Use Of Ultrasound Examination Research Articles

Contrast Enhanced Mammography: Impact on use of ultrasound examination

Contrast Enhanced Mammography: Impact on use of ultrasound examination

Ultrasound Analysis of Patients with Mastalgia with and without Palpable Mass

OBJECTIVES To assess the clinical significance of mastalgia by investigating its association with breast lumps and the utility of diagnostic workup in cases where a palpable abnormality does not accompany mastalgia. METHODOLOGY This prospective cross-sectional study was conducted from May to July 2023 at the Radiology Department, Khyber Teaching Hospital, Peshawar. The sample size was 246, taking 80% prevalence of mastalgia, 5% margin of error and 95% confidence level. All females referred, after physical examination, to ultrasound breast with complaints of mastalgia were included in this study. RESULTSAmong 246 women with a mean age of 30.9 years presented with mastalgia, 17.5% (43) had breast lump. 69.2% (170) women had BIRADS 1, while 31% (76) had BIRADS 2. None had BIRADS 3,4 or 5. 37 (15.1%) had cyclic, while 209 (85%) presented with non-cyclic mastalgia. Pathologies detected in women with lumps were abscess in 15 (34.8%), fibroadenoma in 14 (32.5%), mammary duct ectasia in 9 (20.9%), fibrocystic change in 4 (9.3%) and hematoma in 1 (2.3%) patient. Among 203 patients without palpable lump, 33 (16.3%) had positive sonographic findings, with mammary duct ectasia in 30 (91%), intramammary lymph nodes in 2 (6.1%) and fibroadenoma in 1 (3%) patient. CONCLUSION Sonographic findings of females with mastalgia were either normal or suggestive of benign lesions; hence, excessive use of ultrasound examinations may not be needed due to the fear of breast cancer.

Simple intratesticular cysts: literature review

Introduction. Until recently, simple cysts of the testicular parenchyma were considered extremely rare pathology. Recently, this condition has been diagnosed more often, which is largely due to the widespread use of ultrasound examination of the scrotum. To date, a unified approach to the management of patients with this nosology has not been developed, which served as the basis for a review of the literature on simple cysts of the testicular parenchyma.Results. Simple cysts of the testicular parenchyma are observed in 8–10 % of patients. The etiology of simple intratesticular cysts remains unknown. Small cysts of the testicular parenchyma are most often asymptomatic, pain symptoms of a nature for large cysts larger than 2 cm. Asymptomatic single cysts of the testicular parenchyma do not require surgical treatment and probably need dynamic monitoring. In patients with symptomatic and multiple cysts, surgical treatment should be recommended. Preference should be given to organpreserving techniques in the form of cyst resection/enucleation. Orchiectomy for the treatment of simple intratesticular cysts should be considered in exceptional cases.

The combined use of ultrasound examination of hemodynamics in the umbilical artery and urine microalbumin levels can predict adverse pregnancy outcomes in patients with severe preeclampsia

The aim of this study was to elucidate the application of ultrasound examination of umbilical artery (UA) hemodynamics with urine microalbumin (UmA) determination in evaluating the outcomes of sPE patients. Altogether 80 sPE patients and 75 healthy pregnant women were recruited. UmA, RI (resistance index) and PI (pulsatility index) were separately measured by ELISA and the ultrasonic Doppler flow detector. The correlation between parameters was analysed using Pearson’s coefficient method. The independent risk factors of sPE were identified using the Logistic regression model. sPE patients had increased UmA, RI and PI (all p < 0.05). UmA level was positively correlated with RI and PI in sPE patients. RI, PI and UmA were independent risk factors of sPE (all p < 0.05). sPE can predict adverse pregnancy outcomes. High UmA levels may increase the risk of poor prognosis. Overall, ultrasound examination of UA hemodynamics with UmA determination can predict the adverse pregnancy outcomes of sPE patients. IMPACT STATEMENT What is already known on this subject? Doppler ultrasound and urine microalbumin (UmA) measurement are important tools in assessing the clinical severity of severe preeclampsia (sPE). What do the results of this study add? This study aims to unravel the application of ultrasound examination of hemodynamics in the umbilical artery (UA) combined with the determination of UmA in evaluating the outcomes of sPE patients. What are the implications of these findings for clinical practice and/or further research? Ultrasound examination of hemodynamics in UA combined with the determination of UmA can predict the adverse pregnancy outcomes of sPE patients.

