磁共振腹腔镜检查：一种新的非侵入性技术评估慢性病毒性

StephenW

Magnetic resonance laparoscopy: A new non-invasive technique for the assessment of chronic viral liver disease; Ogura S, Saitoh S, Kawamura Y, Sezaki H, Hosaka T, Akuta N, Kobayashi M, Suzuki F, Suzuki Y, Arase Y, Ikeda K, Kumada H; Hepatology Research 43 (8), 836-45 (Aug 2013)


AIM Laparoscopy-guided liver biopsy is the most accurate method for assessing liver fibrosis but have several limitations. We designed a non-invasive method, called magnetic resonance laparoscopy (MRL), based on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging, to assess liver fibrosis in patients with chronic hepatitis B and C virus.

METHODS We prospectively analyzed 49 patients with normal liver and 353 patients with chronic viral hepatitis, laparoscopic liver biopsy was performed on 109 patients and 244 patients were diagnosed as having liver cirrhosis clinically. The MRL findings of the liver surface were classified into three categories: (i) smooth (essentially smooth surface of the entire liver or with limited areas of depression); (ii) partially irregular (several interconnected depressions on the surface mainly in the left lobe of the liver); and (iii) diffusely irregular (nodules present on the liver surface). Patients with diffusely irregular liver surface was diagnosed as liver cirrhosis.

RESULTS The liver surface changed with the progression of liver fibrosis from smooth, partially irregular to diffusely irregular, irrespective of viral type. The sensitivity, specificity, positive and negative predictive values for the diagnosis of cirrhosis according to the surface findings on MRL were 96%, 100%, 95% and 95%, respectively. The cirrhotic liver showed: (i) disappearance of impression of the right ribs; (ii) enlargement of the lateral segment; and (iii) atrophy of the right lobe according to Child-Pugh classification.

CONCLUSION Our data indicated that MRL is a potentially useful non-invasive examination for evaluation of liver fibrosis associated with viral hepatitis.

StephenW

AIM腹腔镜引导下肝活检是评估肝纤维化的最准确的方法，但有一些局限性。我们设计了一种非侵入性的方法，称为磁共振腹腔镜（MRL），钆乙氧基苯二亚乙基三胺五乙酸增强磁共振成像的基础上，评估肝纤维化慢性乙型和丙型肝炎病毒的患者。

方法我们前瞻性分析49例正常肝和慢性病毒性肝炎353例，腹腔镜肝活检进行了109例和244例确诊为肝硬化临床。光滑（基本上整个肝脏表面光滑，或与抑郁症的有限区域）的MRL发现肝脏表面被分为三大类：（一）（二）部分不规则的（几个相互关联的洼地表面上的，主要是在左叶肝脏）及（iii）弥漫性不规则（结节存在对肝脏的表面）。被诊断为肝硬化患者肝脏弥漫性不规则表面。

结果改变肝表面光滑，肝纤维化的进展部分不规则的漫不规则的，无论病毒类型。的敏感性，特异性，肝硬化的诊断根据对MRL的表面发现的阳性和阴性预测值分别为96％，100％，95％和95％，分别。肝硬化表明：（一）印象右侧肋骨消失;（二）扩大的外侧段及（iii）根据Child-Pugh分级的右叶萎缩。

结论我们的数据表明MRL是一种潜在的有用的非侵入性的检查与病毒性肝炎肝纤维化的评价。