КЛИНИЧЕСКАЯ ИНТЕРПРЕТАЦИЯ РЕЗУЛЬТАТОВ ФИБРО-, СТЕАТОСКАНИРОВАНИЯ ПЕЧЕНИ ПРИ ХРОНИЧЕСКОМ ГЕПАТИТЕ С

Abstract

Background. Imaging of morphological hepatic alteration by fibroscanning is a promising method for diagnosing chronic stages of diffuse liver lesions. Objective – to present the results of fibro-, steatoscanning in patients with chronic hepatitis C (CHC). Materials and methods. Pilot (short-term) fibro-, steatoscanning of the liver was performed in 155 patients with CHC on the basis of “Grodno Regional Infectious Clinical Hospital” over the period of June-July 2018. The project was implemented with the support of “DELRUSEUROPEKff.” (France), that provided the equipment to perform the study within the time frame specified. The fibroscan “Ehosensens VCTEFibroscan 502” (France) was used for imaging. The parameters of liver stiffness (fibrosis) - E (kPa) and steatosis (CAP, dB / m) were studied. The probes were used for processing the data (XL, M, MyFibroScan application) as well as various proprietary methods of processing the findings of fibroscanning (P. Nahon et al.; F. Degos et al.; L. Castera et al., C.S. Pavlov et al., N. Afdahl et al.) and steatoscanning (M. Sasso et al.; T. Karlas et al.). Results. Fibrosis and steatosis of the liver are characteristic attributes of CHC reliably established by the method of fibro-, steatoscanning. The methods of processing the data have different diagnostic value, differ in the frequency of diagnosis of fibrosis stages and steatosis degree. According to various methods of processing the data of fibroscanning, the stage F0-1 is diagnosed in not less than 50% of patients, F2 is established in 15 - 30%, F3 – in 5 - 7%, F4 (cirrhosis) – in 8 - 15%. According to the methods by M. Sasso et al. and T. Karlas et al. steatosis of the liver is not detected (S0) in 37% and 62% of patients, respectively; the first degree of steatosis (S1) was diagnosed in 12-13%, the second (S2) in 34 and 8% (respectively), the third degree (S3) – in 16-20%. The method for assessing steatosis according to M. Sasso et al. is preferable, since it fixes steatosis of all degrees (from S0 to S3) as well as a decrease in the frequency of steatosis as liver fibrosis progresses from F0 to F4. The method by P. Nahon et al. is the most informative one in assessing fibrosis and the most relevant to clinical, laboratory and morphological indicators of fibrosis in patients with CHC. Conclusion. The introduction of the method of fibro-, steatoscanning into the programs of prophylactic medical examination of the population and patients with CHC will increase life expectancy due to early diagnosis of pre-cirrhotic stages of diffuse liver diseases of any etiology.