Диагностическая эффективность контраст-усиленного ультразвукового исследования у пациентов с хроническими вирусными гепатитами

Abstract

Aim: to determine the diagnostic efficiency of contrast-enhanced ultrasound of the liver in patients with chronic viral hepatitis B and C. Study Design: open randomized study. Materials and methods. 240 people were examined on the basis of the Smolensk Clinical Hospital No. 1 from 2019 to 2021: patients with chronic viral hepatitis who have been examined by contrast-enhanced ultrasound; patients with chronic viral hepatitis who have not been examined by contrast-enhanced ultrasound to determine the diagnostic effectiveness of the method in assessing the complicated course development, patients without chronic viral hepatitis who have been examined by contrast-enhanced ultrasound to determine the standardized CEUS parameters. Liver biopsy and shear wave elastography were used as reference methods. Results. It was found that the greatest changes in contrast-enhanced ultrasound parameters were observed in patients with F4 fibrosis stage according to the METAVIR score. It was also found that the assessment of qualitative parameters according to the proposed standardized program has the highest diagnostic potential, and among the quantitative parameters — the difference of quantitative parameters in the proximal and distal zones (time of arrival, time to peak, peak intensity, half-time washout). Conclusion. The use of a contrast agent increases the value of the ultrasound method in the diagnostic algorithm for patients with chronic viral hepatitis. Keywords: contrast-enhanced ultrasound, chronic viral hepatitis, contrast agent, arterial phase, portal venous phase, late venous phase, qualitative parameters, quantitative parameters.