Pereira Keith, Salsamendi Jason, Casillas Javier
Department of Interventional Radiology, Jackson Memorial Hospital, University of Miami Hospital, Miami, Florida, USA.
Department of Diagnostic Radiology (Body Imaging), Jackson Memorial Hospital, University of Miami Hospital, Miami, Florida, USA.
J Clin Imaging Sci. 2015 May 29;5:32. doi: 10.4103/2156-7514.157860. eCollection 2015.
Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of disorders from a benign steatosis to hepatocellular carcinoma (HCC). Metabolic syndrome, mainly obesity, plays an important role, both as an independent risk factor and in the pathogenesis of NAFLD. With the progressive epidemics of obesity and diabetes mellitus, the prevalence of NAFLD and its associated complications is expected to increase dramatically. Therapeutic strategies for treating NAFLD and metabolic syndrome, particularly obesity, are continuously being refined. Their goal is the prevention of NAFLD by the management of risk factors, prevention of progression of the disease, as well as management of complications, ultimately preventing morbidity and mortality. Optimal management of NAFLD and metabolic syndrome requires a multidisciplinary collaboration between the government as well as the health system including the nutritionist, primary care physician, radiologist, hepatologist, oncologist, and transplant surgeon. An awareness of the clinical presentation, risk factors, pathogenesis, diagnosis, and management is of paramount importance to a radiologist, both from the clinical perspective as well as from the imaging standpoint. With expertise in imaging modalities as well as minimally invasive percutaneous endovascular therapies, radiologists play an essential role in the comprehensive management, which is highlighted in this article, with cases from our practice. We also briefly discuss transarterial embolization of the left gastric artery (LGA), a novel method that promises to have an enormous potential in the minimally invasive management of obesity, with details of a case from our practice.
非酒精性脂肪性肝病（NAFLD）涵盖了从良性脂肪变性到肝细胞癌（HCC）的一系列病症。代谢综合征，主要是肥胖，作为独立危险因素以及在NAFLD的发病机制中都起着重要作用。随着肥胖症和糖尿病的不断流行，预计NAFLD及其相关并发症的患病率将大幅上升。治疗NAFLD和代谢综合征，尤其是肥胖症的治疗策略正在不断完善。其目标是通过管理危险因素来预防NAFLD，防止疾病进展以及管理并发症，最终预防发病和死亡。NAFLD和代谢综合征的最佳管理需要政府以及包括营养师、初级保健医生、放射科医生、肝病专家、肿瘤学家和移植外科医生在内的卫生系统之间的多学科合作。从临床角度以及成像角度来看，了解临床表现、危险因素、发病机制、诊断和管理对放射科医生至关重要。凭借在成像模态以及微创经皮血管内治疗方面的专业知识，放射科医生在综合管理中发挥着重要作用，本文通过我们实践中的病例对此进行了强调。我们还简要讨论了胃左动脉（LGA）的经动脉栓塞术，这是一种有望在肥胖症的微创管理中具有巨大潜力的新方法，并介绍了我们实践中的一个病例细节。
