[Prognostic value of renal resistance index in estimating the progression of chronic kidney disease].

AIM: To study a relationship between main renal and intraparenchymal renal arterial resistance indices (RIs) measured by Doppler ultrasonography and clinical and laboratory parameters and to determine their prognostic value in estimating the progression of chronic kidney disease (CKD). SUBJECTS AND METHODS: The investigation enrolled 53 CKD patients divided into groups: glomerular and interstitial diseases. Glomerular filtration rate (GFR) calculated using the CKD-EPI formula, proteinuria (PU) severity, kidney sizes, renal parenchyma thickness, parenchyma/collecting index, and main and intrarenal vessel RIs were determined at the first hospitalization. The mean follow-up was 14 ± 2.64 months. The rate of GFR decline was estimated at the rehospitalization. RESULTS: Main renal and intrarenal vessel RIs depend on patient age and pulse pressure. The RIs are associated with GFR and PU in the group of glomerular diseases and with kidney sizes and structure in that of interstitial diseases. The interlobar arterial RI is the most sensitive predictor for worsening renal function with a threshold of 0.65, which is comparable to the prognostic value of PU. CONCLUSION: The main renal and intrarenal vessel RIs may be considered as a predictor for worsening renal function.

[Capabilities of breast sonotomography (automated breast volume sonography) in the evaluation of the glandular structure of the breast in the context of its cancer risk].

Objective: To study the capabilities of a procedure for sonotomography (STG) versus that of X-ray mammography (MG) in patients from different age groups who have different radiological types of the breast structure and to estimate the diagnostic possibilities of the STF and X-ray MG procedures in detecting cancer in patients its the X-ray dense background. Materials and Methods: The investigation enrolled 143 patients aged 38 to 77 years who had undergone STG after primary X-ray MG. Particular emphasis was placed on a methodological approach to optimizing STG in patients from different age groups with a varying radiological type of the breast structure in different physiological periods. The international breast imaging and reporting data system was used to standardize detected breast masses. Results: Out of the 143 patients, 102 persons, including 16 patients with verified breast cancer (BC), were found to have space-occupying lesions. During the performed investigation, computed processing of 3D scans at the working station confirmed the entire quadrant-by-consentaneity of the glandular structure of the breast at STG and X-ray MG. There were a higher proportion of abnormal breast masses with increased percentage ratio of glandular tissue in the breast. Emphasis was laid on the role of STG as an additional examination technique in patients from all age groups with the radiologically dense breast in order to detect cancer due to a high sensitivity of 100% and a specificity of 96%. Conclusion: The procedure of STG versus that of X-ray MS showed a high degree of compatibility of opinions as to the type of the breast structure in the patients. Due to the fact that standard-projection STG scans can be compared, during mammography the procedure of STG must hold a firm place in the examination algorithm of the breast in women with its X-ray dense structure.

[Sonoelastography in differential diagnosis of thyroid nodes].

The study was aimed to assess the diagnostic possibilities of the new method of sonoelastography. 68 patients with different thyroid nodes were studied. Sonoelastography increased the sensitivity of the routine ultrasound investigation from 89 to 94.8%, the specificity from the 83 to 93%, and the accuracy of the method from 76 to 89%. The method assignes the information of the structural changes of the thyroid, unavailable by the routine ultrasound investigation.

[Three-dimentional echography in diagnosis and staging of urinary bladder cancer].

The role of USI and three-dimentional volumetric reconstruction was studied in diagnosis of urinary bladder cancer diagnosis. 69 UBC patients were examined. Examination included renal USI of the kidneys, urinary bladder, prostate, echoureterography, cystoscopy, CT, MRT. The number of the tumors, volume, area, invasion were studied in 3D mode. US angiography assessed resistance index and tumor vascularization by degrees 0-3. USI findings were compared with those of MRT, cystoscopy, histomorphology of the biopsies. 2D USI technique proved effective in detection of urinary bladder cancer at stage T1 in 66%, 3D in 100. At stage T2a-b informative value of both techniques reached 87%. Overall informative value of 2D in detection of urinary bladder cancer was 81%, three-dimentional echography--96%. USI proved effective in diagnosis and staging of urinary bladder cancer. Use of 3D ultrasonic angiography facilitates the choice of more effective surgical policy in the treatment of urinary bladder cancer patients.

[Ultrasonic technologies in diagnosis and surgery planning in patients with nodular pathologies of the thyroid gland].

Twenty patients of the control group without pathology of the thyroid gland were examined for development of the method of 3D-ultrasonic reconstruction and 3D-angiography. The study group consisted of 74 patients with nodular pathologies of the thyroid gland, 53 of them underwent surgery. Ultrasonic data was compared with results of clinical and laboratory studies, puncture biopsy and intraoperative data. Three-dimensional ultrasonic pictures permitted to detect spatial orientation of the nodes relative to lobes and segments of the thyroid gland, vascular structures, to evaluate character of nodes vascularization, to analyze nature and invasiveness of the tumor. Based on these data optimal variant of surgery was chosen. In 12 cases virtual modeling of surgeries with 3D-echography and ultrasonic angiography was performed. These methods permit to choose optimal variant of surgery and make possible prediction and prevention of complications.

[Cerebrovascular reactivity in elderly patients with essential hypertension]. / Issledovanie tserebrovaskuliarnoi reaktivnosti u bol'nykh pozhilogo vozrasta s éssentsial'noi arterial'noi gipertenziei.

Twenty-six patients (mean age 66.3 +/- 6.5 years) with long-term arterial hypertension were studied. In resting state the indices of cerebral hemodynamics did not differ substantially in the patients comparing to those in controls with normal arterial pressure. However, during functional tests with breath-holding and hyperventilation elderly patients with long-term mild and moderate essential arterial hypertension showed, disturbance of cerebrovascular reactivity manifesting in reduction of reactivity coefficients in response to hypo- and hypercapnic loading, earlier restoration of baseline blood flow speed in medial brain artery after hyperventilation and to breath-holding test (20%).