磁共振弹性成像在肝纤维化无创诊断中的应用

杨明磊; 姚定康

doi:10.3969/j.issn.1001-5256.2016.03.042

磁共振弹性成像在肝纤维化无创诊断中的应用

DOI: 10.3969/j.issn.1001-5256.2016.03.042

上海长征医院内科学教研室

详细信息

中图分类号: R575.2
计量
- 文章访问数: 2251
- HTML全文浏览量: 21
- PDF下载量: 402
- 被引次数: 0
出版历程
- 出版日期: 2016-03-20

Application of magnetic resonance elastography as a non-invasive technique for diagnosis of liver fibrosis

Department of Internal Medicine, Shanghai Changzheng Hospital

摘要

摘要: 目前以活组织病理检查作为肝纤维化诊断分级的金标准,然而其具有明显的局限性,无创检测方法成为临床的需求,磁共振弹性成像(MRE)是目前研究的热点。回顾了MRE在相关领域的临床进展,研究显示其在肝纤维化的诊断和分级中具有很高的灵敏度、特异度,受试者工作特征曲线下面积可达0.95以上,具有极高的诊断价值。与血清学和其他影像学诊断方式相比,MRE可更加明确地进行肝纤维化分期,具有良好的重复性和客观性,可在除血色病患者的其他患者中广泛应用,尤其在肥胖和腹水患者的诊断中具有独特优势,弥补了其他方法的不足。认为MRE可能成为评价肝纤维化,尤其是高级别纤维化最具价值的诊断方法。
- 肝硬化 /
- 弹性成像技术 /
- 诊断 /
- 综述
Abstract: At present,liver biopsy is the gold standard for the diagnosis and grading of liver fibrosis,but its limitations have been widely acknowledged. The non- invasive detection methods are needed in clinical practice,and at present,magnetic resonance elastography( MRE)is a hot research topic. This article reviews the advances in the clinical application of MRE in related fields,and studies have shown that MRE has a high diagnostic value due to its high sensitivity and specificity in the diagnosis and grading of liver fibrosis and an area under the receiver operating characteristic curve as high as 0. 95. Compared with serological and other imaging diagnostic methods,MRE can determine fibrosis stage more accurately and has good reproducibility and objectivity. MRE can be widely applied in all patients except those with hemochromatosis,with special advantages in the diagnosis for patients with obesity and ascites,and can make up for the disadvantages of other methods. This article points out that MRE may become the best non- invasive method for the assessment of liver fibrosis,especially advanced fibrosis.
- liver cirrhosis /
- elasticity imaging techniques /
- diagnosis /
- review

HTML全文

参考文献(31)

[1]GAGGINI MC,NAVARRO RS,STEFANINI AR,et al.Correlation between METAVIR scores and Raman spectroscopy in liver lesions induced by hepatitis C virus:a preliminary study[J].Lasers Med Sci,2015,30(4):1347-1355.

[2]WANG CC,LIU CH,LIN CL,et al.Fibrosis index based on four factors better predicts advanced fibrosis or cirrhosis than aspartate aminotransferase/platelet ratio index in chronic hepatitis C patients[J].J Formos Med Assoc,2015,114(10),923-928.

[3]PETERS L,MOCROFT A,SORIANO V,et al.Hyaluronic acid levels predict risk of hepatic encephalopathy and liver-related death in HIV/viral hepatitis coinfected patients[J].PLo S One,2013,8(5):e64283.

[4]COHEN-EZRA O,BEN-ARI Z.Non-invasive assessment of liver fibrosis[J].Harefuah,2015,154(3):204-207,209,210.

[5]CEQUERA A,GARCA de LEN MNDEZ MC.Biomarkers for liver fibrosis:advances,advantages and disadvantages[J].Rev Gastroenterol Mex,2014,79(3):187-199.

[6]HUWART L,van BEERS BE.MR elastography[J].Gastroenterol Clin Biol,2008,32(Suppl 1):68-72.

[7]TANG A,CLOUTIER G,SZEVERENYI NM,et al.Ultrasound elastography and MR elastography for assessing liver fibrosis:Part1,principles and techniques[J].AJR Am J Roentgenol,2015,205(1):22-32.

[8]ICHIKAWA S,MOTOSUGI U,MORISAKA H,et al.Comparison of the diagnostic accuracies of magnetic resonance elastography and transient elastography for hepatic fibrosis[J].Magn Reson Imaging,2015,33(1):26-30.

[9]SU LN,GUO SL,LI BX,et al.Diagnostic value of magnetic resonance elastography for detecting and staging of hepatic fibrosis:a meta-analysis[J].Clin Radiol,2014,69(12):e545-e552.

[10]BATHEJA M,VARGAS H,SILVA AM,et al.Magnetic resonance elastography(MRE)in assessing hepatic fibrosis:performance in a cohort of patients with histological data[J].Abdom Imaging,2015,40(4):760-765.

