Parenchyma is the name of the parts of the kidney where one of the most important metabolic functions is carried out: blood purification and urine formation occur here. Therefore, if the kidney parenchyma is damaged, this can lead to fatal consequences.
The human body consists of several metabolic systems, each of which has its own functions and characteristics. One of them is the urinary system, which is responsible for removing waste from the body. It consists of:
- pairs of kidneys;
- urethra;
- pairs of ureters;
- renal arteries;
- Bladder.
The kidneys are a paired organ responsible for filtering mineral salts from the blood and producing urine. The vascular part and parenchyma of the kidneys are the main components of this organ. The vascular part is called the renal pelvis, while the parenchyma consists of two parts, the cortex and the renal medulla. It is in the parenchyma that blood purification and urine formation occur.
The basic unit of the kidneys is the nephrons located in the parenchyma (there are millions of them). Nephrons consist of the renal glomeruli, where the main filtration of electrolytes and salts occurs, as well as the renal tubules, which convey purified blood to the center of the kidneys. Thus, it is obvious that parenchymal diseases can cause serious health problems. In 9 out of 10 cases, end-stage kidney disease requires a kidney transplant, but more often requires dialysis, which is a costly and time-consuming procedure that is burdensome for many patients.
What causes parenchymal damage
The causes of diseases of the renal parenchyma are poor nutrition, excess salt intake, diabetes, hypertension, autoimmune and hereditary diseases. The largest number of diseases of the kidney parenchyma is caused by a large group of diseases that belong to glomerulonephritis. This is the name for kidney disease, which is characterized by damage to the kidney glomeruli when proteins and/or blood leak into the urine. With this disease the following are observed:
- Isolated hematuria (blood in the urine) and/or proteinuria (protein in the urine).
- Nephrotic syndrome (severe swelling, a lot of protein, which can cause it to foam).
- Nephritic syndrome (blood in the urine visible to the naked eye, edema, high blood pressure, a lot of protein in the urine).
- Acute renal failure.
- Chronic renal failure.
Glomerulonephritis can occur diffusely (penetration of molecules of one substance between the molecules of another) or locally. Diffuse changes in the renal parenchyma are classified as proliferative diseases (tissue proliferation through cell proliferation), and local ones are non-proliferative. Diagnosis of a specific type of glomerulonephritis is important in order to know the prognosis of the disease and choose the right treatment.
Nonproliferative glomerolonephritis
Non-proliferative glomerulonephritis is characterized by the absence of cell proliferation in the renal glomeruli. Mainly causes nephrotic syndrome. The non-proliferative form is divided into three types:
- Minimal change glomerulonephritis.
- Focal segmental glomerulonephritis.
- Membranous glomerulonephritis.
Minimal change glomerulonephritis, when diagnosed, shows abnormalities in the number of podocytes (the cells that line the capillaries of the glomeruli) that can be seen with an electron microscope in the biopsy specimen, but no structural changes in the tissue are observed. Manifested by nephritic syndrome. According to statistics, it occurs in 80% of diseases in children and 20% in adults. Treatment is aimed at maintenance therapy, plus Prednisolone. In 90% of children and 80% of adults, the prognosis is positive. The disease resolves within 3 months.
With focal segmental glomerulonephritis, sclerosis develops in the glomerular segments, scars and nephrotic syndrome appear. The causes of the disease are determined by genetic studies (primary disease). The disease can also have a secondary form, being provoked by the immunodeficiency virus, nephropathic reflux and some other diseases.
Therapy with steroids, antihypertensive drugs, statins (to treat excess lipids) does not produce results. To reduce edema, limiting salt intake and diuretics is indicated. 50% of cases progress to kidney failure.
Membranous glomerulonephritis is manifested by thickening of the glomerular basement membrane. It is accompanied by nephrotic syndrome, and the disease itself progresses slowly. Occurs most often between the ages of 30-50 years. The reasons are largely unknown, but those at risk are people who have had hepatitis B, malaria, lupus, or who have used penicillamine.
During treatment, steroids are used during the progression stage. In 1/3 of patients, the disease becomes chronic, in 1/3 recovery occurs, in the rest it progresses to renal failure.
Proliferative form
Proliferative glomerulonephritis is characterized by an increase in cells in the glomeruli. Usually this results in nephritic syndrome. This form is more dangerous than nonproliferative glomerulonephritis because it can quickly progress to the final stage of renal failure. There are also several subtypes of this disease.
IgA nephropathy is the most common type of glomerulonephritis in adults and often appears after a respiratory infection. With this disease, nephritic syndrome appears; 24-48 hours after infection of the urinary tract, IgA deposits appear in the glomeruli. Appears sporadically over several months. The disease may be benign or progress to kidney failure.
A biopsy is required to confirm the diagnosis. Microscopic studies in this disease show an increase in mesangial cells and matrix. Treatment is difficult due to the presence of a large number of factors influencing the course of the disease. Therapy with steroids and cyclosporines has had varying success. The prognosis is unstable: 20% of cases progress to renal failure.
