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Diomidova V.N., Valeeva O.V., Vasilyeva L.N., Razbirina E.A.
Informativeness of transient and two-dimensional shear wave elastography in assessing of liver stiffness in post-COVID-19 and cardiohepatic syndromes
Keywords: elastography, shear wave, liver, post-COVID syndrome, chronic heart failure, cardiohepatic syndrome, correlation
Ultrasound elastography of diffuse liver diseases allows to assess liver stiffness and predict the further course of the disease, determine the tactics of patient’s management for post-Covid and cardiohepatic syndrome. The purpose of the research – to study the diagnostic informativeness and evaluate the correlation between one-dimensional and two-dimensional shear wave elastography technologies with elastometry in assessing liver stiffness in patients with post-COVID and cardiohepatic syndromes. Materials and methods. A comparative analysis of the information content and correlation between the results of one-dimensional and two-dimensional shear wave elastography of the liver was carried out in 85 patients with post-COVID (N1; n = 30) and cardiohepatic (N2; n = 25) syndromes. The control group (N3; n = 30) consisted of patients without the new coronavirus infection COVID-19 and without any pathology of the liver and biliary system. In the control group, the study of liver parenchyma stiffness using shear wave elastography was carried out by lobes and segments. Standard variation statistics algorithms were used, taking into account the type of data distribution in the statistical analysis. Quantitative indicators with a normal distribution were described using arithmetic means (M) and standard deviations (SD), boundaries of the 95% confidence interval (95% CI). In the absence of a normal distribution, quantitative data were described using the median (Me) and lower and upper quartiles (Q1–Q3). Research results. The stiffness values (Emean) in the projection of segments VI, VII had larger values (p = 0.02) when compared with other segments. We obtained the following Emean values in transient elastography: in the group of patients with post-COVID syndrome (N1) – 10.02 kPa; in the group of patients with chronic heart failure (N2) – 14.09 kPa, which turned out to be significantly higher than the stiffness of the liver parenchyma among healthy individuals, where the Emean value was 4.90 kPa (p = 0.05). With shear wave elastography, the results were also higher in the group of patients with chronic heart failure (N2), where Emean was 20.90 kPa, compared to the group of patients with post-COVID syndrome (N1) – 11.86 kPa. Conclusions. The results of shear wave elastography were successful in 100% of cases, the results of transient elastography in 84.6% of cases. Correlation analysis of connections in a group of patients with chronic heart failure according to TE and SWE showed a weak positive direct linear correlation. A positive direct linear correlation of medium strength was obtained in assessing the correlation in the group of patients with post-COVID syndrome.
References
- Borsukov A.V. Adaptatsiya mirovykh i evropeiskikh rekomendatsii po elastografii pecheni dlya otechestvennoi luchevoi diagnostiki [Adaptation of world and European recommendations on liver elastography for domestic radiological diagnostics]. Meditsinskaya vizualizatsiya, 2017, vol. 21, no. 6, pp. 63–71.
- Vasil’eva L.N., Ksenofontova A.G., Bayukova S.V. Serdechno-pechenochnyi sindrom: innovatsionnaya diagnostika metodom ul’trazvukovoi elastografii [Cardiohepatic syndrome: innovative diagnostics using ultrasound elastography]. Acta Medica Eurasica, 2022, no. 1, pp. 9–18.
- Diomidova V.N, Razbirina E.A., Valeeva O.V., Vasil’eva L.N. Effektivnost’ elastografii sdvigovoi volnoi v otsenke porazheniya pecheni u patsientov s postkovidnym sindromom [Efficacy of shear wave elastography in assessing liver damage in patients with post-Covid syndrome]. Acta Medica Eurasica, 2022, no. 3, pp. 99–113.
- Diomidova V.N., Vasil’eva L.N., Valeeva O.V., Petrova O.V. Vozmozhnosti ul’trazvukovoi elastografii v otsenke porazheniya pecheni pri khronicheskoi serdechnoi nedostatochnosti [Possibilities of ultrasound elastography in assessing liver damage in chronic heart failure]. Prakticheskaya meditsina, 2021, vol. 19, no. 5, pp. 27–31.
- Il’chenko L.Yu., Nikitin I.G., Fedorov I.G. COVID-19 i porazhenie pecheni [COVID-19 and liver damage]. Arkhiv vnutrennei meditsiny, 2020, no. 10(3), pp. 188–197.
- Kulebina E.A., Surkov A.N., Usol’ceva O.V. Neinvazivnaya diagnostika fibroza pecheni: vozmozhnosti instrumental’nykh metodik na sovremennom etape [Non-invasive diagnosis of liver fibrosis: possibilities of instrumental techniques at the present stage]. Meditsinskoe obozrenie, 2020, no. 4(5), pp. 297–301.
- Pavlov Ch.S. Fibroz pecheni pri khronicheskikh virusnykh gepatitakh: avtoref. dis. … d-ra med. nauk [Liver fibrosis in chronic viral hepatitis. Doct. Diss.] Moscow, 2009, 34 p.
- Solov’eva A.E., Kobalava Zh.D., Villeval’de S.V. et al. Prognosticheskoe znatshenie plotnosti pecheni pri dekompensatsii serdechnoi nedostatochnosti: rezul’taty prospektivnogo nablyudatel’nogo issledovaniya, osnovannye na dannykh nepryamoi elastometrii [Prognostic value of liver density in decompensated heart failure: results of a prospective observational study based on indirect elastometry data]. Kardiologiya, 2018, vol. 28, no. 10, pp. 20–32.