A rare clinical case of the patient with a hygroma of the pubic symphysis (clinical observation)

Annotation. Timely diagnosis of such a rare pathology as hygroma of the pubic symphysis is an urgent problem, since this disease is not always characterized by typical clinical symptoms and can occur under the guise of many urological and gynecological pathologies.Purpose of the study: to study the possibility of radiation methods for diagnosing hygroma of the pubic symphysis on the example of clinical observation.Materials and methods. Patient B., 63 years old, was under observation with a diagnosis of Hygroma of the pubic symphysis. Ultrasound examination was performed on a GE Voluson E10 ultrasound scanner with a RIC5-9-D transvaginal 3D probe (5–10 MHz). Magnetic resonance imaging was performed on a Siemens Magnetom Aera tomograph.Results. According to the ultrasound examination of the urethra, between the symphysis and the anterior wall of the urethra, a volumetric formation with an even, clear contour of 43 × 33 × 40 mm was determined; urethra without focal pathology. On a series of MRI scans of the small pelvis in the retropubic fat between the posterior-lower edge of the symphysis and the anterior wall of the urethra, a heterogeneous avascular cystic-solid mass of 3.0 × 2.8 cm in size was determined that did not separate from them; a solid component of the type of multiple fibrous septa; the cystic component of the formation is associated with an unexpanded cavity of the joint space of the symphysis, containing fluid. The use of ultrasound examination of the urethra using 3D reconstruction in combination with magnetic resonance imaging of the small pelvis helped to make a diagnosis and determine further tactics for managing the patient.Conclusion. The above clinical observation demonstrated that the complex application of various methods of radiation diagnostics helps to accurately determine the organ belonging to a volumetric formation. This allows you to choose the right tactics for managing patients in the shortest possible time.

Dynamic Ultrasonography for Imaging Pediatric Fat Pad Herniation through the Lateral Patellar Retinaculum.

A 3-year-old boy was found to have a painless mass over his right anterior lateral knee for the previous 6 months. The mass was hardly identified during knee extension and became visible upon squatting. There was no specific finding on ultrasound imaging over his right knee at the supine extended position. During squatting, ultrasound imaging showed an ill-demarcated hyperechoic mass protruding next to the cartilage overlying the distal femur towards the subcutaneous layer through a slit over the lateral patellar retinaculum. Herniation of the fat pad through a defect in the lateral patellar retinaculum was diagnosed. Our case highlights the usefulness of ultrasound examination as regards the lateral patellar retinaculum defect in pediatric knees, as well as its capability for dynamic scanning to capture the exact “pathological moment”.

Expressions and difficulty of clinical manifestations in the early diagnosis of psoriatic arthritis

Objectives. Study of clinical manifestations in psoriatic arthritis: enthesitis, dactylitis, peripheral arthritis, axial arthritis, skin manifestations, for early diagnosis, which would allow the establishment of an adjusted treatment and the elaboration of measures to prevent complications. Materials and methods. The performed clinical study has an analytical-observational retrospective and included the patients who were hospitalized in the Rheumatology and Arthrology departments of the “Timofei Moşneaga” Republican Clinical Hospital during 2015-2021. The study included 103 patients with psoriasis (47 men and 56 women) with various clinical forms of psoriasis and different ages. Results. The clinical examination of primary or referred patients with cutaneous manifestations, revealed peripheral arthritis in 15 patients (24.6%), dactylitis – in 37 (60.7%), heel pain was detected in 32 (52.5%), axial arthritis – in 30 (49.2%), enthesitis, distal interphalangeal arthritis and tendonitis were not detected. Those who primary or referred with joint manifestations, in 35 (57.4%) of patients was present peripheral arthritis, dactylitis in 40 (65.6%), enthesis of the elbow joints in 11 (18%), knee joints - in 8 (13.1%), the calcaneal region - to 25 (41%), arthritis of the distal interphalangeal joints was detected in 21 (34.4%), tendinitis - to 13 (21.3%). Discussions. The obtained results allow us to state that one of the directions in improving the diagnosis of PsA consists in the use of ultrasound examination and MRI imaging of the joints of the hands and feet. This makes it possible to effectively identify the characteristic of enthesopathy, edema of tissues, as well as destructive changes in the joints of the hands and feet. Conclusions. In the study group of patients with psoriasis, in 25 (24.2%) no joint damage was detected. The frequency of detection of psoriatic arthritis and other rheumatic diseases (rheumatoid arthritis, osteoarthritis, ankylosing spondylitis etc.) was 59.2% and 16.6%, respectively, 32 (52.5%) out of 61 (59.2%) patients with PsA were primarily diagnosed. The sensitivity and specificity of the mPEST (Psoriasis Epidemiology Screening Tool) questionnaire in relation to the CASPAR criteria were 77% and 69% respectively. The highest indicators of sensitivity, specificity and accuracy in the diagnosis of PsA has ultrasound and MRI: 88%, 92%, 89% and respectively, 89%, 94%, 91%.

