Noninvasive imaging biomarker assessment of liver fibrosis by elastography in NAFLD.
Noninvasive imaging biomarker assessment of liver fibrosis by elastography in NAFLD.
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DOI：
10.1038/nrgastro.2018.10
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发表时间：
2018-05
期刊：
影响因子：
--
通讯作者：
Loomba R
中科院分区：
文献类型：
--
作者：
Tapper EB;Loomba R
非酒精性脂肪性肝病（NAFLD）是一种全球性的流行病。在北美、北欧、澳大利亚、日本、印度和中国，NAFLD的患病率为20% - 30%。至关重要的是，NAFLD患者要接受其进展性肝纤维化风险的评估，因为肝纤维化会增加肝细胞癌和其他肝硬化并发症的风险。高效、具有成本效益、以患者为中心且基于证据的风险分层是肝病临床医生面临的最重要问题之一。鉴于患者倾向于避免肝活检，对评估肝纤维化的非侵入性替代方法的需求很高。最准确的非侵入性方法基于肝脏弹性成像。对这些技术（包括振动控制瞬时弹性成像（VCTE）、磁共振弹性成像（MRE）、剪切波弹性成像和声学辐射力脉冲）的研究已经大量涌现。不幸的是，文献未能跟上临床实践的步伐。对于临床医生应如何预见和处理这些检测的缺陷，指导有限。此外，对于临床医生如何将VCTE、MRE或新兴的弹性成像技术最佳地纳入其临床策略，尤其是针对NAFLD患者，缺乏指导。在本综述中，我们总结了现有证据，强调了进一步研究中需要解决的差距，并探讨了这些技术在临床实践中的优化。
NAFLD is a global epidemic. The prevalence of NAFLD is 20–30% in North America, northern Europe, Australia, Japan, India and China. It is crucial that patients with NAFLD receive an assessment for their risk of advanced fibrosis, which increases the risk of hepatocellular carcinoma and other complications of cirrhosis. Risk stratification that is efficient, cost-effective, patient-centred and evidence-based is one of the most important issues facing clinicians who care for those with liver disease. Given patients’ preference to avoid liver biopsy, noninvasive alternatives to assess liver fibrosis are in high demand. The most accurate noninvasive methods are based on liver elastography. Research on these techniques — which include vibration- controlled transient elastography (VCTE), magnetic resonance elastography (MRE), shear-wave elastography and acoustic radiation force impulse — has proliferated. Unfortunately, the literature has not kept pace with clinical practice. There is limited guidance for how clinicians should anticipate and manage the pitfalls of these tests. Furthermore, guidance is unavailable for clinicians regarding the optimal incorporation of VCTE, MRE or the emerging elastographic techniques into their clinical strategy, particularly for patients with NAFLD. In this Review, we summarize the available evidence, highlight gaps to address in further research and explore optimization of these techniques in clinical practice.
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DOI：
10.1002/hep.29639
发表时间：
2018-04
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Caussy C;Alquiraish MH;Nguyen P;Hernandez C;Cepin S;Fortney LE;Ajmera V;Bettencourt R;Collier S;Hooker J;Sy E;Rizo E;Richards L;Sirlin CB;Loomba R
通讯作者：
Loomba R
影响因子：
25.7
作者：
Dulai PS;Sirlin CB;Loomba R
通讯作者：
Loomba R
影响因子：
6.3
作者：
Ebinuma, Hirotoshi;Saito, Hidetsugu;Hibi, Toshifumi
通讯作者：
Hibi, Toshifumi
影响因子：
13.5
作者：
Bedossa, P;Dargère, D;Paradis, V
通讯作者：
Paradis, V
影响因子：
29.4
作者：
Angulo P;Kleiner DE;Dam-Larsen S;Adams LA;Bjornsson ES;Charatcharoenwitthaya P;Mills PR;Keach JC;Lafferty HD;Stahler A;Haflidadottir S;Bendtsen F
通讯作者：
Bendtsen F