BACKGROUND. According to guidelines the optimal delay between the last dose of purgative and colonoscopy is no longer than 2-4 hours. Morning-only dosing of polyethyleneglycol solution (PEG) prior to colonoscopy versus standard split-dosing with nocturnal pause may be more acceptable for patient. AIM. To compare the efficacy, safety and tolerability of morning-only dosing regimen of 2 liter PEG plus ascorbic acid solution (PEG + Asc) 2 L to split-dose PEG + Asc 2 L for bowel preparation prior to colonoscopy. METHODS. This was a multicenter prospective endoscopist-blinded randomized non-inferiority study comparing morning-only to split dosing with nocturnal pause regimen of PEG + Asc 2 L (MOVIPREP^®) for the bowel preparation prior to colonoscopy. The primary endpoint was successful colon cleansing where «Success» represented grades of bowel cleansing А and В according to Harefield Cleansing Scale© (HCS©). Clinically relevant non-inferiority margin was set at -15 % with one-sided significance level of 5 %. Secondary endpoints were general satisfaction/acceptability ofpatients with the preparationfor colonoscopy, as well as patient compliance and safety of the study drug. RESULTS. Overall 140 patients from 6 centers were enrolled in the study and randomized into two groups of 70 each. ITT analysis showed successful colon cleansing in 94,3 % in the morning-only group versus 91,4 % in the split-dose group. An estimated treatment difference was 2,9 %, 95 % lower confidence limit for the difference -9,7 % with the prespecified non-inferiority margin -15 % (p for non-inferiority <0.001). Furthermore 71,4 % ofpatients had the highest grade A colon cleansing according to HCS© in each group. In patients in the morning-only intake group, the time to first bowel motion following the first liter of PEG + Asc 2 L was shorter, with a median time of 1.08 hours, compared with 1.58 hours in the split-dose group (p<0,001). Nearly all of the patients treated in the morning-only dosing group (69/70) and in the split-dose group (67/70) received the study medication as planned. In general, the study drug was well tolerated in patients of both groups. At least one treatment-emergent adverse event was reported by 58,6 % of patients in the morning-only dosing group and by 61,4 % of patients in the split dosing group. The most frequently reported adverse events were typical gastrointestinal disorders (53,5 % of patients) and changes in laboratory tests (12,1 % of patients). No serious adverse events were reported in this study. CONCLUSION. Morning-only dosing regimen of PEG + Asc 2 L is non-inferior to split-dosing regimen in terms of colon cleansing and is safe and convenient for use as a bowel preparation prior to colonoscopy.

PURPOSE. Development of elastometry and elastography in differential diagnostics of liver hyperechoic lesions (hemangioma and colorectal cancer metastases) MATERIALS AND METHODS. 180 patients examined due to liver hyperechoic lesions. All patients underwent elastography in manual compression mode, ultrasound examination in the аcoustic radiationforce impulse (ARFI) mode and in shear wave velocity (SWV) mode. RESULTS. According to the data from elastography in manual compression mode in patient's group with colorectal liver metastases in 71 % cases lesions were rigid. In patient's group with hemangioma lesions in 88 % cases were soft. According to the data from elastography in the ARFI mode in patient's group with colorectal liver metastases in 71 % cases lesions were rigid. In group of patients with liver hemangioma in 88 % cases lesions were soft. According to the tumor tissue elastometry data in patients with colorectal liver metastases RSTW was high - 3,24 m/sec (range 1,4-4,22 m/sec), median of RTSW was 3,38 m/sec. In patient's group with liver hemangioma RSTW was the lowest -1,07 m/sec (range 0,75-3,86 m/sec), median - 0,93 m/sec. CONCLUSION. Informativeness of elastography in manual compression mode for colorectal liver metastases (n=110): 98 % sensitivity, 98 % accuracy, 100 % positive predictive value. Informativeness of elastography in manual compression mode for liver hemangioma (n=70): 94 % sensitivity, 94 % accuracy, 100 % negative predictive value._ 19 ДИФФЕРЕНЦИАЛЬНАЯ ДИАГНОСТИКА ОЧАГОВЫХ ГИПЕРЭХОГЕННЫХ ОБРАЗОВАНИЙ В ПЕЧЕНИ Informativeness of elastography in ARFI mode for colorectal liver metastases (n=110): 100 % sensitivity, 100 % accuracy, 100 % positive predictive value. Informativeness of elastography in ARFI mode for liver hemangioma (n=45): 94 % sensitivity, 100 % accuracy, 100 % negative predictive value. Elastometry data for liver malignant tumors detection were more informative when RSTW threshold level was 2,0 m/sec (if more than 2,0 m/sec then malignant tumor, if less than 2 m/sec then benign tumor): 94 % accuracy, 91 % sensitivity, 97 % specificity, 92 % negative predictive value.

