Novosti
Khirurgii

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Year 2016 Vol. 24 No 3

GENERAL & SPECIAL SURGERY

B.F. SHEVCHENKO, A.M. BABIY, N.G. GRAVIROVSKAYA, O.P. PETISHKO

THE VALIDITY OF RADIOLOGICAL METHODS IN ASSESSMENT OF INFLAMMATORY ACTIVITY AND FIBROUS TRANSFORMATION OF THE PANCREAS AT CHRONIC PANCREATITIS

SE ''Institute of Gastroenterology of NAMS of Ukraine'',
Dnepropetrovsk
Ukraine

Objectives. To study the validity of radiological methods of diagnosis in assessment of inflammation activity and fibrous transformation degree of the pancreas at chronic pancreatitis.
Methods. The comparison analysis of results of the radiological research methods (CT scan, ultrasound, sonoelastography and sonoelastometry in Shear Wave Elastography mode) with those of morphological assessment of the pancreatic biopsies obtained during surgical interventions due to the complications of chronic pancreatitis had been carried out in 98 patients. Age of patients varied from 26 up to 76, there were 77 (78,6%) males and 21 (21,4%) females.
Results. According to ROC analysis of the non-invasive assessment of inflammation activity and the evaluation of the fibrotic transformation degree of the pancreas, the low sensitivity and specificity of the quantitative and qualitative indices according to ultrasound and computed tomography scan had been established.The high sensitivity, specificity and accuracy of the sonoelastography method with sonoelastometry of the pancreas at chronic pancreatitis in determining rigidity of the anatomical parts of the pancreas in the evaluation of the fibrotic transformation degree of the pancreas according to the data of the conducted ROC-analysis made up in the pancreatic head 83,3%, 88,9% and 85,7% (AUC=0,843 (95% confidence interval (CI) 0,619-0,963), in the pancreas 81,8%, 76,9% and 79,2% (AUC=0,748 (95% CI 0,531-0,901) and it had a high diagnostics value; in the pancreatic tail - 66,7%, 75,0% and 64,3% (AUC=0,604 (95% CI 0,317-0,846), that possessed low diagnostics value.
High prognostic valuation of inflammation activity in the head of pancreas at the early (73,3%, 80,0%, 68,0% (AUÑ=0,727 (95% CI 0,513-0,884) and later (87,5% and 100,0%, 88,2% (AUC=0,972 (95% CI 0,759-1,000) degrees of pancreatic fibrosis at chronic pancreatitis had been determined.
Conclusion. Thus, indices of sonoelastography with sonoelastometry of the pancreas in assessing of fibrotic transformation degree and pancreatic inflammation activity allowed to establish the high informative value of the research methods unlike thoses of the computed tomography scan and ultrasound at chronic pancreatitis.

Keywords: chronic pancreatitis, morphology, sonoelastography, fibrous transformation, inflammation activity, radiological methods of diagnostics, pancreatic parenchyma
p. 240-248 of the original issue
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Address for correspondence:
49074, Ukraine,
Dnepropetrovsk, pr-t im. Gazetyi ''Pravda'', d. 96,
GU ''Institut gastroenterologii NAMN Ukrainyi'',
otdelenie khirurgii organov pischevareniya,
tel. office: 38 0562 27 05 59,
e-mail: Aleksandr_babiy@ukr.net,
Babiy Aleksandr Mihaylovich
Information about the authors:
Shevchenko B.F. MD, professor, a chief researcher of the surgery department of the digestive organs of SE ''Institute of Gastroenterology of NAMS of Ukraine''.
Babiy A.M. PhD, a senior researcher of the surgery department of the digestive organs of SE ''Institute of Gastroenterology of NAMS of Ukraine''.
Gravirovskaya N.G. PhD, a leading researcher of the department of research-organizational, methodical work and informational technologies of SE ''Institute of Gastroenterology of NAMS of Ukraine''.
Petishko OP. A researcher of the department of research-organizational, methodical work and informational technologies of SE ''Institute of Gastroenterology of NAMS of Ukraine''.
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