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Abstract:

Introduction: congenital portosystemic venous shunts (CPVS) are rare vascular abnormalities that occur secondary to abnormal development or involution of fetal vasculature. They allow intestinal blood to enter the systemic circulation, bypassing the liver, which in the long term leads to various symptoms and complications. Today, thanks to advanced imaging techniques, the number of reported cases of CPVS is increasing, although for the most part these are single clinical cases or reports summarizing small series of cases. The overall incidence of CPVS is estimated at 1:30 000 births and 1:50 000 for those persisting beyond early childhood.

Material and methods: article consists of 44 foreign literature sources, that  highlight pathogenesis, classification, clinical picture, diagnosis and treatment of CPVS.

Conclusion: early diagnosis and correction of this anomaly using any (endovascular or surgical) occlusion regresses symptoms and prevents long-term complications. At present, given the rarity of this pathology, there is no large statistical analysis and no standards, developed for the management of this category of patients. However, further collection of material, an emphasis on the pathophysiology and anatomy of these lesions, will help to provide more effective care for patients with congenital portosystemic venous shunts.

  

 

References

 

1.     Kim MJ, Ko JS, Seo JK, et al. Clinical features of congenital portosystemic shunt in children. Eur J Pediatr. 2012; 171(2): 395-400.

2.     Florio F, Nardella M, Balzano S, et al. Congenital intrahepatic portosystemic shunt. Cardiovasc Intervent Radiol. 1998; 21(5): 421-424.

3.     Baiges A, Turon F, Simуn-Talero M, et al. Congenital Extrahepatic Portosystemic Shunts (Abernethy Malformation): An International Observational Study. Hepatology. 2020; 71(2): 658-669.

https://doi.org/10.1002/hep.30817

4.     Ольхова Е.Б., Туманян Г.T., Венгерская Г.В. и др. Мальформация Абернети у новорожденных. Эхографическая диагностика. Радиология-практика. 2015; 5(54): 46-58.

Olkhova EB, Tumanyan GT, Hungarian GV, et al. Abernathy malformation in newborns. Echographic diagnostics. Radiology-practice. 2015; 5 (54): 46-58 [In Russ].

5.     Малышева Е.Б., Захарова Е.М., Рыхтик П.И., Жулина Н.И. Мальформация Абернетти - редкая причина гемодинамического цирроза печени. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. Приложение. 2017; 27(1) S49; 48.

Malysheva EB, Zakharova EM, Rykhtik PI, Zhulina NI. Abernetty's malformation is a rare cause of hemodynamic cirrhosis of the liver. Russian journal of gastroenterology, hepatology, coloproctology. Application. 2017; 27(1) S49; 48 [In Russ].

6.     Abernethy J. Account of two instances of uncommon formation in the viscera of the human body. Philos Trans R Soc Lond B Biol Sci. 1793; 83: 59-66.

7.     Sokollik C, Bandsma RH, Gana JC, et al. Congenital portosystemic shunt: characterization of a multisystem disease. J. Pediatr. Gastroenterol. Nutr. 2013; 56(6): 675-681.

8.     Guérin F, Blanc T, Gauthier F, et al. Congenital portosystemic vascular malformations. Semin. Pediatr. Surg. 2012; 21(3): 233-244.

9.     Bernard O, Franchi-Abella S, Branchereau S, et al. Congenital portosystemic shunts in children: recognition, evaluation, and management. Semin Liver Dis. 2012; 32(4): 273-287.

10.   Lin ZY, Chen SC, Hsieh MY, et al. Incidence and clinical significance of spontaneous intrahepatic portosystemic venous shunts detected by sonography in adults without potential cause. J Clin Ultrasound. 2006; 34(1): 22-26.

11.   Gitzelmann R, Forster I, Willi UV. Hypergalactosaemia in a newborn: self-limiting intrahepatic portosystemic venous shunt. Eur J Pediatr. 1997; 156: 719-722.

12.   Ponziani FR, Faccia M, Zocco MA, et al. Congenital extrahepatic portosystemic shunt: description of four cases and review of the literature. J Ultrasound. 2019; 22(3): 349-358.

https://doi.org/10.1007/s40477-018-0329-y

13.   De Paula Oliveira GJ, Ferreira S, Barbosa A. Abernethy Malformation – Congenital Extra-hepatic Portosystemic Shunt Associated with Multiple Liver Adenomatosis: Case Report. Universal Journal of Public Health. 2019; 7(3): 129-137.

14.   Nagata H, Yamamura K, Ikeda K. Balloon-occluded retrograde transvenous obliteration for congenital portosystemic venous shunt: report of two cases. Pediatr Int. 2012; 54(3): 419-421.

https://doi.org/10.1111/j.1442-200X.2011.03459.x

15.   Passalacqua M, Lie KT, Yarmohammadi H. Congenital extrahepatic portosystemic shunt (Abernethy malformation) treated endovascularly with vascular plug shunt closure. Pediatr Surg Int. 2012; 28(1): 79-83.

https://doi.org/10.1007/s00383-011-2944-y

16.   Raghuram KA, Bijulal S, Krishnamoorthy KM, Tharakan JA. Regression of pulmonary vascular disease after therapy of Abernethy malformation in visceral heterotaxy. Pediatr Cardiol. 2013; 34(8):1882-5.

https://doi.org/10.1007/s00246-012-0428-z

17.   DiPaola F, Trout AT, Walther AE, et al. Congenital Portosystemic Shunts in Children: Associations, Complications, and Outcomes. Dig Dis Sci. 2020; 65(4): 1239-1251.

https://doi.org/10.1007/s10620-019-05834-w

18.   Ogul H, Bayraktutan U, Yalcin A, et al. Congenital absence of the portal vein in a patient with multiple vascular anomalies. Surg Radiol Anat. 2013; 35(6): 529-534.

https://doi.org/10.1007/s00276-012-1059-z

19.   Morgan G, Superina R. Congenital absence of the portal vein: two cases and a proposed classification system forportasystemic vascular anomalies. J Pediatr Surg. 1994; 29(9):1239-1241.

20.   Glonnegger H, Schulze M, Kathemann S, et al. Case Report: Hepatic Adenoma in a Child With a Congenital Extrahepatic Portosystemic Shunt. Front Pediatr. 2020; 8: 501.

https://doi.org/10.3389/fped.2020.00501

21.   Raskin NH, Price JB, Fishman RA. Portal-systemic encephalopathy due to congenital intrahepatic shunts. The New England Journal of Medicine. 1964; 270: 225-229.

22.   Park JH, Cha SH, Han JK, Han MC. Intrahepatic portosystemic venous shunt. Am J Roentgenol. 1990; 155: 527-528.

23.   Senocak E, Oğuz B, Edgьer T, Cila A. Congenital intrahepatic portosystemic shunt with variant inferior right hepatic vein. Diagn Interv Radiol. 2008; 14: 97-99.

