ULTRASOUND AND COMPUTED TOMOGRAPHY DIAGNOSIS OF DIFFUSE LIVER PATHOLOGY
Aim of research - optimization of diagnosis of chronic diffuse liver diseases CDLD by development of diagnosis-prognostic algorithm using USI and CT parameters. Materials and methods. In total 3374 patients with FLD, CH, LC were examined in three retro- and prospective randomized one-time («cross-section») controlled cohort phases: on 1 st - 103 cases for USI, CT and autopsy date accordance check, on 2 nd - 203 patients in hospital conditions with profound instrumental-laboratory investigation, algorithmic USI and CT application, on 3 rd - 3068 persons, examined only with USI and CT for validization of developed diagnosis-prognostic algorithm for pathologic process severity evaluation and course prediction. Controls - 2, 50 and 100 persons accordingly by phases. For USI and CT Xario SSA 660А and Aquilion 16 (Toshiba Medical Systems, Japan) were used. Non-parametric statistic analysis, Wald sequential analysis in modification for medical application, parameters of diagnosis USI and CT value were estimated. Results. Specificity and positive expected value of USI vary from 14,3 % to 96,8 %, results for CT do not significantly differ from them, while USI is more safe, economically and organizationally accessible, and Doppler mode additionally lets the evaluation of liver’s functional condition. Diagnosis-prognostic algorithm containing 3 demographic-antropometric, 15 radiation, laboratory and derived parameters was passed validization successfully on 3 rd phase with above 90 % of sensitivity, specificity, expected value. Conclusions. The clinical significance of radiation methods of investigation in quantitative evaluation of liver morphofucntional state in patients with CDLD was estimated; diagnosis-prognostic algorithm for patients with this pathology was developed, validated and recommended for practical application. Further perspectives are related to detailed CDLD stratification by intensity of steatosis (in FLD), activity (in CH), fibrosis (in CH and LC).