Imaging-based Quantification of Hepatic Fat: Methods and Clinical Applications
Imaging-based Quantification of Hepatic Fat: Methods and Clinical Applications
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DOI：
10.1148/rg.295085186
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发表时间：
2009-09-01
期刊：
影响因子：
5.5
通讯作者：
Sahani, Dushyant V.
中科院分区：
文献类型：
--
作者：
Ma, Xiaozhou;Holalkere, Nagaraj-Setty;Sahani, Dushyant V.
脂肪肝疾病包括一系列病症（单纯性肝脂肪变性、伴有炎症变化的脂肪性肝炎以及伴有纤维化和肝硬化的终末期肝病）。肝脏脂肪变性通常与糖尿病和肥胖相关，并且可能继发于酒精和药物使用、毒素、病毒感染和代谢疾病。肝脏脂肪的检测和定量具有许多临床应用，早期识别对于制定适当的管理和预防进展至关重要。组织学分析是检测和量化肝脏中脂肪的参考标准，但结果容易受到采样误差的影响。此外，它可能导致发病率和并发症，并且不能经常重复以监测治疗反应。成像可以定期重复，并允许评估整个肝脏，从而避免采样错误。选择合适的成像方法需要了解其优点和局限性以及合适的临床环境。超声检查对检测中度或重度脂肪浸润是有效的，但由于缺乏观察者间的可靠性和观察者内的重复性而受到限制。计算机断层扫描允许定量和定性评价，通常具有高度准确性和可靠性;然而，结果可能会受到肝硬化或沉积性疾病引起的肝实质变化的混淆。采用适当序列（例如化学位移技术）的磁共振（MR）成像具有类似的高灵敏度，并且MR光谱为某些应用提供了独特的优势。然而，这两种方法都很昂贵，而且过于复杂，无法用于监测脂肪变性。(C)RSNA，2009年。radiographics.rsna.org
Fatty liver disease comprises a spectrum of conditions (simple hepatic steatosis, steatohepatitis with inflammatory changes, and end-stage liver disease with fibrosis and cirrhosis). Hepatic steatosis is often associated with diabetes and obesity and may be secondary to alcohol and drug use, toxins, viral infections, and metabolic diseases. Detection and quantification of liver fat have many clinical applications, and early recognition is crucial to institute appropriate management and prevent progression. Histopathologic analysis is the reference standard to detect and quantify fat in the liver, but results are vulnerable to sampling error. Moreover, it can cause morbidity and complications and cannot be repeated often enough to monitor treatment response. Imaging can be repeated regularly and allows assessment of the entire liver, thus avoiding sampling error. Selection of appropriate imaging methods demands understanding of their advantages and limitations and the suitable clinical setting. Ultrasonography is effective for detecting moderate or severe fatty infiltration but is limited by lack of interobserver reliability and intraobserver reproducibility. Computed tomography allows quantitative and qualitative evaluation and is generally highly accurate and reliable; however, the results may be confounded by hepatic parenchymal changes due to cirrhosis or depositional diseases. Magnetic resonance (MR) imaging with appropriate sequences (eg, chemical shift techniques) has similarly high sensitivity, and MR spectroscopy provides unique advantages for some applications. However, both are expensive and too complex to be used to monitor steatosis. (C) RSNA, 2009. radiographics.rsna.org