Instrumental Methods Of Diagnosis Research Articles

Expert Center for cardiac amyloidosis: reality and perspectives

Aim. To evaluate the features of diagnosis of amyloid cardiomyopathy (ACMP), differential diagnosis of different types of amyloidosis and its clinical manifestations. Materials and methods. Were analyzed 150 cases of patients who consulted at the Expert Center for Amyloidosis with suspicion of the presence of ACMP. 63 patients were diagnosed with ACMP: 25 (39.7%) – women, 38 (60.3%) – men, with an average age of 64.1±1.5. 36 (57.1%) patients had AL-amyloidosis (immunoglobulin amyloid light-chain amyloidosis), 25 (39.7%) – ATTR-amyloidosis (transthyretin amyloidosis), 2 (3.2%) – AA-amyloidosis with heart failure (reactive systemic amyloidosis caused by hypersecretion of á-globulin). The analysis of clinical manifestations depending on the type of amyloidosis, data of laboratory and instrumental methods of diagnosis is carried out. Results. In most cases, 53 (84.1%) patients, amyloidosis manifested as signs of heart failure. Among cardiac manifestations, shortness of breath (95.2%), general weakness (93.7%), lower limb edema (76.2%) were the most common. To confirm the diagnosis, despite the high accuracy of the speckle-tracking echocardiography and magnetic resonance imaging of the heart with gadolinium, in rare cases a biopsy is required (e.g. there is a combination of clinical signs of several types of amyloidosis). Biopsy of the affected organ was performed in 31 (49.2%) patients. The strategy for further pathogenetic treatment depends on the determination of the type of amyloidosis. Free light chains of immunoglobulins were detected in 57.1% of cases, which allowed diagnosis of AL-amyloidosis. In 17 (38.6%) patients myocardial scintigraphy with 99mTc-pyrophosphate showed signs of ATTR-amyloidosis, which with a negative result of immunochemical studies allows non-invasive diagnosis of it. Conclusion. ACMP is a disease with an extremely adverse prognosis. Raising the awareness of specialists about ACMP is an important goal. With timely diagnosis, pathogenetic therapy can be started early, which will improve the quality of life and prognosis of patients with ACMP.

Multisystem inflammatory syndrome in a child associated with COVID-19: a clinical case report

Multisystem inflammatory syndrome in children (MIS-C) who contracted COVID-19 remains an urgent problem. Mortality due to this disease among children ranges from 0.8 % to 2.0 %. According to reports found in the literature, MIS-C can develop both in children who have experienced COVID-19 without clinical manifestations, and in those who have had a severe course of the disease. To date, there are no well-defined factors that allow predicting the risk of developing MIS-C in children after experiencing COVID-19, and the spectrum of clinical manifestations can be quite diverse. Aim: on the example of a specific case, to examine and analyze the features of the course and the range of diagnostic measures in children with MIS-C using an analytical method and a systemic approach. Materials and methods. The material was a clinical case of MIS-C, methods of instrumental diagnosis and objective analysis. The diagnosis of MIS-C was based on the WHO 2021 criteria for the diagnosis of MIS-C associated with COVID-19. Results. The clinical case of MIS-C associated with COVID-19 in a child with congenital thymus pathology that resulted in rapid, aggressive, and worsening multiple organ failure was studied. The manifestations were dominated by liver failure, respiratory failure, circulatory failure, and neurological deficiency, that led to the child’s death. Conclusions. Multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection can lead to serious and life-threatening complications in previously clinically healthy children. Physicians need to be more alert to children of different age groups with manifestations of respiratory infections as potential COVID-19 and to test for its presence, which will subsequently allow timely identification of children with MIS-C associated with SARS-CoV-2. Considering the probable role of the thymus in the pathogenesis and course of MIS-C associated with SARS-CoV-2, we recommend an ultrasound examination of the thymus for all children under 3 years of age with confirmed COVID-19 and followed by examination of T-cellular response if changes are detected.