Membrane-proliferative glomerulonephritis in most cases progresses to renal failure. It is a combination of nephrotic and nephritic syndromes. The reason is the deposition of immune complexes under the endothelium. It differs from membranous glomerulonephritis in the thickening of the mesangium and basement membrane. Causes include a weak immune system, lupus, and hepatitis B and C.
The cause of post-infectious glomerulonephritis is infections of the urinary system. The most common is streptococcal infection. Usually begins 2 weeks after the onset of infection. During diagnosis, a light microscope shows an increase in the number of mesangial cells, neutrophils and monocytes, and compression of Bowman's capsule. Supportive therapy and antibiotics, the disease resolves in 2-4 weeks.
Goodpasture syndrome is autoimmune in nature, when the action of antibodies is directed against the antigens of the basement membrane of the glomeruli and alveoli in the lungs, which leads to damage to the renal glomeruli and lung tissues and the formation of scar tissue. Accompanied by nephritic syndrome and hemoptysis (hemoptysis). Without treatment, it quickly progresses to kidney failure, and kidney damage is irreversible. For treatment, prednisolone is prescribed intravenously in the form of droppers, cyclophosphamide, and plasmapheresis.
Wegener's granulomatosis (vasculitis) affects the lungs, kidneys and other organs. For treatment, intravenous administration of large doses of steroids with gradual withdrawal, cyclophosphamide is prescribed.
Microscopic polyangitis is a systemic capillary vasculitis that affects all organs and systems of the body. Examination reveals the presence of anti-neutrophil cytoplasmic complexes (p-ANCA) in all cases of the disease. Long-term therapy with prednisone and cyclophosphamide is prescribed as treatment. Plasma exchange is also used to remove neutrophil cytoplasmic complexes (p-ANCA).
Any type of glomerulonephritis can progress to a rapidly progressing stage in which scar tissue forms. The disease progresses rapidly (over weeks) to kidney failure.
It should also be noted that diseases of the renal parenchyma can be acute or chronic. In some cases, a life-threatening disease develops very quickly, but timely and correct treatment can stop the kidneys from completely losing their functions.
Diagnostic features
Diagnosis of kidney parenchymal diseases can be done by ultrasound scanning and other types of testing. Such a scan helps determine that the structure of the parenchyma is heterogeneous. In a healthy kidney, the parenchyma is homogeneous; if this is not the case, the test result indicates kidney damage.
Previously, it was generally accepted that determining the thickness of the parenchyma could indicate the presence of kidney disease. But now this assertion is increasingly being questioned. The fact is that normal kidney size varies greatly from person to person.
Moreover, almost every person has one kidney larger than the other. Some studies indicate that kidney size depends on age and body size (height, weight, amount of fat). The larger the person, the larger the kidney size. Therefore, the thickness of the kidney parenchyma is a rather unreliable indicator of its health. Kidney size increases as we age, reaches a stable size in adulthood, and decreases as we age.
However, it cannot be denied that kidney size often indicates the presence of diseases. For example, polycystic kidney disease and hydronephrosis can lead to enlargement of the organ. Other diseases can lead to kidney atrophy and reduction in their size. These include Allport syndrome, chronic glomerulonephritis and hypertensive nephrosclerosis.
Lung parenchyma is the tissue that forms the basis of the lungs. It is part of external respiration. The quality of diffuse gas exchange and the ratio of oxygen and carbon dioxide in the blood depend on the condition of this tissue.
Morphological features of lung tissue
The lung parenchyma is lined with a certain type of epithelium, the cells of which are functionally active. Clusters of epithelial cells are located in loops formed by connective fibers. This is a kind of reticular stroma - the basis of any parenchymal organ.
Reticular tissue is a matrix in the form of a three-dimensional network, in the loops of which there is an epithelium capable of reproduction and structural renewal. On the outside, the stroma is covered with a dense fibrous capsule (connective fibers).
An integral part of the lung tissue is the alveolus, a bubble-shaped formation that is formed by a network of small vessels (capillaries). It is through these plexuses that gases are exchanged in the respiratory tract.
The alveoli open through a special passage into the respiratory bronchiole (a unit of bronchi). A certain number of such formations are closely grouped and form the acinus - a structural unit of the parenchyma.
Functionality of the main lung tissue
The main function of the parenchyma is to saturate the blood with oxygen and remove carbon dioxide from the body. The barrier to exchange is the membrane, which is formed by the alveolar epithelium, endothelial cells of the capillaries, and intermediate substances.
The alveolar epithelium itself is formed by three types of tissue structures:
- cells that create a strong density, they form a cavity, and gas exchange occurs directly through them;
- another type of cells is club-shaped, they have villi and store a subfactant (an active substance that prevents the alveoli from collapsing and sticking together);
- pulmonary macrophages - eliminate foreign bodies (dust, allergens), form an immunological response.
In addition to its primary respiratory function, the lung parenchyma has other purposes. It is a reservoir of blood in the body (about 9% of the total volume of the blood supply system). The tissue is involved in thermoregulation processes. The lung provides shock absorption for the heart during external pressure - blows, bruises, compression.
