Non-invasive means of measuring hepatic fat content
Non-invasive means of measuring hepatic fat content
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DOI：
10.3748/wjg.14.3476
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发表时间：
2008-06-14
影响因子：
4.3
通讯作者：
Taylor-Robinson, Simon D.
中科院分区：
文献类型：
--
作者：
Mehta, Sanjeev R.;Thomas, E. Louise;Taylor-Robinson, Simon D.
在西方世界，肝脂肪变性影响20%至30%的一般成年人群。目前，确定肝脏脂肪沉积和纤维化阶段的首选技术是肝活检。然而，它是一种侵入性手术，其使用有限，特别是在儿童中。它也可能受到抽样误差的影响。超声、计算机断层扫描（CT）、磁共振成像（MRI）和质子磁共振波谱（H-1 MRS）等非侵入性技术可以检测肝脂肪变性，但目前无法区分单纯性脂肪变性和脂肪性肝炎，也无法准确分期纤维化程度。超声被广泛用于检测肝脏脂肪变性，但其敏感性在病态肥胖和少量脂肪浸润的患者中降低。它已被用于对肝脏脂肪含量进行分级，但这是主观的。CT可以检测肝脂肪变性，但受试者暴露于电离辐射，从而限制了其在纵向研究和儿童中的使用。最近，磁共振（MR）技术，使用化学位移成像提供了一个定量评估的程度，肝脂肪浸润，以及相关的肝活检结果在相同的患者。同样，体内H-1 MRS是一种快速、安全、非侵入性的肝细胞内脂质（IHCL）水平定量方法。这两种技术将是未来纵向临床研究的有用工具，无论是在检查引起肝脂肪变性的疾病（例如非酒精性脂肪肝）的自然史，还是在测试这些疾病的新治疗方法。(C)2008年WJG。All rights reserved.
Hepatic steatosis affects 20% to 30% of the general adult population in the western world. Currently, the technique of choice for determining hepatic fat deposition and the stage of fibrosis is liver biopsy. However, it is an invasive procedure and its use is limited, particularly in children. It may also be subject to sampling error. Non-invasive techniques such as ultrasound, computerised tomography (CT), magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (H-1 MRS) can detect hepatic steatosis, but currently cannot distinguish between simple steatosis and steatohepatitis, or stage the degree of fibrosis accurately. Ultrasound is widely used to detect hepatic steatosis, but its sensitivity is reduced in the morbidly obese and also in those with small amounts of fatty infiltration. It has been used to grade hepatic fat content, but this is subjective. CT can detect hepatic steatosis, but exposes subjects to ionising radiation, thus limiting its use in longitudinal studies and in children. Recently, magnetic resonance (MR) techniques using chemical shift imaging have provided a quantitative assessment of the degree of hepatic fatty infiltration, which correlates well with liver biopsy results in the same patients. Similarly, in vivo H-1 MRS is a fast, safe, non-invasive method for the quantification of intrahepatocellular lipid (IHCL) levels. Both techniques will be useful tools in future longitudinal clinical studies, either in examining the natural history of conditions causing hepatic steatosis (e.g. non-alcoholic fatty liver disease), or in testing new treatments for these conditions. (C) 2008 WJG. All rights reserved.