Abstract
In the strategy of managing patients with chronic diffuse liver diseases, the priority areas are the determination of the diagnosis with the determination of the main risk factors, the activity of the process (steatosis, steatohepatitis), as well as the degree of fibrous transformation. The rate of progression of liver fibrosis is a decisive factor that will determine the prognosis, treatment tactics and the likelihood of severe complications. The “gold standard” for diagnosing chronic liver pathology is a puncture liver biopsy with morphological examination of the liver tissue. At the same time, potential complications, contraindications to the procedure, low patient compliance, as well as errors in the interpretation of the results obtained due to various reasons are significant limitations of this diagnostic method. These shortcomings were the reason for the search for reliable non-invasive methods for diagnosing liver fibrosis both during the initial examination and during subsequent monitoring in dynamics. Modern methods of liver elastography are widely used for non-invasive assessment of fibrosis, demonstrating good diagnostic capabilities and significantly reducing the need for liver biopsy. Various elastography methods, which have their own advantages and disadvantages, effectively complement each other, which is successfully used in clinical practice in the diagnosis of fibrous transformation. The combined use of elastographic methods and commercial predictive diagnostic panels will increase the diagnostic accuracy in the determination of liver fibrosis.
Highlights
Первые три метода ЭГ основаны на принципе формирования сдвиговой волны и оценки ее скорости, в отличии от четвертого, который выдает качественную информацию и характеризует жесткость одного участка ткани по сравнению с другим [23]
Эластограммы при магнитно-резонансной эластографии при различных степенях фиброза печени
Summary
In the strategy of managing patients with chronic diffuse liver diseases, the priority areas are the determination of the diagnosis with the determination of the main risk factors, the activity of the process (steatosis, steatohepatitis), as well as the degree of fibrous transformation. Potential complications, contraindications to the procedure, low patient compliance, as well as errors in the interpretation of the results obtained due to various reasons are significant limitations of this diagnostic method. These shortcomings were the reason for the search for reliable non-invasive methods for diagnosing liver fibrosis both during the initial examination and during subsequent monitoring in dynamics. Хронические диффузные заболевания печени (ХДЗП) являются чрезвычайно важной проблемой современной медицины [1]. В клинической тактике ведения пациентов, страдающих хроническими диффузными заболеваниями печени, приоритетными направлениями являются установление диагноза с определением основных факторов риска, активности процесса (стеатоз, стеатогепатит), а также степени фиброзной трансформации печени [4]. Не выраженность воспаления, а именно скорость прогрессирования ФП представляется тем решающим фактором, который будет определять прогноз, тактику лечения и вероятность развития тяжелых осложнений [5, 6, 7, 8, 9]
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