中国超声弹性成像技术诊断肝硬化门静脉高压专家共识(2023版)  

Chinese expert consensus on the diagnosis of cirrhotic portal hypertension by ultrasound elastography(2023 version)

作　　者：中华医学会超声医学分会 中国门静脉高压联盟(CHESS) 祁小龙 梁萍 何蕊玲 高永艳[5] 郑明华[6] 李婕 曾婕[8] Chinese Society of Ultrasound in Medicine;Chinese Portal Hypertension Alliance(CHESS);Qi Xiaolong;Liang Ping(不详;Center of Portal Hypertension,Department of Radiology,Zhongda Hospital,Medical School,Southeast University,Nanjing 210012,China;Department of Ultrasound,Fifth Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]不详 [2]东南大学附属中大医院门静脉高压中心,南京210012 [3]中国人民解放军总医院第五医学中心超声科,北京100853 [4]兰州大学第一医院超声科 [5]解放军总医院第三医学中心超声诊断科 [6]温州医科大学附属第一医院感染内科 [7]南京大学医学院附属鼓楼医院感染科 [8]中山大学附属第三医院超声科

出　　处：《中华医学杂志》2023年第32期2480-2494,共15页National Medical Journal of China

摘　　要：中国肝硬化患者约700万,门静脉高压是影响肝硬化预后的重要因素,其严重程度决定了肝硬化并发症(如腹水、食管胃静脉曲张破裂出血、肝性脑病等)的发生和发展。近年来,随着超声弹性成像技术的快速发展,其在肝病领域也得到广泛应用。瞬时弹性成像、点剪切波弹性成像、二维剪切波弹性成像均对肝硬化门静脉高压的无创评估具有重要价值。然而,目前超声弹性成像评估肝硬化门静脉高压尚无统一的技术操作规范和参考阈值标准。因此,中华医学会超声医学分会、中国门静脉高压联盟(CHESS)联合发起并组织我国超声医学、肝病学、消化病学等多学科领域专家,结合国内外最新指南、循证医学证据以及我国临床实践形成专家共识,旨在规范化不同超声弹性成像技术的检查流程,标准化肝硬度和脾硬度在代偿期进展性慢性肝病、临床显著性门静脉高压、避免胃镜筛查、门静脉高压危险分层以及个体化管理等方面的临床应用。The population with cirrhosis in China is about 7 million,and portal hypertension is an important factor affecting the prognosis of these patients.The severity of portal hypertension determines the occurrence and development of liver related complications,such as ascites,variceal bleeding,and hepatic encephalopathy.In recent years,ultrasound elastography technology has been rapidly developed and widely applied in the field of liver diseases.Transient elastography,point shear wave elastography,and two‑dimensional shear‑wave elastography are all of great value for non‑invasive evaluation of portal hypertension.However,there is currently no unified operating standard and reference threshold for evaluating cirrhotic portal hypertension using ultrasound elastography.Therefore,Ultrasonic Medicine Branch of the Chinese Medical Association and Chinese Portal Hypertension Alliance(CHESS)initialed and convened domestic experts from multiple disciplines,including ultrasound medicine,hepatology,gastroenterology,to form a consensus based on the latest domestic and international guidelines,medical evidence,and Chinese clinical practice.The aim is to standardize the examination process of different ultrasound elastography techniques,and standardize the application of liver stiffness and spleen stiffness in compensated advanced chronic liver disease,clinically significant portal hypertension,avoidance of endoscopic screening,risk stratification of portal hypertension,and personalized clinical management.

关 键 词：门静脉高压 超声检查 弹性成像 肝硬化 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.2[医药卫生—诊断学]