Assessing Liver Fibrosis with Non-Invasive Methods_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Guangwen , SONG Bin

Department of Radiology，West China Hospital, Sichuan University， Chengdu 610041， China;

Corresponding author：

Keywords：

Liver fibrosis; Serum marker; Ultrasound; Computed tomography/X-ray; Magnetic resonance imaging

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Objective To assess value and limitations of non-invasive methods in assessing liver fibrosis．Methods By summarized current situation and advancement of serum fibrotic markers, ultrasound, CT and MRI in assessing liver fibrosis, we investigated their value and limitations. Results In addition to diagnosis, non-invasive methods of assessing liver fibrosis assess severity of liver fibrosis. For liver fibrosis, however, non-invasive methods can not monitor effectively reaction to therapy and progression. Conclusion Non-invasive methods play important roles in diagnosis and assessing severity of liver fibrosis, and reduce the need of liver biopsy.

Citation： CHEN Guangwen,SONG Bin. Assessing Liver Fibrosis with Non-Invasive Methods. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(5): 414-417. doi: Copy

1.	Standish RA, Cholongitas E, Dhillon A, et al. An appraisal of the histopathological assessment of liver fibrosis [Ｊ]. Gut, 2006; 55(4): 569-578.
2.	Grant A, Neuberger J. Guidelines on the use of liver biopsy in clinical practice. British Society of Gastroenterology [Ｊ]. Gut, 1999; 45(Suppl 4): Ⅳ1-Ⅳ11.
3.	Pinzani M. Non-invasive evaluation of hepatic fibrosis: don’t count your chickens before they’re hatched [Ｊ]. Gut, 2006; 55(3): 310-312.
4.	Sebastiani G, Vario A, Guido M, et al. Sequential algorithms combining non-invasive markers and biopsy for the assessment of liver fibrosis in chronic hepatitis B [Ｊ]. World J Gastroenterol, 2007; 13(4): 525-531.
5.	Guha IN, Parkes J, Roderick PR, et al. Non-invasive markers associated with liver fibrosis in non-alcoholic fatty liver disease [Ｊ]. Gut, 2006; 55(11): 1650-1660.
6.	Poynard T, Morra R, Halfon P, et al. Meta-analyses of FibroTest diagnostic value in chronic liver disease [Ｊ]. BMC Gastroenterol, 2007; 7: 40.
7.	Rossi E, Adams LA, Bulsara M, et al. Assessing liver fibrosis with serum marker models [Ｊ]. Clin Biochem Rev, 2007; 28(1): 3-10.
8.	Halfon P, Bourlière M, Pénaranda G, et al. Accuracy of hyaluronic acid level for predicting liver fibrosis stages in patients with hepatitis C virus [Ｊ]. Comp Hepatol, 2005; 4: 6.
9.	Rosenberg WM, Voelker M, Thiel R, et al. Serum markers detect the presence of liver fibrosis: a cohort study [Ｊ]. Gastroenterology, 2004; 127(6): 1704-1713.
10.	Shen L, Li JQ, Zeng MD, et al. C Correlation between ultrasonographic and pathologic diagnosis of liver fibrosis due to chronic virus hepatitis [Ｊ]. World J Gastroenterol, 2006; 12(8): 1292-1295.
11.	Blomley MJ, Lim AK, Harvey CJ, et al. Liver microbubble transit time compared with histology and Child-Pugh score in diffuse liver disease: a cross sectional study [Ｊ]. Gut, 2003; 52(8): 1188-1193.
12.	Lim AK, Taylor-Robinson SD, Patel N, et al. Hepatic vein transit times using a microbubble agent can predict disease severity non-invasively in patients with hepatitis C [Ｊ]. Gut, 2005; 54(1): 128-133.
13.	罗小华, 宋彬, 陈卫霞. 慢性乙型肝炎CT表现与病情程度的关系 [Ｊ]. 中华肝脏病杂志, 2005; 13（3）: 190-193.
14.	童隆正, 王新光, 贺文. 关于CT图像肝纤维化评定标准的研究 [Ｊ]. 医疗设备信息, 2001; 12(16): 9-11.
15.	宋彬. CT灌注成像的原理、技术及在腹部影像诊断中的应用 [Ｊ]. 中国普外基础与临床杂志, 2004; 11(2): 171-174.
16.	吴苾, 宋彬. 影像学新技术在消化系统的临床应用 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(2): 222-229.
17.	江利, 杨建勇, 杨旭峰, 等. 肝脏CT灌注成像技术及其在肝硬化中的初步应用 [Ｊ]. 临床放射学杂志, 2004; 23(3): 214-217.
18.	Guan S, Zhao WD, Zhou KR, et al. CT perfusion at early stage of hepatic diffuse disease [Ｊ]. World J Gastroenterol, 2005; 11(22): 3465-3467.
19.	上海市肝纤维化课题协作组. 肝纤维化的CT、 MR 诊断初步探讨 [Ｊ]. 上海医学, 2002; 25（4）: 210-213.
20.	Ito K, Mitchell DG, Hann HW, et al. Viral-induced cirrhosis: grading of severity using MR imaging [Ｊ]. AJR Am J Roentgenol, 1999; 173(3): 591-596.
21.	陈克敏, 钟亮, 柴维敏，等. 肝纤维化门脉血流的磁共振相位对比法测定 [Ｊ]. 临床放射学杂志, 2001; 20(1): 53-55.
22.	Aguirre DA, Behling CA, Alpert E, et al. Liver fibrosis: noninvasive diagnosis with double contrast material-enhanced MR imaging [Ｊ]. Radiology, 2006; 239(2): 425-437.
23.	王秋实, 郭启勇, 梁长虹, 等. MR弥散加权成像评价肝纤维化的初步实验研究 [Ｊ].解剖学研究, 2007; 29(3): 212-216.
24.	管生, 赵卫东, 周康荣, 等. 磁共振功能弥散成像对肝脏早期弥漫性病变诊断价值的实验研究 [Ｊ]. 中华肝脏病杂志, 2005; 13（7）: 524-527.
25.	沈文, 尹建忠, 张龙江, 等. 肝纤维化和肝硬化的MR扩散成像及与病理对照、CT灌注参数的相关性研究 [Ｊ]. 临床放射学杂志, 2007; 26(10): 1000-1004.
26.	Aubé C, Racineux PX, Lebigot J, et al. Diagnosis and quantification of hepatic fibrosis with diffusion weighted MR imaging: preliminary results [Ｊ]. J Radiol, 2004; 85(3): 301-306.
27.	吴苾, 宋彬, 杨洋. 肝脏31P-MR波谱成像的临床应用 [Ｊ]. 中国普外基础与临床杂志, 2005; 12(6): 624-627.
28.	崔恩铭, 谭理连, 李志铭, 等. 健康成人肝脏31P-MR 波谱研究 [Ｊ]. 放射学实践, 2007; 22（11）: 1189-1192.
29.	崔恩铭, 谭理连, 李志铭, 等. 慢性乙型肝炎患者31P MRS 与血清肝功能相关性研究 [Ｊ]. 中国临床医学影像杂志, 2007; 18（11）: 789-792.
30.	张艺军, 郭玉峰, 周怀琪, 等. 1HMRS在定性诊断乙肝后早期肝硬化中的初步研究 [Ｊ]. 现代生物医学进展, 2007; 7（7）: 1061-1064.
31.	Xu L, Gao PY. “Palpation by imaging”: magnetic resonance elastography [Ｊ]. Chin Med Sci J, 2006; 21(4): 281-286.
32.	Cobbold JF, Morin S, Taylor-Robinson SD. Transient elastography for the assessment of chronic liver disease: ready for the clinic [Ｊ]. World J Gastroenterol, 2007; 13(36): 4791-4797.
33.	Foucher J, Chanteloup E, Vergniol J, et al. Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective study [Ｊ]. Gut, 2006; 55(3): 403-408.
34.	Moreno-Otero R, Trapero-Marugan M, Mendoza J. Liver fibrosis assessment by transient elastography in hepatitis C patients with normal alanine aminotransferase [Ｊ]. Gut, 2006; 55(7): 1055-1056.
35.	Takeda T, Yasuda T, Nakayama Y, et al. Usefulness of noninvasive transient elastography for assessment of liver fibrosis stage in chronic hepatitis C [Ｊ]. World J Gastroenterol, 2006; 12(48): 7768-7773.
36.	Fraquelli M, Rigamonti C, Casazza G, et al. Reproducibility of transient elastography in the evaluation of liver fibrosis in patients with chronic liver disease [Ｊ]. Gut, 2007; 56(7): 968-973.

