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Факторы, оказывающие влияние на результаты ультразвуковой эластометрии печени

Пиманов С. И., Митькова М.Д., Митьков В.В.
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Пиманов Сергей Иванович - д.м.н., профессор, заведующий кафедрой внутренних болезней и ультразвуковой диагностики факультета повышения квалификации и переподготовки кадров УО “Витебский государственный медицинский университет”, УО “Витебский государственный медицинский университет”, pimanovs@tut.by, г. Витебск, Республика Беларусь
Митькова М.Д. - к.м.н., доцент, доцент кафедры ультразвуковой диагностики ФГБОУ ДПО “Российская медицинская академия непрерывного профессионального образования” Министерства здравоохранения Российской Федерации, ФГБОУ ДПО “Российская медицинская академия непрерывного профессионального образования” Министерства здравоохранения Российской Федерации, г. Москва, Российская Федерация
Митьков В.В. - д.м.н., профессор, заведующий кафедрой ультразвуковой диагностики ФГБОУ ДПО “Российская медицинская академия непрерывного профессионального образования” Министерства здравоохранения Российской Федерации, ФГБОУ ДПО “Российская медицинская академия непрерывного профессионального образования” Министерства здравоохранения Российской Федерации, г. Москва, Российская Федерация

Факторы, которые оказывают влияние на результаты ультразвуковой эластометрии, имеют большое значение при интерпретации данных в рамках диагностики фиброза печени. При использовании ультразвуковой эластометрии в других целях (например, при прогнозировании сердечных событий у пациентов с правосторонней сердечной недостаточностью, мониторинге пациентов с синдромом синусоидальной обструкции печени, мониторинге краткосрочных и долгосрочных результатов ангиопластики у пациентов с синдромом Бадда-Киари) учет факторов, искажающих результаты эластометрии, также необходим. Факторы, искажающие результаты эластометрии, связаны с методикой исследования, оборудованием, артефактами, особенностями состояния организма и внешними воздействиями. Многие из них носят универсальный характер независимо от используемого вида количественной ультразвуковой эластографии. Наличие факторов, искажающих результаты эластометрии, следует отражать в протоколе эластографического исследования печени и оценивать при написании заключения, вплоть до указания о невозможности интерпретации полученных результатов.

Ключевые слова:
ультразвуковая эластография сдвиговой волной, жесткость, модуль Юнга, скорость сдвиговой волны, фиброз печени, ultrasound shear wave elastography, stiffness, Young’s modulus, shear wave velocity, liver fibrosis

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Confounding factors in ultrasound liver elastography

Pimanov S.I., Mitkova M.D., Mitkov V.V.

Confounding factors in ultrasound elastography are of great importance in the results interpretation in the liver fibrosis assessment. The consideration of these factors is necessary also in performing of ultrasound elastometry for other purposes (for example, in prediction of cardiac events in patients with right heart failure, monitoring patients with hepatic sinusoidal obstruction syndrome, monitoring short-term and long-term results of angioplasty in Budd-Chiari syndrome patients). Confounding factors are related to the methodology of examination, ultrasound equipment, artifacts, individual clinical condition and external influences. Many of them are equal for any of methods of shear wave elastography. The presence of confounding factors influencing the results of elastometry should be described in the ultrasound report and considered in the conclusion, up to an indication that interpretation of the results is impossible.

Keywords:
ультразвуковая эластография сдвиговой волной, жесткость, модуль Юнга, скорость сдвиговой волны, фиброз печени, ultrasound shear wave elastography, stiffness, Young’s modulus, shear wave velocity, liver fibrosis

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