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肝脏弹性成像方法用于诊断初发和复发性肝细胞癌

Liver Elastography Methods for Diagnosis of De Novo and Recurrent Hepatocellular Carcinoma.

作者信息

Cerban Razvan, Iacob Speranta, Ester Carmen, Ghioca Mihaela, Chitul Mirela, Iacob Razvan, Gheorghe Liana

机构信息

Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Center for Digestive Diseases and Liver Transplant, Fundeni Clinical Institute, 022328 Bucharest, Romania.

出版信息

Diagnostics (Basel). 2025 Apr 25;15(9):1087. doi: 10.3390/diagnostics15091087.

Abstract

Hepatocellular carcinoma (HCC), a common consequence of chronic liver disease, ranks among the most prevalent cancers globally and contributes significantly to cancer-related mortality. Liver fibrosis is intimately associated with hepatic function and the likelihood of future HCC occurrence. Despite the fact that liver biopsy continues to be the gold standard for diagnosing fibrosis, its utility is hindered by cost and invasiveness, along with patient unease, procedural rejection, and potential adverse effects. Liver elastography has become a leading noninvasive means of assessing tissue stiffness with considerable diagnostic precision. Malignant tumors generally exhibit higher cellularity in comparison to benign ones, resulting in increased stiffness. Elastography techniques capitalize on alterations in tissue elasticity stemming from specific pathological or physiological processes. Technological innovations, such as advanced ultrasound imaging and artificial intelligence (AI)-integrated systems, are paving the way for enhanced diagnostic accuracy and risk prediction. Recent research underscores the potential of elastography in managing HCC patients, presenting novel clinical applications, including prediction of HCC development, differentiation between malignant and benign liver lesions, evaluating treatment response, and forecasting recurrence post-treatment, though certain findings remain contentious. Therefore, this review aims to sum up the latest advancements in liver elastography for HCC patients, outlining its applications while addressing existing limitations and avenues for future progress.

摘要

肝细胞癌(HCC)是慢性肝病的常见后果,在全球最常见的癌症中名列前茅,对癌症相关死亡率有重大影响。肝纤维化与肝功能以及未来发生HCC的可能性密切相关。尽管肝活检仍然是诊断纤维化的金标准,但其应用受到成本、侵入性以及患者不适、操作排斥和潜在不良反应的阻碍。肝脏弹性成像已成为一种主要的非侵入性评估组织硬度的方法,具有相当高的诊断精度。与良性肿瘤相比,恶性肿瘤通常具有更高的细胞密度,导致硬度增加。弹性成像技术利用特定病理或生理过程引起的组织弹性变化。先进的超声成像和人工智能(AI)集成系统等技术创新为提高诊断准确性和风险预测铺平了道路。最近的研究强调了弹性成像在管理HCC患者方面的潜力,提出了新的临床应用,包括预测HCC发展、区分恶性和良性肝脏病变、评估治疗反应以及预测治疗后复发,尽管某些发现仍存在争议。因此,本综述旨在总结针对HCC患者的肝脏弹性成像的最新进展,概述其应用,同时解决现有局限性和未来进展的途径。

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