NAFLD Research Center, Department of Medicine, University of California at San Diego, La Jolla, CA, United States; Division of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA, United States; Division of Epidemiology, Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, CA, United States.
J Hepatol. 2018 Feb;68(2):296-304. doi: 10.1016/j.jhep.2017.11.028. Epub 2017 Dec 2.
Non-alcoholic fatty liver disease (NAFLD) is a major public health problem afflicting approximately one billion individuals worldwide. Liver biopsy is considered the gold standard for assessment of liver disease severity in patients with NAFLD. However, it is invasive, has high inter-observer variability, and is associated with adverse effects, including pain, infection and, albeit rarely, death. It is also impractical because of the large number of individuals who have NAFLD. Therefore, tools to non-invasively assess disease severity in NAFLD are urgently needed. Over the last two decades, tremendous advances have been made in the assessment of NAFLD by non-invasive imaging. In this review, we will discuss the different non-invasive imaging modalities available to quantify liver fat and liver fibrosis. We will also discuss the limitations of current modalities to detect the progressive form for NAFLD, termed non-alcoholic steatohepatitis. Finally, we will discuss the comparative efficacy of various imaging-based elastographic modalities for detection of advanced fibrosis or cirrhosis, as well as their diagnostic characteristics.
非酒精性脂肪性肝病（NAFLD）是全球影响约 10 亿人的主要公共卫生问题。肝活检被认为是评估 NAFLD 患者肝脏疾病严重程度的金标准。然而，它具有侵袭性，观察者间差异较大，并且与不良影响相关，包括疼痛、感染，尽管很少见，但也有死亡的风险。由于有大量的 NAFLD 患者，因此它也不切实际。因此，迫切需要非侵入性工具来评估 NAFLD 的严重程度。在过去的二十年中，非侵入性成像在评估 NAFLD 方面取得了巨大进展。在这篇综述中，我们将讨论可用于量化肝脏脂肪和纤维化的不同非侵入性成像方式。我们还将讨论当前检测 NAFLD 进行性形式（称为非酒精性脂肪性肝炎）的局限性。最后，我们将讨论各种基于成像的弹性成像方式在检测晚期纤维化或肝硬化方面的相对疗效，以及它们的诊断特征。
