肝纤维化的功能磁共振研究进展

Functional MR study of hepatic fibrosis

肝纤维化的准确诊断和分期对于监测肝脏疾病的进展和疗效是非常重要的。肝活检是评估肝纤维化的金标准,然而,因其有创性不能被用作人群筛查和监测疾病进展及观察疗效。磁共振功能成像作为一种无创的评估肝纤维化的手段,而成为当前的研究热点。磁共振弹力成像对肝纤维化分期诊断的价值最大,能够对肝纤维化病变作出分期诊断,磁共振弥散加权成像效果次之。当前,多数磁共振功能成像包括弥散加权成像和波谱成像及灌注成像,能对中晚期肝纤维化或肝硬化作出准确诊断,对于轻中度肝纤维化的鉴别效果尚不肯定。

The accurate diagnosis and staging of hepatic fibrosis is crucial for treatment and prognosis of liver disease.The current gold standard is liver biopsy,but it cannot be used in population-based screening,and has well known drawbacks if used for monitoring of disease progression or treatment results.Functional MR,as a non-invasive method,is increasingly used in hepatic fibrosis and became the current hot spot.Most recently available functional MR imaging techniques including diffusion weighted imaging,perfusion weighted imaging and MR spectroscopy can detect cirrhosis or fibrosis reasonably accurately.However,to date only MR elastography has been able to stage fibrosis or diagnose mild disease.MR diffusion weighted appears next most promising.