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超声在脂肪肝疾病中的诊断价值。

Diagnostic Value of Ultrasound in Fatty Liver Disease.

机构信息

Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.

Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.

出版信息

Ultraschall Med. 2021 Apr;42(2):128-153. doi: 10.1055/a-1352-4313. Epub 2021 Feb 23.

Abstract

Hepatic steatosis is a commonly seen phenomenon in clinical practice and is the result of the accumulation of lipids in the hepatocytes. In most cases steatosis refers to nonalcoholic fatty liver disease (NAFLD), but it also occurs in other diseases of the liver parenchyma of a different etiology and is the result of the dysregulation of metabolic processes. Consequently, inflammatory processes can induce progressive fibrosis. Due to the high prevalence of fatty liver disease, a further increase in metabolic liver cirrhosis with corresponding complications can be expected in the near future. Due to its broad availability, ultrasound is particularly important, especially for the management of NAFLD. In addition to diagnosis and risk stratification, the monitoring of high-risk patients in NAFLD is becoming increasingly clinically important. Multimodality ultrasound includes B-mode and duplex methods, analysis of tissue stiffness (elastography), contrast-enhanced imaging (CEUS), and steatosis quantification. When using ultrasound in fatty liver disease, a standardized approach that takes into account the limitations of the method is essential.

摘要

肝脂肪变性是临床实践中常见的现象,是肝细胞内脂质积聚的结果。在大多数情况下,脂肪变性是指非酒精性脂肪性肝病(NAFLD),但也发生在其他不同病因的肝实质疾病中,是代谢过程失调的结果。因此,炎症过程可诱导进行性纤维化。由于脂肪肝的高患病率,预计在不久的将来,代谢性肝硬化及其相应并发症的发病率会进一步增加。由于超声检查的广泛应用,尤其是在 NAFLD 的管理中,超声检查尤为重要。除了诊断和风险分层外,NAFLD 高危患者的监测在临床上也变得越来越重要。多模态超声包括 B 型和双功能方法、组织硬度分析(弹性成像)、对比增强成像(CEUS)和脂肪变性定量。在使用超声检查脂肪肝时,必须采用一种考虑到方法局限性的标准化方法。

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