Imaging biomarkers of NAFLD, NASH, and fibrosis.
Imaging biomarkers of NAFLD, NASH, and fibrosis.
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DOI：
10.1016/j.molmet.2021.101167
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发表时间：
2021-08
影响因子：
8.1
通讯作者：
Loomba R
中科院分区：
文献类型：
--
作者：
Ajmera V;Loomba R
非酒精性脂肪性肝病（NAFLD）是一种临床病理学实体，需要肝脏活检评估来诊断称为非酒精性脂肪性肝炎（NASH）的NAFLD的进行性形式。肝活检是侵入性的，易受取样和观察者间变异性的影响，并且不切实际地扩展到全球多达10亿受影响个体的受影响人群。非侵入性成像生物标志物已成为解决诊断、分期和纵向监测NAFLD的主要未满足需求的关键模式。在这篇综述中，我们严格检查使用非侵入性成像生物标志物来诊断NAFLD，NASH和纤维化阶段。肝脏脂肪的超声和磁共振成像（MRI）生物标志物可以诊断NAFLD。MRI质子密度脂肪分数（MRI-PDFF）优于肝活检，特别是在临床试验中肝脏脂肪的纵向变化。可靠诊断NASH的成像生物标志物正在研究中，但单独使用时，仍然只有适度的诊断准确性。然而，纤维化阶段与肝脏失代偿和死亡率的相关性最强，弹性成像已成为肝纤维化的可靠生物标志物。我们回顾了生物标志物的组合来对患者进行风险分层，并确定需要治疗的个体以及肝脏硬度测量纵向变化的影响。MRI-PDFF上肝脏脂肪改善≥30%与组织学改善相关。结合MRE ≥3.3 kPa和FIB-4 ≥ 1.6（MEFIB指数）预测高风险NAFLD。肝硬度测量值升高可预测未来的肝功能失代偿。MRE ≥ 4.67kPa和≥8 kPa分别预测肝硬化和肝失代偿。
Non-alcoholic fatty liver disease (NAFLD) is a clinicopathologic entity that requires a liver biopsy assessment to diagnose the progressive form of NAFLD called non-alcoholic steatohepatitis (NASH). Liver biopsy is invasive, subject to sampling and interobserver variability, and impractical to scale to the affected population of up to 1 billion affected individuals worldwide. Non-invasive imaging biomarkers have emerged as a key modality to address the major unmet need to diagnose, stage, and longitudinally monitor NAFLD. In this review, we critically examine the use of non-invasive imaging biomarkers to diagnose NAFLD, NASH, and fibrosis stage. Ultrasound and magnetic resonance imaging (MRI) biomarkers of liver fat can diagnose NAFLD. MRI proton density fat fraction (MRI-PDFF) is better than liver biopsy, particularly for following longitudinal changes in liver fat in clinical trials. Imaging biomarkers to reliably diagnose NASH are under investigation, but when used alone, continue to have only modest diagnostic accuracy. However, the fibrosis stage has the strongest association with liver decompensation and mortality, and elastography has emerged as a reliable biomarker for liver fibrosis. We review the combination of biomarkers to risk stratify patients and identify individuals needing treatment and the implications of longitudinal changes in liver stiffness measurement. An improvement of ≥30% in liver fat on MRI-PDFF is associated with histologic improvement. Combining MRE ≥3.3 kPa and FIB-4 ≥ 1.6 (MEFIB Index) predicts high-risk NAFLD. Elevated liver stiffness measurements predict future hepatic decompensation. MRE ≥ 4.67 kPa and ≥8 kPa predict cirrhosis and hepatic decompensation, respectively.
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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
DOI：
10.1002/hep.29797
发表时间：
2018-08
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Caussy C;Reeder SB;Sirlin CB;Loomba R
通讯作者：
Loomba R
影响因子：
6.7
作者：
Jayaswal, Arjun N. A.;Levick, Christina;Pavlides, Michael
通讯作者：
Pavlides, Michael
DOI：
10.1016/j.cgh.2019.11.060
发表时间：
2020-07
期刊：
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
影响因子：
--
作者：
通讯作者：
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