肝纤维化的影像学诊断现状

郑悠; 许永生; 张旭霞; 刘海峰; 刘钊; 雷军强

doi:10.3969/j.issn.1001-5256.2019.08.042

肝纤维化的影像学诊断现状

DOI: 10.3969/j.issn.1001-5256.2019.08.042

1 兰州大学第一临床医学院
2 兰州大学第一医院放射科
3 甘肃省智能影像医学工程研究中心
4 精准影像协同创新甘肃省国际科技合作基地

基金项目:

兰州大学中央高校基本科研业务费专项资金资助(lzujbky-2019-cd04)；

详细信息

中图分类号: R575.2
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- 被引次数: 0
出版历程
- 收稿日期: 2019-02-11
- 出版日期: 2019-08-20

Current status of the imaging diagnosis of liver fibrosis

The First Clinical Medical College, Lanzhou University

Research funding:

摘要

摘要:
肝纤维化是临床各类慢性肝病进行性发展的结果,可进一步发展为致死率较高的肝硬化及肝癌。早期诊断肝纤维化对疾病的逆转有着重要意义。目前,肝穿刺活组织检查是诊断肝纤维化的"金标准",但由于其有诸多缺点而无法作为常规筛查手段。近年来,各种无创影像学检查技术取得了一定的进展,就CT、MRI、核医学、超声等对肝纤维化诊断的研究现状作一综述。
- 肝硬化 /
- 体层摄影术,X线计算机 /
- 磁共振成像 /
- 核医学 /
- 超声检查
Abstract:
Liver fibrosis is the result of the progressive development of various chronic liver diseases and can develop into liver cirrhosis and liver cancer with high mortality rates. Early diagnosis of liver fibrosis is of great significance for disease reversal. At present, liver biopsy is considered the gold standard for the diagnosis of liver fibrosis, but it cannot be used as a routine screening method due to its shortcomings.In recent years, progress has been made in various noninvasive imaging methods, and this article reviews the current status of the research on computed tomography, magnetic resonance imaging, nuclear medicine, and ultrasound in the diagnosis of liver fibrosis.
- liver cirrhosis /
- tomography, X-ray computed /
- magnetic resonance imaging /
- nuclear medicine /
- ultrasonography

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参考文献(40)

[1] BEDOSSA P, POYNARD T. An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group[J]. Hepatology, 1996, 24 (2) :289-293.

[2] ISHAK K, BAPTISTA A, BIANCHI L, et al. Histological grading and staging of chronic hepatitis[J]. J Hepatol, 1995, 22 (6) :696-699.

[3] HUBER A, EBNER L, MONTANI M, et al. Computed tomography findings in liver fibrosis and cirrhosis[J]. Swiss Med Wkly, 2014, 144:w13923.

[4] OBMANN VC, MERTINEIT N, BERZIGOTTI A, et al. CT predicts liver fibrosis:Prospective evaluation of morphology-and attenuation-based quantitative scores in routine portal venous abdominal scans[J]. PLo S One, 2018, 13 (7) :e0199611.

[5] WANG L, FAN J, DING X, et al. Assessment of liver fibrosis in the early stages with perfusion CT[J]. Int J Clin Exp Med, 2015, 8 (9) :15276-15282.

[6] RONOT M, ASSELAH T, PARADIS V, et al. Liver fibrosis in chronic hepatitis C virus infection:Differentiating minimal from intermediate fibrosis with perfusion CT[J]. Radiology, 2010, 256 (1) :135-142.

[7] LI Y, PAN Q, ZHAO H. Investigation of the values of CT perfusion imaging and ultrasound elastography in the diagnosis of liver fibrosis[J]. Exp Ther Med, 2018, 16 (2) :896-900.

[8] SOFUE K, TSURUSAKI M, MILETO A, et al. Dual-energy computed tomography for non-invasive staging of liver fibrosis:Accuracy of iodine density measurements from contrastenhanced data[J]. Hepatol Res, 2018, 48 (12) :1008-1019.

[9] LAMB P, SAHANI DV, FUENTES-ORREGO JM, et al. Stratification of patients with liver fibrosis using dual-energy CT[J]. IEEE Trans Med Imaging, 2015, 34 (3) :807-815.

