Chouari Tarak, Merali Nabeel, La Costa Francesca, Santol Jonas, Chapman Shelley, Horton Alex, Aroori Somaiah, Connell John, Rockall Timothy A, Mole Damian, Starlinger Patrick, Welsh Fenella, Rees Myrddin, Frampton Adam E
MATTU, The Leggett Building, Daphne Jackson Road, Guildford GU2 7WG, UK.
Department of Hepato-Pancreato-Biliary (HPB) Surgery, Royal Surrey County Hospital, Egerton Road, Guildford GU2 7XX, UK.
Cancers (Basel). 2023 Oct 5;15(19):4863. doi: 10.3390/cancers15194863.
Liver biopsy remains the gold standard for the histological assessment of the liver. With clear disadvantages and the rise in the incidences of liver disease, the role of neoadjuvant chemotherapy in colorectal liver metastasis (CRLM) and an explosion of surgical management options available, non-invasive serological and imaging markers of liver histopathology have never been more pertinent in order to assess liver health and stratify patients considered for surgical intervention. Liver MRI is a leading modality in the assessment of hepatic malignancy. Recent technological advancements in multiparametric MRI software such as the LiverMultiScan offers an attractive non-invasive assay of anatomy and histopathology in the pre-operative setting, especially in the context of CRLM. This narrative review examines the evidence for the LiverMultiScan in the assessment of hepatic fibrosis, steatosis/steatohepatitis, and potential applications for chemotherapy-associated hepatic changes. We postulate its future role and the hurdles it must surpass in order to be implemented in the pre-operative management of patients undergoing hepatic resection for colorectal liver metastasis. Such a role likely extends to other hepatic malignancies planned for resection.
肝活检仍然是肝脏组织学评估的金标准。鉴于其明显的缺点以及肝脏疾病发病率的上升，新辅助化疗在结直肠癌肝转移（CRLM）中的作用以及可用手术管理方案的激增，肝脏组织病理学的非侵入性血清学和影像学标志物对于评估肝脏健康状况以及对考虑进行手术干预的患者进行分层变得前所未有的重要。肝脏磁共振成像（MRI）是评估肝脏恶性肿瘤的主要方式。多参数MRI软件（如LiverMultiScan）的最新技术进展为术前环境下的解剖结构和组织病理学提供了一种有吸引力的非侵入性检测方法，尤其是在CRLM的背景下。这篇叙述性综述探讨了LiverMultiScan在评估肝纤维化、脂肪变性/脂肪性肝炎以及化疗相关肝脏变化的潜在应用方面的证据。我们推测了它未来的作用以及为了在接受结直肠癌肝转移肝切除的患者的术前管理中得到应用而必须克服的障碍。这样的作用可能会扩展到计划进行切除的其他肝脏恶性肿瘤。
