肝纤维化无创诊断技术的临床研究及进展

周家玲; 魏巍; 尤红

doi:10.3969/j.issn.1001-5256.2014.07.007

肝纤维化无创诊断技术的临床研究及进展

DOI: 10.3969/j.issn.1001-5256.2014.07.007

1. 首都医科大学附属北京友谊医院肝病中心
2. 首都医科大学附属北京友谊医院肝硬化转化医学北京市重点实验室
3. 首都医科大学附属北京友谊医院临床流行病学与循证医学中心

详细信息

中图分类号: R575.2
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出版历程
- 收稿日期: 2014-05-15
- 出版日期: 2014-07-20

Progress in clinical studies of noninvasive early diagnosis of liver fibrosis and cirrhosis

Liver Research Center, Beijing Friendship Hospital, Capital Medical University

摘要

摘要: 肝纤维化程度的不断进展直接影响到患者的治疗方案及预后。早期诊断肝纤维化分级并进行动态监测是目前临床急需的技术。无创诊断技术能避免或减少肝活组织检查来早期识别肝纤维化,并能进行动态监测,有着重要的临床应用价值。但因各种局限性也使其应用受到限制。肝脏弹性仪器不同型号探头的使用、脂肪衰减量的检测(CAP系统)、脾脏硬度检测、超声影像引导下的肝脏硬度检测以及通过肝脏弹性检测早期预测原发性肝癌等无创诊断技术已在临床研究中实践。为了更好地理解和应用这些诊断模型,针对目前无创诊断肝纤维化在临床研究的进展以及其局限性进行探讨。
- 肝硬化 /
- 弹性成像技术 /
- 早期诊断 /
- 综述
Abstract: The progression of liver fibrosis directly affects treatment options and prognosis. Early diagnosis and classification of liver fibrosis and dynamic monitoring are clinically needed. Noninvasive diagnostic techniques can avoid or reduce liver biopsy to enable early identification of liver fibrosis and to dynamically monitor the progression of fibrosis. But various limitations have restricted its application. Noninvasive diagnostic techniques, such as liver transient elastography using the different probe mode, controlled attenuation parameter, spleen stiffness measurement, ultrasound- based transient elastography for the early prediction of hepatic fibrosis, and risk assessment of hepatitis B virus-related hepatocellular carcinoma, have been applied in clinical studies. In order to better understand and apply these diagnostic models, the progress in clinical studies of noninvasive diagnosis of liver fibrosis, as well as the limitations, is reviewed.
- liver cirrhosis /
- elasticity imaging techniques /
- early diagnosis /
- review

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参考文献(25)

[1]JI D, CHEN GF.Development and clinical application of noninvasive methods to assess liver fibrosis[J].Infect Dis Info, 2013, 26 (3) :190-194. (in Chinese) 纪冬, 陈国凤.肝纤维化无创诊断研究进展及其临床应用[J].传染病信息, 2013, 26 (3) :190-194.

[2]HERRERO I, INARRAIRAEGUI M, DAVOLA D, et al.Comparison of two different probes for transient elastography for the evaluation of liver stiffness[J].J Hepatol, 2012, 56:s389-s548.

[3]FRIEDRICH-RUST M, HADJI-HOSSEINI H, KRIENER S, et al.Transient elastography with a new probe for obese patients for non-invasive staging of non-alcoholic steatohepatitis[J].Eur Radical, 2010, 20 (10) :2390-2396.

[4]de LDINGHEN V, WONG VW, VERGNIOL J, et al.Diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement:comparison between M and XL probe of FibroScan[J].J Hepatol, 2012, 56 (4) :833-839.

[5]DURANGO E, KOHLHAAS A, MILLONIG G, et al.Transient elastography with more powerful XL probe drastically improves assessent of liver stiffness in patients with obesity and ascites[J].J Hepatol, 2011, 54:s209-s361.

[6]SAADEH S, YOUNOSSI ZM, REMER EM, et al.The utility of radiological imaging in nonalcoholic fatty liver disease[J].Gastroenterology, 2002, 123 (3) :745-750.

[7]de LEDINGHEN V, VERGNIOL J, FOUCHER J, et al.Feasibility of liver transient elastography with FibroScan using a new probe for obese patients[J].Liver Int, 2010, 30 (7) :1043-1048.

[8]MYERS R, POMIER-LAYRARGUES G, KIRSCH R, et al.Feasibility and diagnostic performance of the Fibroscan XL probe for liver stiffness measurement in overweight and obese patients[J].Hepatology, 2012, 55 (1) :199-208.

[9]FERRAIOLI G, LISSANDRIN R, TINELLI C, et al.Reproducibility of controlled attenuation parameter (CAP) for the assessment of liver steatosis[J].Digest Liver Dis, 2013, 45 (Suppl) :s1-s48.