Usefulness of Ultrasound Examination in the Assessment of the Nail Apparatus in Psoriasis.

The assessment of psoriatic nail changes in everyday practice is based exclusively on clinical symptoms that do not reflect the entire disease process in the nail apparatus. The use of imaging methods, especially widely available and inexpensive ultrasonography, creates the possibility of additional revealing and assessing grayscale of morphological changes of the ventral nail plate, nail bed, and matrix, as well as the attachment of the finger extensor tendon to the distal phalanx. What is more, it enables the assessment of inflammation severity in the power Doppler technique. A qualitative classification of nail plate morphological changes corresponding to the severity of psoriatic nail changes has been developed so far and attempts are being made to develop a quantitative method to assess not only the presence of changes but also the severity of inflammation. Nail ultrasonography is not commonly performed, although published studies indicate the possible use of this technique in the assessment of psoriatic changes in nail structures. It can be particularly useful in subclinical changes imaging, preceding clinical manifestation of psoriatic nail changes, enthesopathy: subclinical and in the course of psoriatic arthritis, as well as in the assessment of treatment efficacy. This review article aims to summaries the research on ultrasonography of the nail apparatus which has been carried out so far, taking into account its applicability in clinical practice.

Evaluation of Diaphragmatic Function After Lung Transplantation (DIATRIBE)

<h3>Purpose</h3> Diaphragmatic function may be altered after lung transplant. Use of ultrasound examination may allow to easily studied the diaphragmatic dysfunction. The aim of this study was to investigate the incidence of diaphragmatic dysfunction and its course during the ICU stay. <h3>Methods</h3> Patients who were admitted in cardiothoracic intensive care unit after lung transplant between January 2019 and January 2021 were prospectively evaluated by ultrasound at the first day of spontaneous ventilation under pressure support (day (D) 1). Ultrasound measurements including diaphragmatic excursion (Ex) and diaphragmatic thickening fraction (DTF) were measured during a forced inspiration on each hemidiaphragm and repeated at D3, D7 and D14. Hemidiaphragm function was classified into four different stages. Normal function: Ex≥25 mm and DTF≥40%, moderate dysfunction: Ex<25 mm or DTF<40%, severe dysfunction: Ex<25mm and DTF<40%, or paralysis Ex≤0 and DTF≤0. Patients were then classified into two groups: global normal diaphragmatic function defined by at least one hemidiaphragm with normal function and global diaphragmatic dysfunction. <h3>Results</h3> 75 patients were included in our study for a total of 189 diaphragmatic ultrasounds performed. Evaluations at D1 were realized after 3 days (1-6) of mechanical ventilation. Incidence of dysfunction and recovery of each hemidiaphragm during ICU stay were presented in figure. At D1, 14 patients (19%) had normal global diaphragmatic function and 61 (81%) had global dysfunction. 56% of dysfunction recovered 7 days after initial evaluation. Factors associated with the presence of dysfunction in univariate analysis were duration of surgery (p=0.03), intraoperative transfusion (p=0.02) and the presence of a chest tube (p<0,001). <h3>Conclusion</h3> Diaphragmatic dysfunction, evaluated by ultrasound is a very frequent complication after lung transplant. Diaphragmatic dysfunction improves during the first week of spontaneous ventilation.

