Method for early diagnostics of myocardial dysfunction in case of idiopathic hypertrophic cardiomyopathy in children
SUBSTANCE: two-dimensional echocardiographic study of the myocardium and parallel electrocardiogram recording is performed. The study areas on the left ventricle images are isolated into the diastole at the level of its base and middle third along the short axis of the heart, obtained from the parasternal position. Each study area is divided into lower, posterior, lateral, anterior, anterior septal and septal segments. In each of the isolated segments of the base and middle third of the left ventricle, myocardium thickness in the area of margins and the middle is determined, and the average index of myocardium thickness is calculated. If the value of the calculated indicator is more than 17 mm at least in one of the segments of the base or middle third of the left ventricle, systolic myocardial dysfunction is diagnosed.
EFFECT: method allows to provide early, reliable and accurate diagnosis of this pathology, to prevent complications caused by application of MRI, which requires patient exposure, use of radiopaque preparation with side effects, to expand diagnostic capabilities by increasing the contingent of examined subjects with a pacemaker or defibrillator cardioverter.
SUBSTANCE: invention relates to means for carrying out visualisation-guided medical procedures. Method of processing X-ray image contains stages, at which: 2D X-ray image of anatomical area, which includes ultrasound probe, is received, ultrasound probe s detected on it, ultrasound probe is superposed with reference coordinate system, with taking into account evaluation of position and orientation of ultrasound probe relative to reference coordinate system. Superposition stage additionally contains stage, at which presented in digital form projection of 3D model of ultrasound probe is correlated with ultrasound probe detected on X-ray image, with obtaining evaluation of ultrasound probe position and orientation from correlated 3D model. Computer-readable carrier contains stored in it sets of instructions for system-processing unit for combination of ultrasound and X-ray images, which contains X-ray system of 2D X-ray image, ultrasound system, including ultrasound probe, processing unit and monitor for combined image presentation.
EFFECT: application of invention makes it possible to increase accuracy of position determination.
9 cl, 4 dwg
SUBSTANCE: nephrosonography is performed to determine a kidney volume (V pk, mm3). Child's height and age are specified and used to determine a reference kidney volume (V rk, mm3), to calculate a kidney volume coefficient (Kkv) by formula: , wherein Kkv is the kidney volume coefficient; V pk is the patient's kidney volume, mm3, and V rk is the reference kidney volume, mm3. In the unilateral ureteral obstruction, a healthy kidney volume coefficient (Khkv) and a obstruction kidney volume coefficient (Kokv) are calculated. If K hkv is more than 1.0, the absence of compensatory hypertrophy and hyperfunction is diagnosed; the morphofunctional kidney condition from the side of an obstructed ureter occurs to be noninvolved; the conservative treatment of the obstruction is preferred. If K hkv is more than 1.0 and less than 1.8, K okv is more than 1.0, compensatory hypertrophy and hyperfunction of the healthy kidney; the morphofunctional kidney condition from the side of the obstruction is depressed; a preserving surgery is chosen. Khkv between 1.8 or 2.0 and Kokv less than 1.0 enable diagnosing manifested compensatory hypertrophy and hyperfunction of the healthy kidney; kidney downsizing, functional depression are diagnosed from the side of the obstruction, and a nephrectomy is preferred.
EFFECT: method enables choosing the therapeutic approach to the ureteral obstruction in the children by detecting the clinical manifestations of the urinary outflow obstruction.
SUBSTANCE: invention relates to medicine, namely to ultrasonic diagnostics, neurosurgery, vascular surgery and neurology. Colour duplex scanning in horizontal and vertical position of patient is performed. Pathological tortuosity is diagnosed in case of presence of deformation of main neck arteries with angle of tortuosity less than 60° in horizontal and vertical positions, turbulence of blood flow in area of tortuosity, more than 50% acceleration of systolic blood flow in area of deformation in comparison with proximal part of artery, reduction of blood flow rate more distally than tortuosity in comparison with proximal part of artery to tortuosity more than 20%.
EFFECT: method makes it possible to increase diagnostics accuracy due to change of hemodynamics under impact of change of patient's body position.
