Department of Radiology, University Hospital of Angers, 4, rue Larrey, 49933 Angers cedex, France; HIFIH laboratory, University of Angers, rue Haute-de-Reculée, 49045 Angers, France.
Department of Radiology, University Hospital of Angers, 4, rue Larrey, 49933 Angers cedex, France.
Diagn Interv Imaging. 2017 Jun;98(6):455-468. doi: 10.1016/j.diii.2017.03.003. Epub 2017 Apr 29.
Although biological scores and elastography continue to yield the best results, imaging retains a crucial role in the diagnosis of liver fibrosis and cirrhosis. First, digestive symptoms or biological liver test abnormalities often lead the referring physician to request an abdominal ultrasound, and with an experienced operator, accuracy of ultrasound can reach 85% for the diagnosis of severe fibrosis or cirrhosis. Second, imaging could lead to discovery of nonsymptomatic fibrosis or cirrhosis, with an estimated prevalence of 0.5-2.8% in the population. After diagnosis, imaging is central in the follow-up of cirrhosis. It is used to detect worsening of portal hypertension and hepatocellular carcinoma (HCC). Because many nodules are present in a cirrhotic liver, familiarity with the features of HCC can facilitate noninvasive diagnosis and early and accurate treatment.
虽然生物标志物和弹性成像技术仍能提供最佳结果，但影像学在诊断肝纤维化和肝硬化方面仍起着至关重要的作用。首先，消化症状或肝脏生物化学指标异常通常会促使转诊医生要求进行腹部超声检查，而由经验丰富的操作人员进行操作时，超声检查对严重纤维化或肝硬化的诊断准确率可达 85%。其次，影像学检查可能会发现无症状性肝纤维化或肝硬化，在普通人群中的患病率估计为 0.5-2.8%。确诊后，影像学检查在肝硬化的随访中占据核心地位。它用于检测门静脉高压和肝细胞癌（HCC）的恶化情况。由于肝硬化肝脏中存在许多结节，熟悉 HCC 的特征有助于实现非侵入性诊断以及早期、准确的治疗。
