Unit of Liver Research, Bambino Gesù Children's Hospital, IRCCS, P.le S. Onofrio 4, 00165 Rome, Italy.
Best Pract Res Clin Gastroenterol. 2011 Apr;25(2):259-68. doi: 10.1016/j.bpg.2011.02.008.
Numerous paediatric liver diseases from different origins may be complicated by development of liver fibrosis and progression to cirrhosis. Although fibrogenesis, which represents a major driving force for the development of liver fibrosis, has common tracts whatever the aetiology, liver fibrosis has different histopathological patterns in paediatric liver disease. In these diseases management choices may depend upon the stage of liver fibrosis. Thus, the accurate estimation of histological pattern of liver fibrosis is important for the prevention of the subsequent complications. Liver biopsy has long been considered as a gold standard diagnostic method for assessing liver fibrosis. However, due to its several disadvantages, in the last decades alternative and accurate non-invasive means to estimate fibrosis are developed. In this review, we characterised the most frequent histological patterns of liver fibrosis in paediatric liver diseases. Furthermore, we describe use of liver biopsy in diagnosis and staging of liver fibrosis, list the alternative non-invasive techniques that have an emerging role in the assessment of liver fibrosis, and propose a management algorithm.
许多源自不同病因的儿科肝脏疾病可能会发展为肝纤维化和肝硬化。尽管纤维化是肝纤维化发展的主要驱动力，无论病因如何，都有共同的途径，但在儿科肝脏疾病中，肝纤维化具有不同的组织病理学模式。在这些疾病中，治疗选择可能取决于肝纤维化的阶段。因此，准确估计肝纤维化的组织学模式对于预防随后的并发症很重要。肝活检长期以来一直被认为是评估肝纤维化的金标准诊断方法。然而，由于其多种缺点，在过去几十年中，已经开发出了其他准确的非侵入性方法来估计纤维化。在这篇综述中，我们描述了儿科肝脏疾病中最常见的肝纤维化组织学模式。此外，我们还描述了肝活检在肝纤维化诊断和分期中的应用，列出了在评估肝纤维化方面具有新兴作用的替代非侵入性技术，并提出了一种管理算法。