24.   Niwa T, Aida N, Tachibana K, et al. Congenital absence of the portal vein: clinical and radiologic findings. J Comput Assist Tomogr. 2002; 26(5): 681-6.

https://doi.org/10.1097/00004728-200209000-00003

25.   Kobayashi N, Niwa T, Kirikoshi H, et al. Clinical classification of congenital extrahepatic portosystemic shunts. Hepatol Res. 2010; 40(6): 585-93.

https://doi.org/10.1111/j.1872-034X.2010.00667.x

26.   Benedict M, Rodriguez-Davalos M, Emre S, et al. Congenital Extrahepatic Portosystemic Shunt (Abernethy Malformation Type Ib) With Associated Hepatocellular Carcinoma: Case Report and Literature Review. Pediatr Dev Pathol. 2017; 20(4): 354-362.

https://doi.org/10.1177/1093526616686458

27.   Kroencke T, Murnauer M, Jordan FA, et al. Radioembolization for Hepatocellular Carcinoma Arising in the Setting of a Congenital Extrahepatic Portosystemic Shunt (Abernethy Malformation). Cardiovasc Intervent Radiol. 2018; 41(8): 1285-1290.

https://doi.org/10.1007/s00270-018-1965-5

28.   Alonso-Gamarra E, Parrón M, Pérez A, et al. Clinical and radiologic manifestations of congenital extrahepatic portosystemic shunts: a comprehensive review. Radiographics. 2011; 31(3): 707-722.

https://doi.org/10.1148/rg.313105070

29.   Brasoveanu V, Ionescu MI, Grigorie R, et al. Living Donor Liver Transplantation for Unresectable Liver Adenomatosis Associated with Congenital Absence of Portal Vein: A Case Report and Literature Review. Am J Case Rep. 2015; 16: 637-644.

https://doi.org/10.12659/AJCR.895235

30.   Duprey J, Gouin B, Benazet MF, le Gal J. Glucose intolerance and post-stimulative hypoglycaemia secondary to congenital intra-hepatic porto-caval anastomosis. Annales de Medecine Interne. 1985; 136(8): 655-658.

31.   Watanabe A. Portal-systemic encephalopathy in non-chirrotic patients: classification of clinical types, diagnosis and treatment. Journal of Gastroenterology and Hepatology. 2000; 15(9): 969-979.

32.   Murray CP, Yoo SJ, Babyn PS. Congenital extrahepatic portosystemic shunts. Pediatric Radiology. 2003; 33(9): 614-620.

33.   Nishimura Y, Tajima G, Dwi Bahagia A, et al. Differential diagnosis of neonatal mild hypergalactosaemia detected by mass screening: clinical significance of portal vein imaging. Journal of Inherited Metabolic Disease. 2004; 27(1): 11-18.

34.   Eroglu Y, Donaldson J, Sorensen LG, et al. Improved neurocognitive function after radiologic closure of congenital portosystemic shunts. Journal of Pediatric Gastroenterology and Nutrition. 2004; 39(4): 410-417.

35.   Emre S, Amon R, Cohen E, et al. Resolution of hepatopulmonary syndrome after auxiliary partial orthotopic liver transplantation in Abernethy malformation. A case report. Liver Transplantation. 2007; 13(12): 1662-1668.

36.   Kim MJ, Ko JS, Seo JK, et al. Clinical features of congenital portosystemic shunt in children. European Journal of Pediatrics. 2012; 171(2): 395-400.

37.   Timpanaro T, Passanisi S, Sauna A, et al. Congenital portosystemic shunt: our experience. Case Rep Pediatr. 2015; 691618.

https://doi.org/10.1155/2015/691618

38.   Chocarro G, Amesty MV, Encinas JL, et al. Congenital Portosystemic Shunts: Clinic Heterogeneity Requires an Individual Management of the Patient. Eur J Pediatr Surg. 2016; 26(1): 74-80.

https://doi.org/10.1055/s-0035-1566097

39.   Achiron R, Kivilevitch Z. Fetal umbilical-portal-systemic venous shunt: in utero classification and clinical significance. Ultrasound Obstet Gynecol. 2016; 47: 739-747.

https://doi.org/10.1002/uog.14906

40.   Franchi-Abella S, Gonzales E, Ackermann O, et al. Congenital portosystemic shunts: diagnosis and treatment. Abdom Radiol (NY). 2018; 43(8): 2023-2036.

https://doi.org/10.1007/s00261-018-1619-8

41.   Musa J, Madani K, Saliaj K, et al. Asymptomatic presentation of a congenital malformation of the portal vein with portosystemic shunt. Radiol Case Rep. 2020; 15(10): 2009-2014.

https://doi.org/10.1016/j.radcr.2020.07.076

42.   Back SJ, Maya CL, Khwaja A. Ultrasound of congenital and inherited disorders of the pediatric hepatobiliary system, pancreas and spleen. Pediatr Radiol. 2017; 47: 1069-1078.

https://doi.org/10.1007/s00247-017-3869-y

43.   Nam HD. Living-donor liver transplantation for Abernethy malformation - case report and review of literature. Ann Hepatobiliary Pancreat Surg. 2020; 24(2): 203-208.

https://doi.org/10.14701/ahbps.2020.24.2.203

44.   Papamichail M, Pizanias M, Heaton N. Congenital portosystemic venous shunt. Eur J Pediatr. 2018; 177(3): 285-294.

https://doi.org/10.1007/s00431-017-3058-x

 

Abstract:

Diagnostic criteria for extranodal lymphoma (non-Hodgkin's lymphoma) are well known and described in the literature. However, primary extranodal lymphomas are rare and pose problems for differential diagnosis with primary or secondary lesions.

In the presented clinical case of a woman, 58 years old, with primary extranodal lymphoma of the stomach and spleen, an incorrect preoperative diagnosis was made: a tumor of the stomach and spleen abscess. It was mainly due to the presence of pain in the epigastric region and hospitalization for "severe acute biliary pancreatitis" in anamnesisd. Similar complaints and a "blurry" picture of manifestations of lymphoma did not allow her to be suspected preoperatively. The tumor nature of the focal lesion of the stomach was not in doubt, while the underestimation of MRI data, combined with the anamnesis, led to the erroneous diagnosis o f" spleen abscess". Patient underwent surgical operation: extended combined gastrectomy, distal resection of pancreas, splenectomy “en-bloc”, lymphadenectomy, cholecystectomy, “Roux-Y" reconstruction.

The clinical picture of extranodal lymphoma depends on its primary localization and the degree of its spread. Clinical manifestations of primary lymphoma of the stomach and spleen are often non­specific, therefore, against the background of previously transferred diseases of the hepatopancreatobiliary zone and their residual manifestations, an erroneous assessment of the situation is possible. In the presence of focal lesions, it is advisable to be more attentive to results of radiology examination, which can provide comprehensive information about their nature.

 

 

References

1.     WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Swerdlow S.H., Campo E., Harris N.L., Jaffe E.S., Pileri S.A., Stein H., Thiele J. (Eds). Revised 4th edition. Lyon: IARC Press, 2017; 585.

