Egresi Anna, Lengyel Gabriella, Hagymási Krisztina
Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest Szentkirályi u. 46. 1088.
Orv Hetil. 2015 Apr 5;156(14):543-51. doi: 10.1556/OH.2015.30123.
As the result of various harmful effects (infectious agents, metabolic diseases, unhealthy diet, obesity, toxic agents, autoimmune processes) hepatic damage may develop, which can progress towards liver steatosis, and fibrosis as well. The most common etiological factors of liver damages are hepatitis B and C infection, alcohol consumption and non-alcoholic fatty liver disease. Liver biopsy is considered as the gold standard for the diagnosis of chronic liver diseases. Due to the dangers and complications of liver biopsy, studies are focused on non-invasive markers and radiological imaging for liver steatosis, progression of fatty liver, activity of the necroinflammation and the severity of the fibrosis. Authors review the possibilities of non-invasive assessment of liver steatosis. The statistical features of the probes (positive, negative predictive values, sensitivity, specificity) are reviewed. The role of radiological imaging is also discussed. Although the non-invasive methods discussed in this article are useful to assess liver steatosis, further studies are needed to validate to follow progression of the diseases and to control therapeutic response.
由于各种有害影响（感染因子、代谢性疾病、不健康饮食、肥胖、有毒物质、自身免疫过程），可能会发生肝损伤，进而可能发展为肝脂肪变性和肝纤维化。肝损伤最常见的病因是乙型和丙型肝炎感染、饮酒以及非酒精性脂肪性肝病。肝活检被认为是诊断慢性肝病的金标准。由于肝活检存在风险和并发症，研究主要集中在用于评估肝脂肪变性、脂肪肝进展、坏死性炎症活动度以及肝纤维化严重程度的非侵入性标志物和放射影像学检查。作者回顾了非侵入性评估肝脂肪变性的可能性。文中回顾了各项检测指标的统计学特征（阳性预测值、阴性预测值、敏感性、特异性）。还讨论了放射影像学检查的作用。尽管本文讨论的非侵入性方法对于评估肝脂肪变性很有用，但仍需要进一步研究以验证其在跟踪疾病进展和监测治疗反应方面的有效性。
