21 research outputs found
Application of parameters and requirements for the expert systems assessment in nano fiber based pharmaceutical technology
Todays, the most widely used category of intelligent systems are expert systems that are computer systems capable of partially replacing a highly trained professional in his/her area of expertise by means of information previously gained by the experts. That is why expert systems are agreed to be viewed along with information bases, which are models of the actions of experts in a particular area, and logical assumptions are extended to decision-making procedure
Π£Π»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Ρ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π² Π°Π»Π³ΠΎΡΠΈΡΠΌΠ΅ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΡΠΎΠ»ΠΈΠ΄Π½ΡΡ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΡΠ΅ΠΊ
Most often any kidney lesions are primary renal, but sometimes they can be secondary (metastases, lymphoma). Every year renal cell carcinoma tends to a significant increase in the incidence. Today there are many available methods of examination, however difficulties often remain in the differential diagnosis of kidney lesions. The article discusses about the modern possibilities of methods in the identification and assessment of kidney lesions, their role in determining the tactics of patient management and key approaches in imaging characterization of these masses using CT and PET, MRI and CEUS. The analysis of the modern literature has shown that the currently existing radiation diagnostic methods do not provide an absolute opportunity for differential diagnosis of rare kidney tumors. CEUS, according to various authors, demonstrates high efficiency indicators, but does not exceed these indicators in comparison with CT and MRI. Contrast-enhanced ultrasound is a potentially safe method and can be used as a method for additional examination to characterize indeterminate renal lesions.Π‘ΠΎΠ»ΠΈΠ΄Π½ΡΠ΅ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎΡΠ΅ΠΊ ΡΠ°ΡΠ΅ Π²ΡΠ΅Π³ΠΎ ΠΈΠΌΠ΅ΡΡ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠ΅ ΠΏΡΠΎΠΈΡΡ
ΠΎΠΆΠ΄Π΅Π½ΠΈΠ΅, ΡΠ΅ΠΆΠ΅ ΠΌΠΎΠ³ΡΡ Π±ΡΡΡ Π²ΡΠΎΡΠΈΡΠ½ΡΠΌΠΈ (ΠΌΠ΅ΡΠ°ΡΡΠ°Π·Ρ, Π»ΠΈΠΌΡΠΎΠΌΠ°). ΠΠ»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠ΅ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΡ ΠΏΠΎΡΠ΅ΠΊ Π½Π° ΡΠ΅Π³ΠΎΠ΄Π½ΡΡΠ½ΠΈΠΉ Π΄Π΅Π½Ρ ΠΈΠΌΠ΅ΡΡ ΡΠ΅Π½Π΄Π΅Π½ΡΠΈΡ ΠΊ ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΌΡ Π΅ΠΆΠ΅Π³ΠΎΠ΄Π½ΠΎΠΌΡ ΡΠΎΡΡΡ. ΠΠ΅ΡΠΌΠΎΡΡΡ Π½Π° ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²ΠΎ Π΄ΠΎΡΡΡΠΏΠ½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ, Π½Π΅ΡΠ΅Π΄ΠΊΠΎ Π²ΠΎΠ·Π½ΠΈΠΊΠ°ΡΡ ΡΡΡΠ΄Π½ΠΎΡΡΠΈ Π² Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΡΡΠ΄Π° ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΡΠ΅ΠΊ. Π ΡΡΠ°ΡΡΠ΅ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°ΡΡΡΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ Π»ΡΡΠ΅Π²ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² Π² Π²ΡΡΠ²Π»Π΅Π½ΠΈΠΈ ΠΈ ΠΎΡΠ΅Π½ΠΊΠ΅ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΡΠ΅ΠΊ, ΠΈΡ
ΡΠΎΠ»Ρ Π² ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠΈ ΡΠ°ΠΊΡΠΈΠΊΠΈ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΡΠΎΠΌΠ΅ ΡΠΎΠ³ΠΎ, ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Ρ ΠΊ ΠΎΡΠ΅Π½ΠΊΠ΅ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊ ΡΡΠΈΡ
ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΠΎΠΉ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΠΈ (ΠΠ’) ΠΈ ΠΏΠΎΠ·ΠΈΡΡΠΎΠ½Π½ΠΎ-ΡΠΌΠΈΡΡΠΈΠΎΠ½Π½ΠΎΠΉ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΠΈ (ΠΠΠ’), ΠΌΠ°Π³Π½ΠΈΡΠ½ΠΎ-ΡΠ΅Π·ΠΎΠ½Π°Π½ΡΠ½ΠΎΠΉ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΠΈ (ΠΠ Π’), Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ (Π£ΠΠ) Ρ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ. ΠΠ½Π°Π»ΠΈΠ· ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ ΠΏΠΎΠΊΠ°Π·Π°Π», ΡΡΠΎ ΡΡΡΠ΅ΡΡΠ²ΡΡΡΠΈΠ΅ Π½Π° ΡΠ΅Π³ΠΎΠ΄Π½ΡΡΠ½ΠΈΠΉ Π΄Π΅Π½Ρ Π»ΡΡΠ΅Π²ΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ Π½Π΅ Π΄Π°ΡΡ Π°Π±ΡΠΎΠ»ΡΡΠ½ΡΡ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ Π² ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠΈ Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΡΠ΅Π΄ΠΊΠΈΡ
ΠΎΠΏΡΡ
ΠΎΠ»Π΅ΠΉ ΠΏΠΎΡΠΊΠΈ. ΠΡ
ΠΎΠΊΠΎΠ½ΡΡΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
Π°Π²ΡΠΎΡΠΎΠ² Π΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΡΠ΅Ρ Π²ΡΡΠΎΠΊΠΈΠ΅ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ, Π½ΠΎ Π½Π΅ ΠΏΡΠ΅Π²ΡΡΠ°Π΅Ρ ΡΡΠΈ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ ΠΠ’ ΠΈ ΠΠ Π’. ΠΠΎΠ½ΡΡΠ°ΡΡΠ½ΠΎ-ΡΡΠΈΠ»Π΅Π½Π½ΠΎΠ΅ Π£ΠΠ β ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΠΎ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΡΠΉ ΠΌΠ΅ΡΠΎΠ΄ ΠΈ ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ Ρ ΡΠ΅Π»ΡΡ Π΄ΠΎΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠΎΠΌΠ½ΠΈΡΠ΅Π»ΡΠ½ΡΡ
ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΡΠ΅ΠΊ
ΠΡΠ»ΡΡΠΈΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Ρ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠ½ΡΠΌ ΡΡΠΈΠ»Π΅Π½ΠΈΠ΅ΠΌ ΡΠΎΠ»ΠΈΠ΄Π½ΡΡ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΡΠΊΠΈ Π² ΡΠΎΠΏΠΎΡΡΠ°Π²Π»Π΅Π½ΠΈΠΈ Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΠΎΠΉ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΠΈ
Introduction. Today, we have a lot of difficulties in the focal kidney lesions diagnosis, despite the many available radiation methods of examination. Computed tomography (CT) is the Β«gold standardΒ» of radiological diagnosis of kidney cancer (KC), which over the years of its existence has proven to be highly effectiveness. Ultrasound examination (US) is the best method for the primary diagnosis of solid kidney lesions. Multiparameter ultrasound (mpUS) with using contrast significantly supplements the information obtained in traditional scanning, significantly expanding the range of tasks to be solved. The article discusses the modern possibilities of radiology methods in the detection and assessment of kidney lesions, their role in determining the patient management tactics.Objective. Π’o explore the possibilities and compare the effectiveness of individual multiparameter ultrasound techniques (Bmode, CDI and PDI, ultrasoundcontrast) in assessing solid kidney formations with each other and computed tomography (CT), as a reference method of radiation diagnostics.Material and methods. Πultiparametric ultrasound examination (mpUS) using B-mode, doppler mapping and contrast enhancement (1,0 ml Sonovue) was performed in 79 patients with solid kidney lesions. Most of the detected lesions (n=65) were histologically verified, the rest (n=14) with signs of benign changes were subjected to dynamic control. All patients underwent contrast-enhanced computed tomography as a control method.Results. Π’he effectiveness of the B-mode was: sensitivity (Se) β 76,9%; specificity (Sp) β 29,6%; accuracy (A) β 60,7%, for the CDI mode, these indicators were Se β 80,7%; Sp β 37,1%; A β 65,8%. The use of contrast enhancement significantly increased the overall efficiency of multiparameter ultrasound: Se β 92,1%; Sp β 93,7%; A β 92,4% and showed comparable efficiency with CT: Sp β 94,9%; Se β 85,0%; A β 92,4%.Conclusions. CT to this day remains the Β«gold standardΒ» in the assessment of kidney lesions, however, ultrasound with contrast enhancement due to comparable efficiency, as well as taking into account the absence of radiation exposure, wide availability of equipment, high resolution, in the presence of contraindications to CT in a number of cases can act as a method of choice.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. ΠΠ΅ΡΠΌΠΎΡΡΡ Π½Π° ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²ΠΎ Π΄ΠΎΡΡΡΠΏΠ½ΡΡ
