – 2 breasts; category III – 60 breasts; and category IVa – 8 breasts. Concordance between the ultrasound findings and histopathological results was observed in 56 of the operated breasts (80%). A hematoma was detected by ultrasound on the first postoperative day in 5 patients, involving 1 breast in each case (7.1% of the 70 operated breasts). Residual lesion tissue more than 6 months after surgery was detected in 13 patients, corresponding to 12.3% of the 105 excised masses. Thus, complete excision at 6-month follow-up was confirmed by ultrasound in 87.5% of the removed masses.  Scar tissue was identified in the surgical bed of 36 of the 105 excised breast lesions (34.5%). The dimensions of the scar tissue ranged from 5 x 4 mm to 22 x 13 mm, with a mean size of 12.2 ± 5.0 mm. No scar tissue formation was observed in 75.5% of the VAE sites. In the questionnaire assessment, a high level of satisfaction with the outcome of minimally invasive VAE of a benign breast lesions was reported for 57 of the 70 operated breasts (81%).  When patients with and without postoperative hematoma were compared, statistically significant differences were found only in the maximal lesion diameter.

Comparative analysis according to the presence or absence of residual lesion tissue revealed statistically significant differences in two parameters: scar size and maximal lesion diameter. Neither the number of operated breasts nor the distribution of lesions according to BI-RADS category on ultrasound was significantly associated with the presence of residual lesion tissue.

Conclusions. Correlation analysis demonstrated that the most significant associations were observed among parameters characterizing the extent of the intervention and the severity of postoperative changes.

The strongest inverse correlations with questionnaire-based measures of patient satisfaction were observed for hematoma size, the number of excised neoplasms, and the maximal lesion diameter.

Scar size was not significantly correlated with individual questionnaire items or the overall questionnaire score. This finding was presumably attributable both to the relatively low frequency of scar tissue formation and to the small size of the scars following minimally invasive intervention (mean, 12.2 ± 5.0 mm).

VAE is not associated with the formation of substantial postoperative breast scarring and, consequently, does not appear to adversely affect patients’ self-reported well-being during the postoperative period.

This review addresses the role of elastography in the diagnosis of thyroid diseases, with a focus on strain elastography (SE) as a complementary non‑invasive tool for differentiating benign and malignant thyroid nodules. The study evaluates the diagnostic capabilities and inherent limitations of SE, particularly emphasizing that its isolated application—without integration of quantitative parameters of shear wave elastography (SWE)—is constrained by high equipment‑ and operator‑dependency. Additionally, the paper highlights the utility of SE in assessing radiation‑induced hypothyroidism. The authors underscore the need for further scientific research to integrate elastography into the dynamic follow‑up of patients who have undergone radiation therapy for head and neck malignancies and locally advanced breast cancer.

The article presents a clinical case report of complications associated with polyacrylamide gel (PAAG) injection, identified during breast ultrasound. The ultrasound findings are consistent with polyacrylamide mammary syndrome. Patient N., 58, with a history of PAAG injection in 1995, presented with complaints of breast pain and fullness, asymmetry, compaction, and enlargement of the left breast. A breast ultrasound revealed multiple nodular lesions, which should be differentiated between “gelomas” (silicone or polyacrylamide gel induced granulomas) and breast tumors. This clinical case presents ultrasound features for the differential diagnosis of gel collections and tumors. Particular attention is paid to the potential of multiparametric ultrasound for the differential diagnosis of gelomas and malignant breast masses using modern ultrasound techniques. The patient underwent multiparametric ultrasound in B-mode, color Doppler imaging, and contrast-enhanced ultrasound (CEUS). The use of power and color Doppler imaging (CDI) helps assess the anatomy of breast vessels and blood flow velocity, identifying areas of increased blood flow. It is emphasized that ultrasound in the presence of polyacrylamide gel (PAAG) in the mammary glands is significantly complicated. Due to the similarity in the ultrasound appearance of gelomas and malignant masses, it is important for operator to be familiar with the ultrasound features of complications associated with the  PAAG injections. The article presents data on the subsequent treatment and follow-up of this patient.

The article presents a clinical case of a patient with previously diagnosed right bundle branch block hospitalized with a diagnosis of non-ST-segment elevation acute coronary syndrome (NSTE-ACS). The ECG on admission showed complete right bundle branch block and first-degree atrioventricular (AV) block. The patient underwent transthoracic echocardiography (EchoCG) and speckle-tracking (ST) echocardiography to assess longitudinal strain and left ventricular myocardial work (LVMW): myocardial work index (MWI), constructive work, wasted work, and myocardial work efficiency (MWE). According to standard echocardiography, the left ventricular ejection fraction (LVEF) was 45%, with local contractility disorders in the anteroseptal region. These data were complemented by a decrease in the global longitudinal strain index (GLS = -14.2%), a decrease in regional peak systolic longitudinal strain values ≥-14%, a decrease in the area of the pressure-strain loops with their shift and slight inclination to the right, characteristic of ischemia, and a decrease in global and segmental LV MWI and MWE values in the LV anteroseptal region at all levels. Further examination revealed an increase in troponin I to 3.5 ng/ml. Coronary angiography (CAG) revealed subocclusion of the anterior interventricular branch in the proximal third; transluminal balloon angioplasty with stenting was performed. The following day, a control coronary angiography (CAG) was performed due to ST-segment elevation in the chest leads. The previously inserted stent showed no signs of thrombosis. The diagnosis was updated to "acute myocardial infarction with ST-segment elevation." A CAG echocardiogram (EchoCG) with LV MRI showed some improvement, confirming the findings of the control CAG.
Given the limited information provided by ECG diagnostics, determining the parameters of global and regional longitudinal strain and LV MRI allowed us to clarify the extent of myocardial damage, reduce the delay in invasive diagnosis and treatment, and evaluate the results over time.