SUBSTANCE: invention relates to medical equipment, namely to diagnostic ultrasound systems. Curved converter of high-intensity focused ultrasound (HIFU) contains curved piezoelectric matrix, which has opposite convex and concave surfaces, with concave surface being transmitting surface, and multitude of zones of acoustic transmission. Multitude of electrodes is located on surfaces of curved piezoelectric matrix. Curved adjustment layer, formed in monolithic, continuous way, is formed with required curvature of curves matrix of converters, and is attached to transmitting surface. Printed circuit board and back plate are located on side of matrix, opposite to adjustment layer, with back plate limiting air channel between printed circuit board and plate, and printed circuit board limits air channel between printed circuit board and matrix.
EFFECT: application of invention makes it possible to facilitate giving required shape to converter.
15 cl, 13 dwg
SUBSTANCE: neurovisualisation examination of brain is carried out, Cirs comorbidity index and Kaplan-Feinstein comorbidity index are determined, cochleovestibular syndrome, eye-moving impairments, type of diabetes mellitus are identified. Value of discriminate function (D) is calculated. If D value is higher than zero, diagnosed are consequences of ischemic brain stroke (IBS) with hyperhomocysteinemia (HH), if D is lower than zero, consequences of IBS without HH are diagnosed.
EFFECT: method makes it possible to increase reliability of diagnostics of IBS consequences, which is achieved due to complex analysis of said parameters.
SUBSTANCE: inner angle (α) between back surfaces of an episternum and a mesosternum is preoperatively ultrasonically measured in a patient. A spiral oesophagomyotomy is performed. Tendons of the sternum legs of sternocleidomastoid muscles are dissected away from the episternum. A retrosternal tunnel is created. If α<165°, the episternum is dissected away at the level of a lower edge of the second rib. If α>165°, the episternum is dissected away at the level of a lower edge of the first rib. A colonic graft is delivered onto the neck through the retrosternal tunnel. An end-to-end anastomosis is applied between a cervical segment of the oesophagus and the colonic graft.
EFFECT: reducing invasiveness and postoperative complications by an individual approach to determining the episternum resection extent.
SUBSTANCE: direct size between the most distant points of a presenting segment of the foetus head at the level of the sagittal plane, large transverse size of the foetus head between the most distant points of the parietal tubers, transverse size of the shoulders between the most distant points of the acromial processes and the anteroposterior size of the foetus chest at the level of VII thoracic vertebra and the base of the xiphoid process are determined. A probability coefficient of the foetus shoulder dystocia is calculated by a mathematic formula. Development of the foetus shoulder dystocia is made on the basis of the obtained coefficient value.
EFFECT: method makes it possible to predict the development of the foetus shoulder dystocia due to the evaluation of the significant ultrasonic indices in the foetus.
1 tbl, 4 ex
SUBSTANCE: ultrasonic examination of brachial artery is realised. During ultrasound examination lumen of brachial artery in systole and diastole is determined, reactive hyperaemia test and test with nitroglycerinum intake are performed. After that, values of lumen, obtained before performing test and after them, are compared. Presence of endothelial dysfunction is identified on the basis of degree of obtained data change. If value of brachial artery diameter after reactive hyperaemia test is less than 12% in systole and less than 13% in diastole, as well as after intake of nitroglycerinum, if value of brachial artery diameter in systole is less than 20% and less than 21% in diastole, endothelium dysfunction is diagnosed.
EFFECT: method provides detection of affection of vessel wall in said category of patients at the earliest stages.
SUBSTANCE: predicting neonatal hypoglycaemia in an infant born by a woman suffering diabetes mellitus in the stages of at least 36 weeks of pregnancy is ensured by foetal ultrasonic scanning. A pancreatic gland (PG) is visualised in a cross-section of the foetal abdomen. Its maximum anterior-posterior dimension is measured at the body level, and if its dimension is more than 1.55 cm, the neonatal hypoglycaemia is predicted. In a particular case, the PG is visualised better if displaying the cross-section of the foetal abdomen at the level of a stomach and an intra-abdominal segment of an umbilical vein is followed by rocking and rotating an ultrasonic probe.
EFFECT: method enables improving the early postnatal adaptation, preventing the postnatal complications, incidence of disease and death caused by the hypoglycaemic conditions in the newborns born by the women suffering diabetes mellitus by correcting them timely due to the accurate prediction of developing neonatal hypoglycaemia starting from the stage of 36th week of pregnancy.
