Comparative evaluation of elastometric indices of liver hardness in alcoholic and non-alcoholic liver diseases

Difficulties are known in the process of differential diagnosis between non-alcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD), since the data of the main objective, laboratory and instrumental methods give similar results, not allowing to reliably speak about the etiology of the process. The most sensitive, specific, accurate, minimally invasive and accessible method for diagnosing chronic diffuse liver diseases is the combined use of transient elastometry and shear wave elastography. The scientific novelty of the proposed work is the application of combined use of transient elastometry and shear wave elastography as a method of comparative evaluation of ALD (under conditions of abstinence more than 1 month) and NAFLD. The primary importance of abstinence in ALD therapy has been confirmed. The aim of the study was to make a comparative evaluation of elastometric parameters of liver stiffness in patients with NAFLD and in ALD under abstinence conditions. Materials and methods. The control group included 30 practically healthy persons with a body mass index (BMI) from 20-30 kg / m2, without pathological changes according to the general, biochemical blood tests, when evaluating the echostructure of the abdominal cavity according to ultrasound, without any diseases of the liver and other organs in the history, voluntarily agreed to the study (group N). Two equal subgroups of subjects were included in the experimental group: 30 patients with non-alcoholic fatty liver disease (F1), 60% of whom had a BMI> 25 kg / m2 and 40% <25 kg / m2. 30 patients with confirmed alcohol dependence according to the CAGE, AUDIT, CDT test, who had not consumed alcohol for more than a month and at the time of the study being treated in the rehabilitation department of the Republican Narcological Dispensary, Ministry of Health of the Chuvash Republic (F2). One-dimensional (transient) elastometry of the liver and two-dimensional shear wave elastography with elastometry (SWE) were performed in the liver research algorithm (along with standard laboratory methods). Results: the indicators of general laboratory analyzes do not allow differential diagnosis of NAFLD and ALD; a reliable difference in indicators was found when assessing the responses to CAGE, AUDIT, CDT, SWE; Relatively more pronounced pathological changes in the organ parenchyma were observed in the comparative evaluation of elastometric indices of liver stiffness in alcoholic and fatty liver lesions in NAFLD than in ALD under conditions of abstinence (from one month).

Эластометрия, эластография сдвиговой волной, неалкогольная жировая болезнь печени, алкогольная болезнь печени, неинвазивные методы диагностики, Elastometry, shear wave elastography, non-alcoholic fatty liver disease, alcoholic liver disease, non-invasive diagnostic methods