基于病理和影像学的肝纤维化量化评估技术的临床应用

Clinical application of quantitative assessment of liver fibrosis based on pathology and imaging technology

肝纤维化/肝硬化是慢性肝脏疾病的常见病理结局,准确评估肝纤维化程度对明确疾病诊断、治疗决策、监测疗效及判断预后均有重要参考价值。目前两类量化评估技术得到了较为广泛应用,一是基于肝穿刺病理的量化评估技术,为细化肝纤维化分期及评估肝纤维化进展和逆转提供了金标准;二是基于影像学的无创量化评估技术,因其可重复性而在肝纤维化的动态监测与临床转归预测中发挥重要作用。主要介绍了上述两类量化评估技术的发展及其临床应用,以期更好地指导临床实践。

Liver fibrosis/cirrhosis is a common pathological outcome of chronic hepatic diseases,and an accurate assessment of the degree of liver fibrosis has an important reference value in a definite diagnosis,treatment decision-making,clinical outcome monitoring,and prognostic evaluation.Two quantitative assessment techniques are widely used at present:the quantitative assessment technique based on liver biopsy is the gold standard for identifying the exact liver fibrosis stage and evaluating the progression and reversion of liver fibrosis;the noninvasive quantitative assessment technique based on imaging technology plays an important role in dynamic monitoring and prognostic prediction of liver fibrosis due to its repeatability.This article summarizes the development and application of these two quantitative assessment techniques to provide guidance for clinical practice.