肝脏疾病的影像学诊断——肝纤维化及早期肝硬化的超声研究进展

Advances in ultrasonic diagnosis of hepatic fibrosis and early cirrhosis

随着超声医学检测技术的不断提高,他已成为肝纤维化及早期肝硬化的重要诊断和评价手段.二维超声用于显示肝脏形态及回声,是超声诊断的基础手段.彩色多普勒和频谱多普勒可以显示门静脉系统血流情况,不仅可以作为评价肝实质病变程度的指标,也是判断门脉高压及相关并发症的有效指标.超声造影提供了良好的血池示踪剂,能够反映肝脏的血流灌注,从而能够评估肝脏疾病的严重程度.近年来出现的弹性成像通过测量肝组织弹性模量的差异评估肝脏病变程度.Fibroscan在分期诊断慢性丙型肝炎肝纤维化、监测肝硬化门静脉高压发展中表现出了优异的诊断价值,为无创性诊断肝硬化提供了新的发展方向.以上技术综合应用于临床,大大提高了肝脏疾病的诊断成功率.本文就超声医学在肝纤维化及早期肝硬化诊断中的作用,从以上几个方面作一综述.

With the development of medical ultrasonic technology,sonography has become an important means for diagnosis and evaluation of hepatic fibrosis and early cirrhosis.Two-dimensional sonography is the basic means of ultrasonic diagnosis and can be used to display the appearance and echo of the liver.Color Doppler sonography and Doppler frequency spectrum permit assessment of the portal venous system and detection of portal blood flow.They can be used not only for estimation of hepatic parenchymal changes but also for evaluation of portal hypertension and its complications.Contrastenhanced ultrasound permits use of a bloodpool tracer and can assess the blood flow perfusion of hepatic parenchyma.Elasticity imaging indirectly reflects tissue pathological changes by measuring tissue elastic modulus.Fibroscan has shown great promise for staging and diagnosing hepatic fibrosis and monitoring the development of hepatic cirrhosis and portal hypertension,thus offering a new method for noninvasive diagnosis of hepatic diseases.The clinical application of these techniques has greatly improved the diagnosis of hepatic diseases.In this article,we will review the recent advances in ultrasonic diagnosis of hepatic fibrosis and early cirrhosis.