Evaluation of the dynamics of reconstruction of the act of swallowing in the postoperative period in patients with oncopathology of the oral cavity

Annotation. The article presents the results of the analysis of the data of ultrasound examination of the act of swallowing in patients with oncopathology of the oral cavity in the B- and M-mode in the pre- and postoperative period. The study included 26 patients aged 38-65 years, normotrophic patients who were treated in the Department of Head and Neck Tumors “Podolsk Regional Oncology Center” with malignant tumors of the tongue (group 1 – 12 patients with cancer of the lateral surface of the tongue, group 2 – 8 patients with cancer of the root of the tongue,) and the bottom of the mouth and oropharynx (3rd group – 6 patients). Scanning was performed in the sagittal and frontal planes with a 7.5 MHz sensor in two modes B and M at rest and during the act of swallowing in several stages on a TOSHIBA device (Model USDI-A500A/EL; Serial № ELA14Z2082). Data on several indicators were analyzed: chin-sublingual distance; longitudinal examination of the sublingual muscle group; transverse examination of the supralingual muscle group; examination in the lateral projection of the anterior abdomen of the biceps; determination of the amplitude of muscle contraction on the right and left, which makes it possible to compare their synchronicity and force of contraction. Statistical processing of the obtained data was performed using Excel software from Microsoft Office 2003, STATISTICA 5.5 (owned by CNIT National Pirogov Memorial Medical University, Vinnytsya, licensed № AXXR910A374605FA) according to the Student's test at p&lt;0,05. The results of the study indicate that in patients with cancer of the lateral surface of the tongue on the 10th day resumed the act of swallowing. And in patients with cancer of the mucous membrane of the oral cavity and the root of the tongue for 12-14 days. The use of ultrasound examination of the act of swallowing in the dynamics is informative and provides objective indicators for the transfer of the patient from tube feeding to self.

Use of ultrasound examination in evaluation of the size and advancement of laryngeal and hypopharyngeal tumors to the neighboring anatomical structures

The study objective is to establish the capabilities of ultrasound (US) examination in evaluation of the advancement of squamous-cell carcinoma of the larynx and hypopharynx compared to histological examination and other diagnostic methods.Materials and methods. US examination was performed in 86 patients with squamous-cell carcinoma of the larynx and hypopharynx. The study included 14 (16.3 %) patients with stage I disease, 29 (33.7 %) patients with stage II, 19 (22.1 %) patients with stage III and 24 (27.9 %) patients with stage IV. Patients with primary tumors of the larynx and hypopharynx comprised 75.6 % of the study population, patients with recurrent tumors – 24.4 %. During diagnosis advancement of tumors to the anatomical structures in the laryngeal space and beyond was evaluated. In all cases histological verification of the diagnosis was performed. Comparison of the data on advancement of laryngeal and hypopharyngeal tumors from different diagnostic methods with the results of histological examination depending on the T-category (TNM) was performed.Results. For small tumors (Т1), frequency of agreement between advancement of laryngeal and hypopharyngeal tumors measured by US examination and histological examination was 66.7 %, by endoscopic laryngoscopy (ELS) – 80.0 %; for T2 tumors, results of US examination and ELS were identical, frequency of agreement with histological examination data was 87.2 % for both methods; for T3 tumors, US examination data agreed with histological examination data in 83.3 % of cases, ELS data – in 75.0 %; for T4 tumors, frequency of agreement between US examination and histological examination data was only 44.4 %, between ELS and histological examination – 66.7 %. Therefore, US examination was more accurate for evaluation of advancement of T2 and T3 tumors. Results of evaluation of advancement of laryngeal and hypopharyngeal tumors by US examination, computed tomography and magnetic resonance tomography were close, comparable and weren’t statistically different. For T1 and T2 tumors frequency of agreement between the results of histological examination and US examination data was higher than between the results of histological examination and computed tomography data.Conclusions. High accuracy and value of US examination in evaluation of advancement of primary and recurrent tumors of the larynx and hypopharynx were shown.