2.     Manzella A, Borba-Filho P, D'Ippolito G, Farias M. Abdominal manifestations of lymphoma: spectrum of imaging features. ISRN Radiol. 2013; 2013: 483069.

http://doi.org/10.5402/2013/483069

3.     Lee W-K, Lau EWF, Duddalwar VA, et al. Abdominal manifestations of extranodal lymphoma: spectrum of imaging findings. American Journal of Roentgenology. 2008; 191(1): 198-206.

http://doi.org/10.2214/AJR.07.3146

4.     FSBI «National Medical Research Center of Oncology named after N.N. Blokhin »of the Ministry of Health of Russia Diagnostics and treatment. Types of diseases. Lymphomas, (date of access 08.07.20) [In Russ.].

https://www.ronc.ru/grown/treatment/diseases/limfomy/

5.     Psyrri A, Papageorgiou S, Economopoulos T. Primary extranodal lymphomas of stomach: clinical presentation, diagnostic pitfalls and management. Annals of Oncology. 2008; 19(12): 1992-1999.

http://doi.org/10.1093/annonc/mdn525

6.     Ghai S, Pattison J, Ghai S et al. Primary gastrointestinal lymphoma: spectrum of imaging findings with pathologic correlation. Radiographics. 2007; 27(5): 1371-1388.

http://doi.org/10.1148/rg.275065151

7.     Juarez-Salcedo LM, Sokol L, Chavez JC, Dalia S. Primary Gastric Lymphoma, Epidemiology, Clinical Diagnosis, and Treatment. Cancer Control. 2018; 25(1): 1073274818778256.

http://doi.org/10.1177/1073274818778256

8.     NORD: National Organization for Rare Disorders. Rare Disease Database. Primary Gastric Lymphoma. Luh JY Nabavizadeh N, Thomas CR. Jr., (date of access 20.07.2020).

https://rarediseases.org/rare-diseases/primary-qastric-lymphoma

9.     De Jong PA, Van Ufford HMQ, Baarslag H-J et al. CT and 18F-FDG PET for noninvasive detection of splenic involvement in patients with malignant lymphoma. American Journal of Roentgenology. 2009; 192(3): 745-753.

http://doi.org/10.2214/AJR.08.1160

10.   Ingle SB, Hinge CR. Primary splenic lymphoma: Current diagnostic trends. World J Clin Cases. 2016 December 16; 4(12): 385-389.

http://doi.org/10.12998/wjcc.v4.i12.385

11.   Dobrovolskiene L, Balukeviciute J, Maksimaitiene J. Virskinimo trakto limfomu radiologine diagnostika [Radiographic diagnosis of gastrointestinal lymphoma]. Medicina(Kaunas). 2002; 38(2):165-171.

12.   Chien SH, Liu CJ, Hu YW, et al. Frequency of surveillance computed tomography in non-Hodgkin lymphoma and the risk of secondary primary malignancies: A nationwide population-based study. Int J Cancer. 2015 Aug 1; 137(3): 658-665.

http://doi.org/10.1002/ijc.29433

13.   Chernobai TN, Golovko TS. Radiation diagnosis of extranodal lymphomas. Clinical oncology. 2017; 4(28): 73-76 (date of access 8.07.2020) [In Ukr.].

https://www.clinicaloncology.com.ua/article/19925/luchevaya-diagnostika-ekstranodalnyx-limfom

14.   Frampas E. Lymphomas: Basic points that radiologists should know. Diagnostic and Interventional Imaging. February 2013; 94(2): 131-144.

http://doi.org/10.1016/j.diii.2012.11.006

 

Abstract:

Despite advances made in the treatment of renal cell carcinoma, kidney cancer still remains a «surgical» disease. Radical surgery is the only cure for this pathology If it is technically impossible to perform a resection of the kidney in situ, it is preferable to use the latter treatment option, since it avoids chronic hemodialysis, the need for kidney transplantation and improve the quality of life. The central and intraparenchymal location of tumors does not allow the organ-preserving operation due to the necessity of resection of segmental vessels, cups and renal pelvis, which prolongs the time of thermal ischemia. Conducting extracorporeal resection of the kidney in conditions of chemo-cold ischemia allows you to expand indications for organ-preserving treatment of patients with localized kidney cancer.

Aim: was to evaluate possibilities of ultrasound monitoring during extracorporeal resection of the kidney with orthotopic nephropexy and replantation of renal vessels at all stages of surgical treatment.

Material and methods: 47 patients (74% of men, 26% of women) with a histologically confirmed diagnosis of kidney cancer were hospitalized for treatment at the period from March 2012 to the present in A.V Vishnevsky National Medical Research Center of Surgery All patients underwent extracorporeal resection of the kidney under conditions of pharmaco-cold ischemia without intersection of the ureter with orthotopic replantation of renal vessels. Ultrasound examination (in B-mode, Color and Energy Doppler Imaging and pulsed Doppler) was performed for all patients in the pre-, intra- and postoperative stages.

Results: the analysis of the ultrasound data obtained during the surgical treatment of patients at its stages allowed us to develop an algorithm for examining patients at stages of extracorporeal resection of the kidney under conditions of pharmaco-cold ischemia without crossing the ureter with orthotopic replantation of the renal vessels, taking into account technical features of surgical intervention

Conclusion: extracorporeal resection of the kidney with orthotopic nephropexy and replantation of renal vessels requires constant dynamic monitoring of the functional state of the renal blood flow Doppler ultrasound, performed according to the developed method, is a highly informative method in the qualitative and quantitative assessment of intrarenal blood flow. Ultrasound monitoring allows you to determine the functional state of the kidneys during the preoperative stage, intraoperatively assess the state of vascular anastomoses and monitor changes in the kidneys and the resectior zone in the postoperative period. 

 

References

1.      Clinical oncourology. Ed. B.P Matveyev. M .: Verdana, 2003; 717 p [In Russ].

2.      Sukonko OG, Tkachev LP, Krasny SA, Rolevich AI, Polyakov SL, Poluyanchik AV. Extracorporeal resection of the kidney with autotransplantation in a cancer patient of a horseshoe kidney (clinical case). Oncourology. 2010; 4: 83-87 [In Russ].

3.      Calne RY. Tumour in a single kidney: nephrectomy, excision, and autotransplantation. Lancet 1971; 2: 761-762.

4.      Gittes RF, McCullough D.L. Bench surgery for tumor in a solitary kidney. J Urol 1975; 113: 12-15.

5.      Teplov AA, Gritskevich AA, Pianikin SS. Extracorporeal kidney resection in pharmaco-cold ischemia without intersecting the ureter with orthotopic vascular replantation in renal cell carcinoma. Experimental and clinical urology. 2015; 52-62 [In Russ].

6.      Ultrasound diagnosis in abdominal and vascular surgery. Ed. GI. Kuntsevich. - Minsk: Cavalier Publishers, 1999; 256 p [In Russ].

7.      Lelyuk VG, Lelyuk SE. Ultrasound angiology. - M .: Real time, 2003; 322 p [In Russ].

8.      Kvyatkovsky EA, Kvyatkovskaya TA. Ultrasonography and Doppler in the diagnosis of kidney disease. - Dnepropetrovsk: New Ideology, 2005; 318 p [In Russ].

9.      Radiological diagnosis of diseases of the heart and blood vessels: a national guide. Ch. ed. L.S. Kokov - Moscow: GEOTAR-Media, 2011; 688 p [In Russ].

10.    Practical guide to ultrasound diagnostics. General ultrasound diagnostics. Ed. Mitkova VV. - M .: Publishing House Vidar -M, 2005; 720 p [In Russ].

11.    Hirai T, Ohishi H, Yamada R, Imai Y Hirohashi S, Hirohashi R, Honda N, Uchida H. Usefulness of color Doppler imaging in differential diagnosis of multilocular cystic lesions of the kidney. J. Ultrasound Med. E. 1995; 14(10): 771-776.

12.    Krainnik NA. Ultrasound diagnosis of vascular complications of renal allografts in the intraoperative and early postoperative periods. Diss. ... cand. med. scie., - Moscow, 2016; 127 p [In Russ].


 

Article exists only in Russian.

