超声波在非酒精性脂肪肝疾病及其并发症的诊断和治疗中的

StephenW

Reviews
Role of ultrasound in the diagnosis and treatment of nonalcoholic fatty liver disease and its complications

May 2015, Vol. 9, No. 5 , Pages 603-627 (doi:10.1586/17474124.2015.1007955)

   
Stefano Ballestri, Dante Romagnoli, Fabio Nascimbeni, Giampiero Francica, and Amedeo Lonardo
1Division of Internal Medicine, Hospital of Pavullo – Department of Internal Medicine, Azienda USL, Pavullo, Modena 41126,
Italy
2Division of Internal Medicine, NOCSAE – Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia and Azienda USL, Baggiovara, Modena 41126,
Italy
3Interventional Ultrasound Unit, Pinetagrande Hospital, Castelvolturno, Caserta 81030,
Italy
*Author for correspondence: [email protected]; [email protected]


We review the role of liver ultrasonography (US) and related techniques as non-invasive tools in predicting metabolic derangements, liver histology, portal hypertension and cardiovascular risk as well as allowing early diagnosis and management of hepatocellular carcinoma in patients with nonalcoholic fatty liver disease. In this setting, US detects fatty changes as low as ≥20% and hepatic steatosis identified ultrasonographically, in its turn, closely mirrors coronary and carotid atherosclerosis burden. Semi-quantitative US indices (to exclude nonalcoholic steatohepatitis) and sonoelastography (to quantify fibrosis) help in predicting liver histology and selecting patients to submit to liver biopsy. Surveillance for hepatocellular carcinoma conducted through biannual US is mandatory and US has a role in guiding locoregional treatment and in evaluating the efficacy of treatment. High-intensity focused ultrasound can be delivered with precision resulting in coagulative necrosis of hepatocellular carcinoma without puncturing the liver. Costs and inconveniences have so far hampered its diffusion.
Keywords
cardiovascular risk, cirrhosis, elastography, fatty liver, hepatocellular carcinoma, liver biopsy, liver fibrosis, metabolic syndrome, NASH, portal hypertension, ultrasound



Read More: http://informahealthcare.com/doi ... 474124.2015.1007955

StephenW

点评
超声波在非酒精性脂肪肝疾病及其并发症的诊断和治疗中的作用

2015年5月，卷。 9，5号，页603-627（DOI：10.1586 / 17474124.2015.1007955）

   
斯特凡诺Ballestri，但丁罗马尼奥利，法比奥Nascimbeni，詹皮耶罗弗兰奇卡和阿米地奥L​​onardo
内科，Pavullo医院的1区 - 内科，Azienda与USL，Pavullo，摩德纳41126，
意大利
内科，NOCSAE的2区 - 生物医学，代谢和神经科学，摩德纳和雷焦艾米利亚和Azienda与USL，Baggiovara，摩德纳41126大学的系，
意大利
3Interventional超声单位，Pinetagrande医院，Castelvolturno，卡塞塔81030，
意大利
*作者为通信：[email protected]; [email protected]


我们审查肝脏超声检查（US）和相关技术作为在预测代谢紊乱，肝组织学，门静脉高血压和心血管疾病的危险，以及允许早期诊断和肝细胞癌管理患者非酒精性脂肪肝疾病的非侵入性工具的作用。在这种背景下，美国的检测脂肪变化低至≥20％，并确定了超声检查脂肪肝，反过来，密切反映冠状动脉和颈动脉粥样硬化的负担。半定量美元指数（排除非酒精性脂肪性肝炎）和sonoelastography预测肝组织学和选择患者递交给肝活检（量化纤维化）的帮助。监视用于通过一年两次美国进行的肝癌是强制性的，美国在指导局部治疗和评估治疗效果的作用。高强度聚焦超声能与精度导致肝细胞癌的凝固性坏死，而不刺穿肝脏递送。成本和不便迄今阻碍了它的推广。
关键词
心血管疾病的危险，肝硬化，弹性，脂肪肝，肝细胞癌，肝活检，肝纤维化，代谢综合征，NASH，门脉高压，超声



了解更多：http://informahealthcare.com/doi ... 474124.2015.1007955