Elastography for Longitudinal Assessment of Liver Fibrosis after Antiviral Therapy: A Review.
Elastography for Longitudinal Assessment of Liver Fibrosis after Antiviral Therapy: A Review.
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DOI：
10.14218/jcth.2020.00033
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发表时间：
2020-12-28
影响因子：
3.6
通讯作者：
Song B
中科院分区：
文献类型：
--
作者：
Wei H;Song B
慢性乙型或丙型肝炎病毒感染是肝硬化和肝细胞癌的常见病因。长期抗病毒治疗（AVT）后可实现纤维化消退。监测治疗后肝纤维化的动态变化对于确定预后和制定随访监测计划至关重要。肝活检是肝纤维化评估的金标准，但它的侵入性、采样误差和观察者的可变性阻碍了肝移植后肝纤维化的常规监测。弹性成像是一种非侵入性的定量替代方法，已广泛用于治疗前肝纤维化的分期并得到验证。近年来，越来越多的研究关注于弹性成像在AVT后肝纤维化纵向评估中的作用。本文综述了超声弹性成像和磁共振弹性成像的基本原理、采集技术、诊断性能以及优缺点。总结了关于使用弹性成像技术监测AVT后肝纤维化的新证据。讨论了当前的挑战和未来的发展方向，旨在优化这些技术在临床实践中的应用。
Chronic hepatitis B or C viral infection is a common cause of liver cirrhosis and hepatocellular carcinoma. Fibrosis regression can be achieved after long-term antiviral therapy (AVT). Monitoring of dynamic changes in liver fibrosis after treatment is essential for establishing prognosis and formulation of a follow-up surveillance program. Routine surveillance of fibrosis after AVT by liver biopsy, the gold standard for fibrosis assessment, is hindered by its invasive nature, sampling error and observer variability. Elastography is a noninvasive quantitative alternative that has been widely used and validated for the staging of liver fibrosis prior to treatment. Recently, increasing research interest has been focused on the role of elastography in longitudinal assessment of liver fibrosis after AVT. In this review, the basic principles, acquisition techniques, diagnostic performances, and strengths and limitations of ultrasound elastography and magnetic resonance elastography are presented. Emerging evidence regarding the use of elastography techniques for the monitoring of liver fibrosis after AVT is summarized. Current challenges and future directions are also discussed, designed to optimize the application of these techniques in clinical practice.