Aim. The study objective is studying the possibility of endosonography in the diagnosis of tumor and pretumor pathology of the larynx, oropharynx and laryngopharynx. Materials and methods. Endosonographic study was conducted in 20 patients with tumors and suspected tumors of the larynx, laryngopharynx and oropharynx. Results. The use of endoscopic ultrasound (EUS) method was useful and important in determining the thickness and structure of the tumor, with hyperplasia of the lingual and palatine tonsils. Endosonographic picture of fibrous changes after surgery and post-radiation changes, lack of blood flow in the fibrous tissue and blurred contours gave additional information in the differential diagnosis of tumor and non-tumor changes. The results of the ultrasound examination performed in the standard B-mode for the presence of tumors, cysts and formations, suspicious of the tumor of the submucosal layer of the oropharynx and larynx, which were not determined by endoscopic examination, were confirmed. Conclusion. Obtaining a sonographic image simultaneously with endoscopic examination of the formations in the submucosal layer of the oropharynx and larynx will shorten the diagnostic algorithm of the study in patients with pathological changes in this area. The use of endosonography made it possible to confirm the data obtained by ultrasound examination in B-mode and which were not confirmed by endoscopic examination.
The present review shows a modern view on ultrasound differential diagnosis of hyperechoic benign breast lesions. The main ultrasound semiotic signs of the most common focal benign structures are noted, in comparison with the data of histopathological analysis.
The involvement of axillary lymph nodes is one of the most important prognostic factors, significantly affecting the treatment strategy for early breast cancer (BC). The risk of axillary lymph node metastases depends directly on a number of factors (age of women, size of tumor, presence of lymphovascular invasion and biological characteristics of cancer). The evaluation of regional lymph node status in patients with early BC includes the clinical examination of regional zones and the ultrasound study (US), using these methods can help to study lymph nodes shape, borders, margins and structure. The sensitivity of ultrasound in the evaluation of regional lymph nodes status directly depends on the biological subtype of the tumor; the minimum level of ultrasound sensitivity in the evaluation of lymph nodes status is detected for luminal HER2-negative cancer (less than 40%), and maximum sensitivity is detected for triple negative and HER2-positive subtypes (6871%). Clinical examination and modern ultrasound are the most accessible methods for the evaluation of regional lymph nodes status, but the possibility to misjudge metastatic process can be detected in 1/4 of patients. Verification of the diagnosis in the preoperative phase (fine-needle aspiration biopsy/core-needle biopsy under ultrasound guidance) allows minimize the number of errors for the regional staging. The sentinel lymph node biopsy (SLNB) is the gold standard of regional treatment in patients with early stage BC, nowadays. The randomized trials (NSABP B-32, ACOSOG q0011) show the safety of recession of performing regional lymph node dissection in favor of SLNB not only in case of clinically negative lymph nodes, but also in patients with metastases in 2 sentinel lymph nodes, upon condition that organ-conservative treatment and subsequent radiation therapy will be used. High-quality regional staging, the choice of the therapeutic algorithm in accordance with the biological characteristics of carcinoma, the application of the most effective modern drug regimes, the optimal radiation therapy allow not only minimize the extent of surgery, but also achieve high long-term survival results, provide excellent functional results and high quality of life in patients with the involvement of axillary lymph nodes.
AIM. To evaluate the capability of CEUS in the detection of CRLM in comparison with conventional grayscale B-mode. MATERIALS AND Mffl'HODS. 18 patents with CRLM underwent CEUS using the contrast agent SonoVue (Bracco, Italy). The patients were divided into two groups: the first group - 10 (55 %) patients before to chemotherapy; the second group - 8 (45 %) patients after chemotherapy and stable disease. The enhancement patterns of liver metastases were evaluated during the vascular phases: arterial, venous, and delayed. RESULTS. The enhancement patterns of liver metastases on CEUS were categorized as diffuse homogeneous enhancement (30 % - in the first group; such enhancement wasn't observed in the second group), rim-like hyper enhancement (70 % of the patients from the first group, 75 % of patients from the second group) and is enhancement, such as intact liver parenchyma (25 % of the patients from the second group). There were detected additional metastases in 4 (22,2 %) of patients 18 (100 %) in the delayed phase. There were significant differences in time of the beginning the vascular phases between patients from the first and second groups. The latest beginning of the wash-in stage was observed in liver metastases in patients from the second group (25,8 sec. from the injection of the contrast). The earliest beginning of the washout stage was observed in liver metastases in patients from the first group (42,4 sec. from the injection of contrast). CONCLUSION. CEUS improves visualization of CRLM, in comparison with the grayscale B-mode. It is also possible to apply this technique in the assessment of chemotherapy in patients with CRLM, as there was a difference between the moments of the beginning wash-in and wash-out stages.
To review the clinical case of deep infiltrative endometriosis in the patient with suspicious of colorectal cancer.Material and methods: Patient 47 years old with complaints of pain in the right hypogastrium for several weeks. Anamnesis of laparoscopic surgery for infertility, repeated removal of mammary fibroadenomas. At the initial examination, there is a suspicion of a primary tumor in the rectum with metastatic lesions in the liver, pancreas and peritoneum according to the results of ultrasound diagnosis. Contrast enhanced MRI of the abdominal cavity and pelvic, colonoscopy, lung radiography and PET/CT were performed for the purpose of detailed differential diagnosis of the identified lesions.Conclusion: The multimodal approach in the differentiation of deep infiltrative endometriosis and malignant neoplasms using various methods of radiation diagnosis allows to assess the spread of the pathological process and determine the tactics of treatment of the patient in the shortest time.
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