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瞬时弹性成像技术在慢性乙型肝炎中的应用进展

宋凯敏 刘俊

宋凯敏, 刘俊. 瞬时弹性成像技术在慢性乙型肝炎中的应用进展[J]. 临床肝胆病杂志, 2021, 37(2): 419-424. DOI: 10.3969/j.issn.1001-5256.2021.02.036
引用本文: 宋凯敏, 刘俊. 瞬时弹性成像技术在慢性乙型肝炎中的应用进展[J]. 临床肝胆病杂志, 2021, 37(2): 419-424. DOI: 10.3969/j.issn.1001-5256.2021.02.036
SONG KM, LIU J. Advances in the application of transient elastography in chronic hepatitis B [J]. J Clin Hepatol, 2021, 37(2): 419-424. DOI: 10.3969/j.issn.1001-5256.2021.02.036
Citation: SONG KM, LIU J. Advances in the application of transient elastography in chronic hepatitis B [J]. J Clin Hepatol, 2021, 37(2): 419-424. DOI: 10.3969/j.issn.1001-5256.2021.02.036

瞬时弹性成像技术在慢性乙型肝炎中的应用进展

DOI: 10.3969/j.issn.1001-5256.2021.02.036
详细信息
    通讯作者:

    刘俊,929liujun@163.com

  • 作者贡献声明:宋凯敏负责文献搜集及论文撰写;刘俊指导及修改文章。
  • 中图分类号: R512.62

Advances in the application of transient elastography in chronic hepatitis B

  • 摘要: 肝活检是诊断肝脏疾病的金标准,胃镜是诊断食管胃静脉曲张的金标准;但二者均为有创检查,因此应用受限。近年来瞬时弹性成像技术作为无创检测,临床已经广泛采用。介绍了瞬时弹性成像技术在慢性乙型肝炎患者肝纤维化、肝脂肪变、肝硬化及肝癌等方面的最新进展。未来可在乙型肝炎肝硬化和肝癌早期联合诊疗方面进行更多研究。
  • [1] WHO. Global hepatitis report, 2017[EB/OL]. https://www.who.int/hepatitis/publications/global-Hepatitis-report2017/en/.
    [2] Chinese Society of Infectious Diseases, Chinese Medical Association; Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B (version 2019)[J]. J Clin Hepatol, 2019, 35(12): 2648-2669. (in Chinese)

    中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2648-2669.
    [3] ZENG J, CAI S, LIU J, et al. Dynamic changes in liver stiffness measured by transient elastography predict clinical outcomes among patients with chronic hepatitis B[J]. J Ultrasound Med, 2017, 36(2): 261-268. DOI: 10.7863/ultra.15.12054
    [4] XIE CY, HU JY, MOU N, et al. Prediction of predictive performance of APRI on liver inflammation and fibrosis in patients with chronic hepatitis B[J]. Chin J Immunol, 2020, 36(2): 210-214. (in Chinese) DOI: 10.3969/j.issn.1000-484X.2020.02.015

    谢春艳, 胡景玉, 牟娜, 等. APRI对慢性乙型肝炎肝脏炎症和纤维化程度的预测性能评价[J]. 中国免疫学杂志, 2020, 36(2): 210-214. DOI: 10.3969/j.issn.1000-484X.2020.02.015
    [5] XIONG J, LIN DN, WENG WZ, et al. Assessment of hepatitis B virus associated liver fibrosis by FIB-4 combined with serum PCⅢ, IVC[J]. Int J Virol, 2020, 27(5): 403-406. (in Chinese) DOI: 10.3760/cma.j.issn.1673-4092.2020.05.012

