METHOD FOR PREDICTION OF CLINICAL COURSE OF DIFFUSE LIVER DISEASES

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to ultrasonic diagnostics, and can be used for prediction of clinical course of diffuse liver diseases. Contrast-enhanced ultrasound investigation (CEUSI) of the liver is performed to assess quantitative parameters of contrasting. Phases of contrasting are assessed by zones 5 and 6 with subsequent analysis of the beginning of the arterial phase, the maximum intensity of accumulation of the contrast preparation and time of 50 % excretion of the contrast preparation with calculation of the differences in zones 5 and 6. At that, zones 5 and 6 define the operator himself so that zone 5 is a hepatic tissue segment located between the middle and right hepatic veins, and zone 6 is three sections of hepatic tissue located at equal distance from each other along periphery of right lobe of liver. Zone 5 is located in proximal direction to the liver gates, and zone 6 is distal to the liver gates. Zones 5 and 6 include: homogeneous hepatic tissue, vessels, bile ducts, wherein the liver capsule is not included. After the contrast agent is administered, continuous ultrasound monitoring and video recording of contrast enhancement are performed. At the end of the examination, the catheter through which the contrast preparation was introduced is removed and the analyzed ultrasonic image is analyzed for all phases of contrasting. Zones 5 and 6 are selected on video loops. Then, for zones 5 and 6, time of beginning of arterial phase, maximum intensity of accumulation of contrast agent, time of 50 % excretion of contrast agent are determined. For zone 6 values of each parameter are summed and divided by 3 with calculation of average values. Difference between the indicators of zones 5 and 6 is determined. If arterial phase onset in zone 6 is increased by 15 % and more as compared to zone 5, as well as 15 % decrease or more of the maximum intensity of contrasting in zone 6 compared to zone 5 and the time increase of 50 % of the contrast increase by 20 % and more in zone 6 compared to zone 5, the unfavorable clinical course of the diffuse liver diseases is predicted. If the difference is less than 15 % of the beginning of the arterial phase and the maximum intensity of contrasting, as well as less than 20 % of the time difference of 50 % of the contrast preparation, the prognosis is considered favorable.;EFFECT: method provides eliminating invasiveness, reducing time for evaluating the progression of diffuse hepatic diseases, as well as the possibility of dynamic observation of the clinical course of the disease by using CEUSI.;1 cl, 2 dwg, 1 ex