2 cl, 3 ex
SUBSTANCE: patient's serum asparagine aminotransferase (AST) is measured. That is combined with duplex scanning to measure a splenic vein diameter (SVD) and a body weight. The measured AST, SVD and body weight are used to calculate a fibrosis index by formula: FI=-6.31+0.19*AST-1.02*SVD+0.24*BW, wherein FI is the fibrosis index, -6.31 is a constant, 0.19-1.02 and 0.24 are the coefficients, AST is blood serum asparagine aminotransferase (Unit/l), SVD is the splenic vein diameter (mm), and BW is the patient's body weight (kg). The constant and coefficients in the presented formula are calculated by multiple regression method; a dependent variable is a liver density value according to ultrasonic elastography findings. If the derived fibrosis index is less than 6.3, the absence of fibrosis (stage F0) is stated. If the fibrosis falls within the range of 6.3 to 8.3, the first stage of fibrosis (F1) is diagnosed. The fibrosis index of 8.4 to 10.8 corresponds to the second stage of fibrosis (F2). The fibrosis index of 10.9 to 13.9 corresponds to the third stage of fibrosis (F3). If the fibrosis index is more than 13.9, hepatic cirrhosis (stage F4) is diagnosed.
EFFECT: technique provides the adequate differentiation of the fibrosis stages in the patients with chronic viral hepatitis by the complex assessment of biochemical, ultrasonic and antropometric parameters.
SUBSTANCE: method involves carrying out skeletotopic conjunction and organ element localization description relative to vertebra body. Neck organ picture is described in skeletotopic manner using anterior contour of cervical vertebra body and transverse processes in upper, median and inferior portion of cervical vertebra with the exception of the first and the second one.
EFFECT: high accuracy in diagnosing pathological processes in neck organs and creating computer models.
SUBSTANCE: method involves carrying out ultrasonic examination of aorta coarctation stenosis nature. Apex direction of angle formed with longitudinal axes of ascending and prestenotic aorta area is determined. Four aorta coarctation patterns are selected on measured values combination.
EFFECT: high objectiveness degree in determining aorta coarctation nature and selecting treatment mode.
4 dwg, 1 tbl
SUBSTANCE: method involves recording choledochus diameter changes in carrying out Oddi sphincter relaxation with isosorbide dinitrate in combination with nutrient loading by means of ultrasonography. Diagnosis is carried out in two stages. Maximum choledochus diameter is determined in the morning with empty stomach at the first day at the beginning of the study. The value is taken as the initial value (Din). Then, standard breakfast is given to the patient like 200 ml creamy yogurt containing 10% fat and choledochus diameter (dxi,j) is measured twice with 40 min long pause. Diameter variation (δDij) is measured at 40 and 80 min relative to initial value using formula δDij = (Din - dxi,j)/Din*100%, where i is the parameter values at 40 min of study; j the parameter values at 80 min of the study. At least one δDij value becoming greater than 25%, the second study stage is carried out the next day. 10 mg of isosorbide dinitrate is given to the patient with empty stomach in the morning. 40 min later, the first choledochus diameter D1 value is measured and standard breakfast is given to the patient like at the first day study. Maximum choledochus diameter (dxi,j) is once more measured twice with 40 min long pause at 40 and 80 min, respectively. Diameter variation (δDij) is measured relative to the first measurement using formula δDij = (D1 - dxi,j)/D1*100%, where i is the parameter values at 40 min of study; j the parameter values at 80 min of the study. At least one δDij value becoming greater than 25%, organic change of Oddi sphincter is to be diagnosed. At least one δDij value becoming equal to or less than 25%, functional disorder is diagnosed.
EFFECT: high reliability of diagnosis.
SUBSTANCE: method involves carrying out multi-positional ultrasonic scanning in real-time mode applied to anterior tibia tuberosity surface. 2 mm to 2 cm large hyperechogenic fragment(s) with acoustic shadow remaining at the same place when bending knee joint is/are found.
EFFECT: high accuracy of diagnosis.
SUBSTANCE: method involves determining liquid content volume in stomach cavity in 60 min after taking 150 ml of boiled water in performing ultrasonic examination through frontal abdominal cavity wall. Repeated examinations are done every 5 min later on. Liquid being observed in the stomach for the second time or many times in the amount of 10% of total volume or more, duodenogastric reflux is considered to be the case.