    熊静, 林登娜, 翁伟镇, 等. FIB-4联合血清PCⅢ、ⅣC评估乙型肝炎病毒相关肝纤维化[J]. 国际病毒学杂志, 2020, 27(5): 403-406. DOI: 10.3760/cma.j.issn.1673-4092.2020.05.012
    [6] WONG GL. Non-invasive assessments for liver fibrosis: The crystal ball we long for[J]. J Gastroenterol Hepatol, 2018, 33(5): 1009-1015. DOI: 10.1111/jgh.14103
    [7] LI Y, HUANG YS, WANG ZZ, et al. Systematic review with meta-analysis: The diagnostic accuracy of transient elastography for the staging of liver fibrosis in patients with chronic hepatitis B[J]. Aliment Pharmacol Ther, 2016, 43(4): 458-469. DOI: 10.1111/apt.13488
    [8] SEO YS, KIM MY, KIM SU, et al. Accuracy of transient elastography in assessing liver fibrosis in chronic viral hepatitis: A multicentre, retrospective study[J]. Liver Int, 2015, 35(10): 2246-2255. DOI: 10.1111/liv.12808
    [9] Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Gastroenterology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Consensus on the diagnosis and therapy of hepatic fibrosis(2019)[J]. J Clin Hepatol, 2019, 35(10): 2163-2172. (in Chinese)

    中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会感染病学分会. 肝纤维化诊断及治疗共识(2019年)[J]. 临床肝胆病杂志, 2019, 35(10): 2163-2172.
    [10] DING RR, LU W, WANG YB, et al. Prediction of hepatic fibrosis by FibroScan and serum markers in chronic hepatitis B patients with mildly elevated alanine transaminase levels[J]. Chin J Infect Dis, 2019, 37(2): 72-76. (in Chinese)

    丁荣蓉, 陆伟, 王雁冰, 等. 采用瞬时弹性成像技术和血清标志物预测丙氨酸转氨酶轻度升高的慢性乙型肝炎患者肝纤维化程度[J]. 中华传染病杂志, 2019, 37(2): 72-76.
    [11] ZHAO J, ZHAI F, CHENG J, et al. Evaluating the significance of viscoelasticity in diagnosing early-stage liver fibrosis with transient elastography[J]. PLoS One, 2017, 12(1): e0170073. DOI: 10.1371/journal.pone.0170073
    [12] ZUO ZB, CUI HZ, HUANG CX, et al. Clinical study of FibroTouch and six serological models for assessing the degree of liver fibrosis in patients with chronic hepatitis B[J]. Chin J Hepatol, 2019, 27(6): 430-435. (in Chinese) DOI: 10.3760/cma.j.issn.1007-3418.2019.06.008

    左中宝, 崔怀中, 黄从想, 等. FibroTouch与6种肝纤维化血清学模型评估慢性乙型肝炎患者肝纤维化程度的临床研究[J]. 中华肝脏病杂志, 2019, 27(6): 430-435. DOI: 10.3760/cma.j.issn.1007-3418.2019.06.008
    [13] ZHAO F, ZHAO J, CHEN J, et al. Comparison of diagnostic value of Fibroscan and ARFI on liver fibrosis in patients with chronic hepatitis B[J/CD]. Chin J Liver Dis (Electronic Version), 2019, 11(2): 71-75. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GZBZ201902016.htm

    赵帆, 赵娟, 陈静, 等. Fibroscan和ARFI对慢性乙型肝炎肝纤维化诊断价值比较[J/CD]. 中国肝脏病杂志(电子版), 2019, 11(2): 71-75. https://www.cnki.com.cn/Article/CJFDTOTAL-GZBZ201902016.htm
    [14] BÂLDEA V, SPOREA I, TUDOR A, et al. Virtual touch quantification using acoustic radiation force impulse imaging technology versus transient elastography for the noninvasive assessment of liver fibrosis in patients with chronic hepatitis B or C using liver biopsy as the gold standard[J]. J Gastrointestin Liver Dis, 2020, 29(2): 181-190. DOI: 10.15403/jgld-2256
    [15] ZENG J, ZHENG J, HUANG Z, et al. Comparison of 2-D shear wave elastography and transient elastography for assessing liver fibrosis in chronic hepatitis B[J]. Ultrasound Med Biol, 2017, 43(8): 1563-1570. DOI: 10.1016/j.ultrasmedbio.2017.03.014
    [16] UDOMPAP P, SUKONRUT K, SUVANNARERG V, et al. Prospective comparison of transient elastography, point shear wave elastography, APRI and FIB-4 for staging liver fibrosis in chronic viral hepatitis[J]. J Viral Hepat, 2020, 27(4): 437-448. DOI: 10.1111/jvh.13246
    [17] LIU T, CUI XL. The clinical value of FS combined with APRI and HA in the diagnosis of hepatitis B liver fibrosis[J]. Exp Lab Med, 2019, 37(3): 407-409, 418. (in Chinese) DOI: 10.3969/j.issn.1674-1129.2019.03.018