Urolithiasis: Modern Approaches to Classification, Diagnosis and Treatment

Urinary stone disease (USD) is the most common and progressive disease of the urinary system, which is characterized by frequent exacerbations and a severe course. This is a complex disease caused by various causes, in which several biochemical processes are involved, occurring not only in the urinary system, but also in the whole organism. USD depends on geographical, climatic, ethnic, dietary and genetic factors. Over the past 20 years there has been an increase prevalence of this disease. The course of USD is characterized by the acute and chronic pyelonephritis and frequent recurrence, which leads to the development of renal failure, disability and fatal consequences. Calculus can form de novo anywhere in the urinary tract. The pathophysiology of USD differs depending on the place of stone formation and depends on endogenous and exogenous factors. Urinary tract stones are classified depending on etiology, location, size, number, frequency of occurrence, and radiopacity. The main symptoms of USD are pain of various nature; microscopic hematuria; dysuria, which most often indicates the presence of a stone in the urinary bladder or a low location in the ureters; discharge of crystals of urinary salts or concretions; increased body temperature. The diagnosis of USD is based on a carefully history taking and physical examination, which allows to determine the correct direction of diagnostic approach, which include laboratory and instrumental methods of diagnosis. Ultrasound diagnosis is used as the main method for visualization of calculi, but recently non contrast-enhanced computed tomography has become the standard for the diagnosis of acute low back pain, replacing intravenous urography. The choice of treatment is based on many parameters, such as the number, size, morphology, shape, volume, mobility, hardness and location of the stones and is individualized for each patient. There are two main approaches: conservative treatment and surgic al one. Medicinal treatment of USD is used primarily to prevent the repeated formation of new stones or to increase those inclusions that are already present in the organs. Drug therapy is carried out with the aim of normalizing processes in the body, the failure of which leads to the development of pathology. However, conservative treatment has its limitations and is most often used as a symptomatic treatment. Open laparoscopic interventions are rarely used recently, minimally invasive methods are more popular: extracorporeal shock-wave lithotripsy; ureterorenoscopy; percutaneous nephrolithotomy. Taking into account the increase in the prevalence of USD in Ukraine and disability (the third place among the general spectrum of causes of disability in urological practice), the article analyzes and reviews modern approaches to classification, early and accurate diagnosis, and choosing a timely and correct method of treatment.

Salivary gland immunohistochemistry vs substantia nigra sonography: comparative analysis of diagnostic significance

Introduction. Parkinson's disease (PD) urges for new instrumental methods of diagnosis. Transcranial sonography of the substantia nigra (SN TCS) is an established method for early PD diagnosis but its application is limited. Recently, biopsies (primarily that of salivary gland) and test for abnormal α-synuclein are suggested to verify PD.
 Materials and methods. We assessed 12 individuals with PD, Hoehn–Yahr 2.3 ± 0.4. The assessments included: UPDRS, NMSQ, NMSS, RBDSQ, PDQ-8, MoCA, and HADS scoring; SN TCS; and sublingual gland immunohistochemistry for phosphorylated α-synuclein (PS-129) with automated morphometric analysis.
 Results. Substantia nigra hyperechogenicity was shown in 75% of patients whereas biopsy revealed PS-129 in 100% of patients. Echogenic area of the substantia nigra was 0.24 [0.21; 0.3] cm2. PS-129 inclusion area varied from 28.47 [27.55; 96.26] to 238.77 [234.13; 272.49] μm2, and PS-129 proportion varied from 13.4% to 93.4% of the nervous fiber area across the patients. We found relations between PS-129 and NMSQ (r = 0.8; p 0.001), NMSS (r = 0.9; p 0.001), PDQ-8 (r = 0.7; p = 0.003), UPDRS-I (r = 0.7; p = 0.009), UPDRS-II (r = 0.6; p = 0.03), and HADS (anxiety r = 0.8; p = 0.002; depression r = 0.6; p = 0.04) scores.
 Conclusion. The results demonstrate a higher biopsy sensitivity as compared to SN TCS. Automated morphometric analysis has been newly applied to assess PS-129 occurrence. Immunohistochemistry results are directly related to non-motor symptom severity, which may indicate high probability of PS-129 presence and diagnosis confirmation in early disease.

