[Magnetic resonance imaging in liver function analysis. Modern objective reality]. / Opredelenie funktsii pecheni s pomoshch'yu magnitno-rezonansnoi tomografii. Sovremennaya ob"ektivnaya real'nost'.

Chronic liver disease is a serious worldwide problem because its progression is accompanied by liver fibrosis and cirrhosis at the terminal stages. Primary diagnosis and dynamic assessment of liver fibrosis are essential to determine the prognosis of disease and optimal treatment strategy. Long-term world experience in the use of gadoxetic acid (primovist, eovist) for diagnosis of liver diseases confirms its hepatotropic properties. Thus, magnetic resonance imaging (MRI) in hepatobiliary phase of contrast enhancement is valuable for differential diagnosis of focal liver lesions and assessment of liver structure and fibrotic changes. This review is devoted to the most common methods of contrast-enhanced MRI for assessment of liver function and correlation between severity of diffuse structural liver changes and gadoxetic acid accumulation in liver parenchyma. There is no a single method for MRI-based analysis of liver function that is confirmed by active researches in this direction. It was found that liver biopsy can by unnecessary in some cases if contrast-enhanced MRI with gadoxetic acid is available. The advantage of gadoxetic acid is also elimination properties. Indeed, biliary excretion ensures T1-weighted MR-cholangiography for additional assessment of patency, function and anatomy of the bile ducts. However, there are still several questions in this area that necessitates further research.

[Clinical and morphological analysis of Langerhans cell histiocytosis in a child of early age]. / Kliniko-morfologicheskii analiz sluchaya langergansokletochnogo gistiotsitoza u rebenka rannego vozrasta.

The authors characterize a rare variant of Langerhans cell histiocytosis in a child of early age. Multiple-system form including liver damage is characterized by a particularly severe course, especially in early childhood. The authors report clinical, morphological and immunohistochemical data of the patient aged 1 year and 11 months. It is shown that timely diagnosis of this disease should be carried out in close cooperation of surgeons and morphologists.

[Liver transplantation for hepatoblastoma in children]. / Transplantatsiya pecheni pri gepatoblastome u detei.

OBJECTIVE: To improve the outcomes in children with hepatoblastoma. MATERIAL AND METHODS: There were 160 children with focal liver lesions who underwent surgery at the department of liver transplantation in 2008-2019. Patients with malignant tumors made up 77% (n=123). Hepatoblastoma (HB) prevailed (86%, n=106). Liver transplantation was performed in 19 (18%) patients with HB. Median follow-up after transplantation was 24.3 months by December 2019. Follow-up period did not exceed 4 years in more than 2/3 of patients. RESULTS: Overall and disease-free 10-year survival was 87.1% and 82.7%, respectively. Similar values were observed after resections (91.1% and 86.6%). At the same time, actuarial 4-year survival after liver transplantation for HB was 68%. CONCLUSION: Improvement of treatment outcomes may be achieved through multidisciplinary interaction ensuring timely drug therapy and liver transplantation.

Comparative Analysis of Long Noncoding RNA Expression in Human Hepatocyte Cell Lines and Liver.

Long noncoding RNAs (lncRNAs) are promising biomarkers and potential targets for liver cancer therapy. Stable hepatocyte lines are used in vitro to investigate functions of lncRNAs which amount in cell fluctuates during carcinogenesis. For the first time we compared gene expression of known lncRNAs in human conditional normal liver cells HepaRG and cancer cell lines Huh7 and HepG2. We showed that relative amounts of these lncRNAs in HepaRG are close to analogous variables measured for liver samples from healthy donors. Obtained data demonstrate exclusive peculiarities of HepaRG and confirm its reasonable application as a model of normal human hepatocytes for studying functions of lncRNAs.

[Advisability of biliary drainage in liver fragments reconstruction]. / Tselesoobraznost' karkasnogo drenirovaniya pri rekonstruktsii zhelcheotvedeniya fragmentarnykh transplantatov pecheni.

AIM: to estimate the effect of decompressive stented drainage of biliary anastomosis on incidence of biliary complications. MATERIAL AND METHODS: 294 patients aged from 5 months to 61 years (mean 13.8±0.81) were enrolled. They underwent liver fragments transplantation in the Department of Liver Transplantation of Petrovsky Russian Research Center of Surgery for the period from March 1997 to January 2016. Decompressive stented drainage tubes were used in 28 (9.5%) patients. Reconstruction without drainage was applied in 266 (90.5%) cases. In the group of biliobiliary reconstruction drainage was used in 18 out of 89 cases (20.2%), in the group of biliodigestive reconstruction - in 10 out of 202 cases (4.9%). Incidence of specific biliary complications was assessed. RESULTS: There was significant direct correlation of stented drainage of biliodigestive anastomosis with various biliary complications including bile leakage (r= -0,1253; p=0.06), obturation of anastomosis (r=0.045; p=0.501), stricture of anastomosis (r= -0.0665; p=0.320), other strictures of intrahepatic bile ducts (r= -0.0291; p=0.664), hepatolithiasis (r=0.0857; p=0.199). However significant direct correation was observed between stented drainage and incidence of intrahepatic bile ducts strictures (r=0.2117; p=0.046) and anastomosis obturation (r=0.2330; p=0.028) in case of biliobiliary reconstruction. Significant correation with other biliary complications was absent (p>0.05). CONCLUSION: Unconstrained stented drainage during primary biliary reconstruction is associated with increased incidence of biliary complications and should not be indicated routinely. Clear need for drainage should be determined in further investigations.