    刘涛, 崔晓玲. FS联合APRI、HA诊断乙型肝炎肝纤维化的临床价值分析[J]. 实验与检验医学, 2019, 37(3): 407-409, 418. DOI: 10.3969/j.issn.1674-1129.2019.03.018
    [18] WU L, XUE DY, ZHANG J, et al. Diagnostic value of two liver imaging techniques combined with serological models for hepatitis B virus-related liver fibrosis[J]. Chin J Infect Dis, 2018, 36(5): 270-276. (in Chinese) DOI: 10.3760/cma.j.issn.1000-6680.2018.05.003

    吴柳, 薛冬英, 张洁, 等. 两种肝脏成像技术联合血清型模型对乙型肝炎相关肝纤维化的诊断价值[J]. 中华传染病杂志, 2018, 36(5): 270-276. DOI: 10.3760/cma.j.issn.1000-6680.2018.05.003
    [19] MAK LY, HUI RW, FUNG J, et al. Diverse effects of hepatic steatosis on fibrosis progression and functional cure in virologically quiescent chronic hepatitis B[J]. J Hepatol, 2020, 73(4): 800-806. DOI: 10.1016/j.jhep.2020.05.040
    [20] XU XL, MENG FK, SUN LJ. The application research of ultrasonic elastography in the evaluation of fatty liver disease[J]. J Med Imaging, 2016, 26(10): 1843-1846. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XYXZ201610029.htm

    徐晓鸾, 孟繁坤, 孙丽娟. 超声弹性检测评价脂肪肝的应用研究[J]. 医学影像学杂志, 2016, 26(10): 1843-1846. https://www.cnki.com.cn/Article/CJFDTOTAL-XYXZ201610029.htm
    [21] FERRAIOLI G, TINELLI C, LISSANDRIN R, et al. Controlled attenuation parameter for evaluating liver steatosis in chronic viral hepatitis[J]. World J Gastroenterol, 2014, 20(21): 6626-6631. DOI: 10.3748/wjg.v20.i21.6626
    [22] SETO WK, HUI R, MAK LY, et al. Association between hepatic steatosis, measured by controlled attenuation parameter, and fibrosis burden in chronic hepatitis B[J]. Clin Gastroenterol Hepatol, 2018, 16(4): 575-583. DOI: 10.1016/j.cgh.2017.09.044
    [23] NAN S, LIANG Y, QU Y, et al. Hepatic steatosis in chronic hepatitis B as measured by controlled attenuation parameter: Frequency and distribution[J]. J Coll Physicians Surg Pak, 2019, 29(10): 937-941. DOI: 10.29271/jcpsp.2019.10.937
    [24] LI Q, HUANG C, XU W, et al. Accuracy of FibroScan in analysis of liver fibrosis in patients with concomitant chronic hepatitis B and nonalcoholic fatty liver disease[J]. Medicine (Baltimore), 2020, 99(23): e20616. DOI: 10.1097/MD.0000000000020616
    [25] XU L, LU W, LI P, et al. A comparison of hepatic steatosis index, controlled attenuation parameter and ultrasound as noninvasive diagnostic tools for steatosis in chronic hepatitis B[J]. Dig Liver Dis, 2017, 49(8): 910-917. DOI: 10.1016/j.dld.2017.03.013
    [26] DAI L, WANG Z, ZHANG HY, et al. Comparative study of FibroScan and FibroTouch on liver hardness and fat quantification[J]. J Hunan Normal Univ(Med Sci), 2020, 17(1): 94-98. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-HNYG202001028.htm

