Chronic viral hepatitis B and C in pediatric patients: possibilities of ultrasound techniques for patients’ management

Abstract

Chronic viral hepatitis B and C have already become one of the medical and social problems of modern hepa-tology and paediatrics due to their high prevalence and ability to transform liver parenchyma and form addi-tional complications. Nowadays, it is important to assess and examine patients by ultrasound techniques to esti-mate changes in morphometric, hemodynamic, and echoacoustic characteristics of the liver in patients with viral hepatitis B and C.The aim:to estimate ultrasound morphometric parameters and hemodynamic indexes, morphological deviations of the liver and spleen in pediatric patients with chronic viral hepatitis B and C by implementing of the system as Y. Davoudi diagnostic scale (2015) and analysis of echo-acoustic patterns.Materials and methods.34 children were examined.19 children with chronic viral hepatitis B and C formed group I, while 15 almost healthy children formed group II. All examined patients underwent collecting of anam-nesis, general clinical examination, determination of the degree of liver fibrosis by non-invasive method (Fi-brotest or fibroelastometry) and ultrasound examination of the abdominal cavity organs with the possibility of Doppler scanning. Differences at p<0.05 were considered statistically significant.Results. Obtained data showed that in patientsof group, I index of Y.Davoudi grayscale was higher (2,6±0,26 U) compared with patients of group II (1,4±0,32 U) (p<0,01). Systolic blood flow velocities in the portal vein and the splenic vein were decreased in patients of group I (15,59±0,4 cm/s; 15,7±0,8 cm/s) compared with group II (17,68±0,8 cm/s; 17,54±0,42 cm/s) (p<0,05), resistance index in the hepatic artery was increased in patients of group I (0,78±0,02IU) compared with patients of II group (0,68±0,04 IU) (p<0,05). Histogram indexes of the liver and liver-kidney region were higher in patients of group I (p<0,001).Сonclusions.Y.Davoudi diagnostic scale, hemodynamics parameters of the portal, splenic and hepatic vessels, echoacoustic patterns and other indexes could be prognostic factors which will indicate liver fibrosis progres-sion in patients with chronic viral hepatitis B and C.The analysis of the obtained data showed that deviations in morphometric, echoacoustic and Doppler indexes of liver and spleen in paediatric patients with chronic viral hepatitis B and C were more clinically significant compared with almost healthy children and could be taken in-to account as liver fibrosis predictors.