 

Abstract:

Presented herein is a dynamic ultrasonographic study of soft tissue state in the area of a postoperative wound in 165 patients in order to determine rational policy of postoperative following up of the patient. The patients were subdivided into three groups: Group I - after an operative intervention for surgical pathology of abdominal and retroperitoneal organs; Group II - after herniotomy with combined plasty with a meshed endograft (Surgpro-mesh); Group III - after allografting of the aorta, major arteries of the lower limbs and neck. All patients after the surgical intervention were subjected to an ultrasonographic study of soft tissues of the abdominal wall, lower extremities, and neck in the B-mode in order to reveal pathological alterations, with determining the size, structure and indication of localization in relation to the surface of the skin; five cases suspected for infection of the process were subjected to duplex scanning of soft tissues around the focus revealed; detecting pathological alterations around the vessel or the graft after grafting of major vessels was followed by duplex scanning in order to determine the haemodynamic situation in the vessel or graft. The findings obtained suggest specificity of postoperative alterations characteristic of different surgical interventions, the revealing of which allows the surgeons to determine the policy of rational management of the patient, thus decreasing the risk of purulent complications in the area of the postoperative wound.

  

Reference

1.     Федоров В.Д., Светухин А.М. Стратегия и тактика лечения обширных гнойных ран. Избранный курс лекций по гнойной хирургии. М., Миклош. 2003; 18-30.

2.     Шляпников С.А. Хирургические инфекции мягких тканей - старая проблема в новом свете. Инфекции в хирургии. 2003; 1(1): 14 - 21.

3.     Белобородов В.Б.,Джексенбаев О.Ш.Эндотоксины грамотрицательных бактерий. Цитокины и концепция септического шока; современное состояние проблемы. Анестезия и реаниматология. М., 1991; 4:41 -43.

4.     Белобородова Н.В., Бачинская Е.Н. Иммунологические аспекты послеоперационного сепсиса. Анестезия и реаниматология. 2000; 1: 59 - 66.

5.     Измайлов С.Г., Измайлов Г.А., Тюдушкина И.В. и др. Лечение ран. - Казань: изд-во Казанского государственноготехнического университета. 2003; 137 - 144.

6.     Ерюхин И.А., Гельфанд Б.Р., Шляпников С.А. Хирургические инфекции: руководство. С-Пб.: издательский дом «Питер» (Серия «Спутник врача»), 2003; 864.

7.     Hedrick WR, Hykes L, Starchman DE. Static imaging principles and instrumentation. In: Ultrasound physics and instrumentation. St Louis (MO): Mosby. 1995; 71 -87.

8.     Евдокимова Е.Ю., Жестовская С.И. Роль ЦДК в диагностике стадий раневого процесса мягких тканей у больных с хирургической патологией Материалы краев. науч. практ. конференции, посвященной 50-летию общества рентгенологов и радиологов. Красноярск. 2000; 37 - 38.

9.     Lavoipierre AM, Kremer S. Cabrini Hospital, Melbourne The expanding role of ultrasound in medicine. Aust. Fam. Physician. 1999; 28 (11): 1121 - 7.

10.   Loyer E.M., Kaur H., David C.L., DuBrow R. et al. Importance of dynamic assessment of the soft tissues in the sonographic diagnosis of echogenic superficial abscesses. Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA. Journal ofUltrasound in Medicine. 1995; 14(9): 669 - 671.

11.   Сажин В.П., Жаболенко В.П., Авдовенко А.Л. и др. Роль сонографии в оценке течения раневого процесса у больных после эндовидеохирургического лечения постинъекционных абсцессов ягодиц. Институт хирургии им. А. В. Вишневского РАМН. Материалы конференции, посвященной 10-летию отделения ультразвуковой диагностики: Современные методы ультразвуковой диагностики заболеваний сердца, сосудов и внутренних органов. М., 4-6 октября. 2004; 126 -127.

12.   Sisley Amy С, Bonar J.P. Ultrasound in the Acute Seffing. Ultrasound for Surgeons. Second edition. Lippincott Williams & Wilkins. 2005; (1015): 179 - 191.

13.   Bureau NJ, Cardinal E, Chhem RK. Ultrasound of Soft Tissue Masses. Department de Radiologie, Hopital St-Luc, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada. Semin Musculoskelet Radiol. 1998; 2(3): 283 - 298.

14.   Chhem R.K, Kaplan P.A, Dussault R.G. Ultrasonography of the musculoskeletal system. Radiol. Clin. North Am. 1994; 32 (2): 275 - 89.

15.   Primack S.J. Musculoskeletal ultrasound. The clinician's perspective. North Suburban Rehabilitation Unit, Colorado Rehabilitation and Occupational Medicine, Aurora, USA. Radiol.Clin. North Am. 1999l; 37(4): 617-22.

16.   Newman J.S., Adler R.S., Bude R.O, Rubin J.M. Detection of soft-tissue hyperemia: value of power Doppler sonography. AJRAm. J. Roentgenol. 1994; 163 (2):385-9.

17    Breidahl W.H, Newman J.S, Taljanovic M.S, Adler R.S. Power Doppler sonography in the assessment of musculoskeletal fluid collections. AJR Am. J. Roentgenol. 1996; 166 (6): 1443 -6.

18.   Latifi H.R, Siegel M.J. Color Doppler flow imaging of pediatric soft tissue masses. J. Ultrasound Med. 1994; 13 (3): 16–— 9.

19.   Rubin J.M. Musculoskeletal power Doppler. Eur. Radiol. 1999; 9(3): 403 - 405.

20.   Волчанский А.И. Диагностика и лечение внутрибрюшных гнойно-воспалительных осложнений после операций на печени и желчных путях. Дисс. канд. мед. наук. М., 1997; 143.

21.   Жестовская С.И., Евдокимова Е.Ю. Ультразвуковая диапедевтика послеоперационных гнойных осложнений. Тезисы докладов 4-го съезда Российской ассоциации специалистов ультразвуковой диагностики в медицине. М., 2003; 87-88.

22.   Бордаков В.Н., Абрамов Н.А., Савицкий Д.С. и др. Диагностика и лечение абсцессов брюшной полости. Сб. науч. трудов IV Всеармейской международной конференции: Интенсивная терапия и профилактика хирургических инфекций: М., 23 -24 сентября, 2004; 132 -133.

23.   Чебышева Э.Н. Оценка состояния аорты и ее ветвей убольныханевризмойбрюшнойаортыпо данным ультразвукового исследования. Автореферат дисс. канд. мед. наук. М., 2005; 25.

24.   Минайчев В. Ю, Конон Т. М. Абсцесс передней брюшной стенки. Новости лучевой диагностики. М., 2000; 30 -31.

25.   Биссет Р.А., Хан А.Н. Дифференциальный диагноз при абдоминальном ультразвуковомисследовании. (Под редакцией проф. Пиманова С.И.) М., Мед. литература. 2003; 232 - 233.

26.   Евдокимова Е.Ю. Лечебно-диагностические вмешательства под контролем ультразвука у больных с послеоперационными гнойными осложнениями. Автореферат дисс. канд. мед. наук.Красноярск. 2003; 26.

27.   Hill Robert MD, Conron Richard DO, Greissinser Paul DO, Heller Michael MD. Ultrasound for the Detection of Foreign Bodies in Human Tissue. Annal of Emergency Medicine. 1997; 29(3): 178 - 179.

28.   Цветков В.О. Парапротезная инфекция. Клиника, диагностика, лечение. Дисс. докт. мед. наук. М., 2003; .96 - 104.

29.   Кунцевич Г.И. Оценка результатов хирургического лечения окклюзирующих поражений артерий. Ультразвуковая диагностика в абдоминальной и сосудистой хирургии. (Под редакцией проф. Г.И. Кунцевич). М., Кавалер Паблишерс. 1999; 191 - 195.

 

 

Abstract:

Purpose. Define the role of ultrasound diagnostics in preoperative evaluation, surgical approach, and postsurgical assessment in patients with cystous lesions of pancreas underwent various types of pancreatic distal resection (PDR).

