Modern methods for diagnostics of liver fibrosis in children

This review is dedicated to nowaday methods of liver fibrosis diagnostic in children. The article presents various types of puncture biopsy of the liver. Implementation of the immunohistochemical method in the morphological analysis of biopsy samples allows us to expand our understanding of the pathogenesis of chronic liver diseases, the role of the concomitant infectious agent in the progression of the disease and its outcomes. Instrumental methods for visualizing fibrosis with an assessment of their diagnostic significance are observed in the article. Ultrasound is a screening method among instrumental examination. Computed and magnetic resonance imaging are obligate imaging methods for suspected fibrosis, but they are do not allow to verify its stage. The advantages and disadvantages of various types of elastography are presented. Promising directions of fibrosis diagnostics are associated with scintigraphy, acoustic structural quantitative analysis. Special attention is paid to serum markers for assessing the stage of liver fibrosis in children; data about the role of several fibrosis markers, such as hyaluronic acid, type IV collagen, transforming growth factor β1, as well as APRI, FIB-4, FibroTest indices in children are presented. Further study of the pathogenetic aspects of fibrogenesis, exploration of new non-invasive techniques for differentiation the intermediate stages of liver fibrosis, and the development of its prognostic criteria are required.