FEATURES OF DIAGNOSIS AND TREATMENT OF CROHN’S DISEASE (CLINICAL CASE)

The exact reason for the occurrence of Crohn’s disease remains unknown. It is believed that pathology can be carried out by infectious and viral pathogens, deviations from the norm of natural balance of the microflora of the gastrointestinal tract (hereinafter – the gastrointestinal tract). Many researchers indicate an abnormal autoimmune response of the body on food stimuli – in favor of such an assertion indicates the systematic impression of the internal organs. However, for the emergence and development of this disease, there are significant impacts with harmful habits, such as: smoking, alcoholic beverages and medicines, unbalanced nutrition and the presence of chronic inflammatory gastroids. The inflammatory process begins in the mucous membrane, gradually affects all layers of the wall of the gastrointestinal wall, leads to its destruction and fibrosis and the formation of fistish and stenoses. Therefore, early diagnosis and timely treatment prevents the development of complications, including such severe such as bleeding, perforation of the intestinal wall, intra-abdominal abscesses, internal and external fists, adhesions of the intestine with the development of obstruction. Purpose: on the basis of a specific case of HC to investigate and analyze the features of diagnosis and treatment of these patients using an analytical method and a systematic approach. Materials and methods: The material was a clinical case of HC, methods of instrumental diagnosis and objective analysis. The results: The concrete case of HC is investigated, features of inspection and diagnostics are defined. Conclusions: A feature of the diagnosis and treatment of patients with HC is a constant vigilance about the occurrence of complications, the key to the prevention of which is a multidisciplinary approach in the tactics of diagnosis and treatment of these patients. Key words: Crohn’s disease, features of examination and diagnosis.

THE EFFECT OF TOPOISOMERASE ІІ ALPHA ON THE RESPONSE TO NEOADJUVANT CHEMOTHERAPY OF TRIPLE-NEGATIVE BREAST CANCER

Summary. Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer associated with poor prognosis, lacks of standard biomarkers and tumor heterogeneity. So it is the lack of therapeutic biomarkers and tumor heterogeneity are the main causes of therapeutic resistance in the case of TNBC. Differences in tumor cell properties are provides by enzymes that are important potential therapeutic targets. This is makes the exploring of prognostic biomarkers and potential therapeutic targets of TNBC an important area of research. Aim: to improve treatment outcomes for patients with TNBC by evaluating topoisomerase 2 alpha as a potential predictive marker of treatment efficacy. Objects and methods: the study involved 45 patients with II-III stages of TNBC. In addition to standard biomarkers, the level of topoisomerase II alpha expression was determined by the immunohistochemistry. Instrumental methods of diagnosis, pathomorphological and immunohistochemistry, as well as statistical methods of evaluating the obtained data were used in the study. Results: the taxane-containing chemotherapy regimens in patients with TNBC increases the response to treatment. Topoisomerase II alpha overexpression is associated with better prognosis and response to treatment in patients with TNBC. Conclusions: the main results of study allow us to consider topoisomerase II alpha as a prognostically valuable marker for predicting the course of the disease and the response to chemotherapy, as well as the advantage of taxane-containing treatment regimens in patients with TNBC.

TWO-STAGE SURGICAL TREATMENT OF ULCEROUS-NECROTIC ENTERITIS COMPLICATED BY PERFORATION AND GENERAL PERITONITIS IN A PATIENT WHO UNDERWENT TOTAL COLECTOMY

Abstract. The purpose of the message is to inform the medical community about a rare clinical observation – the case of ulcerous-necrotic enteritis complicated by peritonitis due to numerous bowel wall perforations in a patient who underwent total colectomy with application of ileorectal anastomosis for idiopathic megacolon more than 30 years ago.
 Materials and methods. The results of objective and instrumental methods of diagnosis, as well as the data of intraoperative findings were analyzed. The choice of surgical approach is based on the incisive analysis of the detected changes.
 Results and discussion. A serious problem was the impossibility of correct surgical elimination of the source of peritonitis during the first surgical intervention. Therefore, the decision on staged correction was taken.
 Conclusions: when it is not possible to perform a correct single-step surgical elimination of the source of peritonitis in case of ulcerous-necrotic enteritis, the surgical treatment should be carried out in incremental steps. Relaparotomy “at request” is an operation of choice. The decision on the timing of reintervention should be patient-specific.

Modern approaches to the diagnosis and treatment of coccygodynia

Currently, there are no clear clinical guidelines for the diagnosis and treatment of coccygodynia. There are still debatable issues related to the choice of the most optimal diagnostic method, evaluation of the effectiveness of blockades, establishment of indications for surgical treatment and the determination of the most appropriate method of surgery. The features of the anatomical structure of the coccyx are considered in the scientific paper. The clinical picture and neurological symptoms of coccygodynia are described in detail. Modern instrumental methods of diagnosis of this disease (spondylography, MSCT, MRI) are presented. Modern scientific works on evaluating the effectiveness of conservative and surgical treatment have been studied. The methods of surgical treatment of patients with coccygodynia are analyzed. Indications for surgical treatment and the results of surgeries in patients with coccygodynia are considered. In addition, the authors presented their classification of coccygodynia.

