Taracyuk B. The complex ultrasound diagnostic in children with hepatobiliary's system diseases.

The dissertation covers the issues of the elaboration and the development of early criteria for diagnosis and differetial diagnosis of hepatobiliary's system congenital and acquired diseases by complex ultrasound diagnostic. On the basis of elaboration by ultasound diagnostic 596 pediatic patients (chronic viral hepetitis B,C, autoimmune hepatitis, cystofibrosis, Wilson's disease, rheumatoid arthritis, portal hypertension, biliary atresia and liver cysts) and 120 children of control group the main task of the research have been solved. The new diagnostic criteria for diffuse liver diseases by high freqency echography and dopplerography in comparison with histological study of the liver tissue samples have proposed. The high frequency probes have also give possibility to find small noduls (as the liver chirrosis sign) in the liver parenchyma in patients with autoimmune hepatitis, Wilson's disease and cystifibrosis. These criteria have improve the following figures: sensitivity from 89,3 to 96,4%, specificity from 72,7 to 88,3% and accuracy from 85,1 to 94,2%. Laser Doppler flowmetry have been used for endothelial microcirculation injury evaluation in the same cohort of the patients and show the endothelial damage up to 100% of children with liver cystofibrosis. The echographic signs of portal hypertension (portal vein trombosis) are: the dercreasing diameter of portal vein, the decreasing length of the liver left lobe, increased size of the caudate lobe and varicosis of vessels in the gallbladder wall.