Abstract
Development of chronic diffuse liver diseases occurs through the progression of fibrosis stages with the final formation of cirrhosis and liver cancer. The "gold standard" for detecting the fibrosis process is a liver biopsy followed by a histological examination of the received material, but it has its drawbacks and contraindications. Recently elastometry is becoming increasingly widespread as it reflects the rigidity of the liver, which is increasing in fibrosis. However, at the moment there is no standard protocol for performing ARFI-elastometry of the liver, which should take into account the choice of topography, the depth of installation of the polling zone, the number of measurements of the shear wave. Objectives of the study: standardization of the procedure for performing ARFI-elastometry of the liver for further evaluation of the fibrosis stages; detection of the most sensitive echographic changes in the liver at various stages of fibrosis. Based on healthy volunteers examinations, a standardized protocol for patients with diffuse liver changes was developed. While using shear wave elastography, it was noted that detected number of echographic symptoms corresponds to the elastometry stage of fibrosis not in all cases. During the study, it was determined that in the F1 and F2 stages of fibrosis, 1 to 4 echographic symptoms occurred in patients; in F3 and F4 fibrosis stages — from 3 to 11 echographic symptoms accordingly. It is noted that with an increase in the fibrosis stage, the number of echographic symptoms is basically increases, too. A special group of patients without obvious echographic symp- toms, but with verified F2-F4 fibrosis stages was selected using elastometry. In this group, echographic symptoms were not detected in 42% of cases with verified F2-F4 fibrosis. In 10% of cases with F3 and F4 fibrosis stages there were only 1–2 echographic symptoms. Thus, the detection of at least a single echographic symptom in the patient should be the warning sign of possible presence of fibrosis or cirrhosis.
Highlights
Развитие хронических диффузных заболеваний печени происходит через прогрессирование стадий фиброза с формированием в конечном итоге цирроза и рака печени
Development of chronic diffuse liver diseases occurs through the progression of fibrosis stages with the final formation of cirrhosis and liver cancer
Elastometry is becoming increasingly widespread as it reflects the rigidity of the liver, which is increasing in fibrosis
Summary
Развитие хронических диффузных заболеваний печени происходит через прогрессирование стадий фиброза с формированием в конечном итоге цирроза и рака печени. Однако в настоящий момент не существует стандартного протокола для выполнения ARFI-эластометрии печени с учетом выбора топографии, глубины установки зоны опроса, количества измерений сдвиговой волны. Цели исследования: стандартизация методики проведения ARFI-эластометрии печени для дальнейшей оценки стадий фиброза; выявление наиболее чувствительных эхографических изменений печени при различных стадиях фиброза. При использовании эластографии сдвиговой волны отмечено, что не во всех случаях выявляемое количество эхографических симптомов соответствует стадии фиброза по эластометрии.
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