Modern radiation examination methods allow to visualize structural features in tissues and organs during lifetime, which is widely used in the clinic. Screening tests allow you to detect pathological changes in the early stages, which opens up opportunities for treating diseases that do not yet have clinical manifestations. The most common and safe is the ultrasound examination of the abdominal organs, which absorb ultrasound waves well. Computer tomography is assigned the role of the standard, due to the higher detail, the possibility of obtaining a large number of projections to identify the site of the pathological focus. For examination of the liver, gallbladder and extra hepatic bile ducts, both methods are used. The analysis of sonograms and computer tomograms made it possible to compare the possibilities and informative ness of these methods in the study of hepatobiliary system structures and to investigate their individual characteristics in healthy individuals of mature age. At examination of 136 adults using ultrasound apparatus RadmirUltimaPU-38, in 77 people (56%) pathological changes in the studied structures that could be treated as a disease were not detected: 48% of them were men (37 people), and 52% are women (40 people). CT scan was used to examine 37 adults by the Siemens Somatom Emotion 16, an examination of the abdominal organs for diseases not associated with pathology of the hepatobiliary system or screening test. In 20 people, which is 54% of the total number of subjects, no pathologies of GBS were detected. Both methods allow us to estimate the size of the gall bladder, the thickness of its walls, the width of the common bile duct, morphological features of the structure. However, functional impairments (stagnation of bile) are visualized on ultrasound sonograms, and in the analysis of computer tomograms – the form, length, width of extra hepatic bile ducts and the corners of their incidence, thanks to the 3-D image. Among the subjects we examined, the mature age, without clinical manifestations of diseases on the part of the hepatobiliary system (GBS), the length and width of the gall bladder were determined with the help of the ultrasound scan. At that, in men after 36 years, the length of the gall bladder increases in comparison with the width and the frequency of morphological changes increases (overhangs), and in women with age, the indexes of both the width and length of the gall bladder increases and the bile stasis is more often observed. The same changes were found in the analysis of computer tomograms. At the same time, in all clinically healthy subjects, both male and female, the thickness of the wall of the gall bladder does not exceed 3 mm. The width of the common bile duct is 6-8 mm in 88,3% of the examined people of both sexes. Among patients selected by randomization method, the frequency of morphological changes in healthy subjects with no complaints from the hepatobiliary system was 18.1% (of which 10.3% were men and 7.8% women). CT examination of the organs of the GBS allows measurements of the angle of incidence of the bladder duct in the total bile duct, which allows us to understand some of the functional features of the activity of the biliary system in people of adulthood without clinical manifestations of diseases of the central nervous system. The study of this indicator has shown that in females under the age of 36 years, the bladder duct enters the common bile duct at dull or sharp angles from 37.44 ° to128.48 °, after 36 years of age – from 15.42 ° to113.2 °. In people of a male under the age of 36 years the angle of inclination may also be dull or sharp from 34.52 ° to 101.14 °, after 36 years – from 22.62 ° to 109.02 °. Reproduction of 3-D image in CT examinations of the hepatobiliary system, in addition to the possibility of detecting biliary edema and bile stagnation, allowed to differentiate the variants of the form of the gallbladder of the subjects being examined – pear-shaped, spindle-shaped, rectangular and boomerangshaped, which occur at different rates in people of different sex and age and can affect the functional capacity of the surveyed structures.
gall bladder, extra hepatic biliary tract, ultrasound scan, computed tomography, mature persons
«Bulletin of problems biology and medicine» Issue 4 Part 3 (141), 2017 year, 255-260 pages, index UDK 611.36:616-073.48:616-073.756.8:616-053.8
