Hagara D, Schwarzenbach H R, Cerny A
Clinica Luganese Moncucco, Centro di Epatologia, Lugano.
Praxis (Bern 1994). 2012 Sep 5;101(18):1161-6. doi: 10.1024/1661-8157/a001112.
Ultrasound-based technologies are competing more and more success-fully against computerized tomography and magnetic resonance based imaging procedures. This thanks to technological improvements as well as accumulating evidence, stemming from properly conducted controlled clinical studies. The reduced cost and radiation safety issues are additional arguments in its favor. This article reviews new developments in ultrasound medicine as applied to the liver. Emphasis lies on new data related to contrast-ultrasound (Sulphur Hexafluoride SonoVue®) which allows a dynamic analysis of liver perfusion and hence improved characterization of focal liver lesions, such as metastases of extrahepatic tumors, regenerative nodules in patients with liver cirrhosis, focal nodular hyperplasia, hepatocellular carcinoma, liver hemangioma, liver adenoma and or focal hypo-respectively hypersteatosis. This article also deals with important new techniques, which allow assessment of liver stiffness such as transient elastography (Fibroscan), ARFI (Acoustic Radiation Force Impulse) or real-time-tissue elastography. These new techniques will help us to assess and quantify the levels of liver steatosis with more precision and permit accurate follow-up measurements.
基于超声的技术在与基于计算机断层扫描和磁共振成像的程序竞争中越来越成功。这得益于技术的改进以及来自恰当开展的对照临床研究的越来越多的证据。成本降低和辐射安全问题是支持它的额外论据。本文综述了应用于肝脏的超声医学的新进展。重点在于与超声造影(六氟化硫微泡超声造影剂)相关的新数据,它能够对肝脏灌注进行动态分析,从而改善对肝脏局灶性病变的特征描述,如肝外肿瘤转移、肝硬化患者的再生结节、局灶性结节性增生、肝细胞癌、肝血管瘤、肝腺瘤以及局灶性低回声或高回声脂肪变性。本文还涉及一些重要的新技术,如瞬时弹性成像(Fibroscan)、声辐射力脉冲成像(ARFI)或实时组织弹性成像,这些技术可用于评估肝脏硬度。这些新技术将帮助我们更精确地评估和量化肝脏脂肪变性的程度,并进行准确的随访测量。