[10] LV P, LIN X, GAO J, et al. Spectral CT:Preliminary studies in the liver cirrhosis[J]. Korean J Radiol, 2012, 13 (4) :434-442.

[11] ZHAO LQ, HE W, YAN B, et al. The evaluation of haemodynamics in cirrhotic patients with spectral CT[J]. Br J Radiol, 2013, 86 (1028) :20130228.

[12] LIN ZR. GSI mode of spectral CT in diagnosis of liver fibrosis in experimental animals[D]. Shantou:Shantou University, 2013. (in Chinese) 林植荣.能谱CT GSI mode对肝纤维化诊断价值的实验动物研究[D].汕头:汕头大学, 2013.

[13] LIU HF, XU YS, ZHANG Y, et al. Value of magnetic resonance morphological imaging in the diagnosis and differentiation of post-hepatitis B cirrhosis[J]. J Clin Hepatol, 2018, 34 (12) :2587-2591. (in Chinese) 刘海峰, 许永生, 张跃, 等. MR形态学成像在乙型肝炎肝硬化诊断及分期中的应用价值[J].临床肝胆病杂志, 2018, 34 (12) :2587-2591.

[14] ZHOU JL, ZHANG ZG, HUANG JQ, et al. Modified hilar portal space measurement on MRI:Association with the stage of liver fibrosis and cirrhosis[J]. J Clin Radiol, 2018, 37 (1) :70-73. (in Chinese) 周家龙, 张振光, 黄建强, 等. MRI改良法测量门静脉右支前间隙改变与肝纤维化、肝硬化病理学分期的相关性研究[J].临床放射学杂志, 2018, 37 (1) :70-73.

[15] JIANG H, CHEN J, GAO R, et al. Liver fibrosis staging with diffusion-weighted imaging:A systematic review and metaanalysis[J]. Abdom Radiol (NY) , 2017, 42 (2) :490-501.

[16] KOCAKOC E, BAKAN AA, POYRAZOGLU OK, et al. Assessment of liver fibrosis with diffusion-weighted magnetic resonance imaging using different b-values in chronic viral hepatitis[J]. Med Princ Pract, 2015, 24 (6) :522-526.

[17] OZKURT H, KESKINER F, KARATAG O, et al. Diffusion weighted MRI for hepatic fibrosis:Impact of b-value[J]. Iran J Radiol, 2014, 11 (1) :e3555.

[18] CHEN C, FU F, ZHANG J, et al. Evaluation of liver fibrosis with a monoexponential model of intravoxel incoherent motion magnetic resonance imaging[J]. Oncotarget, 2018, 9 (37) :24619-24626.

[19] ZHANG B, LIANG L, DONG Y, et al. Intravoxel incoherent motion MR imaging for staging of hepatic fibrosis[J]. PLo S One, 2016, 11 (1) :e0147789.

[20] HAGIWARA M, RUSINEK H, LEE VS, et al. Advanced liver fibrosis:Diagnosis with 3D whole-liver perfusion MR imaging—initial experience[J]. Radiology, 2008, 246 (3) :926-934.

[21] SINGH S, VENKATESH SK, LOOMBA R, et al. Magnetic resonance elastography for staging liver fibrosis in non-alcoholic fatty liver disease:A diagnostic accuracy systematic review and individual participant data pooled analysis[J]. Eur Radiol, 2016, 26 (5) :1431-1440.

[22] WANG J, MALIK N, YIN M, et al. Magnetic resonance elastography is accurate in detecting advanced fibrosis in autoimmune hepatitis[J]. World J Gastroenterol, 2017, 23 (5) :859-868.

[23] HENNEDIGE TP, WANG G, LEUNG FP, et al. Magnetic resonance elastography and diffusion weighted imaging in the evaluation of hepatic fibrosis in chronic hepatitis B[J]. Gut Liver, 2017, 11 (3) :401-408.

[24] TANG CM, BANERJEE R, COLLIER J, et al. Liver fibrosis severity is associated with hepatic lipid composition as assessed by proton magnetic resonance spectroscopy[J]. Gut, 2016, 65 (1) :A92.

[25] PUUSTINEN L, HAKKARAINEN A, KIVISAARI R, et al.31Phosphorus magnetic resonance spectroscopy of the liver for evaluating inflammation and fibrosis in autoimmune hepatitis[J]. Scand J Gastroenterol, 2017, 52 (8) :886-892.