Pathological conditions of the parenchyma
Disturbances in the structure of the parenchyma are combined into a group of interstitial diseases. They are chronic in nature and are associated with inflammation, destruction of the alveolar walls, capillary endothelium, and increased fibrosis (replacement of parenchyma with connective tissue scars).
Depending on the type of pathology, morphological changes vary in severity. In some cases, the disease regresses and the parenchyma is completely restored.
If the area of damage to lung tissue is extensive, then the entire architecture of the organ breaks down, areas with cysts (cavities filled with air or liquid) and pneumofibrosis (dystrophy and inflammation) are formed. In this case, the function of gas exchange is seriously impaired.
Diseases of the parenchyma:
Pulmonary parenchyma is of great importance in the human body. Through it, oxygen is supplied at the cellular level and carbon dioxide is removed from the blood. Tissue diseases lead to chronic functional disorders of the lungs.
This is not a diagnosis, but disturbances in the structure of the liver, which indicate hidden pathological processes. Medicine does not consider such changes to be a disease, but they must be treated so as not to bring the organ to a state incompatible with life.
What are diffuse changes in the liver parenchyma
This organ is made up of tissue called parenchyma. It is formed mainly from liver cells - hepatocytes, which renew old or dead areas of tissue. The liver is completely regenerated in about a year and a half. If diffuse (that is, affecting the entire organ) changes are detected in it, then more often this means an increase in parenchymal tissue, less often - its decrease. Such violations can be either minor or large-scale.
Even a banal flu does not go away completely for the liver, but it, as a rule, gets off with minimal changes in the parenchyma. Another thing is severe diffuse lesions after hepatitis of any kind, chronic alcohol poisoning or giardiasis. If scar (fibrous) tissue begins to grow in an organ, it will significantly increase in volume and undergo irreversible structural changes.
Signs and symptoms of hepatomegaly
The liver does not complain for a long time about the difficult conditions of its existence. Organ misfortunes are discovered only by chance during an ultrasound due to completely different patient complaints. Often there is an enlargement of the liver - hepatomegaly, as a result of which the structure of the organ begins to degrade. The density of the parenchyma becomes increased, and its echogenicity is many times higher than normal, that is, ultrasound is reflected from the parenchyma at a much higher speed.
With diffuse changes, the enlarged organ is easily detected by palpation, and this diagnostic procedure causes pain to the patient. If such changes do not occur in an acute form, a person may not experience it. But as the pathology progresses, the symptoms of hepatomegaly become more obvious. Appears:
- heartburn;
- halitosis;
- nausea;
- yellow tint, itchy skin;
- ascites (fluid in the abdominal cavity).
Moderate
Signs of minor liver degradation are common. If they appeared in it, then they are also present in the pancreas. An ultrasound diagnostician determines the presence of moderate diffuse lesions in the liver by increased tissue density, heterogeneity of its structure, and distortion of the pattern of blood vessels. Parenchyma compaction and other echo signs of pathology can manifest themselves through a feeling of discomfort after a fatty meal, a bitter taste in the mouth, headaches, fatigue, and irritability.
According to the type of fatty hepatosis
The liver reacts to metabolic disorders and intoxication of the body in a very unique way: its cells accumulate fat.
Over time, steatosis or fatty infiltration develops, simply - obesity of the organ. The disease is insidious in that it has no symptoms and is often detected by chance during an ultrasound examination of the abdominal cavity. Sometimes a person feels nauseous, weak, tired, and drowsy. Then inhibition may appear in his movements, and monotony in his speech. Even later, a person is overtaken by jaundice, ascites, dizziness, and convulsions.
Reactive changes in the liver parenchyma in a child
Functional immaturity of the stomach and intestines in children, the toxic effects of worms often lead to the development of reactive hepatitis, that is, caused not by liver pathologies. This disease either has no symptoms or manifests itself as mild malaise, digestive disorders, low-grade fever, or emotional decline. With adequate treatment of diffuse abnormalities, liver activity can be restored completely.
Pronounced diffuse changes
When the liver is poisoned by various poisons so severely that it is no longer able to neutralize them, its disintegration begins - cirrhosis. If in the early stages of diffuse-focal degeneration the organ increases in volume, then at a later stage it decreases and shrinks. Its echostructure is diffusely heterogeneous, and its echogenicity is very high. The patient is persistently haunted by pain in the right hypochondrium and right shoulder; his tongue, sclera and skin under his eyes are jaundiced.
Treatment methods
The main treatment for diffuse lesions in the liver consists primarily of eliminating their causes: obesity, alcohol abuse, taking medications that are toxic to this organ, etc. Amino acids, vitamins E and group B improve the condition of the organ. To ensure that liver cells are restored, hepatologists (or therapists) prescribe medications:
- Essentiale forte N;
- Phosphogliv;
- FanDetox;
- Heptral;
- Result Pro;
- Gepabene.