Material and methods. Since 1995 till 2008 in Vishnevsky Institute of Surgery (Moscow) 54 patients with distal cystous lesions of pancreas received a course of treatment. Mean age was 50,6+1,2 years, 37 patients (68.5%) were women. Complex pre- and postoperative ultrasound study was performed in all the cases. Morphologically there were true cysts (2 cases), lymphocysts (1 case), postnecrotic cysts (21 patients), serous cystadenoma (9 cases), mucinous cystadenoma (16 cases), and mucinous cystadenocarcinoma (5 cases).

Results. After laparotomy and abdominal revision the following operations were performed:

1. Spleen-preserving distal pancreatic resection;

2. Distal pancreatic resection with splenectomy.

Pancreatic stump assessment revealed 2 possible complications: external pancreatic fistula and sub. phrenic abscess. Spleen-preserving interventions were shown to associate with fewer complication rate, than those with splenectomy.

Conclusions. The cardinal problem is that the PDR associates with repeatedly high complication rate, and the most common complications are external pancreatic fistulas and subphrenic abscesses. As far as the complication rate has the tendency to decrease in spleen-preserving interventions, it is advisable to avoid splenectomy in cases of benign pancreatic lesions.   

 

References

1.        Fahy B.N., Frey C.F., Ho H.S. et al. Morbidity, mortality and technical factors of distal pancreatectomy. Am. J. Surg. 2002; 183 (3): 237–241.

2.        Andren-Sandberg A., Wagner M., Tihanyi T. et al. Technical Aspects of Left-Sided Pancreatic Resection for Cancer. Dig. Surg. 1999; 16 (4): 305–312.

3.        Шалимов А.А. Хирургия поджелудочной железы. М.: Медицина. 1964.

4.        Mayo W.J. The Surgery of the Pancreas: I. Injuries to the Pancreas in the Course of Operations on the Stomach. II. Injuries to the Pancreas in the Course of Operations on the Spleen. III. Resection of Half the Pancreas for Tumor. Ann. Surg. 1913; 58 (2): 145–150.

5.        Алимов А.Н., Исаев А.Ф., Сафронов Э.П. и др. Обоснование безопасности органосохраняющего метода лечения разрыва селезенки в хирургии изолированной и сочетанной травмы живота. Хирургия. 2005; 10: 55–60.

6.        Lee S.Y., Goh B.K., Tan Y.M. et al. Spleen-preserving distal pancreatectomy. Singapore Maed. J. 2008; 49 (11): 883–885.

7.        Warshaw A.L. Conservation of the spleen with distal pancreatectomy. Arch. Surg. 1988; 123 (5): 550–553.

8         Буриев И.М., Икрамов Р.З. Дистальная резекция поджелудочной железы. Анналы хирургической гепатологии. 1997; 2: 136–138.

9.        Kimura W., Fuse A., Hirai I., Suto K. Spleen-preserving distal pancreatectomy for intraductal papillary-mucinoustumor. Hepatogastroenterology. 2004; 51 (55): 86–90.

10.      Edwin B., Mala T., Mathisen O. et al. Laparoscopic resection of the pancreas: a feasibility study of the short-term outcome. Surg. Endosc. 2004; 18 (3): 407–411.

11.      Vezakis A., Davides M., Larvin M., McMahon M.J. Laparoscopic surgery combined with preservation of the spleen for distal pancreatic tumors. Surg. Endosc. 1999; 13 (1): 26–29.

Abstract:

Fetal with fetal growth restriction (FGR) are at increased risk for acidemia, hypoxemia and adverse perinatal outcomes. Placental insufficiency and FGR are the most common and important clinical problems in obstetrics and the leading causes of perinatal morbidity and mortality. Lots of diagnostic procedures are assessed to evaluate FGR, among them ultrasounds are the most relevant ones. Advances in Doppler velocimetry have improved possibility of assessing cerebral blood flow in this pathology This article discusses the clinical case of brain-sparing effect in fetuses with FGR. Assessment of the fetal cerebral circulation provides important information on the hemodynamic changes associated with chronic hypoxia, intrauterine growth restriction and their clinical management. 

 

References 

1.    Figueroa-Diesel H., Hernandez-Andrade E., Acosta- Rojas R. et al. Doppler changes in the main fetal brain arteries at different stages of hemodynamic adaptation in severe intrauterine growth restriction. Ultrasound Obstet. Gynecol. 2007; 30: 297-302.

2.    Hutter D., Kingdom J., Jaeggi E. Causes and Mechanisms of Intrauterine Hypoxia and Its Impact on the Fetal Cardiovascular System: A Review. J. Pediatr. 2010; 2010: 9 pages.

3.    Zayko N.N., Bytsya Y.V. Pathological physiology. M.: MED-press-inform; 2004; 63 5p [In Russ].

4.    Ageeva M.I. Diagnostic value of Doppler sonography in assessing the functional status of the fetus. Diss. ... dokt. med. nauk. M., 2008; 237 p [In Russ].

5.    Benavides-Serralde A., Hernandez-Andrade E., Fernandez-Delgado J. et al. Three-Dimensional sonographic calculation of the volume of intracranial structures in growth-restricted and appropriate-for-gestational age fetuses. J. Ultras. Obstet Gynecol. 2009; 33(5): 530-537.

6.    Feria L.A., Scheier M., Figueras F. et al. Reference values for Doppler parameters of the fetal anterior cerebral artery throughout gestation. Gynecol Obstet Invest. 2010; 69(1): 33-39.

7.    Lopez D.O. Perinatal and neurodevelopmental out come of late-onset growth restricted fetuses. Programa de Doctorat. Barcelona; 2010; 130 p.

8.    Kurjak A., Pooh R.K., Merce L.T. et al. Brain Vascularity Visualized by Conventional 2D and 3D Power Doppler Technology. J. of Ultrasound in Obstet. and Gynecol. 2010; 4(3): 249-258.

9.    Baschat A.A. Neurodevelopment following fetal growth restriction and its relationship with antepartum parameters of placental dysfunction. Ultrasound Obstet. Gynecol. 2011; 37: 501-514.

10.  Ageeva M.I. Doppler sonography study fetal hemodynamics: A guide for doctors. M.: RMAPO; 2006; 4-5[In Russ].

11.  Oros D., Figueras F., Cruz-Martinez R. et al. Middle versus anterior cerebral artery Doppler for the prediction of perinatal outcome and neonatal neurobehavior in term small-for-gestational-age fetuses with normal umbilical artery Doppler. Ultrasound Obstet. Gynecol. 2010; 35: 456-461.

12.  Gadelha-Costa, Spara-Gadelha P, Mauad-Filho F. The maximum systolic velocity increases in middle cerebral arteryof normal fetus from 22nd to 38th week of gestation. Acta MedPort. 2006; 19(2): 105-108.

13.  Cheema R., Dubiel M., Breborowicz G. et al. cerebral venous Doppler velocimetry in normal and high-risk pregnancy. Ultrasound Obstet Gynecol. 2004; 24: 147-153.

14.  Dubiel M., Gunnarsson G.O., Gudmundsson S. Blood redistribution in the fetal brain during chronic hypoxia. Ultrasound Obstet. Gynecol. 2002; 20(2): 117-121.

15.  Medvedev M.V. Fundamentals of Doppler in obstetrics. M: Real time; 2010; 44 p [In Russ].

16.  Rossi A., Romanello I.F., Fachech G. et al. Evaluation of fetal cerebral blood flow perfusion using power Doppler ultrasound angiography (3D-PDA) in growth-restricted fetuses. J Ultrasound in Ob. Gyn. 2011; 38: 175-180.

