Rofsky N M, Fleishaker H
Department of Radiology, New York University Medical Center, NY 10016, USA.
Semin Ultrasound CT MR. 1995 Feb;16(1):16-33. doi: 10.1016/0887-2171(95)90012-8.
CT and MRI contribute important information to the clinical evaluation of diffuse liver disease. In some cases, these modalities can establish a diagnosis that was not ascertained histologically, which is often the case when sampling errors prevent a definitive tissue diagnosis. Characteristic alterations of liver attenuation on CT, signal changes on MRI, and morphological changes appreciated with both modalities can be used to diagnose fatty infiltration, some parenchymal deposition diseases, and cirrhosis. Furthermore, hepatocellular disease can be confirmed in the setting of indeterminate clinical and laboratory findings. Significant overlap in the imaging findings of this wide range of disorders continues to limit specificity; however, at a minimum, these techniques provide a rapid means to a noninvasive evaluation that often guides clinical decisions. Faster scanning techniques available with CT and MRI may provide additional information by assessing contrast dynamics. This review of CT and MRI in diffuse liver disease considers the diagnostic utility and clinical implications of these modalities. Pathological findings relevant to imaging considerations are discussed.
CT和MRI为弥漫性肝病的临床评估提供了重要信息。在某些情况下，这些检查方式能够确立组织学检查未能明确的诊断，当采样误差导致无法获得明确的组织诊断时，这种情况很常见。CT上肝脏密度的特征性改变、MRI上的信号变化以及两种检查方式都能观察到的形态学改变，可用于诊断脂肪浸润、一些实质沉积性疾病和肝硬化。此外，在临床和实验室检查结果不明确的情况下，肝细胞疾病也能够得到确诊。这一大类疾病的影像学表现存在显著重叠，这继续限制了诊断的特异性；然而，这些技术至少提供了一种快速的无创评估方法，常常能为临床决策提供指导。CT和MRI可用的更快扫描技术，可能通过评估对比剂动力学提供更多信息。本文对CT和MRI在弥漫性肝病中的应用进行综述，探讨了这些检查方式的诊断效用和临床意义，并讨论了与影像学考虑相关的病理结果。
