THE USE OF COMPLEX ELASTOGRAPHY AT DIFFUSE LIVER DISEASES JUSTIFICATION

Background: To justify the use of complex elastography in patients with diffuse liver diseases. Tasks. 1. To determine the role of complex elastographic study for patients with diffuse liver diseases (DLD). 2. To assess the possibility of complex elastographic study in dynamic patients observation. 3. To identify the possibilities of complex elastography in the individual tactics of patients with DLD treatment. Material and methods. 227 patients in the age from 21 till 62 years old with different clinical forms of diffuse liver diseases were surveyed: 123 (54,2%) men, 104 (45,8%) women. Patients are randomized at 3 groups: I – 61 (26,8%) with steatohepatitis, II – 94 (41,5%) with hepatitis, III – 72 (31,7%) with liver cirrhosis. All patients underwent transient elastography, compression liver elastography, shear-wave elastography, compression elastography at endosonography. The aim of all these surveys was the opportunity of its complex realization at first with following interchangeability of methods. Results: patients were followed up for 4 years. Transient elastography is informative for 227 patients up to 9 months of follow-on with the background of weight gain in 17 (8,7%) cases, and the appearance of ascites in 15 (7,6%) cases, the type of elastographic research was selected individually. Compression elastography is informative for 179 (78,9%) patients. Limitation in 19 (10,6%) – increase in body weight; in 6 (3.4%) – narrow intercostal spaces, 5 (2,7%) – ascites, 19 (10,6%) – heart rhythm disturbance. liver shear-wave elastography is informative to 227 (100%) patients. The patients with non-informative transient and compression elastography next months were made shear-wave elastography as a control. Compression elastography at endosonography was made 72 (31,7%) patients. Next elastographic monitoring was not necessary. Conclusion: inclusion of complex elastographic survey in patients with diffuse liver diseases allows to specify the presence of fibrotic process in the parenchyma, monitor effectively, and use the interchangeability of elastographic methods