[10]SASSOA M, MIETTE V, SANDRIN L, et al.The controlled attenuation parameter (CAP) :a novel tool for the non-invasive evaluation of steatosis using Fibroscan[J].Clin Res Hepatol Gastroenterol, 2012, 36 (1) :13-20.

[11]de LDINGHEN V, VERGNIOL J, CAPDEPONT M, et al.Controlled attenuation parameter (CAP) for the diagnosis of steatosis:a prospective study of 5323 examinations[J].J Hepatol, 2014, 60 (5) :1026-1031.

[12]BERZIGOTTI A, CASTERA L.Update on ultrasound imaging of liver fibrosis[J].J Hepatol, 2013, 59 (1) :180-182.

[13]ZHANG CL, ZHU XC, LUO FC, et al.Acoustic radiation force impulse in evaluation of liver fibrosis in patients with chronic hepatitis B[J].J Clin Hepatol, 2012, 15 (1) :4-6. (in Chinese) 张纯林, 朱先存, 罗福成, 等.声脉冲辐射力成像技术评价慢性乙型肝炎肝纤维化程度的研究[J].实用肝脏病杂志, 2012, 15 (1) :4-6.

[14]CHEN W, WENG PJ, GAO GS, et al.Comparison of shear wave velocity with noninvasive serum score systems in diagnosis of liver fibrosis of patients with chronic hepatitis[J].Chin J Clin Infect Dis, 2013, 6 (5) :269-272. (in Chinese) 陈巍, 翁彭剑, 高国生, 等.剪切波速与四种无创血清评分系统对慢性肝炎患者肝纤维化诊断效果的比较[J].中华临床感染病杂志, 2013, 6 (5) :269-272.

[15]SPOREA I, BOTA S, JURCHIS A, et al.Acoustic radiation force impulse and supersonic shear imaging ersus transient elastographyfor liver fibrosis assessment[J].Ultrasound Med Biol, 2013, 39 (11) :1933-1941.

[16]ZHU XC, ZHANG CL, ZUO LS, et al.Clinic value of evaluation of hepatic fibrosis degree with acoustic radiation force impulse (ARFI) [J].JCGP, 2012, 10 (1) :121-122. (in Chinese) 朱先存, 张纯林, 左鲁生, 等.声辐射力脉冲成像技术在评价肝纤维化程度的临床价值[J].中华全科医学, 2012, 10 (1) :121-122.

[17]SINGH S, EATON JE, MURAD MH, et al.Accuracy of spleen stiffness measurement in detection of esophageal varices in patients with chronic liver disease:systematic review and meta-analysis[J].Clin Gastroentero Hepatol, 2014, 12 (6) :935-945.

[18]POZZI R, FRAQUELLI M, GIUNTA M, et al.Combined transient elastography of the liver and spleen to assess disease severity in chronic viral liver[J].J Hepatol, 2012, 56:s389-s548.

[19]COLECCHIA A, MONTRONE L, SCAIOLI F, et al.Measurement of spleen stiffness to evaluate portal hypertension and the presence of esophageal varices in patients with HCV-related cirrhosis[J].Gastroenterology, 2012, 143 (3) :646-654.

[20]DI MARCO, BRONTE F, CALVARUSO V, et al.Fibrospleen:measurement spleen stiffness by transient elastography increases accuracy of staging of liver fibrosis and of portal hypertension in chronic viral hepatitis[J].Digest Liver Dis, 2009, 41:a1-a45.

[21]WONG GL, CHAN HL, WONG CK, et al.Liver stiffness-based optimization of hepatocellular carcinoma risk score in patients with chronic hepatitis B[J].J Hepatol, 2014, 60 (2) :339-345.

[22]JUNG KS, KIM SU, CHOI GH, et al.Prediction of recurrence after curative resection of hepatocellular carcinoma using liver stiffness measurement (FibroScan) [J].Ann Surg Oncol, 2012, 19 (13) :4278-4286.

[23]PESCE A, SCILLETTA R, BRANCA A, et al.Does transient elastography (FibroScan) have a role in decision making in hepatocellular carcinoma?[J].HPB, 2012, 14 (6) :403-408.

[24]CHON YE, JUNG ES, PARK JY, et al.The accuracy of noninvasive methods in predicting the development of hepatocellular carcinoma and hepatic decompensation in patients with chronic hepatitis B[J].J Clin Gastroenterol, 2012, 46 (6) :518-525.

[25]POYNARD T, VERGNIOL J, NGO Y, et al.Staging chronic hepatitis C in seven categories using fibrosis biomarker (FibroTestTM) and transient elastography (FibroScan) [J].J Hepatol, 2014, 60 (4) :706-714.

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