Sherman David, Lung Phillip, Shorvon Philip
Gastroenterology Department, Central Middlesex Hospital, London Northwest Healthcare NHS Trust, London, UK.
Department of Radiology, Central Middlesex Hospital, London Northwest Healthcare NHS Trust, London, UK.
Frontline Gastroenterol. 2017 Jan;8(1):37-44. doi: 10.1136/flgastro-2016-100729. Epub 2016 Oct 12.
Liver stiffness measurement (LSM) is the most widely used non-invasive alternative to biopsy for assessing liver fibrosis in the UK. Virtual touch quantification (VTq, also known as acoustic radiation force impulse) is the principal available alternative to transient elastography (Fibroscan) and is delivered via software enhancements to standard ultrasound (US) machines. It has recently been endorsed by National Institute for Health and Care Excellence in terms of both accuracy and cost-effectiveness for use in viral hepatitis. However, while an increasing proportion of radiologists use VTq, familiarity among gastroenterologists and trainees with LSM techniques is variable and implementation is patchy. This review considers the background, evidence for and practical use of VTq elastography in clinical practice in the UK. Potential future developments in this rapidly evolving field are also highlighted.
在英国，肝脏硬度测量（LSM）是评估肝纤维化时最广泛使用的活检非侵入性替代方法。虚拟触诊定量（VTq，也称为声辐射力脉冲）是瞬时弹性成像（Fibroscan）的主要可用替代方法，通过对标准超声（US）机器进行软件升级来实现。最近，英国国家卫生与临床优化研究所认可了其在病毒性肝炎诊断中的准确性和成本效益。然而，尽管越来越多的放射科医生使用VTq，但胃肠病学家和实习生对LSM技术的熟悉程度参差不齐，实施情况也不一致。本文综述了VTq弹性成像在英国临床实践中的背景、证据及实际应用。还强调了这一快速发展领域未来可能的发展方向。
