de Lédinghen V, Vergniol J
Centre d'Investigation de la Fibrose hépatique, Hôpital Haut-Lévêque, Pessac, France INSERM U889, Université Victor Segalen, Bordeaux, France.
Gastroenterol Clin Biol. 2008 Sep;32(6 Suppl 1):58-67. doi: 10.1016/S0399-8320(08)73994-0.
Transient elastography (FibroScan) is a non-invasive method proposed for the assessment of hepatic fibrosis in patients with chronic liver disease by measuring liver stiffness. It can be easily performed at the bedside or in the outpatients clinic with immediate results and good reproducibility. Limitations include failure (no value) in around 5% of cases, mainly in patients with substantial thoracic fat. In France, FibroScan or FibroTest are recommended for the initial evaluation of liver fibrosis in previously untreated patients with chronic hepatitis C and no concomitant health disorders. FibroScan is validated for the diagnosis of significant fibrosis and cirrhosis in chronic hepatitis C, recurrence of hepatitis C after liver transplantation, co-infections in HIV-HCV patients and chronic cholestatic diseases, but needs further evaluation in other chronic liver diseases. FibroScan is an excellent tool for early detection of cirrhosis and evaluation of portal hypertension, for which it may have prognostic value as well. Studies are needed using FibroScan for the follow-up of patients with and without treatment, and for the screening of patients at risk of liver disease. However, although FibroScan is a good method for the evaluation of fibrosis in patients with chronic liver disease, it has to be borne in mind that FibroScan evaluates liver stiffness. Therefore, FibroScan values have to be interpreted according to clinical, biological and morphological data.
瞬时弹性成像（FibroScan）是一种通过测量肝脏硬度来评估慢性肝病患者肝纤维化的非侵入性方法。它可以在床边或门诊轻松进行，结果即时且重复性良好。局限性包括约5%的病例无法得出结果（无测量值），主要是胸部脂肪较多的患者。在法国，对于既往未接受治疗、患有慢性丙型肝炎且无并发健康问题的患者，建议使用FibroScan或FibroTest进行肝纤维化的初始评估。FibroScan已被验证可用于诊断慢性丙型肝炎、肝移植后丙型肝炎复发、HIV-HCV患者的合并感染以及慢性胆汁淤积性疾病中的显著纤维化和肝硬化，但在其他慢性肝病中还需要进一步评估。FibroScan是早期检测肝硬化和评估门静脉高压的优秀工具，对此它可能也具有预后价值。需要开展研究，利用FibroScan对接受和未接受治疗的患者进行随访，并对有肝病风险的患者进行筛查。然而，尽管FibroScan是评估慢性肝病患者纤维化的一种好方法，但必须牢记FibroScan评估的是肝脏硬度。因此，FibroScan值必须根据临床、生物学和形态学数据进行解读。
