Basis of using ultrasound elastography in diffuse and focal liver diseases

Objective: to develop the basics of ultrasound elastography for diffuse and focal liver diseases.

Material and methods. 180 patients were examined, including 102 (56.7%) men and 78 (43.3%) women. Patients were hospitalized in the gastroenterological and surgical departments: 100 (55.6%) patients with diffuse liver disease (DLD), 80 (44.4%) with focal liver pathology (FLP). All elastographic techniques were used; The liver biopsy served as the reference method (n = 169 (93.8%)).

Results. If a patient has steatohepatitis, it is recommended to begin research with transient elastography (TE), in hepatitis – with compression elastography (CE), according to the study, it is determined that shear wave elastography (SWE) is informative in all clinical forms of DLD. The terms of elastographic monitoring have been developed: upon admission, after 6, 9, 12 months. With dynamic observation of patients, elastographic techniques have a high diagnostic and prognostic value with stable and positive clinical laboratory and instrumental dynamics (liver biopsy – AUROC 0,882, DI 0.741–0.699, elastography – AUROC 0,991, DI 0.779–0.997). At FLP the results of SWE help in determining the “zone of interest” for the subsequent conduct of a morphological study, with the aim of establishing a diagnosis.

Conclusions. 1. In the presence of a patient with steatohepatitis, it is recommended to begin research with TE, in hepatitis with CE, according to the results of the study, it is determined that SWE is informative in all clinical forms of DLD. 2. Dynamic elastographic monitoring in case of DLD should be performed at admission, after 6, 9 and 12 months, and then individually for each patient. 3. With dynamic observation of patients with DLD, elastographic techniques have a high diagnostic and prognostic value with stable and positive clinical laboratory and instrumental dynamics (liver biopsy – AUROC 0.882, DI 0.741–0.66, elastography – AUROC 0.991, DI 0.779–0.997). 4. It has been established that the results of all elastographic techniques can not be used as differential diagnostic tools, SWE helps in choosing a “zone of interest” for biopsy with subsequent verification of the diagnosis (AUROC 0.907 (95% DI 0.889–0.933)).

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