Liver Imaging Group, Department of Radiology, University of California, San Diego, La Jolla, California, USA.
Center for Ultrasound Research & Translation, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
J Magn Reson Imaging. 2020 Jan;51(1):25-42. doi: 10.1002/jmri.26716. Epub 2019 Mar 12.
Liver fibrosis is a histological hallmark of most chronic liver diseases, which can progress to cirrhosis and liver failure, and predisposes to hepatocellular carcinoma. Accurate diagnosis of liver fibrosis is necessary for prognosis, risk stratification, and treatment decision-making. Liver biopsy, the reference standard for assessing liver fibrosis, is invasive, costly, and impractical for surveillance and treatment response monitoring. Elastography offers a noninvasive, objective, and quantitative alternative to liver biopsy. This article discusses the need for noninvasive assessment of liver fibrosis and reviews the comparative advantages and limitations of ultrasound and magnetic resonance elastography techniques with respect to their basic concepts, acquisition, processing, and diagnostic performance. Variations in clinical contexts of use and common pitfalls associated with each technique are considered. In addition, current challenges and future directions to improve the diagnostic accuracy and clinical utility of elastography techniques are discussed. Level of Evidence: 5 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;51:25-42.
肝纤维化是大多数慢性肝病的组织学标志，可进展为肝硬化和肝衰竭，并易导致肝细胞癌。准确诊断肝纤维化对于预后、风险分层和治疗决策至关重要。肝活检是评估肝纤维化的参考标准，但具有侵袭性、费用高，且不适合监测和治疗反应监测。超声弹性成像提供了一种非侵入性、客观和定量的替代肝活检的方法。本文讨论了对肝纤维化进行非侵入性评估的必要性，并回顾了超声和磁共振弹性成像技术在基本概念、采集、处理和诊断性能方面的比较优势和局限性。考虑了每种技术在临床应用背景下的差异以及常见的技术缺陷。此外，还讨论了当前提高弹性成像技术诊断准确性和临床实用性的挑战和未来方向。证据水平：5 技术功效分期：2 J. Magn. Reson. Imaging 2020;51:25-42.