According to indications, courses of treatment with antibiotics, antiviral, anthelmintic and choleretic drugs are carried out. Surgical treatment methods are used when it is necessary to remove stones and tumors in the liver. Patients are prescribed dietary table No. 5 with a ban on fatty, spicy and smoked foods. Salty, sweet, sour foods, alcohol and soda are also prohibited. Priority is given to lean varieties of meat and boiled fish, dairy dishes and soups, cereals and vegetables.
sovets.net
The human liver is an unpaired parenchymal organ consisting entirely of liver tissue. This organ is located in the abdominal cavity towards the right hypochondrium.
The main components of the parenchyma are the liver lobules, between which lie the bile ducts and blood vessels. The bile ducts carry bile to the gallbladder, then the fluid flows into the duodenum, where it reconnects with the pancreatic ducts.
Diseases of the liver and gall bladder are reflected in the health of the pancreas, and in the same way, the condition of the pancreas speaks about the situation of the liver and gall bladder. The liver is the main hematopoietic organ and performs important functions for the human body. An ultrasound examination will help to identify the disease in a timely manner, but laboratory and instrumental studies should be performed to make an accurate diagnosis.
In the normal state, the liver parenchyma is a weakly echogenic structure of uniform consistency. Against its background, you can easily view the bile ducts and vessels. A diffuse change in the liver parenchyma means that the entire tissue of this organ is deformed. It is likely that these are severe lesions. Therefore, it is necessary to conduct additional examinations to determine the severity of such lesions.
The more pronounced the inflammation process is, the larger the swelling of the parenchyma becomes. Echo signs of diffuse liver transformations decrease, and sound conductivity increases.
With obesity, diabetes mellitus and chronic alcoholism, fatty overgrowth of the liver occurs, it increases significantly in size, and the echogenicity of the structure is increased compared to the norm. In chronic hepatitis, the liver is noticeably enlarged, but the structure of the parenchyma may remain homogeneous. In cirrhosis, the structure of the parenchyma becomes diffusely heterogeneous and there are areas of increased, decreased or average echogenicity. In the presence of tumors and cysts, the density of the liver tissue contains local changes.
Diffuse changes in the parenchyma are not considered a disease and cannot be treated specifically. After suffering any disease, moderate diffuse changes in the liver parenchyma occur; treating this condition means identifying the reason why everything happened. It is the underlying disease that needs to be treated. First of all, a qualified specialist should send the patient for blood tests. These are biochemical, serological and tumor marker analysis. A preliminary diagnosis helps to prescribe the necessary methods of instrumental research: MRI and CT, liver puncture with extraction of a histological sample, i.e. a piece of liver tissue.
If the disease was caused by bad habits, then you need to stop smoking and avoid drinking alcohol. If this is due to insufficient nutrition, then the necessary diet is prescribed. A significant role in the treatment of the liver is given to proper nutrition and dietary table No. 5.
If changes occur due to viral infections, then antiviral drugs are prescribed. A specialist may well suggest a hypoprotector, since it helps restore liver cells.
Folk recipes also play an important role in restoring a damaged vital organ. For effective treatment, pumpkin with honey, plum juice, chicory decoction and many other herbs are used.
www.yod.ru
Epidemiology
Diffuse changes in the liver parenchyma indicate impaired liver function and are possible at any age. Changes in the structure of the pancreatic parenchyma are sometimes a consequence of the aging process and are more often detected in older people.
Causes and symptoms
In most cases, diffuse changes in the parenchyma of the liver and pancreas indicate the presence of a serious pathological process in the body.
Changes in the liver parenchyma can develop for the following reasons:
- hepatitis of any form, regardless of severity;
- autoimmune hepatitis;
- sudden change in body weight;
- excess adipose tissue on internal organs;
- long-term treatment with antibiotics or other toxic drugs;
- cirrhosis of the liver;
- alcohol abuse.
Among the most dangerous diseases accompanied by diffuse changes in the liver parenchyma are hemochromatosis and sclerosing cholangitis.
With lesions of the pancreas, part of the glandular tissue is replaced by fatty or scar tissue. Among the most common reasons affecting the structure of the parenchyma of an organ:
- previous acute pancreatitis;
- chronic pancreatitis;
- diseases of the liver and biliary tract;
- long courses of treatment with certain pharmacological drugs;
- excess fat in the diet;
- severe or chronic stress;
- smoking;
- alcohol abuse.
Partial degeneration of the pancreatic parenchyma is typical for patients suffering from diabetes mellitus, as well as the elderly. In case of age-related changes, no special treatment is carried out.
Viral diseases, difficult environmental conditions, an unbalanced diet, and frequent or severe intoxications of the body can provoke changes in the parenchyma of the liver and pancreas.
In liver lesions, sometimes a hereditary predisposition cannot be ruled out.
With a superficial examination, it is quite difficult to establish an accurate diagnosis, so a patient with identified disorders is recommended to undergo additional examination to find out the full picture of the processes occurring in the body.
Symptoms
Since diffuse changes in the parenchyma of the liver and pancreas are themselves part of the symptom complex that accompanies the course of the disease of a particular organ, there are no clearly defined external signs of their presence.
