Progress in non-invasive detection of liver fibrosis.
Progress in non-invasive detection of liver fibrosis.
复制标题
肝纤维化无创检测的进展。
DOI：
10.20892/j.issn.2095-3941.2018.0018
复制
发表时间：
2018-05
影响因子：
5.5
通讯作者：
Zhang W
中科院分区：
文献类型：
--
作者：
Li C;Li R;Zhang W
肝纤维化是肝癌发生的重要病理基础。肝纤维化程度与肝癌呈正相关。肝纤维化是慢性肝损伤后肝细胞坏死、变性，最终导致细胞外基质和胶原沉积的一系列病理生理过程。肝纤维化和肝硬化的早期发现和准确分期对于早期诊断和及时启动适当的治疗方案非常重要。严重肝纤维化最终进展为肝癌的风险> 50%。众所周知，活检是肝纤维化诊断和分期的金标准。然而，这种方法有一些局限性，如潜在的疼痛，采样变异性和低患者接受度。此外，获得肝纤维化组织诊断的必要性仍然存在争议。越来越多的可靠的非侵入性方法现在可广泛应用于临床实践，主要是在病毒性肝炎的情况下，导致肝活检的需要显着减少。事实上，由于目前的血清标志物、超声成像和磁共振成像定量技术，肝硬化的无创检测和评估现在具有良好的准确性。肝纤维化的无创检测和评估的一个突出优点是可以在同一患者中重复且容易地监测肝纤维化。血清生物标志物具有适用性高（>95%）和重现性好的优点。然而，他们的结果可能会受到不同患者状况的影响，因为这些标志物都不是肝脏特异性的。最有前途的技术似乎是瞬态弹性成像和磁共振弹性成像，因为它们为晚期肝纤维化的检测提供了可靠的结果，未来的发展有望提高肝纤维化分期的可靠性和准确性。本文旨在描述肝纤维化分期的非侵入性评估方法的最新进展，特别强调计算机辅助定量和深度学习方法。
Liver fibrosis is an important pathological precondition for hepatocellular carcinoma. The degree of hepatic fibrosis is positively correlated with liver cancer. Liver fibrosis is a series of pathological and physiological process related to liver cell necrosis and degeneration after chronic liver injury, which finally leads to extracellular matrix and collagen deposition. The early detection and precise staging of fibrosis and cirrhosis are very important for early diagnosis and timely initiation of appropriate therapeutic regimens. The risk of severe liver fibrosis finally progressing to liver carcinoma is >50%. It is known that biopsy is the gold standard for the diagnosis and staging of liver fibrosis. However, this method has some limitations, such as the potential for pain, sampling variability, and low patient acceptance. Furthermore, the necessity of obtaining a tissue diagnosis of liver fibrosis still remains controversial. An increasing number of reliable non-invasive approaches are now available that are widely applied in clinical practice, mostly in cases of viral hepatitis, resulting in a significantly decreased need for liver biopsy. In fact, the non-invasive detection and evaluation of liver cirrhosis now has good accuracy due to current serum markers, ultrasound imaging, and magnetic resonance imaging quantification techniques. A prominent advantage of the non-invasive detection and assessment of liver fibrosis is that liver fibrosis can be monitored repeatedly and easily in the same patient. Serum biomarkers have the advantages of high applicability (>95%) and good reproducibility. However, their results can be influenced by different patient conditions because none of these markers are liver-specific. The most promising techniques appear to be transient elastography and magnetic resonance elastography because they provide reliable results for the detection of fibrosis in the advanced stages, and future developments promise to increase the reliability and accuracy of the staging of hepatic fibrosis. This article aims to describe the recent progress in the development of non-invasive assessment methods for the staging of liver fibrosis, with a special emphasize on computer-aided quantitative and deep learning methods.