    代炼, 王左, 张海宇, 等. FibroScan与FibroTouch对肝脏硬度及脂肪定量的检测效能对比研究[J]. 湖南师范大学学报(医学版), 2020, 17(1): 94-98. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYG202001028.htm
    [27] WANG L, ZHU M, CAO L, et al. Liver stiffness measurement can reflect the active liver necroinflammation in population with chronic liver disease: A real-world evidence study[J]. J Clin Transl Hepatol, 2019, 7(4): 313-321.
    [28] LUO HY, LI SJ, LI BX, et al. Diagnostic value of children with liver fibrosis by transient elastography[J]. J Clin Pediatr Surg, 2020, 19(6): 481-485. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-LCXR202006005.htm

    罗海燕, 李双杰, 李碧香, 等. 瞬时弹性成像技术对儿童肝纤维化的诊断价值研究[J]. 临床小儿外科杂志, 2020, 19(6): 481-485. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXR202006005.htm
    [29] XU ZQ, DONG Y, WANG FC, et al. Value of transient elastography in the diagnosis of liver fibrosis in chronic hepatitis B children of different ages[J]. J Clin Hepatol, 2020, 36(6): 1268-1272. (in Chinese) DOI: 10.3969/j.issn.1001-5256.2020.06.016

    徐志强, 董漪, 王福川, 等. 瞬时弹性成像对不同年龄慢性乙型肝炎肝纤维化患儿的诊断价值[J]. 临床肝胆病杂志, 2020, 36(6): 1268-1272. DOI: 10.3969/j.issn.1001-5256.2020.06.016
    [30] SUN J, LI Y, SUN X, et al. Dynamic changes of the aspartate aminotransferase-to-platelet ratio and transient elastography in predicting a histologic response in patients with chronic hepatitis B after entecavir treatment[J]. J Ultrasound Med, 2019, 38(6): 1441-1448. DOI: 10.1002/jum.14822
    [31] FU X, LOU H, CHEN F, et al. Hepatitis B core antibody and liver stiffness measurements predict HBeAg seroconversion in HBeAg-positive chronic hepatitis B patients with minimally elevated alanine aminotransferase (ALT) levels[J]. Clin Exp Med, 2020, 20(2): 241-248.
    [32] CHEN J, WANG ML, LONG Q, et al. High value of controlled attenuation parameter predicts a poor antiviral response in patients with chronic hepatits B[J]. Hepatobiliary Pancreat Dis Int, 2017, 16(4): 370-374.
    [33] LIN X, SHANG GC, QI CH, et al. Measurement of liver and spleen stiffness by transient elastography and their correlation with the degree of esophageal varices in patients with liver cirrhosis[J]. Chin J Dig, 2018, 38(2): 129-131. (in Chinese)

    林欣, 尚国臣, 齐翠花, 等. 利用瞬时弹性成像技术对肝脏、脾脏硬度的测定及其与肝硬化食管静脉曲张程度的关系[J]. 中华消化杂志, 2018, 38(2): 129-131.
    [34] CASSINOTTO C, CHARRIE A, MOURIES A, et al. Liver and spleen elastography using supersonic shear imaging for the non-invasive diagnosis of cirrhosis severity and oesophageal varices[J]. Dig Liver Dis, 2015, 47(8): 695-701.
    [35] de FRANCHIS R, Baveno VI Faculty. Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension[J]. J Hepatol, 2015, 63(3): 743-752.
    [36] YANG XP. Application value of liver and spleen stiffness detected by transient elastography for predicting esophageal varices[J]. Chin J Ultrasound Med, 2017, 33(2): 139-142. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY201702014.htm

