肝脂肪变性的超声检测技术及其应用前景  

Detection and application prospects of ultrasound techniques for hepatic steatosis

作　　者：董怡 王文平 DONG Yi;WANG Wenping(Department of Ultrasound,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Ultrasound,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]上海交通大学医学院附属新华医院超声科,上海200092 [2]复旦大学附属中山医院超声科,上海200032

出　　处：《肿瘤影像学》2023年第4期317-323,共7页Oncoradiology

基　　金：中德合作交流项目(M-0504);国家自然科学基金(82071942)。

摘　　要：非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)是最常见的慢性肝病,在普通人群中的患病率约高达30%。肝脂肪变性是NAFLD的一个重要组织学特征,随着病程的发展,可导致肝纤维化或肝硬化,甚至增加肝细胞肝癌的患病风险。定量评估肝脂肪变性的金标准是肝脏穿刺活检,但其具有侵入性。影像学技术使无创、定量地评估肝脏脂肪成为可能。许多指南推荐超声作为NAFLD首选的影像学诊断手段,具有简便、实时、无创及可视化等优势。近年来,超声定量检测技术层出不穷,技术参数包括衰减系数、背向散射系数和声速。但各类超声新技术临床应用证据较少,需要大量研究探索并优化操作方法,以降低噪声对测量值的影响。本文从脂肪性肝病名称的变更、临床诊断现状、超声医学与生物世界联合会定量评估脂肪变性共识的解读入手,并介绍具有代表性的基于声衰减系数的定量超声技术,以及其在肝脂肪变性检测中的诊断价值。最后从诊断、监测、预测等角度展望超声定量检测技术的临床前景。Non-alcoholic fatty liver disease(NAFLD)is the most common chronic liver disease,with an estimated prevalence of up to 30%in the whole population.Liver steatosis is an important histological feature of NAFLD,which can lead to liver fibrosis or cirrhosis,and even increase the risk of hepatocellular carcinoma as the disease progresses.The gold standard for quantitatively evaluating liver steatosis is liver biopsy,but it is invasive.Imaging technology enables non-invasive and quantitative assessment of liver fat.The guidelines recommend ultrasound as the first-line imaging diagnostic method for NAFLD,which has the advantages of being convenient,real-time,non-invasive and visualization.Recently,quantitative ultrasonic technologies have emerged,and the technical parameters include attenuation coefficient,backscatter coefficient,and sound velocity.However,there is limited evidence for the clinical application of various new ultrasound technologies,and a large amount of research is needed to explore and optimize operational methods to reduce the impact factors on measurement.This review introduced the change in the name of fatty liver disease,the current status of clinical diagnosis,the interpretation of international consensus from the World Federation for Ultrasound in Medicine and Biology,and introduced representative quantitative ultrasound techniques based on attenuation coefficient,with their diagnostic value in the detection of hepatic steatosis.Moreover,this review evaluated diagnosis,monitoring,and prediction by ultrasound quantitative detection technology for the application of hepatic steatosis.

关 键 词：脂肪肝 定量 衰减系数 背向散射 射频信号 

分 类 号：R575.5[医药卫生—消化系统] R445.1[医药卫生—内科学]