Nonlinear computer diagnostics (Biophilia Intruder NLS) of hepato pancreato duodenal area

The problem of pathology in the hepatopancreatoduodenal area still remains urgent and explains why researches are keen on the search for improved diagnosis methods, since the diagnostics proper is the starting point for determining an approach to treatment. Today the basic methods for diagnosing a pathology in this region are traditionally methods of direct artificial contrasting of the pancreatobiliary system, such as endoscopic retrograde cholangiopancreatography (ERCPG) and percutaneous transhepatic cholangiography (PTCG), well established in both diagnostics and treatment of a number of diseases such as cholelithiasis, cysts and tumors in the head of pancreas, tumorous and corrosive strictures of the biliary ducts, tumors of Vater’s papilla, etc.

At the same time, the radioendoscopic methods of investigation of the biliary ducts, though characterized by a rich diagnostic informational content owing to their invasiveness, still do not eliminate the danger of serious complications, such as acute pancreatitis, hyperamylasemia, cholangitis, sepsis, and allergic reactions, biliary flux into the abdominal cavity with developing biliary peritonitis and hemorrhages.

Their incidence rate varies from 2 to 36%. Besides, in the course of ERCPG different technical problems may arise (failure in the cannulation of Vater’s papilla, the impossibility to enter the duodenoscope at esophagus diseases, such as strictures, achalasia). In addition, ERCPG requires involvement of certain specialists like radiologic diagnosticians, surgical endoscopists and anesthetists.

The development of nonlinear computer diagnostics (Biophilia Intruder NLS) as s method for diagnosing abdominal pathology, opened up new opportunities for detecting diseases in the hepatopancreatoduodenal region, with obstructive jaundice being one of their main clinical implications. With the development and adoption of a number of speedy programs for obtaining NLS images, specifically NLS-cholangiopancreatography, which allows to obtain an integrated virtual picture of the biliary system and pancreatic ducts without administration of contrasting agents and intervention into the biliary system, the method was attempted to put into active use as an alternative to ERCPG.

Some published works about Biophilia Intruder NLS, have some distinct trends to pay more attention to this issue with a view of obtaining sufficiently convincing informaion, that would allow to draw a final conclusion about a new relationship between integrated X-rayendoscopic examinations, and in the first place between ERCPG and NLS, when detecting a pathology in the hepatopancreatoduodenal region. Some of the works suggested that NLS be used as a method preceding endoscopic cholecystoectomy.

With all the above in view, this paper aims to present our data on the role and significance of NLS at certain diseases in the hepatopancreatoduodenal region.

To achieve this aim the following tasks were performed:

– examination of the test group to study different versions of a standard NLS-picture of the biliary tract;

– description of the principal NLS semiotics in the patients with a pathology in the hepatopancreatoduodenal region;

– cross-comparison of MRT, ERCPG and NLS for a more objective assessment of the collected data;

– definition of clinical indications and diagnostic potentials of the NLS method for the patients with obstructed biliary ducts.

The NLS investigation was performed on 54 patients, of them 19 made a test group and 35 had different pathologies in the hepatopancreatoduodenal region, with 89% of these patients showing signs of obstructive jaundice. The patients were from 36 to 77 years old. There were 20 women and 15 men in the group of 35. As a primary method of investigation, all patients had a sonography, which acted as a screening tool for performing NLS. A relative comparison of the results of MRT, ERCPG and NLS was made for 18 patients.

The NLS investigation was carried out using the Biophilia Intruder NLS device, manufactured by the Institute of Practical Psychophysics and equipped with a 4.9 GHz digital trigger sensor.

We assessed the condition of the lymph nodes, especially in the portal fissure projection, and the hepaticoduodenal ligament on the virtual images. We used a special computer program for acquisition of a virtual image of the biliary system and Wirsung’s duct.