Jiang Hanyu, Zheng Tianying, Duan Ting, Chen Jie, Song Bin
Department of Radiology, Sichuan University West China Hospital, Chengdu, China.
J Clin Transl Hepatol. 2018 Jun 28;6(2):198-207. doi: 10.14218/JCTH.2017.00038. Epub 2018 Jan 5.
Liver fibrosis (LF), a common consequence of chronic liver diseases with various etiologies, is characterized by excessive accumulation of macromolecules, including collagen, glycoproteins and proteoglycans, in the liver. LF can result in hepatic dysfunction, cirrhosis, portal hypertension and, in some cases, hepatocellular carcinoma. As the current gold standard for diagnosing LF, liver biopsy, however, is invasive and prone to sampling errors and procedure-related complications. Therefore, developing noninvasive, precise and reproducible imaging tests for diagnosing and staging LF is of great significance. Conventional ultrasound (US), computed tomography (CT) and magnetic resonance (MR) imaging can depict morphological alterations of advanced LF, but have relatively limited capability characterizing early-stage LF. In order to optimize the diagnostic performances of noninvasive imaging techniques for LF across its entire spectrum of severity, a number of novel methods, including US elastography, CT perfusion imaging and various MR imaging-based techniques, have been established and introduced to clinical practice. In this review, we intended to summarize current noninvasive imaging techniques for LF, with special emphasis on the possible roles, advantages and limitations of the new emerging imaging modalities.
肝纤维化（LF）是各种病因所致慢性肝病的常见后果，其特征是肝脏中包括胶原蛋白、糖蛋白和蛋白聚糖在内的大分子过度蓄积。肝纤维化可导致肝功能障碍、肝硬化、门静脉高压，在某些情况下还会引发肝细胞癌。然而，作为目前诊断肝纤维化的金标准，肝活检具有侵入性，且容易出现抽样误差和与操作相关的并发症。因此，开发用于诊断和分期肝纤维化的非侵入性、精确且可重复的成像检查具有重要意义。传统超声（US）、计算机断层扫描（CT）和磁共振（MR）成像能够描绘晚期肝纤维化的形态学改变，但在表征早期肝纤维化方面能力相对有限。为了优化非侵入性成像技术在肝纤维化整个严重程度范围内的诊断性能，已经建立了许多新方法，包括超声弹性成像、CT灌注成像以及各种基于MR成像的技术，并将其引入临床实践。在本综述中，我们旨在总结目前用于肝纤维化的非侵入性成像技术，特别强调新兴成像模式可能发挥的作用、优势和局限性。