Π»ΡΡΠ΅Π²ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ, Π½Π° ΡΠ΅Π³ΠΎΠ΄Π½ΡΡΠ½ΠΈΠΉ Π΄Π΅Π½Ρ, Π½Π΅ΡΠ΅Π΄ΠΊΠΎ Π²ΠΎΠ·Π½ΠΈΠΊΠ°ΡΡ ΡΡΡΠ΄Π½ΠΎΡΡΠΈ Π² Β Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΠΎΡΠ°Π³ΠΎΠ²ΡΡ
ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΡΠ΅ΠΊ. ΠΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½Π°Ρ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΡ (ΠΠ’), Π½Π° Β ΡΠ΅Π³ΠΎΠ΄Π½ΡΡΠ½ΠΈΠΉ Π΄Π΅Π½Ρ, ΡΠ²Π»ΡΠ΅ΡΡΡ Β«Π·ΠΎΠ»ΠΎΡΡΠΌ ΡΡΠ°Π½Π΄Π°ΡΡΠΎΠΌΒ» Π»ΡΡΠ΅Π²ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΡΠ°ΠΊΠ° ΠΏΠΎΡΠΊΠΈ (Π Π), ΠΊΠΎΡΠΎΡΠ°Ρ Π·Π° Π³ΠΎΠ΄Ρ ΡΠ²ΠΎΠ΅Π³ΠΎ ΡΡΡΠ΅ΡΡΠ²ΠΎΠ²Π°Π½ΠΈΡ Π΄ΠΎΠΊΠ°Π·Π°Π»Π° Π²ΡΡΠΎΠΊΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ. Π£Π»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ (Π£ΠΠ) ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΡΠΎΠ»ΠΈΠ΄Π½ΡΡ
ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΡΠ΅ΠΊ. ΠΡΠ»ΡΡΠΈΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π£ΠΠ (ΠΌΠΏΠ£ΠΠ) Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΡΡ
ΠΎΠΊΠΎΠ½ΡΡΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ Π΄ΠΎΠΏΠΎΠ»Π½ΡΠ΅Ρ ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΡ Π² ΡΠ°ΠΌΠΊΠ°Ρ
ΡΡΠ°Π΄ΠΈΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ ΡΠΊΠ°Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΡ, ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ ΡΠ°ΡΡΠΈΡΡΡ ΡΠΏΠ΅ΠΊΡΡ ΡΠ΅ΡΠ°Π΅ΠΌΡΡ
Π·Π°Π΄Π°Ρ. Π ΡΡΠ°ΡΡΠ΅ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°ΡΡΡΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ Π»ΡΡΠ΅Π²ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² Π² Π²ΡΡΠ²Π»Π΅Π½ΠΈΠΈ ΠΈ ΠΎΡΠ΅Π½ΠΊΠ΅ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΡΠ΅ΠΊ, ΠΈΡ
ΡΠΎΠ»Ρ Π² ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠΈ ΡΠ°ΠΊΡΠΈΠΊΠΈ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ².Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΈΠ·ΡΡΠΈΡΡ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΈ ΡΡΠ°Π²Π½ΠΈΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΎΡΠ΄Π΅Π»ΡΠ½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊ ΠΌΡΠ»ΡΡΠΈΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π£ΠΠ (ΠΡΠ΅ΠΆΠΈΠΌ, Π¦ΠΠ ΠΈ ΠΠΠ, ΡΡ
ΠΎΠΊΠΎΠ½ΡΡΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅) Π² ΠΎΡΠ΅Π½ΠΊΠ΅ ΡΠΎΠ»ΠΈΠ΄Π½ΡΡ
ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΡΠ΅ΠΊ ΠΌΠ΅ΠΆΠ΄Ρ ΡΠΎΠ±ΠΎΠΉ ΠΈ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΠΎΠΉ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΠ΅ΠΉ (ΠΠ’), ΠΊΠ°ΠΊ ΡΠ΅ΡΠ΅ΡΠ΅Π½ΡΠ½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π»ΡΡΠ΅Π²ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠ»ΡΡΠΈΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ (ΠΌΠΏΠ£ΠΠ) Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ Π-ΡΠ΅ΠΆΠΈΠΌΠ°, Π΄ΠΎΠΏΠΏΠ»Π΅ΡΠΎΠ²ΡΠΊΠΎΠ³ΠΎ ΠΊΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΈ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠ½ΠΎΠ³ΠΎ ΡΡΠΈΠ»Π΅Π½ΠΈΡ (1,0 ΠΌΠ» Π‘ΠΎΠ½ΠΎΠ²ΡΡ) ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ 79 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ Ρ ΡΠΎΠ»ΠΈΠ΄Π½ΡΠΌΠΈ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡΠΌΠΈ ΠΏΠΎΡΠ΅ΠΊ. ΠΠΎΠ»ΡΡΠ°Ρ ΡΠ°ΡΡΡ Π²ΡΡΠ²Π»Π΅Π½Π½ΡΡ
ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ (n=65) Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈ Π²Π΅ΡΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Ρ, ΠΎΡΡΠ°Π»ΡΠ½ΡΠ΅ (n=14), ΠΈΠΌΠ΅ΡΡΠΈΠ΅ ΠΏΡΠΈΠ·Π½Π°ΠΊΠΈ Π΄ΠΎΠ±ΡΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ, ΠΏΠΎΠ΄Π²Π΅ΡΠ³Π°Π»ΠΈΡΡ Π΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠΎΠΌΡ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ. Π Β ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ ΠΊΠΎΠ½ΡΡΠΎΠ»ΡΠ½ΠΎΠ³ΠΎ ΠΌΠ΅ΡΠΎΠ΄Π° Π²ΡΠ΅ΠΌ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ Π²ΡΠΏΠΎΠ»Π½ΡΠ»Π°ΡΡ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½Π°Ρ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΡ Ρ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π-ΡΠ΅ΠΆΠΈΠΌΠ° ΡΠΎΡΡΠ°Π²ΠΈΠ»Π°: ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ (Π§) β 76,9%; ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡ (Π‘) β 29,6%; ΡΠΎΡΠ½ΠΎΡΡΡ (Π’) β 60,7%, Π΄Π»Ρ ΡΠ΅ΠΆΠΈΠΌΠ° Π¦ΠΠ Π΄Π°Π½Π½ΡΠ΅ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ Π§ β 80,7%; Π‘ β 37,1%; Π’ β 65,8%. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠ½ΠΎΠ³ΠΎ ΡΡΠΈΠ»Π΅Π½ΠΈΡ Π·Π½Π°ΡΠΈΠΌΠΎ ΠΏΠΎΠ²ΡΡΠΈΠ»ΠΎ ΠΎΠ±ΡΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΌΡΠ»ΡΡΠΈΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π£ΠΠ: Π§ β 92,1%; Π‘ β 93,7%; Π’ β 92,4% ΠΈ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΎ ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΠΌΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Ρ ΠΠ’: Π§ β 94,9%; Π‘ β 85,0%; Π’ β 92,4%.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ’ ΠΏΠΎ ΡΠ΅ΠΉ Π΄Π΅Π½Ρ ΠΎΡΡΠ°Π΅ΡΡΡ Β«Π·ΠΎΠ»ΠΎΡΡΠΌ ΡΡΠ°Π½Π΄Π°ΡΡΠΎΠΌΒ» Π² ΠΎΡΠ΅Π½ΠΊΠ΅ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΡΠ΅ΠΊ, ΠΎΠ΄Π½Π°ΠΊΠΎ ΠΌΠΏΠ£ΠΠ Ρ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠ½ΡΠΌ ΡΡΠΈΠ»Π΅Π½ΠΈΠ΅ΠΌ Π·Π° ΡΡΠ΅Ρ ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΠΌΠΎΠΉ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ, Π° ΡΠ°ΠΊΠΆΠ΅ Ρ ΡΡΠ΅ΡΠΎΠΌ ΠΎΡΡΡΡΡΡΠ²ΠΈΡ Π»ΡΡΠ΅Π²ΠΎΠΉ Π½Π°Π³ΡΡΠ·ΠΊΠΈ, ΡΠΈΡΠΎΠΊΠΎΠΉ Π΄ΠΎΡΡΡΠΏΠ½ΠΎΡΡΠΈ ΠΎΠ±ΠΎΡΡΠ΄ΠΎΠ²Π°Π½ΠΈΡ, Π²ΡΡΠΎΠΊΠΎΠΉ ΡΠ°Π·ΡΠ΅ΡΠ°ΡΡΠ΅ΠΉ ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΠΈ, ΠΏΡΠΈ Π½Π°Π»ΠΈΡΠΈΠΈ ΠΏΡΠΎΡΠΈΠ²ΠΎΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΠΉ ΠΊ Β ΠΠ’ Π² Β ΡΡΠ΄Π΅ ΡΠ»ΡΡΠ°Π΅Π² ΠΌΠΎΠΆΠ΅Ρ Π²ΡΡΡΡΠΏΠΈΡΡ Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ ΠΌΠ΅ΡΠΎΠ΄Π° Π²ΡΠ±ΠΎΡ
ΠΡΠ»ΡΡΠΈΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Ρ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠ½ΡΠΌ ΡΡΠΈΠ»Π΅Π½ΠΈΠ΅ΠΌ ΠΊΠΈΡΡΠΎΠ·Π½ΡΡ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΡΠΊΠΈ Π² ΡΠΎΠΏΠΎΡΡΠ°Π²Π»Π΅Π½ΠΈΠΈ Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΠΎΠΉ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΠΈ
Objective: to evaluate the effectiveness and capabilities of multiparametric ultrasound (mpUS) with contrast enhanced in the assessment of renal cystic lesions and compare data with the results of computed tomography (CT).Patients and Methods. The study included 61 patients with cystic kidney tumors (category Bosniak β₯ II). Cysts of categories Bosniak β₯ III were morphologically verified, the rest (categories II-IIF) were under long-term dynamic control. All patients underwent mpUS including greyscale mode, color doppler imaging (CDI) and contrast-enhanced ultrasound (CEUS), as well as contrast-enhanced CT.Results. Contrast-enhanced mpUS with CEUS demonstrated high efficiency of the method: sensitivity (Se) β 97.2%; specificity (Sp) β 91.6%; accuracy (A) β 95.1%. The effectiveness of CT with contrast in