Lăpădat A M, Jianu I R, Ungureanu B S, Florescu L M, Gheonea D I, Sovaila S, Gheonea I A
Radiology and Medical Imaging, University of Medicine and Pharmacy, Craiova, Romania.
Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Craiova, Romania.
J Med Life. 2017 Jan-Mar;10(1):19-26.
Non-alcoholic fatty liver disease (NAFLD) is an ailment affecting and increasing a number of people worldwide diagnosed via non-invasive imaging techniques, at a time when a minimum harm caused by medical procedures is rightfully emphasized, more sought after, than ever before. Liver steatosis should not be taken lightly even if its evolution is largely benign as it has the potential to develop into non-alcoholic steatohepatitis (NASH) or even more concerning, hepatic cirrhosis, and hepatocellular carcinoma (HCC). Traditionally, liver biopsy has been the standard for diagnosing this particular liver disease, but nowadays, a consistent number of imagistic methods are available for diagnosing hepatosteatosis and choosing the one appropriate to the clinical context is the key. Although different in sensitivity and specificity when it comes to determining the hepatic fat fraction (FF), these imaging techniques possessing a diverse availability, operating difficulty, cost, and reproducibility are invaluable to any modern physician. Ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), elastography, and spectroscopy will be discussed in order to lay out the advantages and disadvantages of their diagnostic potential and application. Although imagistics has given physicians a valuable insight into the means of managing NAFLD, the current methods are far from perfect, but given the time, they will surely be improved and the use of liver biopsy will be completely removed.
非酒精性脂肪性肝病(NAFLD)是一种影响着全球越来越多人群的疾病,通过非侵入性成像技术进行诊断。在当今时代,医疗程序造成的最小伤害比以往任何时候都更受重视和追捧。即使肝脂肪变性的发展在很大程度上是良性的,也不应轻视它,因为它有可能发展为非酒精性脂肪性肝炎(NASH),甚至更令人担忧的肝硬化和肝细胞癌(HCC)。传统上,肝活检一直是诊断这种特定肝病的标准,但如今,有多种成像方法可用于诊断肝脂肪变性,选择适合临床情况的方法是关键。尽管在确定肝脏脂肪分数(FF)时,这些成像技术在敏感性和特异性方面存在差异,但它们具有不同的可用性、操作难度、成本和可重复性,对任何现代医生来说都非常宝贵。将讨论超声检查(US)、计算机断层扫描(CT)、磁共振成像(MRI)、弹性成像和光谱学,以阐述它们诊断潜力和应用的优缺点。尽管成像技术为医生提供了管理NAFLD的有价值见解,但目前的方法远非完美,但假以时日,它们肯定会得到改进,肝活检的使用也将完全被淘汰。