Konenko I. Predictors of fibrosis progression in patients with chronic diffuse liver diseases

The thesis is devoted to improving the diagnostics of structural and functional changes in the liver by identifying the leading predictors of fibrosis progression in patients with chronic diffuse liver diseases (CDLD). For the first time, on the basis of comparison of morphological data and shear wave elastography indices, the threshold values of liver and spleen stiffness in CDLD were determined to assess the liver fibrosis progression. As a result of the comprehensive study of clinical, laboratory and instrumental parameters, as well as the study of correlation links between them, the diagnostic markers of the liver fibrosis progression were determined. For the first time, the value of the quantitative assessment of liver stiffness by shear wave elastography was shown in the non-invasive diagnosis of fibrosis in patients with CDLD. For the first time, the importance of the use of multiparametric ultrasound indicators for the diagnosis of severe fibrosis in patients with chronic hepatitis C and NAFLD was justified, by developing a diagnostic algorithm for screening the structural changes in the liver. With the help of logistic analysis, predictors of severe hepatic fibrosis were identified in patients with CDLD. Algorithms for predicting severe fibrosis in patients have been scientifically substantiated, taking into account the stiffness and the functional state of the liver as well as hemodynamic changes in the portal system, which will improve the quality of diagnostic care for this category of patients.