[11]KIM D,KIM WR,TALWALKAR JA,et al.Advanced fibrosis in nonalcoholic fatty liver disease:noninvasive assessment with MR elastography[J].Radiology,2013,268(2):411-419.

[12]SINGH S,VENKATESH SK,WANG Z,et al.Diagnostic performance of magnetic resonance elastography in staging liver fibrosis:a systematic review and meta-analysis of individual participant data[J].Clin Gastroenterol Hepatol,2015,13(3):440-451.

[13]LI B,MIN J,LIANG WR,et al.Use of magnetic resonance elastography for assessing liver functional reserve:a clinical study[J].World J Gastroenterol,2015,21(24):7522-7528.

[14]ROSTAMI S,PARSIAN H.Hyaluronic acid:from biochemical characteristics to its clinical translation in assessment of liver fibrosis[J].Hepat Mon,2013,13(12):e13787.

[15] LYNCH M,HIGGINS E,MCCORMICK PA,et al.The use of transient elastography and Fibro Test for monitoring hepatotoxicity in patients receiving methotrexate for psoriasis[J].JAMA Dermatol,2014,150(8):856-862.

[16]SALKIC N,JOVANOVIC P,HAUSER G,et al.Fibro Test/Fibrosure for significant liver fibrosis and cirrhosis in chronic hepatitis B:a meta-analysis[J].Am J Gastroenterol,2014,109(6):796-809.

[17]CUI J,ANG B,HAUFE W,et al.Comparative diagnostic accuracy of magnetic resonance elastography vs.eight clinical prediction rules for non-invasive diagnosis of advanced fibrosis in biopsy-proven non-alcoholic fatty liver disease:a prospective study[J].Aliment Pharmacol Ther,2015,41(12):1271-1280.

[18]HORVATH G.New non-invasive tool for assessment of liver fibrosis:transient elastography[J].Orv Hetil,2011,152(22):860-865.

[19]SPOREA I,SIRLI R,POPESCU A,et al.Acoustic radiation force impulse(ARFI)——a new modality for the evaluation of liver fibrosis[J].Med Ultrason,2010,12(1):26-31.

[20]SHARMA P,DHAWAN S,BANSAL R,et al.The usefulness of transient elastography by Fibro Scan for the evaluation of liver fibrosis[J].Indian J Gastroenterol,2014,33(5):445-451.

[21]SANDRIN L,FOURQUET B,HASQUENOPH JM,et al.Transient elastography:a new noninvasive method for assessment of hepatic fibrosis[J].Ultrasound Med Biol,2003,29(12):1705-1713.

[22]GUO Y,PARTHASARATHY S,GOYAL P,et al.Magnetic resonance elastography and acoustic radiation force impulse for staging hepatic fibrosis:a meta-analysis[J].Abdom Imaging,2015,40(4):818-834.

[23]OUDRY J,CHEN J,GLASER KJ,et al.Cross-validation of magnetic resonance elastography and ultrasound-based transient elastography:a preliminary phantom study[J].J Magn Reson Imaging,2009,30(5):1145-1150.

[24]HINES CD,BLEY TA,LINDSTROM MJ,et al.Repeatability of magnetic resonance elastography for quantification of hepatic stiffness[J].J Magn Reson Imaging,2010,31(3):725-731.

[25]COLAGRANDE S,CARBONE SF,CARUSI LM,et al.Magnetic resonance diffusion-weighted imaging:extraneurological applications[J].Radiol Med,2006,111(3):392-419.

[26]ZOU LQ,CHEN J,PAN L,et al.Comparison of magnetic resonance elastography and diffusion-weighted imaging for staging hepatic fibrosis[J].Chin Med J(Engl),2015,128(5):620-625.

[27]WANG Y,GANGER DR,LEVITSKY J,et al.Assessment of chronic hepatitis and fibrosis:comparison of MR elastography and diffusion-weighted imaging[J].AJR Am J Roentgenol,2011,196(3):553-561.

[28]HENNEDIGE TP,HALLINAN JT,LEUNG FP,et al.Comparison of magnetic resonance elastography and diffusion-weighted imaging for differentiating benign and malignant liver lesions[J].Eur Radiol,2015,26(2):398-406.

[29]ICHIKAWA S,MOTOSUGI U,NAKAZAWA T,et al.Hepatitis activity should be considered a confounder of liver stiffness measured with MR elastography[J].J Magn Reson Imaging,2015,41(5):1203-1208.

[30]CROSSAN C,TSOCHATZIS EA,LONGWORTH L,et al.Cost-effectiveness of non-invasive methods for assessment and monitoring of liver fibrosis and cirrhosis in patients with chronic liver disease:systematic review and economic evaluation[J].Health Technol Assess,2015,19(9):1-409.

[31]ZHANG E,WARTELLE-BLADOU C,LEPANTO L,et al.Cost-utility analysis of nonalcoholic steatohepatitis screening[J].Eur Radiol,2015,25(11):3282-3294.

施引文献

资源附件(0)

访问统计