磁共振成像评估肝纤维化、脂肪和铁与超声评估纤维化和脂肪：放射科医师实用指南。

Liver Fibrosis, Fat, and Iron Evaluation with MRI and Fibrosis and Fat Evaluation with US: A Practical Guide for Radiologists.

机构信息

From the Department of Radiology, Thomas Jefferson University, 132 S 10th St, Philadelphia, PA 19107 (F.F.G.); Department of Radiology, Northeastern Ohio Medical University, Rootstown, Ohio (R.G.B.); Department of Radiology and Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Tex (T.Y.); Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy (G.F.); Department of Radiology, University of Kentucky, Lexington, Ky (J.T.L.); Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio (J.R.D.); Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (J.M.H., F.H.M.); Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Ontario, Canada (K.S.J.); Department of Radiology, ChristianaCare, Newark, Del (R.Y.M.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (A.M.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (M.A.O., B.M.Y.); Departments of Radiology and Medical Physics (A.P.) and Departments of Radiology, Medical Physics, Biomedical Engineering, Medicine, and Emergency Medicine (S.B.R.), University of Wisconsin, Madison, Wis; Department of Radiology, NYU Langone Health, New York, NY (K.S.); Department of Radiology, Mayo Clinic, Phoenix, Ariz (A.C.S.); Department of Radiology, University of Alabama at Birmingham, Birmingham, Ala (E.N.S.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (V.R.S.); Department of Diagnostic, Molecular and Interventional Radiology, BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (B.T.); and Department of Radiology, Mayo Clinic, Rochester, Minn (C.L.W., S.K.V.).

出版信息

Radiographics. 2023 Jun;43(6):e220181. doi: 10.1148/rg.220181.

DOI:10.1148/rg.220181

PMID:37227944

Abstract

Quantitative imaging biomarkers of liver disease measured by using MRI and US are emerging as important clinical tools in the management of patients with chronic liver disease (CLD). Because of their high accuracy and noninvasive nature, in many cases, these techniques have replaced liver biopsy for the diagnosis, quantitative staging, and treatment monitoring of patients with CLD. The most commonly evaluated imaging biomarkers are surrogates for liver fibrosis, fat, and iron. MR elastography is now routinely performed to evaluate for liver fibrosis and typically combined with MRI-based liver fat and iron quantification to exclude or grade hepatic steatosis and iron overload, respectively. US elastography is also widely performed to evaluate for liver fibrosis and has the advantage of lower equipment cost and greater availability compared with those of MRI. Emerging US fat quantification methods can be performed along with US elastography. The author group, consisting of members of the Society of Abdominal Radiology (SAR) Liver Fibrosis Disease-Focused Panel (DFP), the SAR Hepatic Iron Overload DFP, and the European Society of Radiology, review the basics of liver fibrosis, fat, and iron quantification with MRI and liver fibrosis and fat quantification with US. The authors cover technical requirements, typical case display, quality control and proper measurement technique and case interpretation guidelines, pitfalls, and confounding factors. The authors aim to provide a practical guide for radiologists interpreting these examinations. RSNA, 2023 See the invited commentary by Ronot in this issue.

摘要

MRI 和 US 测量的肝脏疾病定量成像生物标志物正在成为慢性肝病 (CLD) 患者管理中的重要临床工具。由于其准确性高且为非侵入性，在许多情况下，这些技术已取代肝活检，用于 CLD 患者的诊断、定量分期和治疗监测。最常评估的成像生物标志物是肝纤维化、脂肪和铁的替代物。磁共振弹性成像现在通常用于评估肝纤维化，并且通常与基于 MRI 的肝脂肪和铁定量相结合，以分别排除或分级肝脂肪变性和铁过载。超声弹性成像也广泛用于评估肝纤维化，与 MRI 相比，它具有设备成本更低和可用性更高的优势。新兴的超声脂肪定量方法可以与超声弹性成像同时进行。由腹部放射学会 (SAR) 肝纤维化疾病重点小组 (DFP)、SAR 肝铁过载 DFP 和欧洲放射学会的成员组成的作者小组，回顾了 MRI 测量肝纤维化、脂肪和铁以及 US 测量肝纤维化和脂肪的基础知识。作者涵盖了技术要求、典型病例展示、质量控制以及适当的测量技术和病例解释指南、陷阱和混杂因素。作者旨在为解释这些检查的放射科医生提供实用指南。RSNA，2023 请参阅本期 Ronot 的特邀评论。