The Global Nonalcoholic Fatty Liver Disease Epidemic: What a Radiologist Needs to Know.
The Global Nonalcoholic Fatty Liver Disease Epidemic: What a Radiologist Needs to Know.
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DOI：
10.4103/2156-7514.157860
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发表时间：
2015
影响因子：
0.9
通讯作者：
Casillas J
中科院分区：
文献类型：
--
作者：
Pereira K;Salsamendi J;Casillas J
非酒精性脂肪性肝病（NAFLD）代表了从良性脂肪变性到肝细胞癌（HCC）的一系列疾病。代谢综合征，主要是肥胖，在NAFLD的发病机制中扮演着重要的角色，既是一个独立的危险因素。随着肥胖和糖尿病的逐渐流行，NAFLD及其相关并发症的患病率预计将急剧增加。治疗NAFLD和代谢综合征，特别是肥胖的治疗策略正在不断完善。他们的目标是通过控制危险因素、预防疾病进展以及控制并发症来预防NAFLD，最终预防发病率和死亡率。NAFLD和代谢综合征的最佳管理需要政府和卫生系统之间的多学科合作，包括营养师、初级保健医生、放射科医生、肝病学家、肿瘤学家和移植外科医生。无论是从临床角度还是从影像学角度，对临床表现、危险因素、发病机制、诊断和治疗的认识对放射科医生来说都是至关重要的。放射科医生在影像方式和微创经皮血管内治疗方面的专业知识，在综合治疗中起着至关重要的作用，本文将重点介绍我们的实践案例。我们还简要讨论了经动脉栓塞胃左动脉（LGA），这是一种在肥胖的微创治疗中具有巨大潜力的新方法，并详细介绍了我们实践中的一个病例。
Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of disorders from a benign steatosis to hepatocellular carcinoma (HCC). Metabolic syndrome, mainly obesity, plays an important role, both as an independent risk factor and in the pathogenesis of NAFLD. With the progressive epidemics of obesity and diabetes mellitus, the prevalence of NAFLD and its associated complications is expected to increase dramatically. Therapeutic strategies for treating NAFLD and metabolic syndrome, particularly obesity, are continuously being refined. Their goal is the prevention of NAFLD by the management of risk factors, prevention of progression of the disease, as well as management of complications, ultimately preventing morbidity and mortality. Optimal management of NAFLD and metabolic syndrome requires a multidisciplinary collaboration between the government as well as the health system including the nutritionist, primary care physician, radiologist, hepatologist, oncologist, and transplant surgeon. An awareness of the clinical presentation, risk factors, pathogenesis, diagnosis, and management is of paramount importance to a radiologist, both from the clinical perspective as well as from the imaging standpoint. With expertise in imaging modalities as well as minimally invasive percutaneous endovascular therapies, radiologists play an essential role in the comprehensive management, which is highlighted in this article, with cases from our practice. We also briefly discuss transarterial embolization of the left gastric artery (LGA), a novel method that promises to have an enormous potential in the minimally invasive management of obesity, with details of a case from our practice.