ДИАГНОСТИЧЕСКИЕ ВОЗМОЖНОСТИ ЭЛАСТОГРАФИИ ПЕЧЕНИ
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Введение: Обзор посвящен аспектам неинвазивной инструментальной диагностики диффузной патологии печени на стадии фиброза и цирроза, которые характеризуются склонностью к прогрессированию и быстрым развитием осложнений. Приведены современные данные результатов исследований, посвященных изучению наиболее популярных методов эластографии. Цель: Анализ литературных данных о современных способах диагностики фиброза и цирроза печени. Материалы и методы: проведен поиск публикаций c применением ключевых слов в базе данных PubMed Medline и в научной поисковой системе Google Scholar. Результаты: Существуют различные мнения авторов о преимуществах и недостатках транзиентной эластографии (ТЕ) и акустической импульсно-волновой эластографии (ARFI) в диагностике фиброза и цирроза печени. Однако объем исследований и клинико-диагностических аспектов в области ТЕ в значительной мере превышает число таковых для ARFI. Выводы: Вопросы определения эффективных неинвазивных инструментальных методов обследования пациентов с хронической патологией печени остаются актуальными.
Л. Касым1, З.К. Жумадилова1, Н.Р. Баркибаева1, А. Дажани2 1 Кафедра внутренних болезней, Государственный медицинский университет города Семей, Казахстан; 2 Гастроэнтерологическое отделение, ADSC Центр, Шарджа, Объединенные Арабские Эмираты.
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G., Laffi G., Bosch J., Marra F., Pinzani M. Reliability of transient elastography for the diagnosis of advanced fibrosis in chronic hepatitis C. Gut. 2008. Vol. 57, №9. P. 1288-1293. 5. Bamber J., Cosgrove D., Dietrich C. F., Fromageau J., Bojunga J., Calliada F., Cantisani V., Correas J. M., D'Onofrio M., Drakonaki E. E. et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: Basic principles and technology. Ultraschall Med. 2013. Vol. 34, № 2. P. 169-184. 6. Bedossa P P. T. Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. Hepatology. 1994. Vol. 20, № 1.P. 15-20. 7. Berzigotti A., Castera L. Update on ultrasound imaging of liver fibrosis. J Hepatol. 2013. Vol. 59, № 1. P. 180-182. 8. Berzigotti A., Seijo S., Reverter E., Bosch J. Assessing portal hypertension in liver diseases. Expert Rev Gastroenterol Hepatol. 2013. Vol. 7, № 2. P. 141-155. 9. Bosch J., Abraldes J. G., Berzigotti A., García-Pagan J. C. The clinical use of HVPG measurements in chronic liver disease. Nat Rev Gastroenterol Hepatol. Vol. 6, № 10. P. 573-582. 10. Bravo A. A., Sheth S. G., Chopra S. Liver biopsy. N Engl J Med. 2001. Vol. 344, № 7. P. 495-500. 11. Castéra L., Foucher J., Bernard P. H., Carvalho F., Allaix D., Merrouche W., Couzigou P., de Lédinghen V. Pitfalls of liver stiffness measurement: a 5-year prospective study of 13,369 examinations. Hepatology. 2010. Vol. 51, № 3. P. 828-35. 12. Castéra L., Vergniol J., Foucher J., Le Bail B., Chanteloup E., Haaser M., Darriet M., Couzigou P., De Lédinghen V. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology. Vol. 128, № 2. P. 343-350. 13. Chan H. L., Wong G. L., Choi P. C., Chan A. W., Chim A. M., Yiu K. K., Chan F. K., Sung J. J., Wong V. W. Alanine aminotransferase-based algorithms of liver stiffness measurement by transient elastography (Fibroscan) for liver fibrosis in chronic hepatitis B. J Viral Hepat. 2009. Vol. 16, № 1. P. 36-44. 14. Chan W. K., Nik Mustapha N. R., Mahadeva S. Controlled attenuation parameter for the detection and quantification of hepatic steatosis in nonalcoholic fatty liver disease. J Gastroenterol Hepatol. 