ULTRASOUND TECHNOLOGIES IN ALGORITHMS OF CHRONIC LIVER DISEASE MANAGEMENT

Abstract

Aim. To improve the management algorithm of chronic hepatobiliary pathology by using ultrasound technologies to assess the structure of the liver. Materials and methods. The results of an anonymous electronic survey of 304 doctors using a tailored questionnaire and the authors' own experience of implementing quantitative ultrasound methods of liver assessment at the University Clinic of the Bogomolets National Medical University were analyzed. In accordance with the objective, an analysis of current international guidelines of relevant medical associations was performed. The study of the use of ultrasound diagnostics in the healthcare system of Ukraine was performed using data from open sources of the Ministry of Health of Ukraine and dashboards of the National Health Service of Ukraine (NHSU). Statistical analysis was performed using the MedStat program. The study was approved by the local ethics committee. Results. The availability of basic ultrasound diagnostics of hepatobiliary pathology is high and growing, while modern technologies for quantitative assessment of the liver structure are not sufficiently implemented in medical practice. An improved multilevel patient’s pathway with suspected steatotic liver disease is proposed. Conclusions. Significant limitations of the use of specialized liver examinations in medical practice may adversely affect the quality of medical care. Given the trends in the prevalence of chronic liver disease, the healthcare system needs additional technical equipment for healthcare facilities and focused continuing professional development activities for doctors to ensure the implementation of evidence-based management of chronic hepatobiliary pathology. An improved algorithm of interaction between doctors and the staged use of non-invasive diagnostic tests can help improve the medical care quality and the efficient use of human and financial resources of the healthcare system.

Keywords

• chronic liver diseases
• radiological diagnostics
• ultrasound liver steatometry
• liver elastometry