Kazi Iqra Nadeem, Kuo Lily, Tsai Eugenia
UT Health San Antonio, San Antonio, Texas.
Texas Liver Institute, San Antonio, Texas.
Gastroenterol Hepatol (N Y). 2024 Jan;20(1):21-29.
Accurate diagnosis and staging of liver fibrosis is crucial to the individualized management of patients with chronic liver disease. Liver biopsy remains the reference standard for the assessment of steatosis, necroinflammation, and fibrosis. However, over the past decade, there has been an exponential growth in noninvasive tests (NITs) designed to assess liver fibrosis and steatosis. These NITs range from serum biomarkers to imaging assessments of liver tissue stiffness. Current noninvasive methods overcome the limitations of non-specific laboratory markers, conventional imaging, and invasive procedures, and are now starting to be adopted. The Fibrosis-4 index, Enhanced Liver Fibrosis test, and elastography have gained the strongest clinical footholds for the diagnosis of advanced fibrosis. There remains significant interest in demonstrating superiority of any specific test or, alternatively, optimizing a sequential algorithm to provide the most accurate diagnosis of fibrosis staging. This article reviews currently available noninvasive methods for assessing liver fibrosis and steatosis.
肝纤维化的准确诊断和分期对于慢性肝病患者的个体化管理至关重要。肝活检仍是评估脂肪变性、坏死性炎症和纤维化的参考标准。然而，在过去十年中，旨在评估肝纤维化和脂肪变性的非侵入性检测（NITs）呈指数级增长。这些NITs范围从血清生物标志物到肝组织硬度的成像评估。当前的非侵入性方法克服了非特异性实验室标志物、传统成像和侵入性程序的局限性，现已开始被采用。Fibrosis-4指数、增强肝纤维化检测和弹性成像在晚期纤维化诊断方面获得了最强的临床立足点。人们仍然非常感兴趣于证明任何特定检测的优越性，或者优化一种序贯算法以提供最准确的纤维化分期诊断。本文综述了目前可用的评估肝纤维化和脂肪变性的非侵入性方法。