- Tkach S.M. Zabolevaniya pecheni i pechenochnaya disfunktsiya u bol’nykh s serdechnoi nedostatochnost’yu [Liver diseases and liver dysfunction in patients with heart failure]. Sertseva nedostatnіst’ ta komorbіdnі stani, 2017, no. 3, pp. 90–96.
- Khasanova D.R., Zhitkova Yu.V., Vaskaeva G.R. Postkovidnyi sindrom: obzor znanii o patogeneze, neiropsikhiatricheskikh proyavleniyakh i perspektivakh lecheniya [Post-Covid syndrome: a review of knowledge about pathogenesis, neuropsychiatric manifestations and treatment prospects]. Nevrologiya, neiropsikhiatriya, psikhosomatika, 2021, no. 13(3), pp. 93–98.
- Antúnez-Montes O.Y., Buonsenso D.Routine use of point of care lung ultrasound during the COVID-19 pandemic. Med Int., 2020, vol. 46(1), pp. 42–45.
- Bavu E., Gennisson J.L., Couade M. et al. Noninvasive in vivo liver fibrosis evaluation using supersonic shear imaging: a clinical study on 113 hepatitis C virus patients. Ultrasound Med Biol, 2011, vol. 37, pp. 1361–1373. DOI: 10.1016/j.ultrasmedbio.2011.05. 016.
- Bertolini A., van de Peppel I.P., Bodewes F.A., Moshage H. et al. Abnormal liver function tests in COVID-19 patients: relevance and potential pathogenesis. Hepatology, 2020, vol. 72(5), pp. 1864–1872.
- Ferraioli G., Tinelli C., Dal Bello B. et al. Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: a pilot study. Hepatology, 2012, vol. 56, pp. 2125–2133. DOI: 10.1002/hep.25936.
- Gargani L., Soliman-Aboumarie H., Volpicelli G. et al. Why, when, and how to use lung ultrasound during the COVID-19 pandemic: enthusiasm and caution. Eur Heart J Cardiovasc Imaging, 2020, vol. 21(9), pp. 941–948.
- Garrido I., Liberal R., Macedo G. Review article: COVID-19 and liver disease – what we know on 1st May 2020. Aliment Pharmacol Ther., 2020, vol. 52(2), pp. 267–275.
- Leung V., Shen J., Wong V. et al. Quantitative elastography of liver fibrosis and spleen stiffness in chronic hepatitis B carriers: comparison of shear-wave elastography and transient elastography with liver biopsy correlation. Radiology, 2013. vol. 269, pp. 910–918. DOI: 10.1148/radiol.13130128.
- Metawea M.I., Yousif W.I., Moheb I. COVID 19 and liver: An A–Z literature review. Digestive and liver disease, 2021, vol. 53, no. 2, pp. 146–
- Nikolaou M., Parissis J., Yilmaz M. Liver function abnormalities, clinical profile, and outcome in acute decompensated heart failure. Eur Heart J., 2012, vol. 34(10), pp. 742–749.
- Olry A., Meunier L., Delire B., Larrey D. et al. Drug Induced Liver Injury and COVID 19 Infection: The Rules Remain the Same. Drug Safety, 2020, vol. 43, pp. 615–617.
- Radzina M., Putrins D.S., Micena A. et al. Post‐COVID‐19 Liver Injury: Comprehensive Imaging With Multiparametric Ultrasound. Journal of Ultrasound in Medicine, 2022, vol. 41(4), pp. 935–949.
- Shah S.C., Sass D.A. A review of liver dysfunction in heart failure. Liver Res Open J. Cardiac Hepatopathy, 2015, vol. 1(1), pp. 1–10.
About authors
- Diomidova Valentina N.
- Doctor of Medical Sciences, Professor, Head of the Department of Propaedeutics of Internal Diseases with a Course of Radiation Diagnostics, Chuvash State University; Head of the Department of Ultrasound Diagnostics, City Clinical Hospital № 1, Russia, Cheboksary (diomidovavn@rambler.ru; ORCID: https://orcid.org/0000-0002-3627-7971)
- Valeeva Olga V.
- Candidate of Medical Sciences, Associate Professor, Department of Propaedeutics of Internal Diseases with a Course of Radiation Diagnostics, Chuvash State University; Ultrasound Diagnostics Doctor, City Clinical Hospital № 1, Russia, Cheboksary (valeeva-usd@mail.ru; ORCID: https://orcid.org/0000-0002-0349-1883)
- Vasilyeva Lidiya N.
- Senior Lecturer, Department of Propaedeutics of Internal Diseases with a Course of Radiation Diagnostics, Chuvash State University, Russia, Cheboksary (klni21@mail.ru; ORCID: https://orcid.org/0000-0002-3298-3051)
- Razbirina Ekaterina A.
- Assistant Lecturer, Department of Propaedeutics of Internal Diseases with a Course of Radiation Diagnostics, Chuvash State University; Ultrasound Diagnostics Doctor, Emergency Hospital, Russia, Cheboksary (razbirinae@mail.ru; ORCID: https://orcid.org/0000-0003-3189-0360)
Article link
Diomidova V.N., Valeeva O.V., Vasilyeva L.N., Razbirina E.A. Informativeness of transient and two-dimensional shear wave elastography in assessing of liver stiffness in post-COVID-19 and cardiohepatic syndromes [Electronic resource] // Acta medica Eurasica. – 2023. – №4. P. 31-43. – URL: https://acta-medica-eurasica.ru/en/single/2023/4/4/. DOI: 10.47026/2413-4864-2023-4-31-43.