SMOKING, PRODUCTION FACTORS AND PULMONARY INJURIES IN MECHANICAL ENGINEERING WORKERS

The aim of the study is to determine what is the incidence of respiratory diseases among workers in mechanical engineering enterprises and which are leading risk factors. The subject of the study are 80 persons working in mechanical engineering enterprises. The studies were carried out at the University Hospital - Pleven during the period 2017-2020. Specific clinical and instrumental methods of diagnosis have been used. The largest number are people with professional experience over 15 years, 72% of them are smokers. The most frequent cases are Chronic Obstructive Pulmonary Disease and Chronic bronchitis. The risk of developing lung disease in smokers (OR) is 22,71 times higher than their non-smoker counterparts in the same work environment. When using modern protective equipment, the main risk factors for respiratory diseases among mechanical engineering workers are related to lifestyle and smoking as a leading factor.

Markers of brain damage in full-term newborns with intrauterine growth retardation

The increase in the number of newborns with intrauterine growth retardation, who are characterized not only by high perinatal morbidity and mortality, but also by neurodevelopmental disorders in later life, has determined a wide search for diagnostic markers of prenatal hypoxia for a timely objective assessment of brain damage and a justification of neuroprotection methods. This article presents literature data on biomarkers and methods of instrumental diagnosis of brain damage that have received evidence of the effectiveness of their use in early neonatal life of newborns with intrauterine growth retardation. It is emphasized that such biomarkers as S100B, NSE, and BDNF proteins are the most reliable and easy to determine non-invasively. However, for their wide application in clinical practice, it is necessary to establish reference values in umbilical cord blood and urine, while taking into account the gestational age, sex, and method of giving birth, and to unify the use of laboratory analysis systems and diagnostic tests for this purpose. The comparison of biomarker indicators with cerebral oximetry, electroencephalogram and magnetic resonance imaging data will allow for developing new approaches to the treatment of perinatal pathology and, largely, preventing adverse consequences in those born with intrauterine growth retardation.

МЕТОДОЛОГИЯ КЛИНИЧЕСКОГО ОБСЛЕДОВАНИЯ ПАЦИЕНТОВ С НАРУШЕНИЯМИ РИТМА СЕРДЦА: ВАЖНОСТЬ СИСТЕМНОГО ПОДХОДА

Despite the rapid development of complex instrumental methods of diagnosis of rhythm and conduction disorders, careful history taking and physical examination do not lose their relevance and significance. Based on the literature analysis, this article reflects the methodology of complaints and history taking, and physical examination in patients with cardiac arrhythmias. Particular attention is paid to the importance of a systemic approach to the clinical examination of patients, which allows not only to suspect the presence of cardiac arrhythmias before recording an electrocardiogram, but also to suggest their character and features, which sets the direction for subsequent diagnostic search.

Suprasellar mature teratoma: case report

Intracranial teratomas are tumors that occur mainly in childhood and extremely rare in adulthood. They account up to 50% congenital CNS tumors. In this article a case of mature teratoma in 33 year-old female patient with progressive visual impairment is presented. Differential diagnosis at preoperative stage was difficult. Outcome analysis of neuroimaging study method and clinical picture provided evidence of epidermal cyst. Transnasal endoscopic approach as a treatment method was chosen, but during the surgery the atypical tissue for epidermal cyst was identified with tight adhesion to the right internal carotid artery which limited the extent of surgical tretment. Pathohistological and immune histochemical study detected mature teratoma. Detailed visual impairment dynamic and instrumental methods of diagnosis during postoperative supervision are presented in the article. The choice of management, namely, surgical intervention using extended endoscopic transnasal approach is considered to be controversial and risky among different authors taking into account intraoperative characteristics of this tumor.

