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肝脏磁共振成像的临床意义。

Clinical Significance of Liver MR Imaging.

机构信息

Department of Radiology, Hamamatsu University School of Medicine.

出版信息

Magn Reson Med Sci. 2023 Apr 1;22(2):157-175. doi: 10.2463/mrms.rev.2022-0100. Epub 2023 Feb 1.

Abstract

MRI is widely used in clinical practice for detecting liver diseases. Since the introduction of gadoxetic acid, MRI has become the most effective modality for the detection and characterization of focal liver lesions. According to previous meta-analyses, the area under the receiver operating characteristic curve (AUROC) was 0.97-0.99 for the diagnosis of small hepatocellular carcinoma (≥ 2 cm) by gadoxetic-acid-enhanced MRI. Moreover, the AUROC for the diagnosis of colorectal liver metastases was significantly high (0.98). Despite gadoxetic acid's drawbacks, its clinical utility outweighs them, making it the contrast agent of choice in routine liver MRIs. Moreover, clinically, liver MRI has become more prevalent for a quantitative assessment. Liver fibrosis can be evaluated using MR elastography; whereas, hepatic steatosis and iron overload can be evaluated using proton density fat fraction, with high accuracy and reproducibility. This article reviewed the usefulness of liver MRI, which can be a comprehensive imaging modality in clinical practice.

摘要

磁共振成像(MRI)在临床实践中被广泛用于肝脏疾病的检测。自从钆塞酸增强 MRI 的问世,它已成为检测和诊断局灶性肝脏病变的最有效方式。根据之前的荟萃分析,在诊断直径≥2cm 的小肝癌时,其诊断效能的受试者工作特征曲线下面积(AUROC)为 0.97-0.99。此外,其诊断结直肠癌肝转移的 AUROC 也显著较高(0.98)。尽管钆塞酸存在一些缺点,但它的临床应用价值仍然超过了这些缺点,使它成为常规肝脏 MRI 检查的首选对比剂。此外,在临床实践中,肝脏 MRI 也越来越多地用于定量评估。磁共振弹性成像可用于评估肝纤维化;而质子密度脂肪分数可用于评估肝脂肪变和铁过载,具有较高的准确性和可重复性。本文综述了肝脏 MRI 的实用性,它可以成为临床实践中一种全面的影像学检查方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79fc/10086396/ae08f09f1d69/mrms-22-157-g1.jpg

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