The main symptom is a change in the echogenicity of the structure of the organ being examined. External clinical manifestations of parenchymal changes correspond to the typical symptoms of the underlying disease.
It should be noted that hepatitis and some other liver diseases can occur asymptomatically or in the so-called anicteric form. In such cases, changes in the structure of the organ are discovered by chance, during a full examination, or when visiting a doctor for another reason.
Subclinical forms of liver disease often look like a general malaise of unknown etiology: general weakness, lethargy, increased fatigue, poor appetite.
Clinical manifestations typical of liver diseases:
- yellowness of the skin and sclera;
- very light stool;
- pain in the right hypochondrium;
- dark coloration of urine.
Sometimes liver diseases are accompanied by severe itching.
Similarly, diffuse changes in the pancreas by themselves do not in any way affect the general condition of the patient. Symptoms of the disorders correspond to the clinical manifestations of the underlying disease.
In acute pancreatitis, the patient complains of severe pain in the left hypochondrium, the deterioration of the condition is accompanied by nausea and vomiting. In severe cases, tachycardia develops against the background of damage to the pancreas.
Chronic pancreatitis has a similar clinical picture, but the increase in manifestations of the disease occurs more slowly as the disease progresses. Similar first symptoms are characteristic of fibrous inflammation of the pancreas. As untreated fibrosis progresses, digestive disorders appear, allergization of the body occurs, and the process of insulin synthesis is disrupted, which becomes the cause of diabetes mellitus.
Forms
Minor changes in the liver parenchyma occur quite often, as a reaction to a pathological process or features of the patient’s lifestyle. When the reasons that caused the change in the structure of the organ are eliminated, it is possible to restore it, depending on the type of tissue change. In the absence of treatment and prevention, the changes will progress and become irreversible.
Moderate diffuse changes are provoked by external factors. As a rule, they arise as a result of poor nutrition, bad habits, intoxication or viral liver damage.
In the pancreas, diffuse changes can be:
- focal;
- parenchymal;
- fibrous;
- dystrophic.
Diagnostics
Diffuse changes in the parenchyma of the liver and pancreas are detected by ultrasound.
Additional research will be required to determine the reasons, in particular:
- general analysis of urine and blood;
- blood chemistry;
- determination of the level of pancreatic enzymes and glucose in the blood;
What and how to examine
If pathological processes in the liver and pancreas are suspected, the problematic organs should be examined first. To identify changes in the structure of the organ, ultrasound and laboratory tests are required.
If there is not enough information to establish an accurate diagnosis, the doctor refers the patient to a computed tomography scan, angiography or biopsy. In some cases, testing for tumor markers is required.
Treatment
Changes in the liver and pancreas parenchyma themselves do not require treatment.
It is necessary to establish and eliminate the cause of their occurrence. Treatment is prescribed only by a doctor, depending on the nature and severity of the underlying pathology.
In addition to anti-inflammatory or antiviral therapy, patients with severe signs of liver pathology are prescribed drugs from the group of hepatoprotectors, as well as multivitamin preparations.
Prevention and prognosis
The prognosis in each specific case depends on the characteristics of the underlying disease and can vary greatly from favorable to potentially fatal.
In order to prevent diffuse changes in the parenchyma of the liver and pancreas, it is recommended to make adjustments to the diet and lifestyle.
Patients with chronic diseases of the liver and pancreas need to give up too spicy, salty, sour foods, eliminate fatty foods, smoked foods, and give up alcohol.
In some cases, to prevent further complications, the patient is prescribed lifelong maintenance therapy with hepatoprotectors.
gormonexpert.ru
Signs of diffuse changes and compaction of the liver parenchyma
The liver is an unpaired parenchymal organ; it consists entirely of hepatic tissue. This organ is located in the abdominal cavity in the right hypochondrium. The basis of the parenchyma is the liver lobules, between which blood vessels and bile ducts pass. The bile ducts supply bile to the gallbladder, after which this fluid flows through the bile duct into the duodenum, where it connects with the pancreatic duct.
Diseases of the liver and gall bladder always affect the condition of the pancreas, and vice versa, the health of the pancreas speaks about the condition of the liver and gall bladder. The liver is the main organ of hematopoiesis and performs important functions for the body. An ultrasound examination can detect liver diseases, but laboratory and instrumental studies are necessary for an accurate diagnosis.
Normally, the liver parenchyma is a homogeneous, weakly echogenic structure, against which the vessels and bile ducts are clearly visible. Diffuse changes in the liver parenchyma mean that the entire tissue of this organ is changed. These can be severe lesions. Therefore, more research is needed to clarify the extent of these lesions.
In this case, all organs of the gastrointestinal tract are examined. Diffuse liver damage can be divided into acute hepatitis, chronic hepatitis, cirrhosis, fatty infiltration, diffuse changes in the liver with other concomitant diseases. With hepatitis, the liver enlarges, but the structure of the parenchyma may remain homogeneous. When the hydrophilicity of the parenchyma increases, its structure may be disrupted and thickening of the liver walls occurs.
