Alternative approach of hepatocellular carcinoma surveillance: abbreviated MRI.
Alternative approach of hepatocellular carcinoma surveillance: abbreviated MRI.
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DOI：
10.20517/2394-5079.2020.50
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发表时间：
2020-01-01
期刊：
影响因子：
--
通讯作者：
Marks, Robert M
中科院分区：
文献类型：
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作者：
Brunsing, Ryan L;Fowler, Kathryn J;Marks, Robert M
这篇综述的重点是新兴的简化磁共振成像（AMRI）监测慢性肝病患者的肝细胞癌（HCC）。这种监测策略已被提出作为一种高灵敏度的替代超声识别早期HCC患者，特别是在肝硬化或肥胖患者，其中小肿瘤的超声可视化可能会受到影响。在文献中已经开发和研究了三种一般的AMRI方法-非造影剂AMRI、动态造影剂增强的AMRI和肝胆相造影剂增强的AMRI -每种方法都包含少量专门针对HCC检测的选定序列。解释了每种AMRI方法的原理、一般技术、优点和缺点以及诊断性能。此外，目前的知识差距和未来的方向进行了讨论。基于新出现的证据，我们谨慎地建议在超声检查受到影响的情况下使用AMRI进行HCC监测。
This review focuses on emerging abbreviated magnetic resonance imaging (AMRI) surveillance of patients with chronic liver disease for hepatocellular carcinoma (HCC). This surveillance strategy has been proposed as a high-sensitivity alternative to ultrasound for identification of patients with early-stage HCC, particularly in patients with cirrhosis or obesity, in whom sonographic visualization of small tumors may be compromised. Three general AMRI approaches have been developed and studied in the literature - non-contrast AMRI, dynamic contrast-enhanced AMRI, and hepatobiliary phase contrast-enhanced AMRI - each comprising a small number of selected sequences specifically tailored for HCC detection. The rationale, general technique, advantages and disadvantages, and diagnostic performance of each AMRI approach is explained. Additionally, current gaps in knowledge and future directions are discussed. Based on emerging evidence, we cautiously recommend the use of AMRI for HCC surveillance in situations where ultrasound is compromised.