肝纤维化程度的评估对预测肝病的进展和患者的预后是一种很重要的方式。肝硬度测试与肝脏疾病的进展阶段息息相关。我们将通过陈述两个病例来介绍导致过高评价肝纤维化程度的一个新的原因。病例一：肝右叶血管瘤导致肝纤维化程度被过高评估。但对肝左叶行肝纤维化扫描检查时结果完全改变。在另一个肝左叶血管瘤的病例中，肝左叶纤维化程度被过高评估，但肝右叶肝纤维化扫描检查结果是正常的。我们发现肝血管瘤或许可以导致肝纤维化程度被过高评估。在肝硬度测定之前，建议行肝实质回声检查。我们建议对于肝纤维化扫描面值高的病人需在另一肝叶重复检查。此外，应该排除可能的混杂因素。
吉林大学第一医院肝胆内科 李雅君 摘译
本文首次发表于[ Hepat Mon.2012;12(6):408-410 ]
The assessment of liver fibrosis is an important way for prediction of liver disease progression and patient’s prognosis. Liver stiffness measurement (LSM) is strongly associated with stage of liver diseases. We would like to introduce a new leading cause of liver fibrosis overestimation by presentation of two cases. One case with right lobe hemangioma has an overestimation of liver fibrosis. The result completely changed when Fibroscan was performed in patient’s left lobe. Case number one:the left lobe median fibrosis score is 17.1,Metavir histological index is F4.But the right lobe is 4.4,metavir histological index isF0. Another case with left lobe hemangioma had overestimation of fibrosis in her left lobe but, right lob Fibroscan was normal. Case number two:the right lobe :stiffness score is5.6Kpa which was equal with F0-F1.the left lobe :fibroscan score for liver was 11.8Kpa(F3-F4). We found that liver hemangioma may leads to overestimation of liver stiffness and the correct inspection of liver echogenicity before any interpretation of high liver stiffness is recommended. We suggest that patient with higher level of Fibroscan score repeat it in other sides of the liver. Also, they should be evaluated by sonography for ruling out of possible confounders .
吉林大学第一医院肝胆内科 李雅君 摘译
本文首次发表于[ Hepat Mon.2012;12(6):408-410 ]
Liver Hemangioma Might Lead to Overestimation of Liver Fibrosis by Fibroscan
The assessment of liver fibrosis is an important way for prediction of liver disease progression and patient’s prognosis. Liver stiffness measurement (LSM) is strongly associated with stage of liver diseases. We would like to introduce a new leading cause of liver fibrosis overestimation by presentation of two cases. One case with right lobe hemangioma has an overestimation of liver fibrosis. The result completely changed when Fibroscan was performed in patient’s left lobe. Case number one:the left lobe median fibrosis score is 17.1,Metavir histological index is F4.But the right lobe is 4.4,metavir histological index isF0. Another case with left lobe hemangioma had overestimation of fibrosis in her left lobe but, right lob Fibroscan was normal. Case number two:the right lobe :stiffness score is5.6Kpa which was equal with F0-F1.the left lobe :fibroscan score for liver was 11.8Kpa(F3-F4). We found that liver hemangioma may leads to overestimation of liver stiffness and the correct inspection of liver echogenicity before any interpretation of high liver stiffness is recommended. We suggest that patient with higher level of Fibroscan score repeat it in other sides of the liver. Also, they should be evaluated by sonography for ruling out of possible confounders .