ANTIMICROBIAL PEPTIDES AND UBIQUITIN PROTEIN LIGASE E3 IN DESTRUCTIVE FORMS OF PANCREATITIS

The development of methods for predicting and pre-venting the development of infectious destructive forms of acute pancreatitis for clinical practice is one of the important problems of pancreatology, the solu-tion of which would reduce post-operative mortality in severe acute pancreatitis, reaching 30-80%. To date, traditional laboratory and instrumental methods of diagnosis do not fully satisfy clinicians, since they do not always allow timely and reliable determination of the probability and time of microbial contamina-tion of pancreatic and parapancreatic tissue in pa-tients with destructive pancreatitis. In this regard, it is of interest to search for new methods for predicting and timely diagnosis of infected forms of pancreatic necrosis, which would significantly improve the re-sults of treatment of severe forms of acute pancreatitis. The use of changes in the dynamics of levels of antimi-crobial peptides - α-defensins and Ubiquitin Protein Ligase E3 in the blood serum of patients for diagnos-tic purposes makes it possible to predict and deter-mine earlier the transformation of sterile pancreone-crosis into infected and can be used as markers of the development of contamination of destructive forms of acute pancreatitis.

Features of chronic pain syndrome in professional polyneuropathies

Pain in the hands is a key symptom of professional upper limb polyneuropathy. Its occurrence is caused by physical overloads and functional overstrain of the upper limb muscles, leading to traumatization of peripheral nerve fibers due to tension or damage to the nerve endings in the tense muscle in conditions of a pronounced decrease in blood flow.The aim of study was to study the features of pain syndrome in professional polyneuropathies is an important task, the solution of which can contribute to more effective treatment of the main clinical manifestations of this disease.We examined 236 patients with a diagnosis of occupational upper limb polyneuropathy aged 18 to 65 years without significant comorbidities. The study was conducted using standard questionnaires (DN4 neuropathic pain diagnostic questionnaire, short pain questionnaire, hospital scale of anxiety and depression).The DN4 questionnaire survey revealed the presence of a neuropathic component of pain syndrome in 91.4% of patients. Quantitative assessment of pain using a short pain questionnaire confirmed the high intensity of pain in the hands of patients, as well as its impact on professional activities and other areas of life. In addition, most of the examined individuals showed signs of subclinical and clinical anxiety and depression.Pain in the hands is a key symptom of professional upper limb polyneuropathy. Its occurrence is caused by physical overloads and functional overstrain of the upper limb muscles, leading to traumatization of peripheral nerve fibers due to tension or damage to the nerve endings in the tense muscle in conditions of a pronounced decrease in blood flow. The study of the features of pain syndrome in professional polyneuropathies is an important task, the solution of which can contribute to more effective treatment of the main clinical manifestations of this disease.We examined 236 patients with a diagnosis of occupational upper limb polyneuropathy aged 18 to 65 years without significant comorbidities. The study was conducted using standard questionnaires (DN4 neuropathic pain diagnostic questionnaire, short pain questionnaire, hospital scale of anxiety and depression).The DN4 questionnaire survey revealed the presence of a neuropathic component of pain syndrome in 91.4% of patients. Quantitative assessment of pain using a short pain questionnaire confirmed the high intensity of pain in the hands of patients, as well as its impact on professional activities and other areas of life. In addition, most of the examined individuals showed signs of subclinical and clinical anxiety and depression.Hand pain in patients with occupational polyneuropathy is a complex problem due to its high intensity, long-term chronic course and impact on many aspects of the patient’s daily life. The disease is characterized by a mixed nociceptive-neuropathic nature of the pain syndrome. This explains the persistence of pain for many years after the termination of contact with the etiological harmful production factor (physical overload) and the low effectiveness of conventional courses of conservative therapy. Persistent symptoms of professional upper limb polyneuropathy, confirmed by clinical and instrumental methods of diagnosis, dictate the need to search for new methods of therapy aimed at reducing patient complaints and clinical manifestations of the disease.

On the issue of evaluation of vertebrogenic pathology in professional drivers at the stage of outpatient visit

Truck drivers represent one of numerous occupational groups employed in many economic sectors. Their work is characterized by a complex of adverse occupational factors. The greatest risk for the development of musculoskeletal diseases, including vertebral pathology, is associated with vibration, adverse environment, and work stress. Analysis of the state of health in 65 male drivers from trucking industry is carried out on the basis of results of outpatient examination. It included medical history, assessment of the severity of pain according to a visual analog scale, and instrumental methods of diagnosis. Vertebrogenic diseases of the cervical spine (cervicalgia, cervicobrachialgia) were detected according to the results of examination in 73.8% of drivers and diseases of the lumbosacral region (low back pain, lumbar ischialgia, radiculopathy) in 89.2% of drivers. Increase in the length of service negatively affects the course of the disease, leading to an increase in neurologic impairment from the reflex stage in the group of people with work experience of up to 9 years to the stage of radicular compression in the group with work experience of more than 20 years. Presented data indicate the need to develop a set of targeted measures of sanitary and hygienic and therapeutic and preventive nature.

