CLINICAL AND DIAGNOSTIC EFFICACY OF MULTIPARAMETRIC ELASTOGRAPHY IN DIFFUSE LIVER DISEASES
Abstract
Background. The use of elastography methods is the current stage of the algorithm of patients’ examination in modern hepatology.
Objective. Analysis of the up-to-date opportunities of a multiparametric elastography approach in the diagnosis of diffuse liver diseases.
Materials and methods. A survey of 235 patients (aged 21 to 62 years old) suffering from various clinical forms of diffuse liver diseases was performed. Among them, there were 128 (54.5%) men and 107 (45.5%) women. The patients were randomized into 3 groups. The first group included 64 (27.2%) patients with steatogepatitis, the second – 97 (41.3%) patients with hepatitis, the third - 74 (31.5%) subjects with Child-Pugh class B cirrhosis. Using multiparametric elastography was obligatory in the algorithm of patients’ examination. Results. In the first phase of examination of the patients the sensitivity and specificity of the liver biopsy and multiparametric elastography had high informative value (AUROC 0.992, CI 0.893 – 0.998 and AUROC 0.889, CI 0.632 – 0.995, respectively). During the dynamic observation of patients who followed the doctor’s recommendations the sensitivity and specificity of multiparametric elastography were highly informative (AUROC 0.991, СI 0.779 - 0,997), as was the liver biopsy ( AUROC 0.882, CI 0.741 – 0. 996). During the dynamic observation of patients with negative clinical laboratory and instrumental dynamics we received the following values: for biopsy – AUROC 0.999, СI 0.996 – 1.000, for multiparametric elastography – AUROC 0.881, СI 0.632-0.901.
Conclusion. The results of using multiparametric elastography allows us to consider it as a universal screening method of diagnosis of the liver fibrosis process both at entry and during the dynamic monitoring of patients.
References
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