Promotion of reproductive and metabolic health - current trends in the treatment and prevention of polycystic ovary syndrome in different periods of life

Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders and causes of infertility in women in reproductive age. Diagnostic criteria of PCOS in adult women include: ovulation disorders, hyperandrogenism and polycystic ovaries. According to most recommendations, 2 out of these 3 criteria are confirm the diagnosis of PCOS. In girls during puberty and in the first years after menarche, different diagnostic criteria of menstrual disorders should be taken into account (variable length of menstrual cycles, monophasic cycles) and the limited usefulness of ultrasound examination for PCOS diagnosis within 8 years after menarche. Fairly extensive differential diagnosis is also necessary, especially – exclusion of adrenal hyperandrogenism. Moreover, the diagnostic criteria of PCOS do not take into account the metabolic disorders found in most patients (obesity, insulin resistance, type 2 diabetes), which should be diagnosed as early as possible and treated appropriately. This is especially true for teenagers, in whom the unequivocal diagnosis of PCOS or its exclusion may be very difficult. Current recommendations regard hormonal contraception as the first-line therapy in PCOS, in both adult women and adolescents. Together with its beneficial effect on the reduction of hyperandrogenism and obtaining regular bleeding (which in fact are not menstruations), the unfavorable metabolic effects of hormonal contraception are emphasized, as well as the inadequacy of its use if it is expected to achieve or restore ovulation and fertility. The latest reports indicate the legitimacy of treatment aimed at correcting disorders of carbohydrate metabolism and its greater effectiveness compared to the use of oral contraceptives in both adult women and girls with PCOS. In the pharmacotherapy of insulin resistance, metformin is of fundamental importance, the use of pioglitazone, GLP-1 receptor agonists or inositols is also proposed. Adequate lifestyle and dietary modification are of major importance in the treatment and prevention of PCOS. The mechanisms of "inheritance" of PCOS and insulin resistance with the participation of epigenetic modifications are still better understood, taking into account the effects of exposure to androgen excess in utero, intrauterine growth retardation, and maternal obesity and hyperalimentation. This creates new possibilities for PCOS prophylaxis.

Usefulness of ultrasound in sub-Saharan patients with a serological diagnosis of schistosomiasis

To evaluate the usefulness of ultrasound examination in patients with just a serological diagnosis of schistosomiasis but no other evidence of active infection. 346 sub-Saharan patients with possible schistosomiasis that presented at a Tropical Medicine Unit between 2008 and 2019 were retrospectively selected. Possible schistosomiasis was considered in those patients with a positive serology for schistosomasis in the absence of direct microbiological isolates, hematuria and/or eosinophilia. Data from ultrasound examinations before and after treatment with praziquantel were collected and categorized following the World Health Organization-Niamey score to standardize the use of ultrasonography for the assessment of schistosomiasis-related morbidity. Ultrasound examinations were abnormal in only ten patients (2.89%). Main findings were focal thickening of the bladder wall (n = 6), ureteral dilatation (n = 3) and grade I hydronephrosis (n = 1). No malignant lesions, hepatic lesions nor hepatobiliary related disorders were found. After treatment, the S. haematobium global score (5 vs 3.4, p = 0.06) and the urinary bladder score (2 vs 1, p = 0.059) showed a trend towards improvement after treatment. In three patients the score after treatment dropped to 0, and in another three it remained the same although with signs of improvement. No worsening of the score was observed in any case. For those patients with a diagnosis of schistosomiasis based solely in a positive serology, the ultrasound examination could safely be spared due to the low prevalence of pathological findings and its response to treatment anyway.

A comprehensive use of ultrasound examination in infertility workup.

Considering the growing availability of ultrasound diagnostic methods in gynecology, its role in the infertility setting is increasing.In this review, we present an up-to-date ultrasound based diagnostic scheme in infertility workup comprising the evaluation of ovarian anatomy and function, uterine exploration, as well as tubal patency. The possibility of performing the vast majority of infertility diagnostics by ultrasound in the ambulatory settings is not only attractive and beneficial to patients, but also to health care system.Thus, it is vital for gynecologists to implement modern non-invasive ultrasound modalities in their everyday practice.