17.  Valkovich E.I. General and Medical Embryology. SPb.: Foliant; 2003; 317 p[ In Russ].

18.  Kornev M.A. Anatomy of the human embryology to maturity. SPb.: Foliant; 2003; 229 p [In Russ].

19.  Barashnev Y.I. Perinatal neurology. M.: Triada-X; 2005; 672 p[In Russ].

20.  Kurjak A., Pooh R.K., Merce L.T. Structural and functional early human development assessed by threedimensional and four-dimensional sonography. Fertil. Steril. 2005; 84(5): 1285-1299.

21.  Hernandez-Andrade E., Figueroa-Diesel H., Jansson T. et al. Changes in regional fetal cerebral blood flow perfusion in relation to hemodynamic deterioration in severely growth-restricted fetuses. Ultrasound Obstet Gynecol. 2008; 32: 71-76.

 


 

Article exists only in Russian.


Article exists only in Russian.


Article exists only in Russian.


 

Article exists only in Russian.


 

Article exists only in Russian.


Article exists only in Russian.


 

Article exists only in Russian.

 

 Article exists only in Russian.

 

Article exists only in Russian.

 

 

Abstract:

Acute severe pancreatitis remains one of the actual issue in urgent surgery Forecast of the disease is dependant on spread of purulent necrotic process in pancreas and retroperitoneal tissues. Therefore diagnosis of purulent complications becomes extremely important.

The aim of the study was to demonstrate and evaluate features of ultrasonography in diagnosis and treatment strategy definition of purulent necrotic complications of acute severe pancreatitis.

Materials and methods. The study included 115 patients with acute destructive pancreatitis aged of 21-81 years The major part of them (50%) were persons at most able-bodied (working) aged 32-59 years. All patients underwent ultrasound diagnostics for determination the spread of pathology and detection of complications of the disease.

Ultrasound scanning was carried out as follows:

1. inspection of pancreatic parenchyma;

2. inspection of cellular tissues;

3. detection of free liquid in the abdominal cavity;

4. evaluation of the abdomen and kidneys;

5. inspection of the pleural cavity

Results. Examination of the parenchyma revealed that the pancreas was often inlarged, had a fuzzy, uneven contours and heterogeneous structure. However, it should be noted that in some cases, the pancreas was normal size and structure. Infected necrosis, acute liquid accumulation and/or free liquid in the abdominal cavity had occurred in 100% of cases in various combinations during examination of cellular tissues. Regarding the abdominal organs following complications were revealed: obstructive jaundice - in 5(4.3%) cases; portal vein thrombosis - in 1 (0.9%) case; splenic abscess - in 1 (0.9%) case. The presence of liquid in the pleural cavity was determined by leaves dissociation of the parietal and visceral pleura. The volume of the liquid was determined according standard classification.

Conclusion. Ultrasound scanning allows to determine the presence and extent of local complications arising at the stage of purulent necrotic complications of acute severe pancreatitis and general complications as a result of systemic pathological effect on the body of the disease.

 

References

1.     Охотников О.И. Перкутанная диапевтика в неотложной абдоминальной хирургии органов панкреато-билиарной зоны. Автореф. ... дис. докт. мед. наук. Воронеж. 1998; 39 с.

2.     Echenique A.M., Sleeman D., Yrizarry J. et al. Percutaneous catheter-directed debridement of infected pancreatic necrosis in 20 patients. J. Vase. Interv. Radiol. 1998; 9: 565-571.

3.     Затевахин И.И., Цициашвили М.Ш., Будурова М.Д. Комплексное ультразвуковое исследование при остром панкреатите. Анналы хирургии. 1999; 3: 36-42.

4.     Scaglione M., Casciani E., Pinto A. et al. Imaging Assessment of Acute Pancreatitis. Semin Ultrasound CT MRI. 2008; 29:322-340.

5.     Багненко С.Ф., Курыгин А.А., Синенченко ГИХирургическая панкреатология. Санкт-Петербург: Речь. 2009; 608 с.

6.     Loser C., Folsch U.R. Acute pancreatitis: medical and endoscopic treatment. Pancreatic disease. State of the art and future aspects of research. 1998; 12: 66-78.

7.     Martines-Noguera A., Mohtserat E., Torruba S. etal. Ultrasound of the pancreas: update and controversies. Eur. Radiol. 2001; 11: 1594-1606.

8.     Mortele KJ, Girshman J, Szejnfeld D, et al. CT-guided percutaneous catheter drainage of acute necrotizing pancreatitis: clinical experience and observations in patients with sterile and infected necrosis. AJR Am. J. Roentgenol. 2009; 192(1): 110-116.

9.     Kumar P., Mukhopadhyay S., Sandhu M. et al. Ultrasonography computed tomography and percutaneous intervention in acute pancreatitis: A serial study. Austral. Radiology. 1995; 39(2): 145-152.

10.   Balthazar E.J., Freeny P.C., van Sonnenberg E. Imaging and intervention in acute pancreatitis. Radiology. 1994; 193: 297-306.

11.   Mortele K.J., Wiesner W., Intriere L. et al. Modified CT severity index for evaluating acute pancreatitis: improved correlation with patient outcome. Am. J. Roentgenol. 2004; 183(5): 1261-1265.

12.   Bharwani N., Patel S., Prabhudesai S. et al. Acute pancreatitis: The role of imaging in diagnosis and management. Clinical Radiology.2011; 66: 164-175.

13.   De Waele J.J., Delrue L., Hoste E.A. et al. Extrapancreatic inflammation on abdominal computed tomography as an early predictor of disease severity in acute pancreatitis: evaluation of a new scoring system. SourcePancreas. 2007; 34 (2): 185-190.

14.   Биссет Р., Хан А. Дифференциальный диагноз при абдоминальном ультразвуковом исследовании. Пер. с англ. под ред. С.И. Пиманова. М.: Медицинская литература. 2001; 272 с.

15.   Бенсман В.М. Облегченные способы статистического анализа в клинической медицине. Краснодар: Издательство КГМА. 2002; 30 с.

16.   Кармазановский ГГ, Степанова Ю.А. Классификация острого панкреатита - современное состояние проблемы и нерешенные вопросы. Медицинская визуализация. 2011; 4: 133-137.

17.   Сидорова Ю.В., Шабунин А.В., Араблинский А.В., Шиков Д.В., Бедин В.В., Лукин А.Ю. Острый панкреатит: некоторые вопросы диагностики и лечения. Диагностическая и интервенционная радиология. 2011; 5(2): 15-26. 

 

 

Abstract:

Hepatocellular carcinoma (HCC) of liver is a widespread oncologic disease. The main risk factor of HCC development is liver cirrhosis. The aim of this article is to describe findings of HCCs in diagnostic imaging, including ultrasound, computed tomography, and magnetic resonance imaging. 

 

References

1.     Cruite I., Tang A., Sirlin C.B. Imaging-based diagnostic systems for hepatocellular carcinoma. Am.J. Roentgenol. 2013; 201(1): 41-55.

2.     Gomes M.A., Priolli D.G., Tralhro J.G., Botelho M.F. Hepatocellular carcinoma: epidemiology, biology, diagnosis, and therapies. Rev. Assoc. Med. Bras. 2013; 59(5): 514-524.