the study group was 91.7%; 84.0%; 88.5% respectively. Also, mpUS showed a more accurate assessment of cystic tumors according to the Bosniak classification, in comparison with contrast-enhanced CT.Conclusions. Contrast-enhanced mpUS with CEUS demonstrated a significant increase in the effectiveness of the method as a whole, as well as higher rates in comparison with CT in the assessment of cystic formations of the kidneys. This technique should be considered as the method of choice in cases where CT is not possible, and it is recommended to include it in the algorithm for examining patients with cystic kidney tumors.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΎΡΠ΅Π½ΠΈΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΈ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΌΡΠ»ΡΡΠΈΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ (ΠΌΠΏΠ£ΠΠ) Ρ ΡΡ
ΠΎΠΊΠΎΠ½ΡΡΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π² ΠΎΡΠ΅Π½ΠΊΠ΅ ΠΊΠΈΡΡΠΎΠ·Π½ΡΡ
ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΡΠ΅ΠΊ, ΡΡΠ°Π²Π½ΠΈΡΡ Π΄Π°Π½Π½ΡΠ΅ Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌΠΈ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΠΎΠΉ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΠΈ (ΠΠ’) Ρ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΎΡΠ΅Π½ΠΈΠ²Π°Π»ΠΈΡΡ Π΄Π°Π½Π½ΡΠ΅ 61 ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ° Ρ ΠΊΠΈΡΡΠΎΠ·Π½ΡΠΌΠΈ ΠΎΡΠ°Π³Π°ΠΌΠΈ ΠΏΠΎΡΠ΅ΠΊ (ΠΊΠ°ΡΠ΅Π³ΠΎΡΠΈΡ Bosniak β₯ II). ΠΠΈΡΡΡ ΠΊΠ°ΡΠ΅Π³ΠΎΡΠΈΠΉ Bosniak β₯ III Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈ ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π΅Π½Ρ, ΠΎΡΡΠ°Π»ΡΠ½ΡΠ΅ (ΠΊΠ°ΡΠ΅Π³ΠΎΡΠΈΠΈ IIβIIF) ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π°Π»ΠΈΡΡ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΡΠΌ Π΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠΈΠΌ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠ΅ΠΌ. ΠΡΠ΅ΠΌ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΎ ΠΌΠΏΠ£ΠΠ, Π²ΠΊΠ»ΡΡΠ°ΡΡΠ΅Π΅ Π² ΡΠ΅Π±Ρ ΡΠ΅ΡΠΎΡΠΊΠ°Π»ΡΠ½ΡΠΉ ΡΠ΅ΠΆΠΈΠΌ, Π΄ΠΎΠΏΠΏΠ»Π΅ΡΠΎΠ²ΡΠΊΠΎΠ΅ ΠΊΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ (Π¦ΠΠ) ΠΈ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠ½ΠΎ-ΡΡΠΈΠ»Π΅Π½Π½ΠΎΠ΅ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ (ΠΠ£Π£ΠΠ), Π° ΡΠ°ΠΊΠΆΠ΅ ΠΠ’ Ρ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΌΠΏΠ£ΠΠ Ρ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠ½ΡΠΌ ΡΡΠΈΠ»Π΅Π½ΠΈΠ΅ΠΌ ΠΏΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π»ΠΎ Π²ΡΡΠΎΠΊΠΈΠ΅ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΌΠ΅ΡΠΎΠ΄Π°: ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ β 97,2%, ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡ β 91,6%, ΡΠΎΡΠ½ΠΎΡΡΡ β 95,1%. ΠΠ½Π°Π»ΠΎΠ³ΠΈΡΠ½ΡΠ΅ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΡ ΠΠ’ Ρ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π² ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΠΌΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ 91,7, 84,0, 88,5% ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ. Π’Π°ΠΊΠΆΠ΅ ΠΌΠΏΠ£ΠΠ ΠΏΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π»ΠΎ Π±ΠΎΠ»Π΅Π΅ ΡΠΎΡΠ½ΡΡ ΠΎΡΠ΅Π½ΠΊΡ ΠΊΠΈΡΡΠΎΠ·Π½ΡΡ
ΠΎΠΏΡΡ
ΠΎΠ»Π΅ΠΉ ΠΏΠΎ ΠΊΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΠΈ Bosniak Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ ΠΠ’ Ρ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΌΠΏΠ£ΠΠ Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΡΡ
ΠΎΠΊΠΎΠ½ΡΡΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π»ΠΎ ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ΅ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΌΠ΅ΡΠΎΠ΄Π° Π² ΡΠ΅Π»ΠΎΠΌ, Π° ΡΠ°ΠΊΠΆΠ΅ Π±ΠΎΠ»Π΅Π΅ Π²ΡΡΠΎΠΊΠΈΠ΅ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ ΠΠ’ ΠΏΡΠΈ ΠΎΡΠ΅Π½ΠΊΠ΅ ΠΊΠΈΡΡΠΎΠ·Π½ΡΡ
ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΡΠ΅ΠΊ. ΠΠ°Π½Π½ΡΡ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΡ ΡΠ»Π΅Π΄ΡΠ΅Ρ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°ΡΡ Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ ΠΌΠ΅ΡΠΎΠ΄Π° Π²ΡΠ±ΠΎΡΠ° Π² ΡΠ»ΡΡΠ°ΡΡ
, ΠΊΠΎΠ³Π΄Π° Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΠ΅ ΠΠ’ Π½Π΅Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎ, ΠΈ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄ΡΠ΅ΡΡΡ Π²ΠΊΠ»ΡΡΠΈΡΡ Π² Π°Π»Π³ΠΎΡΠΈΡΠΌ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΊΠΈΡΡΠΎΠ·Π½ΡΠΌΠΈ ΠΎΠΏΡΡ
ΠΎΠ»ΡΠΌΠΈ ΠΏΠΎΡΠ΅ΠΊ
ΠΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΌΡΠ»ΡΡΠΈΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΠΊΠΎΠΌΠΏΡΠ΅ΡΡΠΈΠΎΠ½Π½ΠΎΠΉ ΡΠ»Π°ΡΡΠΎ-Π³ΡΠ°ΡΠΈΠΈ Π² ΡΠ°Π½Π½Π΅ΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΌΠΎΠ»ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ
Modern ultrasound examination (US), unlike other modalities, allows to assess the stiffness of the lesions, with the help of a new technology named sonoelastography (SEG). According to many scientific studies, with the addition of SEG to the B-mode, the diagnostic efficiency of ultrasound of breast lesions significantly increases. According to Thomas et al. B-mode has a sensitivity of 91,8% and a specificity of 78%. When a compression SEG is added to a diagnostic study, the specificity increases to 91,5%.The purpose of this study was to determine the diagnostic effectiveness of SEG and compare it with the effectiveness of B-mode and color Doppler mapping (CDC) in the primary diagnosis of breast tumors, as well as to identify diagnostically and statistically significant SEG signs of breast cancer (ΠΠ‘).Materials and methods. The study was performed from 2017 to 2019 on the basis of the Β«NMRC Oncology. named after N. N. PetrovΒ» Ministry of Health of Russia. 277 women with complaints of lump or pain in the breast were included in the study, for all of them there was performed the multiparametric ultrasound examination with application of CDM and SEG. According to our own results, SEG is more effective at detection of malignant and benign lesions, than ultrasoumd examination in B and CDM modes.Results: 0, 1, 2, 3 elastotypes are the highly significant diagnostic signs of benign process, and the elastotype 5 is a reliable diagnostic marker of malignant process. The effectiveness of CDM and SEG in the differential diagnosis of breast lesions showed: sensitivity β 77,6% vs. 85,5%; specificity β 51,7% vs. 84,6%; accuracy β 58,8% vs. 84,8%.Conclusions: according to our own research results, SEG is more effective in detecting malignant and benign tumors than ultrasound in B and CDM modes.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. Π‘ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠ΅ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ (Π£ΠΠ) Π² ΠΎΡΠ»ΠΈΡΠΈΠ΅ ΠΎΡ Π΄ΡΡΠ³ΠΈΡ
ΠΌΠΎΠ΄Π°Π»ΡΠ½ΠΎΡΡΠ΅ΠΉ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΎΡΠ΅Π½ΠΈΠ²Π°ΡΡ ΠΆΠ΅ΡΡΠΊΠΎΡΡΡ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΡΠ°Π³Π° Ρ ΠΏΠΎΠΌΠΎΡΡΡ Π½ΠΎΠ²ΠΎΠΉ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ β ΡΠΎΠ½ΠΎΡΠ»Π°ΡΡΠΎΠ³ΡΠ°ΡΠΈΠΈ (Π‘ΠΠ). Π‘ΠΎΠ³Π»Π°ΡΠ½ΠΎ ΠΌΠ½ΠΎΠ³ΠΈΠΌ Π½Π°ΡΡΠ½ΡΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡΠΌ ΠΏΡΠΈ Π΄ΠΎΠ±Π°Π²Π»Π΅Π½ΠΈΠΈ Π‘ΠΠ ΠΊ ΡΠ΅ΡΠΎΡΠΊΠ°Π»ΡΠ½ΠΎΠΌΡ Π-ΡΠ΅ΠΆΠΈΠΌΡ Π·Π½Π°ΡΠΈΠΌΠΎ ΠΏΠΎΠ²ΡΡΠ°Π΅ΡΡΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π£ΠΠ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΌΠΎΠ»ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ. ΠΠΎ Π΄Π°Π½Π½ΡΠΌ Π. Thomas ΠΈ ΡΠΎΠ°Π²Ρ. Π-ΡΠ΅ΠΆΠΈΠΌ ΠΈΠΌΠ΅Π΅Ρ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ 91,8% ΠΈ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡ 78%. ΠΡΠΈ Π΄ΠΎΠ±Π°Π²Π»Π΅Π½ΠΈΠΈ ΠΊ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠΌΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΊΠΎΠΌΠΏΡΠ΅ΡΡΠΈΠΎΠ½Π½ΠΎΠΉ Π‘ΠΠ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π΅ΡΡΡ Π΄ΠΎ 91,5%.