GASTROINTESTINAL TUBE INSERTION TECHNIQUES IN CRITICAL PATIENTS: SCOPING REVIEW

ABSTRACT Objective to map the production of knowledge about the different techniques of gastrointestinal tube insertion in critically ill and/or coma patients. Method scope review carried out in December 2020 in ten data sources, following the assumptions established by the Joanna Briggs Institute (2020) and the PRISMA-ScR protocol. Results 25 studies were selected and analyzed, identifying as the main techniques for insertion of gastrointestinal tube in critically ill and/or coma patients: techniques without the aid of instrumentals, such as head flexion, lateral neck pressure, tube freezing, measurement with corrected formula of the tip of the ear-lobe tip-xiphoid process, Sellick´s maneuver, cricoid cartilage compression, SORT maneuver and gastric insufflation. In addition to techniques with the aid of instruments, such as the use of laryngoscopes and video laryngoscopes. It is noteworthy that, in order to facilitate insertion, the use of ultrasound examination, radiological, endoscopic and fluoroscopy were also identified. Conclusions the evidence analyzed reveals that there is no specific gastrointestinal tube insertion technique for universally accepted critically ill patients.

The usefulness of ultrasound examination in detecting testicular nubbin in Japanese boys with non-palpable testes

In the case of non-palpable testes, we often find a small nodule which is called "testicular nubbin (TN)" in scrotum or inguinal canal. There is no agreement about the treatment for TN. This time we investigated whether or not ultrasound examination (US) can be a useful modality for detecting TN. We recruited 66 boys who were diagnosed with non-palpable testes and who had undergone US studies. We examined age, affected side, size of the unaffected side, presence of testicular hypertrophy, and findings from US studies. Radiologists or sonographers familiar with examination of testicular nubbin carried out the ultrasound studies. When TN is detected in a patient, preservation or excision of the TN was chosen by their families. Sixty-six boys and 76 testes were examined. Thirty-four testes (44.7%) were diagnosed as having TN, 39 (51.3%) were undescended testes, and 3 (3.9%) were retractile testes. The median age of all participants was 13 months (range: 2-118 months). The mean ages of patients with TN, undescended testes, and retractile testes were 7.6 months, 14.5 months and 55 months, respectively. The size ratio between the affected and unaffected sides in cases of TN was 0.144 (range; 0.03-0.48) and in cases of undescended testes was 0.99 (0.46-1.2). Thirty cases of TN (88.2%) had testicular hypertrophy on the unaffected side. Only one case of TN underwent excision; viable cells were not seen. A high US region was observed in 31 (91.1%) cases with TN. US was a useful modality for detecting TN. From this study, TN can be detected if the size ratio between the affected and unaffected sides is<0.4 and a high US region is seen. If TN can be detected using US, preservation can recommended, preventing unnecessary surgeries. However, there is no evidence on the required duration and interval of follow-up for these cases and examination will be needed over a period of time.

Sub-optimal use of ultrasound examinations may result in underperformance of Vietnamese maternity care – A qualitative study of midwives’ experiences and views

ObjectiveTo explore Vietnamese midwives’ experiences and views on the role of obstetric ultrasound in relation to clinical management, including ethical aspects. MethodsUsing a qualitative design, content analysis of focus group discussions with midwives (N = 25) working at Departments of Obstetrics and Gynecology at three hospitals in urban, semi-urban and rural parts of Hanoi were performed. ResultsObstetric ultrasound was reported as being a highly valuable tool, although replacing ordinary antenatal care surveillance with ultrasound examinations and misuse of ultrasound without medical indication was perceived as troubling. Participants generally viewed the fetus as a human being already at an early stage of pregnancy. However, when complications occurred, the pregnant woman’s health was mostly prioritised. ConclusionAlthough the use of ultrasound has many benefits during pregnancy, replacing ordinary antenatal care surveillance with ultrasound examinations and misuse of ultrasound without medical indication is concerning and needs to be addressed. There is also a need to communicate the benefits of adequate antenatal care to pregnant women and caution about the non-beneficial use of repeated ultrasound examinations without medical indication. Additionally, non-medical ultrasounds consume limited healthcare resources and its use needs to be better regulated in Vietnam.