EFFECT: high objectivity of diagnosis; reduced risk of traumatic complications; low costs.
SUBSTANCE: method involves carrying out Doppler tissular echocardiography examination. Left ventricle myocardium segments movement characteristics are measured in time in each j-th segment. Regional myocardium productivity index Ij of the left ventricle is measured with formula containing isovolumic contraction time, isovolumic relaxation time and withdraw period duration being used. Ij values estimation is carried out in segments fed by single coronary artery branch with blood. Left ventricle regional myocardium productivity index value being not less than in two segments fed by single coronary artery branch with blood and equal to or greater than 0.8, cardiac ischemia disease is to be diagnosed.
EFFECT: simplified diagnosis method.
SUBSTANCE: one should perform trans-abdominal ultrasound studying of abdominal department of operated esophagus to detect its length, contours, external diameter, thickness of muscular duplication of artificial sphincter, structure of esophageal bagasse as layered structure, the value of bagasse lumen both at closed and opened variants during evacuation of esophageal content. One should either register or reject the fact of gastroesophageal reflux, detect the sites of liquid congestion beyond bagasse contour in case of its failure, detect the nature of circulation in area of esophageal anastomosis with gastric or intestinal stump in case of chromatic and energetic Doppler-scanning. In the course of endoscopic ultrasound testing of esophageal transition into gastric or intestinal stump on should determine the volume of muscular coupling of bagasse in distal esophageal edge by the following formula (V1 - V2), where V1 - the volume of bagasse cylinder along its external surface, V2 - that of along internal surface of muscular membrane of esophageal wall, percentage ratio of postoperational scar size against circumference of bagasse muscular duplication at its cross-sectional ultrasound scanning. Depending upon the above-mentioned data one should detect both organic and functional state of bagasse muscular coupling in postoperational period.
EFFECT: higher efficiency of evaluation.
11 dwg, 2 ex
SUBSTANCE: method involves carrying out ultrasonic orbit scanning. Retrobulbar anesthetic injection is administered in the amount of 3 ml before beginning the ultrasonic scanning. Ring bath is set into conjunctival cavity. The bath is filled with immersion liquid to immerse upper part of the object under study. 2% lidocaine solution is applied as the anesthetic solution.
EFFECT: complete picture of orbit implant and surrounding tissues position and state.
FIELD: medicine, nephrology.
SUBSTANCE: in patients with chronic renal failure at program dialysis it is necessary to form an arteriorvenous fistula, carry out standard echocardiographic survey, detect maximal sizes of right-hand cardiac chambers. In case of dilatation of right-hand cardiac chambers the volume of circulation along the developed arteriovenous fistula corresponds to above 500 ml/min. The method suggested simplifies the evaluation of the volume of shunt circulation along arteriovenous fistula.
EFFECT: higher accuracy of evaluation.
4 ex, 1 tbl
FIELD: medicine, hepatology.
SUBSTANCE: one should detect splenic length in mm (X1) and circulation in portal vein, moreover, additionally, on should detect volumetric circulation in splenic vein in cu. cm/min. (X2), the index for the ratio of volumetric circulation in splenic vein to the area of longitudinal splenic section (X3), circulatory direction in left-hand gastric vein (X4) by establishing its direction towards the liver to be 1, from the liver to be 2, diameter of splenic artery in cm (X5) and transhepatic portal volumetric circulation in cu. cm/min. (X6), then one should calculate discriminant function Z = 15.9850 - 0.0187X1 + 0.2006X3 - 1.9025X4 - 19.0493X5 - 0.0025X6, where Z - the criterion for predicting "healthy-sick" state; then it is necessary to detect the group with hepatic diseases by the value of Z ≤ 1.621 to calculate for them discriminant function Y = 9.7396 - 0.0279X1 - 0.0018X2 + 0.1873X3 - 4.9174X4, where Y - the criterion to predict "patients with chronic hepatitis - patients with cirrhosis" state and at Y > 1.239 one should diagnose chronic hepatitis, at Y ≤ 1.239 - cirrhosis.
EFFECT: higher efficiency of diagnostics.