Π¦Π΅Π»ΡΡ ΠΈ Π·Π°Π΄Π°ΡΠ΅ΠΉ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠ²ΠΈΠ»ΠΎΡΡ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π‘ΠΠ ΠΈ ΡΡΠ°Π²Π½Π΅Π½ΠΈΠ΅ Ρ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡΡ Π-ΡΠ΅ΠΆΠΈΠΌΠ° ΠΈ ΡΠ²Π΅ΡΠΎΠ²ΠΎΠ³ΠΎ Π΄ΠΎΠΏΠΏΠ»Π΅ΡΠΎΠ²ΡΠΊΠΎΠ³ΠΎ ΠΊΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ (Π¦ΠΠ) Π² ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΌΠΎΠ»ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ, Π° ΡΠ°ΠΊΠΆΠ΅ Π²ΡΡΠ²Π»Π΅Π½ΠΈΠ΅ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈ ΠΈ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΡΡ
Π‘ΠΠ ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ² ΡΠ°ΠΊΠ° ΠΌΠΎΠ»ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ (Π ΠΠ).ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΎΡΡ Ρ 2017 ΠΏΠΎ 2019 Π³. Π½Π° Π±Π°Π·Π΅ Π€ΠΠΠ£ Β«ΠΠΠΠ¦ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈΠΌ. Π. Π. ΠΠ΅ΡΡΠΎΠ²Π°Β» ΠΠ Π Π€. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π±ΡΠ»ΠΈ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ 277 ΠΆΠ΅Π½ΡΠΈΠ½ Ρ ΠΆΠ°Π»ΠΎΠ±Π°ΠΌΠΈ Π½Π° ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΈΠ»ΠΈ Π±ΠΎΠ»Π΅Π·Π½Π΅Π½Π½ΡΠ΅ ΠΎΡΡΡΠ΅Π½ΠΈΡ Π² ΠΌΠΎΠ»ΠΎΡΠ½ΡΡ
ΠΆΠ΅Π»Π΅Π·Π°Ρ
, Π²ΡΠ΅ΠΌ ΠΈΠΌ Π²ΡΠΏΠΎΠ»Π½ΡΠ»ΠΎΡΡ ΠΌΡΠ»ΡΡΠΈΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π£ΠΠ Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ Π¦ΠΠ ΠΈ Π‘ΠΠ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΊ Π²ΡΡΠΎΠΊΠΎΠ·Π½Π°ΡΠΈΠΌΡΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΡΠΈΠ·Π½Π°ΠΊΠ°ΠΌ Π΄ΠΎΠ±ΡΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ° ΠΎΡΠ½ΠΎΡΡΡΡΡ 0, 1, 2, 3 ΡΠ»Π°ΡΡΠΎΡΠΈΠΏΡ, Π° 5 ΡΠ»Π°ΡΡΠΎΡΠΈΠΏ ΡΠ²Π»ΡΠ΅ΡΡΡ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΡΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠΌ Π·Π»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ. ΠΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π¦ΠΠ ΠΈ Π‘ΠΠ Π² Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΌΠΎΠ»ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ ΠΏΠΎΠΊΠ°Π·Π°Π»Π°: ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ β 77,6% ΠΏΡΠΎΡΠΈΠ² 85,5%; ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡ β 51,7% ΠΏΡΠΎΡΠΈΠ² 84,6%; ΡΠΎΡΠ½ΠΎΡΡΡ β 58,8% ΠΏΡΠΎΡΠΈΠ² 84,8%.ΠΡΠ²ΠΎΠ΄Ρ: ΡΠΎΠ³Π»Π°ΡΠ½ΠΎ ΡΠΎΠ±ΡΡΠ²Π΅Π½Π½ΡΠΌ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ, Π‘ΠΠ Π±ΠΎΠ»Π΅Π΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½Π° Π² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ Π·Π»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΈ Π΄ΠΎΠ±ΡΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ, ΡΠ΅ΠΌ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΡΠ΅ Π- ΠΈ Π¦ΠΠ-ΡΠ΅ΠΆΠΈΠΌΡ
Accounting and Analytical Support of State Development Programs for Tourism Π£ΡΠ΅ΡΠ½ΠΎ-Π°Π½Π°Π»ΠΈΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΏΠΎΠ΄Π΄Π΅ΡΠΆΠΊΠ° Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΡΡ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΡΡΠΈΠ·ΠΌΠ°