    杨学平. 瞬时弹性成像检测肝脾硬度预测食管静脉曲张的价值[J]. 中国超声医学杂志, 2017, 33(2): 139-142. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY201702014.htm
    [37] ZHENG JF, LI L. Predictive value of FibroScan combined with non-invasive serum indicators for the degree of esophageal varices in patients with hepatitis B cirrhosis[J]. Chin J Gastroenterol Hepatol, 2019, 28(9): 999-1002. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-WCBX201909008.htm

    郑俊福, 李磊. FibroScan联合无创血清指标对乙型肝炎肝硬化患者食管静脉曲张程度的预测价值[J]. 胃肠病学和肝病学杂志, 2019, 28(9): 999-1002. https://www.cnki.com.cn/Article/CJFDTOTAL-WCBX201909008.htm
    [38] LIU JQ, WANG SY, JIAO XJ, et al. Value of liver-spleen FibroScan in predicting the degree of esophageal varices and esophageal variceal bleeding in patients with hepatitis B cirrhosis[J]. Shandong Med J, 2018, 58(33): 72-74. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SDYY201833022.htm

    刘加群, 王守云, 焦秀娟, 等. 肝脾FibroScan对乙型肝炎肝硬化患者食管静脉曲张程度及其破裂出血的预测价值[J]. 山东医药, 2018, 58(33): 72-74. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYY201833022.htm
    [39] XIN KF, ZHANG J, LI M, et al. Value of combined measurement of liver and spleen stiffness in predicting esophageal variceal bleeding in patients with liver cirrhosis[J]. Anhui Med J, 2018, 39(9): 1116-1118. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-AHYX201809026.htm

    辛克锋, 张健, 李铭, 等. 肝脾硬度联合检测对肝硬化食管静脉曲张破裂出血的预测价值[J]. 安徽医学, 2018, 39(9): 1116-1118. https://www.cnki.com.cn/Article/CJFDTOTAL-AHYX201809026.htm
    [40] XU B, LI R, GUO YL, et al. Relationship between liver stiffness and hepatocellular carcinoma presence in chronic heptatitis B patients with negative α-fetoprotein tests[J/CD]. Chin J Med Ultrasound(Electronic edition), 2015, 12(4): 301-305. (in Chinese)

    徐斌, 李锐, 郭燕丽, 等. 瞬时弹性测定评估甲胎蛋白阴性的慢性乙型病毒性肝炎患者发生原发性肝细胞癌风险的价值[J/CD]. 中华医学超声杂志(电子版), 2015, 12(4): 301-305.
    [41] LEE HW, PARK SY, LEE M, et al. An optimized hepatocellular carcinoma prediction model for chronic hepatitis B with well-controlled viremia[J]. Liver Int, 2020, 40(7): 1736-1743.
    [42] SEO YS, KIM MN, KIM SU, et al. Risk assessment of hepatocellular carcinoma using transient elastography vs. liver biopsy in chronic hepatitis B patients receiving antiviral therapy[J]. Medicine (Baltimore), 2016, 95(12): e2985.
    [43] LIU Y, WANG X, XIAO J, et al. Prognostic value of postoperative change in liver stiffness in patients with HBV-related hepatocellular carcinoma[J]. J Int Med Res, 2020, 48(4): 300060520908763.
    [44] European Association for Study of Liver, Asociacion Latinoamericana para el Estudio del Higado. EASL-ALEH clinical practice guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis[J]. J Hepatol, 2015, 63(1): 237-264.
    [45] LIN Z, LIANG J, ZHU J, et al. Diverse correlations between fibrosis-related factors and liver stiffness measurement by transient elastography in chronic hepatitis B[J]. Eur J Gastroenterol Hepatol, 2018, 30(2): 217-225.
    [46] SHEN F, MI YQ, XU L, et al. Moderate to severe hepatic steatosis leads to overestimation of liver stiffness measurement in chronic hepatitis B patients without significant fibrosis[J]. Aliment Pharmacol Ther, 2019, 50(1): 93-102.
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  • 收稿日期:  2020-07-31
  • 修回日期:  2020-09-24
  • 刊出日期:  2021-02-20
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