From Big Medical Encyclopedia

REOGEPATOGRAFIYA (Greek rheos a current, a flow + hepar, hepatos a liver + grapho to write, represent) — the graphical method of a research of a blood-groove of a liver based on registration of fluctuations of electric resistance of tissue of liver during the passing of current of high frequency through it. The river is a private look reografiya (see).

Reogepatografiya allows to judge the processes happening in vascular system to some extent liver (see), features of its krovenapolneniye. The method is physiologic and available, however small informational content, and also high percent of false results limit its use at inspection of patients. Considering close connection between a krovenapolneniye of a liver and the general hemodynamics, along with reogepatogrammy register also an ECG (see. Elektrokardiografiya ).

The ruble is carried out on an empty stomach after 10 — 15-minute rest, in position of the patient lying on spin at breath holding after a superficial exhalation. In some cases it will be out after pharmacological loading (a papaverine, an Euphyllinum, Nospanum, etc.).

For record of a reogepatogramma various types of reograf can be used (see. Reografiya ). At the same time the small (active) electrode is imposed on skin directly over a costal arch on the right sredneklyuchichny line; the big (passive) electrode is imposed on skin in the field of hepatic dullness — 10 mm lower than the lower bound of the right lung defined perkutorno between paravertebral and back axillary lines.

the Electrocardiogram (a) and a reogepatogramma (b) are normal: The expert — amplitude of a systolic wave; The ABP — amplitude of a diastolic wave; α — a rise time, β — time of decrease in a systolic wave and the diastolic wave which is imposed on it; the top of a systolic wave corresponds to the beginning of a tooth of T on an ECG.

Reogepatogramma (fig.) represents a curve, on a cut judge the size and dynamics of a krovenapolneniye of arteries and veins of a liver taking into account resilient-elastic properties of their walls. Reogepatogramma consists of the greatest on amplitude (Expert) of a systolic wave with abrupt ascending and flat descending knees. The ascending part of a systolic wave is caused by inflow of an arterial blood to a liver and acceleration of a blood-groove, arising right after a systole of heart; the descending part — outflow from a liver of a venous blood and delay of a blood-groove. The top of a systolic wave corresponds to the beginning of a tooth of T on an ECG and reflects the moment of the smallest electric resistance, i.e. temporary balance between inflow of blood to a liver and its outflow; blood at the same time passes through a capillary network of a liver. After recession of a systolic wave outflow of blood from a liver begins to exceed inflow, degree of a krovenapolneniye of hepatic vessels decreases and decreases conductivity of body. At first the systolic wave falls down hollow, then abruptly, then process of change of conductivity is gradually slowed down, and again there comes balance between inflow and outflow of blood. Increase of inflow of blood on a portal vein leads to increase in a krovenapolneniye of a liver and emergence of a diastolic (venous) wave, smaller on amplitude (ABP), again, edges is imposed on the descending knee of a systolic wave and, merging with it, passes into the diastolic plateau. The descending part of a systolic wave and a diastolic wave — the most labile parts of a reogepatogramma.

The qualitative characteristic reogepatogramm includes a regularity oxen and their identity, a form of all curve and its basic elements. The most essential in a wedge, practice quantitative indices are: sizes of amplitudes Expert and ABP; the reografichesky index (I) characterizing extent of arterial filling of a liver and the Expert equal to the relation / To where To — a calibration index of this device; a rise time (alpha) and decrease (beta) in a systolic wave in seconds. The form and the main indicators of a reogepatogramma depend on many factors: age, growth, pulse rate, breath, a structure, diameter and elasticity of vessels, from a phase of a menstrual cycle, and also from a form of electrodes, etc.

At focal damages of a liver owing to great compensatory opportunities for blood circulation of a reogepatogramm it is usually changed only at an arrangement of an active electrode directly over patol. center (topographical R.). At diffusion damages of a liver of a reogepatogramm, as a rule, differs from normal a little. So, at an acute hepatitis decrease in amplitude of a systolic wave and reduction of a reografichesky index is noted, at severe defeats the relation decreases At hron. hepatitis of change of a reogepatogramma are constant and expressed: the reografichesky index usually lower than 0,5, duration of systolic rise is shortened, on a curve flattening of a systolic wave in the form of the systolic plateau appears. The greatest expressiveness of change of a reogepatogramma is reached at cirrhosis: amplitude of a curve is sharply reduced, behind top of a systolic wave there are a cutting and the second wave caused by existence of a numerous arteriovenous anastomosis (the reografichesky index does not exceed 0,2 — 0,3); sometimes the curve has an appearance of the broken line with difficult differentiable main waves.

Bibliography: Dzhenkner F. L. A rheoencephalography, the lane with English, M., 1966; A. S's Logins. and To r e l P. E. Papaverinovy test in a reogepatografiya, Rubbed. arkh., t. 43, century 2, page 81, 1971, bibliogr.; they, Value of a reogepatografiya in differential diagnosis of chronic diffusion damages of a liver, Owls. medical, No. 12, page 29, 1974; Fundamentals of hepathology, under the editorship of A. F. Blyuger, page 126, Riga, 1975; In ieganovska-Klamut Z. u. a. Angiographische Untersuchungen bei chronisch aggressiver Hepatitis und aktiver Leberzirrhose, Radiol. diagn., Bd 20, S. 331, 1979; To u-cera J., Nevrtal M. Ober-m a j e of J. Teoreticke jaklady a meto-dika reohepatografie, Vnitfni Lek., sv. 19, s. 873, 1973.

A. F. Blyuger, V. A. Valuk.