The study demonstrates significant variety of neovascularization degree and vessel diameter in the carotid atherosclerotic plaque. It is suggested that the increase in the number of vessels with a diameter <20 μ can be indicative of increased atherosclerosis activity, while the increase in the number of vessels with a diameter ≥40 μ indicates "reparative potential" of plaques. Duplex contrast-enhanced ultrasound scanning allows characterization of the localization and number of vessels with a diameter of ≥30 μ in the plaque, while even slight elevation of plasma concentration of basic fibroblast growth factor attests, first of all, to increased content of small vessels <30 μ in the plaque. The level of fibroblast growth factor >1.5 pg/ml is a reliable marker of increased number of both small and large vessels in the plaque.

Степень неоваскуляризации атеросклеротической бляшки (АСБ) каротидного синуса связывают с повышенным риском развития инсульта. Для выявления новообразованных сосудов в структуре бляшки in vivo широко применяют контраст-усиленное ультразвуковое исследование (КУУЗИ), однако до настоящего времени отсутствует единый подход к интерпретации результатов. Целью работы было установить наиболее надежный метод оценки неоваскуляризации АСБ каротидного синуса по данным КУУЗИ. У 73 пациентов удалено при каротидной эндартерэктомии, проанализировано, и морфологически исследовано 78 АСБ. Всем пациентам проводили стандартное дуплексное сканирование сонных артерий и КУУЗИ с введением эхоконтрастного препарата «Соновью». Неоваскуляризацию АСБ оценивали с использованием 4-балльной визуальной шкалы и трех методов количественной оценки в программе QLAB. По данным визуальной шкалы (метод 1), преобладали слабо и умеренно васкуляризированные бляшки (37% и 51% соответственно). Результаты количественной оценки (Ме (Q1; Q3)): количество сосудов на 1 см2 бляшки (метод 2) составило 16 (10; 26); соотношение площадей сосудов и бляшки (метод 3) — 6% (3; 9); значение ROI АСБ (метод 4) — 2,6 дБ (1,8; 4,1). Значимая корреляция отмечена: между результатами оценки по методам 2 и 3 (р < 0,0001); по методам 3 и 1 (р = 0,0006); морфологическими данными и результатами оценки по методам 1–3, особенно по методу 2 (р < 0,004). Значение ROI АСБ с данными других методов не коррелировало. Продемонстрировано резкое снижение надежности УЗ-оценки неоваскуляризации с увеличением объема гиперэхогенного компонента (кальцификатов) в АСБ. Наиболее точным способом количественной оценки неоваскуляризации АСБ при КУУЗИ является подсчет количества сосудов на 1 см2 бляшки.

Background. Carpal tunnel syndrome is the most common tunnel neuropathy in which the median nerve is compressed at the level of the wrist in the carpal canal. Treatment of carpal tunnel syndrome can be conservative and surgical. Surgical treatment is indicated in case of ineffective conservative treatment. However, the strategy of managing patients with carpal tunnel syndrome in the postoperative period has not yet been determined; there is no clear understanding of the effectiveness and necessity of rehabilitation in the early and long-term postoperative periods.Aim. Follow-up the patients after decompression of the median nerve in the late (up to 3 weeks after surgery) and long-term (3 weeks after surgery) postoperative periods to assess the effectiveness of different methods of rehabilitation.Materials and methods. A randomized controlled study included 108 cases of idiopathic carpal tunnel syndrome (unilateral and bilateral). After surgery, the patients were divided into three groups: the restorative treatment group using magnetic therapy, the kinesiotherapy group, and the control group. Clinical, neurophysiological and ultrasound monitoring was carried out for six months.Results. Patients of all the groups showed similar improvement in the most of the analyzed parameters, without any significant difference.Conclusion. Thus, according to the results of a comprehensive study, it is evident that early diagnosis of carpal tunnel syndrome and a high-quality surgical decompression of the median nerve with a complete dissection of the flexor retinaculum of the hand guarantee improvement within six months or later after surgical treatment without additional rehabilitation measures.

Neovascularization of a carotid atherosclerotic plaque (AP) is associated with an increased risk of stroke. Contrast-enhanced ultrasonography (CEUS) is a widely used method for imaging intraplaque neovascularization in vivo. Unfortunately, there are no standardized guidelines for CEUS interpretation. The aim of this study was to identify the most reliable method for CEUS-based assessment of AP neovascularization. Seventy-eight AP were removed during carotid endarterectomy in 73 patients, of whom 5 had AP on both sides, and examined morphologically. All patients underwent preoperative duplex scanning and CEUS; Sonovue was used as a contrast agent. AP neovascularization was assessed on a 4-grade visual scale and with 3 different quantitative methods using QLAB software. On the visual scale (method 1), poorly (37%) and moderately (51%) vascularized plaques were the most common. Quantitative analysis (data were presented as Me (Q1; Q3)) revealed that the number of blood vessels per 1 cm2 of the plaque (method 2) was 16 (10; 26), the ratio of the total vessel area to the plaque area (method 3) was 6% (3; 9), and AP ROI (method 4) was 2.6 dB (1.8; 4.1). Significant correlations were demonstrated between the results produced by method 2 and method 3 (р < 0.0001), method 3 and method 2 (p = 0.0006), and between pathomorphological findings and the results produced by methods 1–3, especially method 2 (p < 0.004). AP ROI brightness did not correlate with other results. The presence of hyperechoic components (calcifications) in AP dramatically reduced the reliability of US-based intraplaque neovascularization assessment. The most accurate CEUS-based quantitative method for assessing intraplaque neovascularization is estimation of blood vessel number per 1 cm2 of the plaque.

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