[Compression elastography as a new method of ultrasound imaging in the differential diagnosis of chronic tonsillitis]. / Kompressionnaya elastografiya kak novyi metod ul'trazvukovoi vizualizatsii v differentsial'noi diagnostike khronicheskogo tonzillita.

Chronic tonsillitis remains as an urgent problem in modern otorhinolaryngological practice, which requires improving the diagnostic methods of this pathology. OBJECTIVE: To increase the diagnostic information content of objective methods for differential diagnosis of different forms of chronic tonsillitis. MATERIAL AND METHODS: The study involved 97 patients who were divided into two groups: the 1st group (39 patients) - with a simple form; the 2nd group (58 patients) - with a toxic-allergic form of chronic tonsillitis. To assess the structure of the palatine tonsils, patients underwent ultrasound in the compression elastography mode. RESULTS: According to results, patient with simple form of chronic tonsillitis in 64.1±7.68% cases had rigid structure of palatine tonsils, while toxic-allergic form is characterized by an elastic structure of the tonsils (58.62±6.47%). CONCLUSION: The ultrasound compression elastography helps to value efficiently the pathology of the palatine tonsils and conduct a differential diagnosis of clinical forms of chronic tonsillitis.

[The state of regional lymph nodes in chronic tonsillitis according to ultrasound]. / Sostoyanie regionarnykh limfaticheskikh uzlov pri khronicheskom tonzillite po dannym ul'trazvukovogo issledovaniya.

Despite the variety of chronic tonsillitis clinical symptoms, none of the known signs of this disease is typical for it. PURPOSE OF STUDY: Is development of a method for differential diagnosis of complicated (toxic-allergic) and uncomplicated (simple) forms of chronic tonsillitis. METHODS: 147 patients were divided into 2 groups: 1) 61 (42%) - with a simple form and 2) 86 (58%) - with a toxic-allergic form of chronic tonsillitis of the II degree. Patients underwent ultrasound examination of regional lymph nodes, to determine their localization, quantity (single, multiple), shape, size and structure. RESULTS: According to ultrasound data, it was revealed that for the simple form of chronic tonsillitis the following characteristics of the lymph nodes were typical - bean-like form, single, clear contours, homogeneous central parts and reduced vascularization; for the toxic-allergic form of chronic tonsillitis, the following characteristics of lymph nodes were revealed - oval shape, lymph nodes conglomerates, hypoechoic central parts, increased vascularization and irregular shape of the gates. CONCLUSION: The proposed method allows to quickly and efficiently conduct differential diagnosis of chronic tonsillitis. This technique is easily reproducible in the conditions of any (outpatient, inpatient) medical facility using standard equipment for ultrasound examination, does not require the use of any drugs.

[Criteria for instability of atherosclerotic plaques in carotid arteries]. / Kriterii nestabil'nosti ateroskleroticheskikh bliashek sonnykh arterii.

The purpose of the study was to determine the criteria for instability of atherosclerotic plaques in carotid arteries with the use of improved and new diagnostic techniques. The study enrolled a total of 92 patients examined with the help of instrumental methods of diagnosis, including ultrasound triplex scanning, magnetic resonance imaging and multislice computed tomography. All patients were subjected to the operation of carotid endarterectomy in various standard modifications. The specimens of atherosclerotic plaques taken intraoperatively were examined with the help of morphological, immunofluorescent methods, electron paramagnetic resonance, electron microscopy. A multivariate logistic regression analysis demonstrated that the plaques with an area over 90 mm2 (OR 4.05; 95% CI 1.32-13.2; p=0.006), a volume of more than 0.6 cm3 (OR 2.72; 95% CI 1.05-9.58; p=0.04), and the JBA value of not less than 8 mm2 (OR 2.82; 95% CI 1.22-6.23; p=0.02) were statistically significant independent predictors of histologically verified unstable plaques. The results were compared to the findings of histological methods. In patients with the above mentioned ultrasonographic parameters, unstable plaques were encountered in 94% of cases. Immunofluorescent assay demonstrated a significant increase in the number of inflammatory markers (CD68+, CD36+ cells), as well as CD31+ cells as markers of neovasculogenesis in unstable plaques. According to the findings of electron paramagnetic resonance, bivalent manganese is a marker of plaque instability. Further studies will help reveal the mechanisms of plaque calcification. A decrease in the content of manganese correlated with an increase in the degree of plaque calcification (r =-0.69, p<0.01). This serves as indirect evidence of a destabilizing effect of calcification on plaque stability. It was demonstrated that ultrasound elastography makes it possible to significantly extend the capabilities of standard ultrasound examination in detecting instability of atherosclerotic plaques in carotid arteries.

[Ultrasound elastography in assessing efficacy of treatment for lower limb varicose veins with a phlebotrophic drug containing a micronized purified flavonoid fraction].

UNLABELLED: Venous hypertension combined with other pathogenetic links of the development of chronic venous insufficiency creates conditions for activation of an inflammatory process. Chronization of inflammation leads to alterations in the histological structure of the vascular wall and perivasal tissues, which is reflected by changes in their physical properties (elasticity or compressibility), which may be studied by means of ultrasound elastography (USEG). OBJECTIVE: The study was aimed at exploring the possibility of using ultrasound elastography for monitoring efficacy of conservative treatment of varicose disease of lower extremities with an agent containing a micronized purified flavonoid fraction (MPFF). MATERIAL AND METHODS: we examined a total of 19 patients (38 limbs) presenting with varicose disease of clinical class C2 according to the CEAP classification. The standard ultrasound examination and USEG were carried out using the unit of expert-class "Toshiba" (Japan) with a multi-frequency linear transducer 5-12 Hz. We examined the great saphenous vein in the area of the femur and crus, its tributaries, and the small saphenous vein. All examinations were performed with the patient in the supine, prone and standing positions from the standard approaches in the second half of the day prior to treatment with a phlebotrophic agent containing MPFF (Detralex) and three months after taking the drug at a dose of 1,000 mg/day. RESULTS: at baseline, according to the findings of USEG the intact veins of the lower limbs had a homogeneous pattern of the elastogram in the perivasal area. The presence of varicose transformation was associated with an inhomogeneous elastographic picture. On the background of treatment with MPFF, all patients showed a positive clinical effect in the form of decreased intensity of manifestations of complaints or complete disappearance thereof. According to the findings of ultrasound examination, there was a tendency towards a decrease in the wall thickness and diameter of the examined veins. USEG demonstrated an increase in the perivasal zones of elastographic homogeneity of tissues. The USEG-revealed alterations were more pronounced in large-diameter vessels. On the background of treatment with Detralex there was a trend towards normalization of the elastographic pattern of the vessel as a whole. CONCLUSION: the obtained findings confirm feasibility of using the technique of ultrasound elastography for identification of objective markers of treatment response to MPFF in varicose disease.