From the Department of Radiology, University of Washington, Seattle, Wash (G.M.C.); Department of Radiology, Université Laval, Québec, Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester, Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de l'Université de Montréal, 1058 Rue Saint-Denis, Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology, University of California San Diego, San Diego, Calif (C.B.S.).
Radiology. 2024 Mar;310(3):e231220. doi: 10.1148/radiol.231220.
Chronic liver disease is highly prevalent and often leads to fibrosis or cirrhosis and complications such as liver failure and hepatocellular carcinoma. The diagnosis and staging of liver fibrosis is crucial to determine management and mitigate complications. Liver biopsy for histologic assessment has limitations such as sampling bias and high interreader variability that reduce precision, which is particularly challenging in longitudinal monitoring. MR elastography (MRE) is considered the most accurate noninvasive technique for diagnosing and staging liver fibrosis. In MRE, low-frequency vibrations are applied to the abdomen, and the propagation of shear waves through the liver is analyzed to measure liver stiffness, a biomarker for the detection and staging of liver fibrosis. As MRE has become more widely used in clinical care and research, different contexts of use have emerged. This review focuses on the latest developments in the use of MRE for the assessment of liver fibrosis; provides guidance for image acquisition and interpretation; summarizes diagnostic performance, along with thresholds for diagnosis and staging of liver fibrosis; discusses current and emerging clinical applications; and describes the latest technical developments.
慢性肝病的发病率很高，常导致纤维化或肝硬化，以及肝功能衰竭和肝细胞癌等并发症。肝纤维化的诊断和分期对于确定治疗方案和减轻并发症至关重要。肝组织学评估的肝活检存在一些局限性，如采样偏差和高观察者间变异性，这降低了其准确性，在纵向监测中尤其具有挑战性。磁共振弹性成像（MRE）被认为是诊断和分期肝纤维化最准确的无创技术。在 MRE 中，低频振动施加于腹部，通过分析剪切波在肝脏中的传播来测量肝脏硬度，这是检测和分期肝纤维化的生物标志物。随着 MRE 在临床护理和研究中的应用越来越广泛，出现了不同的应用场景。本综述重点介绍了 MRE 在评估肝纤维化方面的最新应用进展；为图像采集和解释提供了指导；总结了诊断性能，以及肝纤维化的诊断和分期阈值；讨论了当前和新兴的临床应用；并介绍了最新的技术进展。