De Quervain’s disease (etiology, pathogenesis, diagnosis and treatment). Part II

De Quervains disease, despite its low prevalence, is accompanied by pain syndrome, dysfunction and a decrease in the strength of the hand. This leads to a significant decrease in the quality of life of the patient, disruption of his work and daily activities. Patients with de Quervains disease, make up a significant part of those who turn to orthopedists, surgeons, rehabilitation doctors. However, the individual features of the structure of the first back canal of each person, formed in the process of phylogenesis, the lack of data on the exact cause of the disease cause the complexity of diagnosis and treatment of the disease. In the first part of the lecture, devoted to de Quervains disease, modern literature data concerning the features of the anatomical structure of the first back canal, the etiology and pathogenesis of the disease are summarized. It also presents a description of the clinical picture of de Quervains disease, tests and instrumental methods of diagnosis, the algorithm of examination of the patient with this pathology.

De Quervain’s disease (etiology, pathogenesis, diagnosis and treatment). Part I

De Quervains disease, despite its low prevalence, is accompanied by pain syndrome, dysfunction and a decrease in the strength of the hand. This leads to a significant decrease in the quality of life of the patient, disruption of his work and daily activities. Patients with de Quervains disease, make up a significant part of those who turn to orthopedists, surgeons, rehabilitation doctors. However, the individual features of the structure of the first back canal of each person, formed in the process of phylogenesis, the lack of data on the exact cause of the disease cause the complexity of diagnosis and treatment of the disease. In the first part of the lecture, devoted to de Quervains disease, modern literature data concerning the features of the anatomical structure of the first back canal, the etiology and pathogenesis of the disease are summarized. It also presents a description of the clinical picture of de Quervains disease, tests and instrumental methods of diagnosis, the algorithm of examination of the patient with this pathology.

Capabilities of ultrasound in detection of diverticulitis in conditions of emergency department

The aim of this prospective study was to evaluate ultrasound capabilities in differential diagnosis of intestinal diverticular disease, diverticulitis and other acute abdomen pathology. Material and methods . The study included 29 patients at the age of 48-95 years, which were admitted to emergency department with clinical symptoms of acute abdomen pain. All patients underwent complex clinical examination, comprising laboratory and instrumental diagnostic methods. Ultrasound of intestines was performed according to a specially developed step-by-step algorithm. Results. Sensitivity of the method was 68%, specificity 80%, accuracy 72.0%, PPT 86.0%, NPT 57.0%. Conclusion . Rather high diagnostic informative value and non-invasiveness of intestine's ultrasound allow to reconsider the sequence of instrumental methods of diagnosis for patients with suspicion on acute diverticulitis, and to consider ultrasound as a first line method of diagnosis.

Crohn’s disease: modern diagnosic and treatment

A review of modern laboratory and instrumental methods of diagnosis in patients with Crohn’s disease, their rational combined use is given. Conservative and surgical treatment are considered. Particular attention is paid to minimally invasive endoscopic treatment of Crohn’s disease complications.

Possibilities of instrumental methods of diagnosis in choice of the treatment tactics in women–patients, suffering varicose dilation of the lower extremities and pelvic veins

Objective. To elaborate the algorithm for preoperative diagnosis of combined varicose dilation in the lower extremities (LE) and pelvis with the aim to select and use the elective planning of surgical treatment.
 Маterials and methods. The results of examination of 301 women-patients of a reproduction age, suffering varicose dilation of the LE veins in a 2012 - 2017 yrs period, were analyzed.
 Results. The elaborated algorithm application made possible to diagnose a pelvic varicosis with reflux in 14 women-patients, what was confirmed by results of phlebography.
 Conclusion. Sensitivity of transvaginal ultrasound investigation in diagnosis of pelvic varicose constitutes 100%. Women-patients, complaining on pelvic pain, mostly have nonsaphenous varicosis.