[26] GODFREY EM, PATTERSON AJ, PRIEST AN, et al. A comparison of MR elastography and31P MR spectroscopy with histological staging of liver fibrosis[J]. Eur Radiol, 2012, 22 (12) :2790-2797.

[27] YANG ZX, LIANG HY, HU XX, et al. Feasibility of histogram analysis of susceptibility-weighted MRI for staging of liver fibrosis[J]. Diagn Interv Radiol, 2016, 22 (4) :301-307.

[28] BALASSY C, FEIER D, PECK-RADOSAVLJEVIC M, et al. Susceptibility-weighted MR imaging in the grading of liver fibrosis:A feasibility study[J]. Radiology, 2014, 270 (1) :149-158.

[29] FUCHS BC, WANG H, YANG Y, et al. Molecular MRI of collagen to diagnose and stage liver fibrosis[J]. J Hepatol, 2013, 59 (5) :992-998.

[30] FARRAR CT, DEPERALTA DK, DAY H, et al. 3D molecular MR imaging of liver fibrosis and response to rapamycin therapy in a bile duct ligation rat model[J]. J Hepatol, 2015, 63 (3) :689-696.

[31] ZHU B, WEI L, ROTILE N, et al. Combined magnetic resonance elastography and collagen molecular magnetic resonance imaging accurately stage liver fibrosis in a rat model[J]. Hepatology, 2017, 65 (3) :1015-1025.

[32] HATORI A, YUI J, XIE L, et al. Utility of translocator protein (18 kDa) as a molecular imaging biomarker to monitor the progression of liver fibrosis[J]. Sci Rep, 2015, 5:17327.

[33] SCHNABL B, FARSHCHI-HEYDARI S, LOOMBA R, et al.Staging of fibrosis in experimental non-alcoholic steatohepatitis by quantitative molecular imaging in rat models[J]. Nucl Med Biol, 2016, 43 (2) :179-187.

[34] TANIGUCHI M, OKIZAKI A, WATANABE K, et al. Hepatic clearance measured with (99m) Tc-GSA single-photon emission computed tomography to estimate liver fibrosis[J].World J Gastroenterol, 2014, 20 (44) :16714-16720.

[35] ZHANG D, ZHUANG R, GUO Z, et al. Desmin-and vimentin-mediated hepatic stellate cell-targeting radiotracer 99mTc-GlcNAc-PEI for liver fibrosis imaging with SPECT[J]. Theranostics, 2018, 8 (5) :1340-1349.

[36] SANGWAIYA MJ, SHERMAN DI, LOMAS DJ, et al. Latest developments in the imaging of fibrotic liver disease[J]. Acta Radiol, 2014, 55 (7) :802-813.

[37] LEI JW, TAN BB, LI WB, et al. Value of transient elastography measured with FibroTouch in the diagnosis of liver fibrosis in chronic hepatitis patients with hepatocellular carcinoma[J].Clin J Med Offic, 2017, 45 (9) :930-933. (in Chinese) 雷洁雯, 谭碧波, 李万斌, 等. FibroTouch瞬时弹性成像诊断慢性乙型肝炎合并肝癌患者肝纤维化程度应用研究[J].临床军医杂志, 2017, 45 (9) :930-933.

[38] LIU BR, DONG X, HUANG LP. Diagnostic efficacy of shear wave elastography in evaluating chronic hepatitis B liver fibrosis and related influencing factors[J]. J Clin Hepatol, 2018, 34 (11) :2329-2333. (in Chinese) 刘博儒, 董雪, 黄丽萍.剪切波弹性成像评估慢性乙型肝炎肝纤维化的价值及影响因素[J].临床肝胆病杂志, 2018, 34 (11) :2329-2333.

[39] LEUNG VY, SHEN J, WONG VW, et al. Quantitative elastography of liver fibrosis and spleen stiffness in chronic hepatitis B carriers:Comparison of shear-wave elastography and transient elastography with liver biopsy correlation[J]. Radiology, 2013, 269 (3) :910-918.

[40] ISHIBASHI H, MARUYAMA H, TAKAHASHI M, et al. Assessment of hepatic fibrosis by analysis of the dynamic behaviour of microbubbles during contrast ultrasonography[J]. Liver Int, 2010, 30 (9) :1355-1363.

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