Potential of Contrast-Enhanced Ultrasound in Diffuse Liver Diseases (Evidence From Chronic Viral Hepatitis)

Abstract

Background. Contrast-enhanced ultrasound is a modern imaging modality providing with the possibility of real-time liver state assessment that is important in determining the degree of parenchymal damage in order to predict the course of the disease and to change the treatment strategy accordingly. Objective. To determine the diagnostic and prognostic value of contrast-enhanced ultrasound (CEUS) of the liver in patients with chronic viral hepatitis (CVH) B and C. Material and methods. 284 individuals were examined from 2018 to 2021. All the patients were divided into 3 groups. The experimental group included CVH patients who underwent CEUS examination; there were 2 control groups: № 1 – patients with CVH who did not undergo CEUS examination; the aim was to determine the predictive effectiveness of the method, № 2 - patients with CVH and without CEUS examination - to determine the diagnostic effectiveness of the method. Results. During the study, it was found out that the greatest changes in CEUS parameters were observed in patients with F4 fibrosis stage according to the METAVIR score. It was the assessment of qualitative parameters according to the proposed standardized program that had the highest prognostic and diagnostic potential. As far as the quantitative parameters of CEUS are concerned the values of the difference of quantitative parameters in the proximal and distal zones (ΔTOA, ΔTTP, ΔPI, ΔHTWo) were of considerable importance. Conclusions. Contrast-enhanced ultrasound makes it possible to detect signs of an unfavorable course of chronic viral hepatitis already at an early clinical stage, thus enabling to adjust the treatment strategy and improve long-term prognosis.