肝纤维化和预后的非侵入性评估：血清和弹性成像标志物的

StephenW

Non-invasive assessment of liver fibrosis and prognosis: an update on serum and elastography markers
Uchenna Agbim & Sumeet K Asrani
Received 10 Aug 2018, Accepted 04 Feb 2019, Accepted author version posted online: 06 Feb 2019

    Download citation https://doi.org/10.1080/17474124.2019.1579641



Accepted author version
Abstract

Introduction: Non-invasive assessment of fibrosis is increasingly utilized in clinical practice to diagnose hepatic fibrosis. Non-invasive assessment of liver fibrosis relies on biologic and/or physical properties to assess tissue fibrosis. Serum markers estimate fibrosis by incorporating markers reflecting hepatic function (indirect markers) and/or markers measuring extracellular matrix degradation/fibrogenesis (direct markers). Radiology based techniques relay the mechanical properties and stiffness of a tissue, with increased stiffness associated with more advanced fibrosis.

Areas covered: In this comprehensive review, the recent literature discussing serum markers and elastography-based techniques will be covered. These modalities are also explored in the setting of various liver diseases.

Expert opinion: The etiology of liver disease and clinical context should be taken into consideration when non-invasive markers are incorporated in clinical practice. Non-invasive assessment of fibrosis has been most extensively utilized in hepatitis C, followed by hepatitis B and nonalcoholic fatty liver disease, but its role remains less developed in other etiologies of liver disease such as alcohol associated liver disease and autoimmune liver disease. The role of non-invasive markers in predicting progression or regression of fibrosis, development of liver related events and survival needs to be further explored.
Keywords: elastography, hepatitis C, hepatitis B, liver fibrosis, liver stiffness, magnetic resonance elastography, nonalcoholic fatty liver disease, shear wave elastography, vibration-controlled transient elastography

StephenW

肝纤维化和预后的非侵入性评估：血清和弹性成像标志物的更新
Uchenna Agbim和Sumeet K Asrani
收稿日期2018年8月10日，接受于2019年2月4日，接受作者发布于2019年2月6日

    下载引文https://doi.org/10.1080/17474124.2019.1579641



接受的作者版本
抽象

简介：纤维化的非侵入性评估在临床实践中越来越多地用于诊断肝纤维化。肝纤维化的非侵入性评估依赖于生物学和/或物理性质来评估组织纤维化。血清标志物通过掺入反映肝功能的标志物（间接标志物）和/或测量细胞外基质降解/纤维发生的标志物（直接标志物）来估计纤维化。基于放射学的技术传递组织的机械特性和刚度，与更晚期的纤维化相关的硬度增加。

涵盖的领域：在这篇全面的综述中，将讨论最近关于血清标志物和基于弹性成像技术的文献。在各种肝病的背景下也探讨了这些方式。

专家意见：当非侵入性标记物纳入临床实践时，应考虑肝病的病因和临床背景。纤维化的非侵入性评估在丙型肝炎中得到最广泛的应用，其次是乙型肝炎和非酒精性脂肪性肝病，但其在肝病的其他病因如乙醇相关性肝病和自身免疫性肝病中的作用仍然较少。需要进一步探索非侵入性标志物在预测纤维化进展或消退，肝脏相关事件发展和生存方面的作用。
关键词：弹性成像，丙型肝炎，乙型肝炎，肝纤维化，肝硬度，磁共振弹性成像，非酒精性脂肪肝，剪切波弹性成像，振动控制瞬态弹性成像