CT在肝纤维化与肝硬化诊断中的研究进展

Research Progress of CT in Diagnosis of Liver Fibrosis and Cirrhosis

肝纤维化的病程延长,且病情加重便会进展为肝硬化,而肝纤维化的主要病因是乙型肝炎加重。肝纤维化可通过系统化治疗取得较佳疗效,病情具有可逆性,但一旦发展至肝硬化,则病情呈进行性加重特征,且会导致多种并发症,最为常见的是肝功能衰竭。临床认为尽早诊断肝纤维化可以阻断其进展为肝硬化,而早期检出肝硬化可合理制定治疗方案,改善远期疗效。肝脏穿刺活检被认为是以上两种病型的诊断金标准,但穿刺活检属于侵入性操作,会增加患者的诊断痛苦度。此外,穿刺活检无法重复检查,单凭一次肝脏穿刺活检难以明确诊断病情,具有局限性。相比较而言,CT诊断可利用对比剂动态化评估病灶部位的血液循环,可借助灌注成像以及分子影像学等先进技术判断病情程度,诊断无创可重复,具有实用性。为此,本研究全面综述CT对于肝纤维化/肝硬化的诊断价值,以指导临床诊断工作。

The course of liver fibrosis is prolonged,and if the condition is aggravated,it will progress to cirrhosis.The main cause of liver fibrosis is hepatitis B aggravation.Liver fibrosis can achieve better results through systematic treatment,and the disease is reversible,but once it progresses to cirrhosis,the disease will be progressively worsening and will cause many complications,the most common being liver failure.It is clinically believed that early diagnosis of liver fibrosis can block the progression of liver cirrhosis,and early detection of liver cirrhosis can make reasonable treatment plans and improve long-term efficacy.Liver biopsy is considered to be the gold standard for the diagnosis of the above two types of diseases,but the biopsy is an invasive procedure that will increase the distress of patients.In addition,the needle biopsy cannot be repeated,and the distribution of liver lesions is not uniform.Therefore,it is difficult to clearly diagnose the disease with a single liver biopsy,which has limitations.In comparison,CT diagnosis can dynamically evaluate the blood circulation of the lesion with contrast agents,and can use advanced technologies such as perfusion imaging and molecular imaging to determine the degree of the disease.The diagnosis is noninvasive,repeatable,and practical.To this end,this study comprehensively reviews the diagnostic value of CT for liver fibrosis/cirrhosis to guide clinical diagnosis.