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Endosonography takes a leading role in solid pancreatic neoplasms diagnostics. This article presents the main indicators of diagnostics efficiency of the method depending on the nosology of a tumor. The article describes the research results of domestic and foreign authors about the possibility of endoscopic ultrasonography in determining the resectability of solid pancreatic neoplasms based on the diagnostics of biliopancreatoduodenal zone blood vessels invasion. We consider the auxiliary techniques of endosonography, particularly, their role and informative value in differential diagnosis of pancreatic lesions.

An active discussion of TI-RADS modifications (Thyroid Imaging Reporting And Diagnostic System) classification continues in the world professional medical community. This system of thyroid nodules stratification on the malignancy signs is intended primarily to select thyroid nodules for a fine needle aspiration biopsy. The classification should be uniform for all medical institutions of our country, easy to use and understandable by various medical specialists. This article presents a modification of TI-RADS prepared for discussion in the professional communities of Russia. Some “major” ultrasound features of malignancy (with specificity >95%) and additional or “minor” features (with specificity >90%) of thyroid nodules are pointed out to emphasise the need of fine needle biopsy. After comparison of diagnostic parameters of proposed TI-RADS and European TIRADS (EU-TIRADS), both systems showed comparable specificity of 93%, while sensitivity of proposed TI-RADS was slightly higher than for EU-TIRADS, with 94.2% and 91.0%, respectively. This discrepancy may be related to “minor” features of malignancy which were taken into consideration.

Background. Liver lesions are increasingly found in a huge number of patients. Ultrasound (US) is the method of choice in liver lesion characterization. The limitations of traditional US techniques are well known. Multiparametric ultrasound (MPUS) includes multiple facets of the US examination, and their combination can significantly improve the diagnostic capabilities of the method.Objective. To evaluate the capabilities of MPUS in the differential diagnosis of liver tumors.Material and Methods. A retrospective analysis included 172 patients with morphologically confirmed liver tumors. All patients underwent an MPUS examination.Results. Traditional US techniques have a rather low specificity in the differential diagnosis of liver neoplasms: the sign of “contour clarity” was typical for hemangiomas, hepatocellular adenomas (HCA), liver metastases and was recorded in 82, 100, 96% cases, respectively; heterogeneous echostructure was noted in all nosological entities, groups of hepatocellular carcinomas (HCC), liver metastases and HCA were characterized by foci of various types of echogenicity. Specific symptoms were discovered in patients with liver metastases (32%) and focal nodular hyperplasia (FNH) (96%). Intratumoral blood flow was recorded in 34 (19.7%) cases. The study of spectral characteristics was possible only in 11 (6.4%) patients. Statistically significant differences in contrast-enhanced US parameters “contrasting onset in focus” were found between the groups “FNH & hemangioma” (р < 0.000046), “FNH & HCA” (р < 0.006293), “MTS & FNH” (р < 0.028125), “FNH & HCC” (р < 0.024933), “maximum fill-in time” – “FNH & hemangioma” (р < 0.012590), “FNH & HCC” (р < 0.007983), “MTS & HCC” (р < 0.000243). Statistically significant differences in the wash-out time were obtained in “MTS & HCC” and “MTS & HCA” groups.Conclusion. Conventional US should be used as basic screening, follow-up and navigation in the neoplastic biopsy. Contrast-enhanced US within MPUS is currently a well-established technique which allows a more precise and confident diagnosis of liver tumors.