B-Mode and Doppler Ocular Ultrasound Evaluation in Healthy and Positive Dogs for Visceral Canine Leishmaniasis

Background: The use of ultrasound examination in the evaluation of ophthalmopathies has been gaining more and more space within the ophthalmologic clinical routine. The hemodynamic study of ocular vascularization may anticipate future changes, aiding in the adequate establishment of therapeutic conduits. The objective of this study was to evaluate the structures of the ocular bulb and to perform the hemodynamic evaluation of the flow of the external ophthalmic artery of dogs with canine visceral leishmaniasis (CVL) correlating with healthy animals.Materials, Methods &amp; Results: For this purpose, 100 animals were used, of these 70 positive for CVL and 30 healthy animals, submitted to B-mode and Doppler ultrasound examination. Two-dimensional evaluation included identification of ocular changes and biometry of the following segments: axial length (M1), anterior chamber depth (M2), lens thickness (M3), lens length (M4), glass chamber depth (M5), optical disc length (M6) and optic nerve length (M7). The Doppler velocimetric evaluation included the identification and hemodynamic evaluation of the external ophthalmic artery, being measured: systolic peak velocity (SPV), final diastolic velocity (FDV), resistivity index (RI) and pulsatility index (PI). Ophthalmopathies were frequent in animals with leishmaniasis in both right (91.42%) and left (29.14%) eyes, with identification of capsular cataract, lens dislocation, retinal detachment and lens rupture. No significant statistical difference (P &gt; 0.05) was observed when comparing the biometric values between the right and left eyes of the animals with CVL, as well as for the measurements between healthy and CVL animals. Hemodynamic indexes of the flow of the external ophthalmic artery presented narrow limits for the right and left eyes of the positive animals, not statistically different from each other. However, a significant difference was observed when compared to hemodynamic evaluations of the flow of the ophthalmic artery between the right eyes of the group of normal animals and that of the carriers of leishmaniasis, with the latter presenting values superior to the first one. The B-mode and Doppler ultrasonographic evaluation enabled the morphological characterization of the ocular bulb, the identification of ophthalmopathies and the hemodynamic evaluation of the external ophthalmic artery of dogs with canine visceral leishmaniasis, establishing values that could be used in clinical ophthalmologic routine.Discussion: The presence of ocular changes diagnosed by B-mode ultrasonography were common in dogs with canine visceral leishmaniasis. Ocular lesions were observed in 80.5% of dogs with leishmaniasis, presenting a high frequency, corroborating with the results in the present research. In 22% of the animals, B-mode ultrasonographic lesions were identified in both eyes, 64 of these presented changes only in the right eye and 16 in the left eye. Ophthalmopathies can be uni or bilateral and cause more than one alteration in the same eye, resulting from both the immune-mediated mechanisms caused by the agent and direct parasitism. Although the literature reports that the highest frequency of lesions is bilateral, only 16 animals had alterations in both eyes. The origin of ophthalmopathies may be related to the species and tropism of the parasite, type and duration of the immune response developed by the host. The greater frequency of bilateral ophthalmopathies can have correlation with the systemic disease, in which in the initial stages of the disease only one eye is affected and the occurrence of bilateral manifestations is related to the chronic cases.

ESTIMATION OF RELATIVE RISK OF DEVELOPMENT AND INFORMATIVENESS OF DIAGNOSTIC METHODS OF HYPERPROLIFERATIVE PROCESSES OF ENDOMETRIUM