This review addresses the utility of ultrasound in the diagnosis of adenomyosis. Over the past 45 years, the topic has been extensively covered in the literature. To date, at least 20 ultrasound criteria for adenomyosis have been proposed by various research groups. Currently, the most clinically relevant are the direct and indirect ultrasound features of adenomyosis as delineated by the MUSA (Morphological Uterus Sonographic Assessment) international consensus. Reported diagnostic value for ultrasound in adenomyosis detection vary across studies: sensitivity ranges from 72 % to 91 %, specificity from 49 % to 90 %, positive predictive value (PPV) from 72 % to 82 %, negative predictive value (NPV) from 49 % to 80 %, and accuracy from 56 % to 63 %. A correlation between ultrasound findings and clinical manifestations of adenomyosis has been described (including an association between the severity of symptoms and the number of detected imaging features), although this relationship remains a subject of debate among experts.

A choledochocele is a cystic enlargement of the distal segment of the common bile duct protruding into the lumen of the duodenum. This is an extremely rare congenital abnormality. The article describes the case of a 5-year-old child with uncomplicated choledochocele. During the preoperative diagnosis, both ultrasound and magnetic resonance cholangiopancreatography failed to make a reliable differential diagnosis between type III bile duct cyst and duodenal duplication cyst. The child underwent a planned duodenotomy with cyst excision, and the postoperative period was successful. The article describes the ultrasound features  characteristic of this type of biliary tract malformation, provides a review of the literature describing the embryogenesis of the disease, and provides information on the comparative accuracy of ultrasound, radiologic, and endoscopic diagnostic modalities. 

Diagnosis of non‑traumatic rhabdomyolysis presents a considerable diagnostic challenge due to its subtle clinical presentation. Existing laboratory methods – in particular, assessment of creatine phosphokinase (CPK) levels – do not allow for rapid point-of-care diagnosis. Therefore, evaluation of diagnostic value of shear wave elastography, a technique capable of promptly detecting muscle tissue damage, is of high relevance.

Aim: to evaluate the diagnostic value of shear wave elastography in detecting non‑traumatic rhabdomyolysis using 4–9 MHz and 5–18 MHz ultrasound probes.

Material and methods. A prospective case-control study compared shear-wave velocity (Vs) in the quadriceps femoris muscle between two groups: 45 patients with confirmed non-traumatic rhabdomyolysis (median age 81.0 [68.0; 90.0] years) and 82 healthy volunteers. All patients were  sequentially examined with the use of two expert ultrasound systems: Siemens Acuson S2000 (9L4 probe, 4.0–9.0 MHz) and Canon Aplio i800 (i18LX5 probe, 5.0–18.0 MHz). Correlation and ROC analyses were performed. The following factors influencing muscle tissue stiffness values were assessed: thickness of the muscle tissue and subcutaneous fat, age, and plasma concentrations of CPK and myoglobin.

Results. Vs was significantly lower in rhabdomyolysis patients (1.12 m/s and 1.08 m/s, respectively) than in controls (2.38 m/s and 2.48 m/s; p < 0.001). A moderate inverse correlation was found between Vs and creatine kinase level (rs from –0.370 to –0.481; p < 0.05). A threshold Vs < 1.3 m/s yielded high diagnostic accuracy (AUC 0.982–0.997; sensitivity 98%, specificity 99–100%) in rhabdomyolysis. Age, sex, subcutaneous fat thickness and muscle thickness did not significantly affect Vs.

Conclusion. SWE is a highly informative, reproducible, and non‑invasive method for non‑traumatic rhabdomyolysis diagnosis. A threshold  Vs < 1.3 m/s serves as a highly accurate diagnostic criterion, making the technique promising for use in intensive care units.

Assessment of lymphatic drainage areas is a critical task in ultrasound (US) examination of organs and tissues involved in various pathological processes. Superficially located lymph nodes (LNs) are more accessible for US evaluation. The numerous LN changes identified in ultrasound often are challenging for interpretation. The proposed classification provides grading of the detected ultrasound features in superficial LNs into groups, facilitating a risk stratification system for LN malignancy.

Objective. To stratify LN ultrasound features according to the degree of deviation from the normal pattern – from loss of benign features to appearance of signs of malignancy – and to establish a classification of changes in superficially located LN based on US findings.

Results. The classification comprises six levels: normal/unchanged LNs; probably benign LN changes; indeterminate/uncertain LN changes; suspicious LN changes; highly suspicious LN changes; morphologically confirmed malignant LN.

Conclusion. The presented Russian classification for risk stratification of malignancy in superficial LNs will enable a more accurate US assessment of superficial lymph nodes, allowing identification of distinct types of ultrasound structure and selection of suspicious lymph nodes for biopsy.