There are presented data of the integrated ultrasound (US) examination of 85 children with urolithiasis (IBC) at the age of from 3 months up to 17 years. In traditional ultrasound study (in gray scale mode), the main criterion for the presence of stone - distal acoustic «shadow» was evaluated in dependence on its intensity from 0 to 4 scores. When using color Doppler mapping (CDM) there was established the existence of flaring artifact (FA), which occurred in the reflection of the ultrasonic wave from the reflective stone structure. According to the density index (DI) the presence and density of calculus were detected with the use of Acoustic Structure Quantification (ASQ) methodology for quantifying the structure. The obtained data were compared with data of computed tomography (CT). It has been established that in case of the presence of the «shadow» accounted of 4 scores, FA has been clearly defined, DI ranged from 5,5 to 6,8, CT indices exceed 1100-1500 Hu. When the severity of the «shadow» was of 3 scores, FA remained to be intensive, DI was in the range of 3,5-5,5 and CT density ranged from 800 to 1100 Hu. «Shadow» at 2 scores came from the central department of calculus, FA spectrum corresponded to its width, DI ranged from 3,5 to 2,0 and CT radiodensity - 250 to 800 Hu. Weak «shadow» at 1 score corresponds to a low density stone, FA was narrow, DI ranged from 2,0 to 1,5. At 0 score DI was less than 0,9 and easily permitted ultrasound through. Established patterns indicate to the feasibility of the integrated use of ultrasonic methods in the evaluation of the density of the stone in preparing the patient for performing remote lithotripsy.

Currently, the method of ultrasound diagnostics (echography) is the leading one among other imaging tools in medicine. The history of the method begins in 1942, but the main developments should be attributed to the 1950-1960s, when owing to the first ultrasound machines created in various countries, the fundamental possibility of visualizing tissue structures of various organs in normal and in various forms of pathology was proved. Since the 1970s, the solution of technical problems has led to the creation of ultrasound systems close to modern types of equipment. In the same years, ultrasound examinations for the first time began to be effectively used in the Research Institute of Pediatrics of the USSR Academy of Medical Sciences, where they took a worthy place among other diagnostic methods. For the first time, ultrasound techniques of various organs were developed, their normal age characteristics were established, the possibilities in the diagnosis of many forms of pathology were proved and the criteria for their differential diagnosis were determined. But at the same time, despite the significant diagnostic potential of ultrasound diagnostics, we must not forget about the sufficient subjectivity of the method, which requires special attention and knowledge when obtaining and interpreting echographic images. The newest ultrasound methods that have appeared in recent years include three- and four-dimensional echography, ultrasound tomography, the possibility of panoramic, contrast and intra-organ studies, pulse inversion harmonics, quantitative assessment of organ parenchyma, elastography, various variants of Doppler (including intravascular) methods.

The data of the examination of 73 children aged 1 to 18 years with mononucleosis of Epstein-Barr virus etiology are presented. The use of non-invasive quantitative assessment methodology of the parenchyma (Acoustic Structure Quantification) was shown to allow objectify the examination and to found that infectious mononucleosis in 1st Group patients with a minimum degree of diffuse changes of the liver proceeded without structural changes in the liver parenchyma. In the 2nd group patients the estimation of density index according to Acoustic Structure Quantification allowed to reveal the signs of cholestasis. The heterogeneity of the structure of the liver and the elevation of the parenchymal density index indicated on signs of acute hepatitis and was confirmed by the increase in ALT level in blood serum. Despite the pronounced splenomegaly no structural changes in the spleen were found in any patients.

There were examined 209 children, agedfrom 3 months to 18years with metabolic liver diseases (MLD) of various etiology. The diagnosis of MLD was based on data of totality of clinical laboratory indices and data of molecular genetic studies. By means of ultrasonic (US) methods there was performed an evaluation both of the structure of the liver parenchyma and the grade of the pronouncement offibrosis with the use of traditional US method and non-invasive method for the quantitative assessment of the structure of liver parenchyma Acoustic Structure Quantification (ASQ) with the determination of density index (DI). At that US data were compared with morphological observations. According to data of the traditional US examination the signs of liver cirrhosis were of the «streaking» of the hepatic image, cirrhotic nodes and signs of portal hypertension. According to ASQ data in the end-stage cirrhosis DI was in the range of from 2.77 to 4.58 in dependence on etiologic factor: in glycogen storage disease in the average accounted of 2.88, in patients with Wilson disease -3.08, in hereditary tyrosinemia type 1 (HT-1) - 3.37, in cystic fibrosis patients - 3.89 and in congenitalfibrosis - 4.18. Comparative analysis of US and morphological data showed the expediency of complex non-invasive US observations in the assessment of the pronouncement of the stage of liver fibrosis in MLD children.

By methods of ultrasound (US) diagnostics there were examined 177 children at the age offrom 2 months to 17 years, with liver cirrhosis (LC) in the outcome of chronic hepatitis (CH) of various etiologies. It was found that, irrespective of the etiological factor there is noted a large number of general ultrasound characters typical for stages of the formation of the LC: «streaking» of the hepatic image, cirrhotic nodes, splenomegaly and signs ofportal hypertension. The rate of the formation of LC was analyzed in dependence on the etiological factor. It was established that often, and in a short time LS develops in the outcome of CHD, autoimmune hepatitis and cryptogenic chronic hepatitis. In the examination of 135 children there were included invasive (biopsy) and non-invasive ultrasound methodologies for the quantitative assessment of the liver parenchyma structure: Acoustic Structure Quantification (ASQ) and Transient elastography (TEP). Based on a comparative analysis of US and morphological data SP values> 2.77 and elasticity> 13.90 were established to indicate LC (F4) according to METAVIR system. There were established additional diagnostic criteria for the assessment of the severity of the state of LC patients: density index (DI) increased significantly as far as the disease progresses. The use of non-invasive techniques dramatically expands the diagnostic capabilities of a traditional ultrasound examination of the liver.