Diagnostic Efficacy of Contrast-Enhanced Ultrasound in Patients with Chronic Viral Hepatitis

A. V. Tikhankova, A. Borsukov
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Abstract

Aim: to determine the diagnostic efficiency of contrast-enhanced ultrasound of the liver in patients with chronic viral hepatitis B and C. Study Design: open randomized study. Materials and methods. 240 people were examined on the basis of the Smolensk Clinical Hospital No. 1 from 2019 to 2021: patients with chronic viral hepatitis who have been examined by contrast-enhanced ultrasound; patients with chronic viral hepatitis who have not been examined by contrast-enhanced ultrasound to determine the diagnostic effectiveness of the method in assessing the complicated course development, patients without chronic viral hepatitis who have been examined by contrast-enhanced ultrasound to determine the standardized CEUS parameters. Liver biopsy and shear wave elastography were used as reference methods. Results. It was found that the greatest changes in contrast-enhanced ultrasound parameters were observed in patients with F4 fibrosis stage according to the METAVIR score. It was also found that the assessment of qualitative parameters according to the proposed standardized program has the highest diagnostic potential, and among the quantitative parameters — the difference of quantitative parameters in the proximal and distal zones (time of arrival, time to peak, peak intensity, half-time washout). Conclusion. The use of a contrast agent increases the value of the ultrasound method in the diagnostic algorithm for patients with chronic viral hepatitis. Keywords: contrast-enhanced ultrasound, chronic viral hepatitis, contrast agent, arterial phase, portal venous phase, late venous phase, qualitative parameters, quantitative parameters.
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超声造影对慢性病毒性肝炎的诊断价值
目的:探讨肝脏超声造影对慢性乙型肝炎和丙型肝炎的诊断价值。研究设计:开放随机研究。材料和方法。2019年至2021年,在斯摩棱斯克第一临床医院的基础上对240人进行了检查:通过对比增强超声检查的慢性病毒性肝炎患者;未行超声造影检查确定该方法在评估病程发展中的诊断有效性的慢性病毒性肝炎患者,未行超声造影检查确定标准化超声造影参数的慢性病毒性肝炎患者。肝活检和横波弹性成像作为参考方法。结果。根据METAVIR评分发现,F4期纤维化患者超声造影参数变化最大。研究还发现,根据所提出的标准化程序评估定性参数具有最高的诊断潜力,在定量参数中-近端和远端区域定量参数的差异(到达时间,峰值时间,峰值强度,半衰期冲刷)。结论。造影剂的使用增加了超声方法在慢性病毒性肝炎患者诊断算法中的价值。关键词:超声造影,慢性病毒性肝炎,造影剂,动脉期,门静脉期,静脉晚期,定性参数,定量参数。
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