INFORMATIVENESS OF TRANSIENT AND TWO-DIMENSIONAL SHEAR WAVE ELASTOGRAPHY IN ASSESSING OF LIVER STIFFNESS IN POST-COVID-19 AND CARDIOHEPATIC SYNDROMES

Abstract

Ultrasound elastography of diffuse liver diseases allows to assess liver stiffness and predict the further course of the disease, determine the tactics of patient’s management for post-Covid and cardiohepatic syndrome. The purpose of the research – to study the diagnostic informativeness and evaluate the correlation between one-dimensional and two-dimensional shear wave elastography technologies with elastometry in assessing liver stiffness in patients with post-COVID and cardiohepatic syndromes. Materials and methods. A comparative analysis of the information content and correlation between the results of one-dimensional and two-dimensional shear wave elastography of the liver was carried out in 85 patients with post-COVID (N1; n = 30) and cardiohepatic (N2; n = 25) syndromes. The control group (N3; n = 30) consisted of patients without the new coronavirus infection COVID-19 and without any pathology of the liver and biliary system. In the control group, the study of liver parenchyma stiffness using shear wave elastography was carried out by lobes and segments. Standard variation statistics algorithms were used, taking into account the type of data distribution in the statistical analysis. Quantitative indicators with a normal distribution were described using arithmetic means (M) and standard deviations (SD), boundaries of the 95% confidence interval (95% CI). In the absence of a normal distribution, quantitative data were described using the median (Me) and lower and upper quartiles (Q1–Q3). Research results. The stiffness values (Emean) in the projection of segments VI, VII had larger values (p = 0.02) when compared with other segments. We obtained the following Emean values in transient elastography: in the group of patients with post-COVID syndrome (N1) – 10.02 kPa; in the group of patients with chronic heart failure (N2) – 14.09 kPa, which turned out to be significantly higher than the stiffness of the liver parenchyma among healthy individuals, where the Emean value was 4.90 kPa (p = 0.05). With shear wave elastography, the results were also higher in the group of patients with chronic heart failure (N2), where Emean was 20.90 kPa, compared to the group of patients with post-COVID syndrome (N1) – 11.86 kPa. Conclusions. The results of shear wave elastography were successful in 100% of cases, the results of transient elastography in 84.6% of cases. Correlation analysis of connections in a group of patients with chronic heart failure according to TE and SWE showed a weak positive direct linear correlation. A positive direct linear correlation of medium strength was obtained in assessing the correlation in the group of patients with post-COVID syndrome.