The aim: To conduct a comparative analysis of the results of ultrasound and hysteroscopic examinations with further histopathological findings and the clinical and anamnestic features of patients with hyperproliferative pathology in order to determine the etiopathogenetic mechanisms of the development of endometrial pathological processes. Materials and methods: We studied 119 medical records of patients of the Gynecological Department of Minipal Non-Commercial Enterprise "Ternopil Municipal City Hospital No. 2", who applied for medical assistance because of benign endometrial hyperplasia in the reproductive age with a verified diagnosis of "uterine polyp" during 2017-2018. The control group consisted of 30 patients of the same age group, with menstrual disorders with no signs of hyperplastic processes of endometrium. With the consent of the patients, they were treated with diagnostic hysteroscopy in order to study evacuated material from the uterus. The results of the histological study confirmed the absence of signs of hyperplastic processes of endometrium. The results of diagnostic methods were evaluated by comparing the material's histological data with the results of ultrasound and hysteroresectoscopy. Results: Taking into account the results of our research, women with hyperplastic processes of endometrium have the risk of the pathology of the nervous system is in 2.71 times higher (OR=2.71, CI-0.88: 8.33), cardiovascular pathology-in 2.04 (OR=2.04, CI-0.57:7.34), vascular diseases of the lower extremities-in 1.81 times (OR=1.81, CI-0.21:15.32) compared with the control group. While the risk of pathology of the urinary system and organs of vision is only-OR=0.48, CI-0.11:2.03 and OR=0.75, CI-0.08:7.48, respectively. Analyzing the results of the study using ultrasound examination, it was found that endometrial polyposis in combination with uterine leiomyoma was not detected in 3 women (15%), while all the results of hysteroscopy were confirmed by histopathological studies. When the endometrial hyperplastic processes were combined with adenomyosis- according to ultrasound examination a false positive result was obtained in 2 patients (13.3%), and in a hysteroscopic study we determined -1 false positive result. In patients the diagnosis of "endometrial polyp" according to the results of hysteroscopy was not confirmed in 2 women (2 false positive results 2.99%) and in 5 cases of ultrasound examination (5 false negative results 7.46%). The use of ultrasound examinations in patients with endometrial hyperplastic changes, according to our data, made it possible to identify pathology in 88.39% of cases, while the information content of the hysteroscopy was 98.21% (p<0.001). Conclusions: Thus, the results of the subjective examination of patients in the gynecological department: complaints, anamnestic data on gynecological and extragenital pathology should be used to identify etiopathogenetic factors and the formation of risk groups for the occurrence of hyperplastic processes of endometrium. Women with cervical erosion, uterine myoma and episodes of herpetic rash on the mucous membranes in past medical history have a higher likelihood of hyperplastic processes of endometrium. The vast majority of patients (63.87%) with polyps of the body of the uterus have a combined hyperproliferative pathology, which requires an individual approach to planning the scope of diagnostic examination and the choice of treatment method. Visualization of endometrium with hysteroscopy is more informative than ultrasound for diagnosing hyperproliferative processes, including uterine polyps. Hysteroscopic polypectomy has a high level of both clinical and economic benefits as well as diagnostic value in patients with hyperplastic processes of endometrium.

Utility of ultrasound examination in the diagnosis of laryngeal and hypopharyngeal cancers

The study objective is to evaluate the utility of ultrasound (US) examination in the diagnosis of laryngeal/hypopharyngeal squamous cell carcinoma and in the assessment of tumor spread. Materials and methods . We performed US examination in 100patients (7 females and 93 males) with laryngeal/hypopharyngeal cancer aged between 36 and 85 years. We evaluated vocal cord mobility, condition of the laryngeal cartilages, and tumor invasion to the adjacent tissues within the larynx and beyond it. In all patients, the diagnosis was confirmed by histological examination. Results. Seventy-five patients had primary laryngeal/hypopharyngeal tumors, whereas the remaining 25patients presented with recurrent cancer. Eighty-one participants were found to have laryngeal cancer; of them, 13 patients had tumors in the supraglottis; 67 patients had tumors located in the glottis; and 1 patient had a tumor of the subglottis. Nineteen patients were diagnosed with hypopharyngeal tumors. We have identified the most typical US signs of laryngeal/hypopharyngeal tumors considering their location and compared the results of US examination with histology of surgical specimens. US examination demonstrated a sensitivity of 94.1 %, accuracy of 91.9 %, efficacy of 47.0 %, and positive predictive value of 97.5 %. Specificity was not evaluated since we had no negative results. Conclusion. US examination is a highly accurate methodfor the diagnosis of both primary and recurrent laryngeal/hypopharyngeal tumors.