Fedulenkova Y. Diagnostic and prognostic aspects of ultrasonographic and computed tomography signs in chronic diffuse liver diseases

A novel approach to use of ultrasonographic investigation and computed tomography has been scientifically grounded and developed for chronic diffuse liver diseases (fatty liver disease, chronic hepatitis, liver cirrhosis) is represented in the dissertation. The scientific confirmation of efficacy of developed complex diagnosis of this pathology has been received. The clinico-pathogenetical and logico-statistical basis of two-step diagnostic sequence of actions with use of discriminant functions has been proposed. This allows to improve the diagnostic information capacity of ultrasonographic and computed tomography methods in verification of chronic diffuse liver pathology: sensitivity, specificity, positive and negative predicting values are 63.4 %, 74.5 %, 87.7 % and 93.5 % accordingly for fatty liver disease; 92.3 %, 81.4 %, 93.2 % and 69.1 % accordingly for chronic hepatitis; 94,8 %, 96,1 %, 97,5 % and 83,3 % accordingly for liver cirrhosis. The scientific evidence base has been widened for forecasting the course and outcome of the diseases. The prognostic approach to evaluation of chronic diffuse liver diseases has beem developed, approved and introduced. It includes the complex of radiation, clinical and laboratory parameters. Its application improves the procedure of recognition of the presence of this pathology in patient with following parameters: sensitivity - 91.3 %, specificity - 96.2 %, positive prognostic value - 92.7 %, negative prognostic value - 23.9 %. Further development has been conducted for analysis and comparison of total diagnostic value of ultrasonographic and computed tomography methods in recognition of chronic diffuse liver pathology, most informative criteria and values reference diapasones for estimation of severity of parenchyma and vessels affection have been defined. The solution of formulated tasks made it possible to concretize the role of such non-invasive radiation visulalizational methods of investigation as computed tomography and echography in diagnostic process and development of prognostic conclusion in such pathology. The theoretical substantiation of complex medical checkup of patients with chronic diffuse liver disease using different radiation methods of investigation has been represented.