The more pronounced the inflammatory process, the greater the swelling of the parenchyma, the echogenicity decreases, and the sound conductivity increases. The increase in echogenicity of the parenchyma during hepatitis can be uneven, low or high in individual areas in different ways. The structure of the parenchyma in liver cirrhosis usually becomes diffusely heterogeneous and has many areas of increased, average or decreased echogenicity.
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The size of areas of heterogeneity can be from 0.5 to 2.0 cm or more. Violation of the homogeneity of the parenchyma is possible as a result of stagnation in the liver ducts and, in connection with this, an increase in bilirubin. The cause of diffuse processes in the parenchyma can be fatty degeneration of the liver.
The liver is the only organ that detoxifies food and metabolism; it carries the maximum load, eliminates various foreign substances and excess hormones. Participating in the digestive processes, it provides the body with glucose and is a producer of protein and cholesterol.
Our liver is able to restore its shape thanks to complex treatment, which includes cleansing the body, normalizing nutrition, taking immunosuppressants, drugs from the group of hepatoprotectors and immunomodulators. With tumors, cysts and stones, tissue density will have local changes. Always diffuse changes are constant companions of fatty liver disease, hepatitis, cirrhosis, and various metabolic lesions.
Due to its size and density, the liver reflects ultrasound waves quite well and therefore is excellently scanned using an ultrasound machine. To assess the condition of the liver, its size, wall thickness, structure of its constituent elements and parenchyma are measured. In addition to the liver, the same manipulations are also performed with the spleen. An ultrasound examination of the liver is required to determine the diagnosis of hepatitis, cirrhosis and other serious diseases. After the ultrasound diagnostician gives a conclusion that sounds like “Diffuse changes in the liver parenchyma,” the origin of these changes should be determined using a blood test and other instrumental studies - X-rays, retrograde cholangiopancreatography, liver biopsy and laparoscopy.
Excellent prevention of compaction of the liver parenchyma is early diagnosis, timely hospitalization and productive, competent treatment, protection from various industrial, medicinal and household intoxications. If the liver functions are impaired, then harmful substances entering the bloodstream become toxic to the body. It is very important to maintain the health of one of the vital organs by eliminating problems that have arisen with the help of a highly qualified doctor.
www.ayzdorov.ru
The liver is responsible for many processes occurring in the body. Its functions include controlling fats and glucose, saturating the blood with beneficial enzymes, and neutralizing toxins coming from outside. When exposed to external unfavorable factors, as well as due to internal disorders in the body, various changes can occur in the liver tissues.
What are diffuse liver changes?
Normally, the liver parenchyma (the main functional tissue consisting of hepatocytes) is a homogeneous, weakly echogenic structure, among which the bile ducts and blood vessels are clearly distinguished.
Diffuse changes in the structure of the liver indicate that the parenchyma is completely modified. Moreover, this can characterize both minor functional changes (moderate diffuse changes in the liver parenchyma) and very serious lesions (hepatic parenchyma with increased echogenicity).
Diffuse change can have a different character. Thus, the following types of changes are distinguished:
- fibrous;
- sclerotic;
- hypertrophic;
- dystrophic;
- swelling.
Diffuse liver steatosis is a disease associated with metabolic disorders in hepatocytes. As a result, dystrophic changes in the liver are observed, and fat accumulates in the liver cells.
During ultrasound diagnostics, a uniform enlargement of the liver is observed, a diffuse increase in its echogenicity (the intensity of the reflected ultrasound signal) while maintaining the homogeneity of its structure. With further progression of the process, “graininess” of the parenchyma appears, which indicates the beginning of the development of steatohepatitis and hepatitis.
Causes of diffuse liver changes
Changes in liver tissue can occur for various reasons, since there are many factors that have a negative impact on this organ. These include:
- alcohol abuse;
- taking medications;
- metabolic disorders;
- consumption of low-quality food;
- hereditary pathologies, etc.
Diffuse changes in the liver parenchyma do not always indicate some kind of disease. But in some cases they may be a consequence of the following pathologies:
- viral hepatitis;
- alcoholic hepatitis;
- fatty liver;
- chronic hepatitis;
- cirrhosis;
- cholangitis, etc.
Signs of diffuse liver changes
Diffuse changes in liver tissue can begin without any clinical symptoms, without disturbing the person. Often changes are recorded during a routine examination, which involves ultrasound diagnostics.
The liver, due to its size and density, reflects ultrasound waves quite well, so it can be scanned well during ultrasound. Sonographic signs (echo signs) of diffuse changes in the liver are the following manifestations detected during the study:
- heterogeneous tissue structure;
- increased echo density of the parenchyma;
- the presence of areas of reduced and increased echogenicity;
- increased liver size;
- change in the pattern of blood vessels.
Treatment of diffuse liver changes
Treatment of diffuse changes is carried out after determining the exact cause that led to 
these phenomena. This requires some additional research, which includes:
- blood analysis;
- Magnetic resonance imaging;
- angiography;
- histological examination of liver tissue, etc.
In addition to examining the condition of the liver, diagnostics of all digestive organs may be required.
