非酒精性脂肪性肝病肝纤维化的无创性影像学生物标志物:现状与展望。

Noninvasive imaging biomarkers for liver fibrosis in nonalcoholic fatty liver disease: current and future.

机构信息

Department of Internal Medicine, Inha University Hospital and School of Medicine, Incheon, Korea.

Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.

出版信息

Clin Mol Hepatol. 2023 Feb;29(Suppl):S136-S149. doi: 10.3350/cmh.2022.0436. Epub 2022 Dec 12.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is increasingly prevalent worldwide and becoming a major cause of liver disease-related morbidity and mortality. The presence of liver fibrosis in patients with NAFLD is closely related to prognosis, including the development of hepatocellular carcinoma and other complications of cirrhosis. Therefore, assessment of the presence of significant or advanced liver fibrosis is crucial. Although liver biopsy has been considered the "gold standard" method for evaluating the degree of liver fibrosis, it is not suitable for extensive use in all patients with NAFLD owing to its invasiveness and high cost. Therefore, noninvasive biochemical and imaging biomarkers have been developed to overcome the limitations of liver biopsy. Imaging biomarkers for the stratification of liver fibrosis have been evaluated in patients with NAFLD using different imaging techniques, such as transient elastography, shear wave elastography, and magnetic resonance elastography. Furthermore, artificial intelligence and deep learning methods are increasingly being applied to improve the diagnostic accuracy of imaging techniques and overcome the pitfalls of existing imaging biomarkers. In this review, we describe the usefulness and future prospects of noninvasive imaging biomarkers that have been studied and used to evaluate the degree of liver fibrosis in patients with NAFLD.

摘要

非酒精性脂肪性肝病(NAFLD)在全球范围内日益流行,成为与肝脏疾病相关发病率和死亡率的主要原因。NAFLD 患者肝纤维化的存在与预后密切相关,包括肝细胞癌和其他肝硬化并发症的发展。因此,评估是否存在显著或晚期肝纤维化至关重要。尽管肝活检一直被认为是评估肝纤维化程度的“金标准”方法,但由于其侵袭性和高成本,并不适合所有 NAFLD 患者广泛使用。因此,已经开发了非侵入性的生化和影像学生物标志物来克服肝活检的局限性。使用不同的影像学技术,如瞬时弹性成像、剪切波弹性成像和磁共振弹性成像,已经在 NAFLD 患者中评估了用于分层肝纤维化的影像学生物标志物。此外,人工智能和深度学习方法越来越多地被应用于提高影像学技术的诊断准确性,并克服现有影像学生物标志物的缺陷。在这篇综述中,我们描述了已经研究和用于评估 NAFLD 患者肝纤维化程度的无创影像学生物标志物的有用性和未来前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f6a/10029967/1d08bb338b85/cmh-2022-0436f1.jpg

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