PURPOSE OF THE STUDY. Analysis of the possibility of a shearwave elastography (2D-SWE) approach in the diagnosis of metastatic liver damage within the framework of multiparametric ultrasound. MATERIALS AND METHODS. A survey of 95 patients with liver metastases with a primary focus: 28 (29,4 %) - lung cancer, 31 (32,6 %) -malignant neoplasm of the stomach (SNO), 9 (9,5 %) - pancreatic cancer, 16 - colorectal cancer, 9 (17,8 %) - uterine cancer, 11 (20 %) - ovarian malignancy was conducted. Metachronous metastases were detected in all patients (n=95) (6-18 months after surgical treatment.) The use of multiparametric ultrasound (B-mode, shearwave elastography and ultrasound with contrast enhancement) was mandatory in the patient examination algorithm. RESULTS. The results of B-mode, color Doppler mapping and SWE are important for evaluating non-invasive or invasive nature of metastasis growth AUC=0,889 (95 % CI 0,879-0,957), indicating very good quality. The predictive value of SWE increased with dynamic observation of patients: AUC=0,991 (95 % CI 0,944-0.997), which indicated a very good quality. CONCLUSION. The criteria for noninvasive and invasive growth of the metastatic process in the liver parenchyma with SWE are developed, it is important for preoperative planning. Prognostic significance of SWE within the scope of mutiparametric ultrasound increases at dynamic observation of patients for more than 6 months.

At present, aggressive surgical approach in combination with perioperative chemotherapy allows to extend indications for surgical intervention in patients with metastatic colorectal cancer, since only a radical liver resection provides better long-term survival. Contrast enhancement imaging techniques are important before considering treatment options to identify patients with resectable and potentially resectableliver metastases. Our study evaluated the qualitative and quantitative parameters of thedynamic enhancement pattern of liver metastases. This review will be analyzed the results of liver contrast-enhanced ultrasound studies in 104 patients with secondary colorectal liver metastases before primary tumor resection, as well as the monitoring of systemic chemotherapy and post-ablation follow-up to access treatment respond.

THE PURPOSE OF THE STUD. Determination of ultrasound semiotics of Crohn’s disease and ulcerative colitis by evaluation of activity of inflammatory process, assessment of the possibilities of echography in the differential diagnosis of these diseases. MATERIALS AND METHODS. The study included 91 patients between the ages of 4 months up to 17 years. There were examined 24 patients with verified Crohn's disease and 37 patients with verified ulcerative colitis. 30 patients without any clinical and laboratory data of the gastrointestinal diseases were included in to control group. Bowel ultrasound was done without any preparation and contrast enhancement. RESULT OF RESEARCH. Sensitivity of the test «bowel wall thickness >2.5 mm - inflammatory bowel disease» - 90,2 %, specificity - 100.0 %, positive predictive value -100.0 %, negative predictive value - 83,3 %, and AUC - 0,957. Sensitivity of the test «doppler signals amount in bowel wall >2 - inflammatory bowel disease» - 93,4 %, specificity -100.0 %, positive predictive value - 100.0 %, negative predictive value - 88,2 %, and AUC -0,967. Significant differences in pathological vascularization, ascites, terminal ileum affection, mesentery and (or) omentum inflammatory infiltration and lymph nodes size were revealed between group ofCrohn's disease and ulcerative colitis (P<0,05 for all comparisons). Significant differences in pathological vascularization during the activity and remission periods were revealed in all groups; in lymphatic nodes size - in group of ulcerative colitis and combined group of bowel inflammatory disease; in ascites, terminal ileum affection, and mesentery and (or) omentum inflammatory infiltration - in group of Crohn's disease (P<0.05 for all comparisons). CONCLUSION. Ultrasound examination is an essential method in the diagnosis and monitoring of inflammatory bowel disease in children.