Treatment methods depend on the results of diagnostic measures. In some cases, you will only need to follow a diet and give up bad habits; in others, you will need to take medications and even undergo surgery.
PARENCHYMA
PARENCHYMA
(new Latin). In botany: the pulp of a plant. In anatomy: cellular tissue, cellular plexus.
Dictionary of foreign words included in the Russian language. - Chudinov A.N., 1910 .
PARENCHYMA
spongy pulpy substance of the internal organs of animals (liver, spleen, kidneys, etc.); in botany, a tissue consisting of roundish, thin-walled cells that fills the space between specialized cells.
Dictionary of foreign words included in the Russian language. - Pavlenkov F., 1907 .
PARENCHYMA
animal or plant tissue; in particular: porous substance of the liver, kidneys, etc.
A complete dictionary of foreign words that have come into use in the Russian language. - Popov M., 1907 .
Parenchyma
1) specific tissue of an animal organ that performs the main function of this organ; is opposed to the supporting frame of this organ, consisting of connective tissue;
2) the main tissue of plants, consisting of thin-walled, polyhedron-shaped living cells of more or less the same size in all directions; n. participates in various life processes.
New dictionary of foreign words. - by EdwART,, 2009 .
Parenchyma
[gr. near, near + poured, spilled] – 1) anat. specific tissue of an organ that performs its main function; is opposed to the supporting frame of this organ, consisting of connective tissue; 2) bot. plant tissue consisting of cells more or less equally developed in length, width and thickness; found in all plant organs
Large dictionary of foreign words. - Publishing House "IDDK", 2007 .
Parenchyma (re), s, and. (German Parenchym Greek para near, around, with + enchyma poured, spilled; textile).
1.
biol. Specific fabric of some kind. animal organ ( eg liver, lungs, etc.), performing the main function of this organ.
2.
bot. The main tissue of plants.
Parenchymal- related to parenchyma 1, 2, parenchymas.
Explanatory dictionary of foreign words by L. P. Krysin. - M: Russian language, 1998 .
Synonyms:
See what "PARENCHYMA" is in other dictionaries:
PARENCHYMA- (correctly pronounce parenchyma) (from the Greek para about, near and en cheo I pour, I fill). In the present time, this word has lost the meaning of the term, but is still used descriptively and in a microscope. anatomy in the same sense as in antiquity.... ... Great Medical Encyclopedia
Chlorenchyma Dictionary of Russian synonyms. parenchyma noun, number of synonyms: 2 tissue (474) chlorenchyma ... Synonym dictionary
- (from the Greek parenchyma lit. poured side by side), 1) in plants the main tissue is made up of cells of more or less the same size; carries out assimilation, selection and other functions. Types of parenchyma: absorptive, assimilation (chlorenchyma), ... ... Big Encyclopedic Dictionary
PARANCHYMA, soft tissue consisting of unspecialized thin-walled CELLS of a rounded shape or cells with obtuse angles, often with spaces between the cells. It is one of the main tissues of plant stems, leaves and fruit pulp.… … Scientific and technical encyclopedic dictionary
- (from the Greek parenchyma, lit. poured nearby), in animals P. is called. the main functioning tissue of certain organs of the liver, spleen, other glands, lungs, etc. In plants, P. main. the fabric, inside the cut are highly specialized. (conductive, mechanical)… … Biological encyclopedic dictionary
parenchyma- Main fabric; in animals this is the main functioning tissue of the internal organs, in plants the main tissue within which highly specialized conducting tissues are differentiated; plant parenchyma tissue can return to... ... Technical Translator's Guide
- (from the Greek parenchyma, literally poured nearby) 1) the main tissue of plants, consists of cells of more or less the same size in all directions. P. cells form homogeneous clusters in the plant body, filling the spaces between... ... Great Soviet Encyclopedia
- (ancient Greek παρέγχυμα, literally poured next to): in medicine, the totality of the main functioning elements of an internal organ, limited by the connective tissue stroma and capsule (for example, the epithelium of the liver, kidneys, lungs, etc.).;... ... Wikipedia
- (from the Greek parenchyma, literally poured next to each other), 1) in plants, the main tissue is made up of cells of more or less the same size; carries out assimilation, selection and other functions. Types of parenchyma: absorptive, assimilation (chlorenchyma) ... encyclopedic Dictionary
Parenchyma parenchyma. Main fabric; in animals this is the main functioning tissue of the internal organs, in plants the main tissue within which highly specialized conducting tissues are differentiated; plant parenchyma tissue can... ... Molecular biology and genetics. Dictionary.
We know that for normal functioning, metabolic processes must constantly occur in the body. Moreover, they are associated not only with the supply of oxygen and nutrients to the cells, but also with the removal of unnecessary and waste substances. Along with the intestines, the urinary system and kidney parenchyma play an important role in cleansing the body: what is it? In our detailed review, we will consider its structure, its constituent elements and signs of pathology: what indicates the development of organ failure, and why thinning of the kidney parenchyma occurs.
Structure
In medicine, parenchyma refers to the specific functional cells of any internal organ in which all active work occurs. This distinguishes them from connective tissue and integumentary epithelium, which play a supporting role. Parenchymal tissue is isolated in the liver, stomach, lungs, brain, and kidneys.