3.     Weinmann A., Koch S., Niederle I.M. et al. Trends in Epidemiology, Treatment, and Survival of Hepatocellular Carcinoma Patients Between 1998 and 2009: An Analysis of 1066 Cases of a German HCC Registry. J. Clin. Gastroenterol. 2013 Sep 25. [Epub ahead of print].

4.     Hyder O., Dodson R.M., Nathan H. et al. Referral patterns and treatment choices for patients with hepatocellular carcinoma: a United States population-based study. J. Am.Coll. Surg. 2013; 217(5): 896-906.

5.     Chamadol N., Somsap K., Laopaiboon V.. Sukeepaisarnjaroen W. Sonographic findings of hepatocellular carcinoma detected in ultrasound surveillance of cirrhotic patients. J. Med. Assoc. Thai. 2013; 96(7): 829-838.

6.     Семендяева М.И., Меркулов И.А., Пастухов А.И. с соавт. Гепатоцеллюлярная карцинома - день сегодняшний. Клиническая практика. 2013; 2: 35-49. Semendyaeva M.I., Merkulov I.A., Pastukhov A.I. et al. Hepatocellular carcinoma - day today's. Klinicheskaya praktika. 2013; 2: 35-49 [In Russ].

7.     Stepanova Yu.A. «Ultrasonic diagnostics of diseases of a liver» (manual). Ed. cor.-mem. of RAMSci L.S. Kokov. M.: «11-y FORMAT», 2013; 38-43 [In Russ].

8.     Willatt J.M., Hussain H.K., Adusumilli S. et al. MR Imaging of hepatocellular carcinoma in the cirrhotic liver: challenges and controversies. Radiology. 2008; 247(2): 311-330.

9.     Asham E.H., Kaseb A., Ghobrial R.M. Management of hepatocellular carcinoma. Surg. Clin. North. Am. 2013; 93(6):1423-1450.

10.   Marks W.M., Jacobs R.P., Goodman PC. et al. Hepatocellular carcinoma: clinical and angiographic findings and predictability for surgical resection. Am. J. Roentgenol. 1979; 132(1): 7-11.

11.   Bruix J., Sherman M., Llovet J.M. et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver, Barcelona September 15-17, 2000. 2001; 35(3): 421-430.

12.   Mayev I.V., Dicheva D.T., Zhilyaev E.V. et al. Difficulties of diagnostics of a hepatocellular carcinoma. Consilium Med. 2010; 8: 63-66 43 [In Russ].

13.   Ayuso C., Rimola J., Garcia-Criado A. Imaging of HCC. Abdominal Imaging. 2012: 37(23): 215-230.

14.   Colombo M., Ronchi G. Clinico-pathological features of hepatocellular carcinoma. Focal Liver Lesions Detection, Characterization, Ablation. Ed by Lencioni R., Cioni D., Bartolozzi C. Springer-Verlag. Berlin, Heidelberg, 2005;169-176.

15.   Forner A., Vilana R., Ayuso C. et al. Diagnosis of hepatic nodules 20 mm or smaller in cirrhosis: prospective validation of the noninvasive diagnostic criteria for hepatocellular carcinoma. Hepatology. 2008; 47(1): 97-104.

16.   Pang R., Poon R.T. Angiogenesis and antiangiogenic therapy in hepatocellular carcinoma. Cancer Lett. 2006; 242(2): 151-167.

17.   Tajima T., Honda H., Taguchi K. et al. Sequential hemodynamic change in hepatocellular carcinoma and dysplastic nodules: CT angiography and pathologic correlation. Am. J. Roentgenol. 2002; 178(4): 885-897.

18.   Sahani D.V., Holalkere N.S., Mueller PR. et al. Advanced hepatocellular carcinoma: CT perfusion of liver and tumor tissue — initial experience. Radiology. 2007; 243(3): 736-743.

19.   Kim YK., Kwak H.S., Kim C.S. et al. Hepatocellular carcinoma in patients with chronic liver disease: comparison of SPIO-enhanced MR imaging and 16-detector row CT Radiology. 2006; 238(2): 531-541.

20.   Iavarone M., Sangiovanni A., Forzenigo L.V. et al. Diagnosis of hepatocellular carcinoma in cirrhosis by dynamic contrast imaging: the importance of tumor cell differentiation. Hepatology. 2010; 52(5): 1723-1730.

21.   Di Benedetto N., Peralta M., Alvarez E. et al. Incidence of hepatocellular carcinoma in hepatitis C cirrhotic patients with and without HIV infection: a cohort study, 1999-2011. Ann. Hepatol. 2013 Jan-2014 Feb; 13(1): 38-44

22.   Okada M., Murakami T. CT Imaging Characteristics of Hepatocellular Carcinoma. In: Abdomen and Thoracic Imaging. Springer Science+Business Media New York. 2014; 317-346.

23.   Kim C.K., Lim J.H., Lee W.J. Detection of hepatocellular carcinomas and dysplastic nodules in cirrhotic liver: accuracy of ultrasonography in transplant patients. J.Ultrasound. Med. 2001; 20(2): 99-104.

24.   Itoh Y, Akamatsu K. Relationships between echo level and histologic characteristics in small hepatocellular carcinomas. J. Clin. Ultrasound. 1998; 26(6): 295-301.

25.   Практическое руководство по ультразвуковой диагностике. Общая ультразвуковая диагностика. Под ред. В.В. Митькова. М. Видар. 2005; 33-132. Practical guidance on ultrasonic diagnostics. General ultrasonic diagnostics. Ed. V.V. Mitkov. M. Vidar. 2005; 33-132 43 [In Russ].

26.   Albrecht T., Blomley M., Bolondi L. et al. Guidelines for the use of contrast agents in ultrasound. Ultraschall. Med. 2004; 25(4): 249-256.

27.   Lencioni R., Cioni D., Bartolozzi C. Tissue harmonic and contrast-specific imaging: back to gray scale in ultrasound. Eur. Radiol. 2002; 12(1): 151-165.

28.   Kelekis N.L., Semelka R.C., Worawattanakul S. et al. Hepatocellular carcinoma in North America: a multi institutional study of appearance on T1-weigh- ted, T2-weighted, and serial gadolinium-enhanced gradient-echo images. Am. J. Roentgenol. 1998; 170(4): 1005-1013.

29.   Choi B.I. The current status of imaging diagnosis of hepatocellular carcinoma. Liver Transpl. 2004; 10 (Suppl 1): 20-25.

30.   Iannaccone R., Laghi A., Catalano C. et al. Hepatocellular carcinoma: role of unenhanced and delayed phase multi-detector row helical CT in patients with cirrhosis. Radiology. 2005; 234(2): 460-474.

31.   Kim C.K., Lim J.H., Park C.K. et al. Neoangiogenesis and sinusoidal capillarization in hepatocellular carcinoma: correlation between dynamic CT and density of tumor microvessels. Radiology. 2005; 237(2): 529-533 

 

Abstract:

Diffuse liver lesion is one of the leading positions in the structure of hepatobiliary pathology Dispite the large number of available diagnostic methods biopsy followed by histological examination is a «gold standart» untill now. Bioimpedancemetry is a potential method of evaluation of morpho-functional analysys of the organ.

Aim: was to clarify dependence of indices of an electrical impedance of liver tissue on its morfo-functional status and to define general valuation principles of absolute and relative measures of an electrical impedance of an organ in case of liver diffusion pathology in an experiment.

