научно клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико биологического агентства", Москва 3 МСЧ № 119 ФМБА России, Москва Борсуков А.В.-доктор мед. наук, профессор, директор ПНИЛ "Диагностические исследования и малоинвазив ные технологии" СГМА, зав. отделением диагностических и малоинвазивных технологий ОГБУЗ "Клиническая больница № 1". Морозова Т.Г.-канд. мед. наук, старший научный сотрудник ПНИЛ "Диагностические и малоин вазивные технологии". Ковалёв А.В.-младший научный сотрудник ПНИЛ "Диагностические и малоинвазивные технологии", ординатор кафедры эндокринологии СГМА, врач ультразвуковой диагностики отделения диагнос тических и малоинвазивных технологий ОГБУЗ "Клиническая больница № 1". Сафронова М.А.-аспирант кафед ры онкологии СГМА, врач онколог ОГБУЗ СООКД. Казакова О.П.-зав. амбулаторно хирургическим операцион ным отделением. Иванов Ю.В.-доктор мед. наук, профессор, зам. директора НИИ клинической хирургии, зав. хирургическим отделением.
A method for photodynamic therapy was developed in experiments on the model of melanoma B16. The photosensitizer is injected by two doses, while laser exposure is carried out during coincidence of its maximum accumulation phases in tumor vessels and cells. This method increased the percentage of animals with complete regression of the tumor, decreased the coefficient of absolute tumor increase in animals with progressive tumor growth, increased survival of mice, and significantly decreased melanoma metastasizing to the lungs in comparison with untreated animals and even with the standard photodynamic therapy.
Objective. Evaluate the main criteria for ASL-liver perfusion in viral hepatitis.Material and methods. 111 patients with viral hepatitis, including 69 (62.2%) men and 42 (37.8) women, were examined on the basis of “Clinical hospital N 1”, Smolensk. The average age of patients was 48 ± 5.4 years. All subjects (n = 111) underwent abdominal ultrasound with Doppler vascular examination, clinical elastography, and ASL-liver perfusion with magnetic resonance imaging (MRI). The reference method was trepan liver biopsy in 69 (62.1%) people.Results. Patients were observed for 9 months. A proportion of the prognosis of the course of the viral hepatitis was compiled, followed by a coefficient-PHBF/PABF, where PHBF is the coefficient of blood flow in the liver parenchyma, PABF is the blood flow in the hepatic artery or abdominal aorta. According to the results of observation of patients, it was found that 54 (48.6%) received more than 1, and 57 (51.3%) had a prognosis coefficient of less than 1. There was a high correlation between positive clinical and laboratory dynamics and an increase in ASL-perfusion of the liver (r = 0.889), as well as negative clinical and laboratory dynamics and a decrease in ASL-perfusion of the liver (r = 0.887). it was found that in patients with a minimum degree of VH activity, the volume of hepatic blood flow (HBF) according to ASL-perfusion of the liver during MRI was from 140 – 159 ml/100 g/min, with a moderate – 118–139 ml/100 g/min, with high – 40–117 ml/100 g/min.Conclusion. Thus, if the ratio of forecast of more than 1 predict a favorable course (AUC = 0,897 (95% CI 0,884– 0,951)), with a coefficient less than 1 is unfavorable (AUC = 0,895 (95% CI 0,881–0,953)).
Objective:to develop the basics of ultrasound elastography for diffuse and focal liver diseases.Material and methods.180 patients were examined, including 102 (56.7%) men and 78 (43.3%) women. Patients were hospitalized in the gastroenterological and surgical departments: 100 (55.6%) patients with diffuse liver disease (DLD), 80 (44.4%) with focal liver pathology (FLP). All elastographic techniques were used; The liver biopsy served as the reference method (n = 169 (93.8%)).Results.If a patient has steatohepatitis, it is recommended to begin research with transient elastography (TE), in hepatitis – with compression elastography (CE), according to the study, it is determined that shear wave elastography (SWE) is informative in all clinical forms of DLD. The terms of elastographic monitoring have been developed: upon admission, after 6, 9, 12 months. With dynamic observation of patients, elastographic techniques have a high diagnostic and prognostic value with stable and positive clinical laboratory and instrumental dynamics (liver biopsy – AUROC 0,882, DI 0.741–0.699, elastography – AUROC 0,991, DI 0.779–0.997). At FLP the results of SWE help in determining the “zone of interest” for the subsequent conduct of a morphological study, with the aim of establishing a diagnosis.Conclusions.1. In the presence of a patient with steatohepatitis, it is recommended to begin research with TE, in hepatitis with CE, according to the results of the study, it is determined that SWE is informative in all clinical forms of DLD. 2. Dynamic elastographic monitoring in case of DLD should be performed at admission, after 6, 9 and 12 months, and then individually for each patient. 3. With dynamic observation of patients with DLD, elastographic techniques have a high diagnostic and prognostic value with stable and positive clinical laboratory and instrumental dynamics (liver biopsy – AUROC 0.882, DI 0.741–0.66, elastography – AUROC 0.991, DI 0.779–0.997). 4. It has been established that the results of all elastographic techniques can not be used as differential diagnostic tools, SWE helps in choosing a “zone of interest” for biopsy with subsequent verification of the diagnosis (AUROC 0.907 (95% DI 0.889–0.933)).
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