Normal kidneys have a rather complex structure. They contain:
- outer cortex;
- inner medulla.
The cortical layer contains more than a million tiny structural and functional elements - nephrons. It is in them that the continuous processes of blood filtration, reabsorption and secretion occur, which lead to the formation of urine.
The task of the medulla, or inner layer, is the primary collection and further transportation of urine to the urinary tract. The formed “final” version of secondary urine enters from the tubular system into the collecting ducts, and only then enters the small and large cups (there are from 10 to 16-18 in each kidney) and, finally, single pelvises.
Normal indicators of renal parenchyma
It is not surprising that normal kidney function is of great importance for the health of the entire body. How can you understand that something is wrong with your urinary organs? You can assume any problems based on the patient’s complaints, but an ultrasound examination will allow you to accurately assess the condition of the renal parenchyma. During an ultrasound, the doctor determines several parameters.
Thickness
The thickness of the kidney parenchyma is not a constant value; it tends to vary depending on the height, weight and age of the subject. Thus, in a newborn child or infants under one year old, it is rarely determined and does not exceed 8 mm. The standard sizes of renal parenchyma in children and adults, depending on height, are presented in the table below.
In addition, the thickness of the functional layer is also affected by past pathologies. If in healthy young people this figure can exceed 20-25 mm, then in elderly patients suffering from chronic diseases it barely reaches 10-11 mm. However, despite its high vulnerability, kidney tissue is capable of regeneration and successful restoration of its functions.
Thus, the normal thickness of the renal parenchyma in an adult is 15-25 mm. Deviation of these values, both upward and downward, indicates various health problems. Risk factors for which the parenchyma becomes thinner or thicker are:
- elderly age;
- infectious and non-infectious (for example, allergic, autoimmune) inflammatory processes;
- oncological processes of benign and malignant nature;
- transition of various acute pathological processes in the kidneys into a chronic form.
One example of physiological thickening of the kidney parenchyma can be considered vicarious hypertrophy - a compensatory mechanism that develops when one of the paired urinary organs is removed. Moreover, just one kidney, provided that it is healthy, functions successfully “for two.”
If the parenchyma of one or both kidneys is thinned, most often this indicates pathological processes in the urinary system and the development of renal failure. It can be either reversible or progressive irreversible.
Echogenicity
Echogenicity is one of the main terms of ultrasound diagnostics. It reflects the ability of internal organs and tissues to differently reflect the signal sent by the ultrasound sensor. Fluid structures and cavities are considered anechoic (non-echoic) and appear black on the monitor screen. However, the denser the tissue, the higher its echogenicity. Therefore, bone structures appear on ultrasound as light, almost white areas.
Normally, the urinary organs have normal (average) density. If the echogenicity of the renal parenchyma is increased, this may indicate the development of:
- glomerulonephritis;
- diabetic nephropathy;
- other metabolic disorders.
Structure
Another important indicator of kidney ultrasound diagnostics is the structure of their parenchyma. Normally, it is homogeneous, without pathological inclusions.
Diffuse changes
If, after the examination, diffuse changes in the kidneys were discovered, you should be wary: sometimes this indicates serious pathologies. Common reasons for such changes are:
- nephrolithiasis;
- glomerular or tubular inflammation;
- endocrine and systemic metabolic diseases - diabetes mellitus, atherosclerosis, thyrotoxicosis;
- vascular pathologies that cause circulatory problems in the kidneys.
Acute diffuse pathological processes in the kidney usually cause an increase in the size of the organ. With chronicity, the reverse process is observed - thinning of the parenchyma and shrinkage of the kidney.
Focal changes
Local disturbances in the homogeneity of the renal parenchyma are also considered pathological. They are caused by the growth of tumors and cysts.
Benign kidney tumors include:
- oncocytoma;
- adenoma;
- angiomyolipoma.
Despite their rather large size (up to 15-16 cm), such formations do not grow into surrounding tissues and remain asymptomatic for a long time. The first signs of the disease can be seen on ultrasound or in the event of compression of the ureter and disruption of the physiological outflow of urine.
However, about 85% of all diagnosed kidney tumors are malignant. They are prone to rapid and aggressive growth, tissue destruction and changes in organ size. The success of their treatment is determined, first of all, by early diagnosis, as well as an integrated approach.
Another common cause of focal changes in the structure of the renal parenchyma on ultrasound is cysts. They can be located singly, or in groups of 2-3 or more formations. The cysts are filled with fluid inside and their diameter is 3-5 centimeters. Depending on the number of such elements, as well as on the degree of compression of functional tissues, treatment tactics are chosen. Cyst therapy is carried out using both conservative and surgical methods.
Anyone can experience kidney disease. Unfortunately, most pathologies are accompanied by damage to functionally active tissues (parenchyma) and organ failure. You can avoid health problems: just follow the principles of a healthy lifestyle, avoid hypothermia, regularly undergo preventive examinations and promptly treat identified disorders.