Metarials and methods: the experimental study was carried out on 66 Wistar rats 180-230 g. The diffuse liver failure was modeled by using 0,02% solution of N-nitrozodiethylamin with water that animals were drinking during all the period of experiment (120 days). Bioimpedancemetry and morphological investigation as a next step were performed on 14, 30, 60, 90, 120 days in parallel with biochemical blood analysis, sonography of the liver and morphological analysis.

Results: biophysical parameters of liver's parenchyma in cases of toxic hepatitis were characterized by increasing of absolute bioimpedance indices more than 50% and increasing of impedance dispersion coefficient of 16%. But in cases of drrhosis of the liver biophysical paremeters were characterized by decreasing of absolute indices of electrical impedance and increasing of heterogeneity coefficient of the liver of 50 to 100% at different measurement frequencies.

Conclusion: obtained data confirm the diagnostic value of bioimpedancemetry and give prerequisites for further studying of parameters of an electric impedance of liver parenchyma in clinical practice.  

 

References

1.     Shirokikh I.N., Mavlitova L.A., Tuev A.V., Khlynova O.V Diagnostika fibroza pecheni: ideal'ny li metody? [Liver fibrosis diagnosis: are methods perfect?] Permskiy meditsinskiy zhurnal. 2013; 30(3): 93-102 [In Russ].

2.     Yuschuk N.D., Znoyko O.O., Dudina K.R., Belyy PA. Problema virusnogo gepatita C v Rossijskoj Federacii. [The problem of viral hepatitis C in the Russian Federation.] Terapevticheskiyarkhiv. 2014; 86 (10): 77-81 [In Russ].

3.     Fedeli U., Avossa F., Guzzinati S., Bovo E., Saugo M. Trends in mortality from chronic liver disease. Ann. Epidemiol. 2014; 24(7): 522-526.

4.     Morozov S.V., Isakov V.A., Kaganov B.S. Sovremennye metody neinvazivnoj ocenki vyrazhennosti fibroza pecheni. [Modern methods of non-invasive evaluation of the severity of hepatic fibrosis. ] Infektsionnye bolezni. 2009; 7(4): 44-49 [In Russ].

5.     Saba L., di Martino M., Bosco S., Del Monte M., de Cecco C.N., Lombardo V., Piga M., Catalano C. MDCT classification of steatotic liver: a multicentric analysis. Eur. J. Gastroenterol. Hepatol. 2015; 27 (3): 290-297.

6.     Toosi A.E. Liver Fibrosis: Causes and Methods of Assessment, A Review. Rom. J. Intern. Med. 2015; 53 (4): 304-314.

7.     Beloborodova E.V., Beloborodova E.I., Purlik I.L., Kalacheva T.P. State of the liver at chronic hepatites of various etiology (according to data of morphological study of liver biopsy specimens). Klinicheskie perspektivy gastroenterologii, gepatologii. 2014; 1: 31-36 [In Russ].

8.     Kobyliak N., Abenavoli L. The role of liver biopsy to assess non-alcoholic Fatty liver disease. Rev. Recent Clin. Trials. 2014; 9 (3): 159-169.

9.    Nikolaev D.V., Smirnov A.V., Bobrinskaya I.G., Rudnev S.G. Bioimpedansnyj analiz sostava tela cheloveka. [Bioelectric impedance analysis of human body composition.] Moscow: Nauka. 2009: 392 p. [In Russ].

10.  Rodin A.V., Pleshkov V.G., Leonov S.D. Opredelenie zhiznesposobnosti kishechnika pri ostroj kishechnoj neprohodimosti v ehksperimente. [Determination of the viability of the intestine during experimental acute intestinal obstruction.] Vestnik eksperimentalnoy i klinicheskoy khirurgii. 2011; 4(1): 145-147 [In Russ].

11.  Panchenkov D.N., Leonov S.D., Rodin A.V. Razrabotka algoritma bioimpedansnogo analiza novoobrazovanij na modeli perevivaemoj opuholi RS-1 v ehksperimente [Development of bioimpedance analysis algorithm of tumors on an experimental model with transplanted RS-1 tumor.] Vestnik eksperimentalnoy i klinichesk,oy khirurgii. 2013; 6 (3): 287-291 [In Russ].

12.  Panchenkov D.N., Leonov S.D., Rodin A.V. Bioimpedansnyj analiz v medicine. [Bioimpedance analysis in medicine.] Patologicheskaya fiziologiya i eksperimentalnaya terapiya. 2014; 2: 80-86 [In Russ].

13.   Tornuev Yu.V., Koldysheva E.V., Lapiy G.A., Molodykh O.P., Balakhnin S.M., Bushmanova G.M., Semenov D.E., Preobrazhenskaya V.K. Bioimpedancemetry in the diagnostics of inflammatory process in the mammary gland. Bulletin of Experimental Biology and Medicine. 2014; 156 (3): 381-383.

14.   Abdullaev N.A., Balahnin S.M., Bushmanova G.M., Karpova A. A., Koldysheva E.V., Krinicyna Ju.M., Lapij G.A., Mzhelskaja M.M., Majborodin I.I., Manvelidze R.A., Preobrazhenskaya V.K., Senchukova S.R., Tornuev Y.V., Shelkovnikova N.V., Sholenberg E.V., Yakovleva A.Y. Kriterii differencial'noj diagnostiki novoobrazovanij, gastritov i yazvennoj bolezni zheludka po pokazatelyam bioimpedansa. [Differential diagnostic criteria of tumors, gastritis and gastric ulcer by bioimpedance measuring]. Fundamentalnie issledovaniya. 2015; 1: 1775-1779 [In Russ].

15.   Antonienko S.G., Berdinskikh I.K., Mishnaevskaya E.G. Rol' nekotoryh komponentov sistemy ciklicheskih nukleotidov pri gepatokancerogeneze, inducirovannom N-nitrozdiehtilaminom u krys. [The role of some components of the cyclic nucleotide system in hepatocarcinogenesis induced by N- nitrozdietilaminom in rats.] Eksperimentalnaya onkologiya. 1990; 12 (5): 18-21 [In Russ].

16.   Portyanaya N.I., Osipenko B.G., Moskadynova G.A., Novokhatskiy N.K., Guschina A.A., Dobrolyubova B.A., Chernyak Yu.I., Sokolovskiy V.V. K biohimicheskomu mekhanizmu toksicheskogo dejstviya gidrazinov. [Biochemical mechanism of toxic action of hydrazines.] Materials of the 1 Congress of Toxicologists of Russia. М. 1998; 306 [In Russ].

17.   Bogdanov N.A. Patologiya, klinika i terapiya porazhenij zhidkimi raketnymi toplivami. [Pathology, clinic and therapy of damages with liquid rocket fuel. Leningrad:] VMA. 1970: 152 p [In Russ].

18.   Avakyan A.Kh. Novye molekulyarnye kriterii ocenki toksicheskogo dejstviya proizvodnyh gidrazina. Aktivnye formy kisloroda kak klyuchevye agenty v mekhanizme toksichnosti. [New molecular criteria for assessment the toxic effects of hydrazine derivatives. Reactive oxygen species as key agents in the mechanism of toxicity.] Farmakologiya i toksikologiya. 1990; 53 (1): 70-73 [In Russ].

19.   Obraztsov S.A., Leonov S.D., Troitskiy Yu.V., Fedorov G.N. Ustrojstvo dlya izmereniya impedansa biologicheskih tkanej. [Device to measure biological fabric impedance. ]Patent RF, no 2366360, 2009.

20.   Smorodinov A.V., Leonov S.D. Elektrod dlya provedeniya bioimpedansometrii. [Electrode for performing electric impedancemetry.] Patent RF, no 2318435, 2008.

 

 

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