Journal de santé et d'informatique médicale

Multi parameter approach at the diagnosis of the stage and severity of chronic hepatitis

Abstract

N.M. Mamajanova

Study relevance :

The chronic hepatitis, especially with viral etiology are considered to be valuable problem of the public healthcare due to the wide spread, long lasting course and adverse complications. The main aim of this study was determining the multi parameter ultrasound approach at the validation of stage activity of the disease in patients who has a verifies diagnosis of chronic hepatitis.

Materials and methods. There were three groups formed from 172 people for the investigation. The first group consisted of 80 patients with verifies diagnosis of chronic hepatitis, who have no any clinical laboratory data for the signs of liver cirrhosis. The second group consisted of 72 patients with different somatic pathologies without chronic hepatitis. The third group consisted of 20 professional sportsmen. The complex investigation, liver ultrasound and elastography of the patients of all groups was conducted. By the standard methodic the doppler ultrasound conducted to investigate the blood circulation of the portal vein.

Results and discussions.

According to our study, ultrasound signs were present in 35% of patients with chronic hepatitis in a seroscale ultrasound examination. The echo graphical signs, mentioned in the literature as typical for chronic hepatitis, were even observed in young healthy people in 2 cases (11%). In the group of patients without liver disease, the described symptoms occurred in 8 (10.5%) cases. The most common symptom was the liver parenchyma echogenicity. In all patients of the chronic hepatitis group with weak liver fibrosis, the portal vein diameter did not significantly change. The doppler graphical data more clearly showed the difference between the groups.

In all patients with mild hepatic fibrosis, the portal vein diameter increased, but the changes were not significant. As the severity of the liver parenchyma fibrosis increased, a varied change in blood flow velocity in the portal vein was noted. In patients with severe fibrosis, a decrease in the average blood flow velocity in the portal vein was noted. The presence and stage of fibrosis do not significantly affect the frequency of manifestation of each of the studied symptoms, however, the frequency of absence of echographic changes in the liver is significantly lower in healthy people than in hepatitis with severe fibrosis.

Conclusions

The ultrasound liver examination is not considered to be sufficient to diagnose the chronic hepatitis, and assess its stages and activity.

The doppler graphic study is informative for the differential diagnosis of stages of liver fibrosis.