2014. Vol. 29, № 7. P. 1470-1476. 15. Colombo S, Belloli L, Buonocore M, Jamoletti C, Zaccanelli E, Del Poggio P. True normal liver stiffness measurement (LSM) and its determinants. Hepatology. 2009, 50 Suppl, A741. 16. Corpechot C., El Naggar A., Poupon R. Gender and liver: is the liver stiffness weaker in weaker sex? Hepatology. 2006. Vol. 44, № 2. P. 513-514. 17. D'Onofrio M., Gallotti A., Mucelli R. P. Tissue quantification with acoustic radiation force impulse imaging: Measurement repeatability and normal values in the healthy liver. AJR Am J Roentgenol. 2010. Vol. 195, № 1. P. 132-136. 18. de Lédinghen V., Vergniol J., Capdepont M., Chermak F., Hiriart J. B., Cassinotto C., Merrouche W., Foucher J., Brigitte l. B. Controlled attenuation parameter (CAP) for the diagnosis of steatosis: a prospective study of 5323 examinations. J Hepatol. 2014. Vol. 60, № 5. P. 1026-1031. 19. de Lédinghen V., Wong V. W., Vergniol J., Wong G. L., Foucher J., Chu S. H., Le Bail B., Choi P. C., Chermak F., Yiu K. K., Merrouche W., Chan H. L. Diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement: comparison between M and XL probe of FibroScan®. J Hepatol. 2012. Vol. 56, № 4. P. 833-839. 20. Fierbinteanu Braticevici C., Sporea I., Panaitescu E., Tribus L. Value of acoustic radiation force impulse imaging elastography for non-invasive evaluation of patients with nonalcoholic fatty liver disease. Ultrasound Med Biol. 2013. Vol. 39, № 11. P. 1942-1950. 21. Friedrich-Rust M., Wunder K., Kriener S., Sotoudeh F., Richter S., Bojunga J., Herrmann E., Poynard T., Dietrich C. F., Vermehren J., Zeuzem S., Sarrazin C. Liver fibrosis in viral hepatitis: noninvasive assessment with acoustic radiation force impulse imaging versus transient elastography. Radiology. 2009. Vol. 252, № 2. P. 595-604. 22. Frulio N., Trillaud H. Ultrasound elastography in liver. Diagn Interv Imaging. 2013. Vol. 94, № 5. P. 515-534. 23. Fung J., Lai C. L., Chan S. C., But D., Seto W. K., Cheng C., Wong D. K., Lo C. M., Fan S. T., Yuen M. F. Correlation of liver stiffness and histological features in healthy persons and in patients with occult hepatitis B, chronic active hepatitis B, or hepatitis B cirrhosis. Am J Gastroenterol. 2010. Vol. 105, № 5. P. 1116-1122. 24. Guzmán-Aroca F., Frutos-Bernal M. D., Bas A., Luján-Mompeán J. A., Reus M., Berná-Serna J. e. D., Parrilla P. Detection of non-alcoholic steatohepatitis in patients with morbid obesity before bariatric surgery: preliminary evaluation with acoustic radiation force impulse imaging. Eur Radiol. 2012. Vol. 22, № 11. P. 2525-2532. 25. Kim S. U., Kim d. Y., Ahn S. H., Kim H. M., Lee J. M., Chon C. Y., Park Y. N., Han K. H., Park J. Y. The impact of steatosis on liver stiffness measurement in patients with chronic hepatitis B. Hepatogastroenterology. 2010. Vol. 57, № 101. P. 832-838. 26. Kuroda H., Kakisaka K., Kamiyama N., Oikawa T., Onodera M., Sawara K., Oikawa K., Endo R., Takikawa Y., Suzuki K. Non-invasive determination of hepatic steatosis by acoustic structure quantification from ultrasound echo amplitude. World J Gastroenterol. 2012. Vol. 18, № 29. C. 3889-3895. 27. Kuroda H., Kakisaka K., Tatemichi Y., Sawara K., Miyamoto Y., Oikawa K., Miyasaka A., Takikawa Y., Masuda T., Suzuki K. Non-invasive evaluation of liver fibrosis using acoustic radiation force impulse imaging in chronic hepatitis patients with hepatitis C virus infection. Hepatogastroenterology. 