The paper presents a proposal for composition of information and analytic support system for state regulation of tourism. On the base of proposed indicators the paper reveals tourism impact on gross domestic product, international balance of payments and national accounts. The proper estimates and analytical findings on international tourist arrivals for Ukraine are given. Also the paper discloses the main problems of national travel market and potential leverages of state regulation of tourism in Ukraine.Π‘ΡΠ°ΡΡΡ ΠΏΠΎΡΠ²ΡΡΠ΅Π½Π° ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠΈΡΡΠ΅ΠΌΡ ΡΡΠ΅ΡΠ½ΠΎ-Π°Π½Π°Π»ΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΠΎΠ΄Π΄Π΅ΡΠΆΠΊΠΈ Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΡΠ΅Π³ΡΠ»ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΡΠ½ΠΊΠ° ΡΡΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΡΠ»ΡΠ³. ΠΠ° ΠΎΡΠ½ΠΎΠ²Π΅ ΠΏΡΠ΅Π΄Π»ΠΎΠΆΠ΅Π½Π½ΡΡ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΎ Π²Π»ΠΈΡΠ½ΠΈΠ΅ ΡΡΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΡΡΠ°ΡΠ»ΠΈ Π½Π° ΠΠΠ ΠΈ ΠΏΠ»Π°ΡΠ΅ΠΆΠ½ΡΠΉ Π±Π°Π»Π°Π½Ρ Π£ΠΊΡΠ°ΠΈΠ½Ρ, ΠΏΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π° Π΄ΠΎΡ
ΠΎΠ΄Π½ΠΎΡΡΡ ΡΡΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΈΠ±ΡΡΠΈΠΉ. Π Π°ΡΠΊΡΡΡΡ ΠΎΡΠ½ΠΎΠ²Π½ΡΠ΅ ΠΏΡΠΎΠ±Π»Π΅ΠΌΡ Π½Π°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΡΠ½ΠΊΠ° ΡΡΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΡΠ»ΡΠ³ ΠΈ ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΡΠ΅ ΡΡΡΠ°Π³ΠΈ Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΡΠ΅Π³ΡΠ»ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΡΡΠΈΠ·ΠΌΠ° Π² Π£ΠΊΡΠ°ΠΈΠ½Π΅
Accounting and analytical base for management of logistic flows in tourism business
The paper grounds that the existing potential of the tourism industry of Ukraine can be realized through the introduction of efficient logistic approaches for the development of tourism and recreation and management of tourist enterprises. Based on modern knowledge of the theory and practice of tourism management, a logistic strategy in tourism business serves for the creation of tourism product which is highly competitive in the global market due to implementation efficient management decision upon each component of the logistics system of the company. The paper reveals the essence and major functions of accounting and analytical subsystem of logistic management of tourism companies that enables to shorten the duration of the operating cycle, improve the quality and expand the range of travel services, and increase the flexibility of the travel service. The paper concludes that efficient accounting and analytical subsystem of logistic management gives travel companies wide opportunities to gain competitive advantages on global travel market
3R philosophy for sustaining recreational attractiveness and development of hotel business in Ukraine
The paper highlights the problem of waste accumulation and ways of its solution. It was established that landfills occupy 7% of the total territory of Ukraine and their area is larger than the area of natural reserve funds. Based on the dynamics of garbage accumulation the paper forecasts increase solid household waste in geometric progression. The article shares experience in field of utilization and waste management and grounds the necessity of separating rubbish into fractions and processing each component that is sold separately on the market. It is proposed to use a systematic approach to waste management in hotel business. The paper justifies the conclusion that only the proliferation of 3R philosophy β Reuse-Reduce-Recycle β in behaviour of tourists and the local population in everyday life will preserve the recreational attractiveness of Ukraine and provide the basis for the development of hotel business