2010. Vol. 57, № 102. P. 1203-1207. 28. Marcellin P., Ziol M., Bedossa P., Douvin C., Poupon R., de Lédinghen V., Beaugrand M. Non-invasive assessment of liver fibrosis by stiffness measurement in patients with chronic hepatitis B. Liver Int. 2009. Vol. 29, № 2. P. 242-247. 29. Myers R. P., Pomier-Layrargues G., Kirsch R., Pollett A., Duarte-Rojo A., Wong D., Beaton M., Levstik M., Crotty P., Elkashab M. Feasibility and diagnostic performance of the FibroScan XL probe for liver stiffness measurement in overweight and obese patients. Hepatology. 2012. Vol. 55, № 1. P. 199-208. 30. Nitta Y., Kawabe N., Hashimoto S., Harata M., Komura N., Kobayashi K., Arima Y., Shimazaki H., Nakano T., Murao M., Ichino N., Osakabe K., Aoki H., Hosoe Y., Sugiyama H., Nishikawa T., Yoshioka K. Liver stiffness measured by transient elastography correlates with fibrosis area in liver biopsy in patients with chronic hepatitis C. Hepatol Res. 2009. Vol. 39, № 7. P. 675-684. 31. Petta S., Di Marco V., Cammà C., Butera G., Cabibi D., Craxì A. Reliability of liver stiffness measurement in non-alcoholic fatty liver disease: the effects of body mass index. Aliment Pharmacol Ther. 2011. Vol. 33, № 12. P. 1350-1360. 32. Regev A., Berho M., Jeffers L. J., Milikowski C., Molina E. G., Pyrsopoulos N. T., Feng Z. Z., Reddy K. R., Schiff E. R. Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection. Am J Gastroenterol. 2002. Vol. 97, № 10. P. 2614-2618. 33. Robic M. A., Procopet B., Métivier S., Péron J. M., Selves J., Vinel J. P., Bureau C. Liver stiffness accurately predicts portal hypertension related complications in patients with chronic liver disease: a prospective study. J Hepatol. Vol. 55, № 5. P. 1017-24. 34. Roulot D., Czernichow S., Le Clésiau H., Costes J. L., Vergnaud A. C., Beaugrand M. Liver stiffness values in apparently healthy subjects: influence of gender and metabolic syndrome. J Hepatol. 2008. Vol. 48, № 4. P. 606-613. 35. Sirli R., Sporea I., Tudora A., Deleanu A., Popescu A. Transient elastographic evaluation of subjects without known hepatic pathology: does age change the liver stiffness? J Gastrointestin Liver Dis. 2009. Vol. 18, № 1. P. 57-60. 36. Sporea I., Sirli R., Bota S., Popescu A., Sendroiu M., Jurchis A. Comparative study concerning the value of acoustic radiation force impulse elastography (ARFI) in comparison with transient elastography (TE) for the assessment of liver fibrosis in patients with chronic hepatitis B and C. Ultrasound Med Biol. 2012. Vol. 38, № 8. P. 1310-1316. 37. Sporea I., Sirli R., Deleanu A., Tudora A., Popescu A., Curescu M., Bota S. Liver stiffness measurements in patients with HBV vs HCV chronic hepatitis: a comparative study. World J Gastroenterol. 2010. Vol. 16, № 38. P. 4832-4837. 38. Yoneda M., Suzuki K., Kato S., Fujita K., Nozaki Y., Hosono K., Saito S., Nakajima A. Nonalcoholic fatty liver disease: US-based acoustic radiation force impulse elastography. Radiology. 2010. Vol. 256, № 2. P. 640-647. 39. Ziol M., Handra-Luca A., Kettaneh A., Christidis C., Mal F., Kazemi F., de Lédinghen V., Marcellin P., Dhumeaux D., Trinchet J. C., Beaugrand M. Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis C. Hepatology. 2005. Vol. 41, № 1. P. 48-54.
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Kassym L., Zhumadilova Z. K., Barkibayeva N. R., Dajani A. Diagnostic possibilities of liver elastography. Nauka i Zdravoohranenie [Science & Healthcare]. 2015, 6, pp. 18-27.

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