1. Standish RA, Cholongitas E, Dhillon A, et al. An appraisal of the histopathological assessment of liver fibrosis [Ｊ]. Gut, 2006; 55(4): 569-578.
2. Grant A, Neuberger J. Guidelines on the use of liver biopsy in clinical practice. British Society of Gastroenterology [Ｊ]. Gut, 1999; 45(Suppl 4): Ⅳ1-Ⅳ11.
3. Pinzani M. Non-invasive evaluation of hepatic fibrosis: don’t count your chickens before they’re hatched [Ｊ]. Gut, 2006; 55(3): 310-312.
4. Sebastiani G, Vario A, Guido M, et al. Sequential algorithms combining non-invasive markers and biopsy for the assessment of liver fibrosis in chronic hepatitis B [Ｊ]. World J Gastroenterol, 2007; 13(4): 525-531.
5. Guha IN, Parkes J, Roderick PR, et al. Non-invasive markers associated with liver fibrosis in non-alcoholic fatty liver disease [Ｊ]. Gut, 2006; 55(11): 1650-1660.
6. Poynard T, Morra R, Halfon P, et al. Meta-analyses of FibroTest diagnostic value in chronic liver disease [Ｊ]. BMC Gastroenterol, 2007; 7: 40.
7. Rossi E, Adams LA, Bulsara M, et al. Assessing liver fibrosis with serum marker models [Ｊ]. Clin Biochem Rev, 2007; 28(1): 3-10.
8. Halfon P, Bourlière M, Pénaranda G, et al. Accuracy of hyaluronic acid level for predicting liver fibrosis stages in patients with hepatitis C virus [Ｊ]. Comp Hepatol, 2005; 4: 6.
9. Rosenberg WM, Voelker M, Thiel R, et al. Serum markers detect the presence of liver fibrosis: a cohort study [Ｊ]. Gastroenterology, 2004; 127(6): 1704-1713.
10. Shen L, Li JQ, Zeng MD, et al. C Correlation between ultrasonographic and pathologic diagnosis of liver fibrosis due to chronic virus hepatitis [Ｊ]. World J Gastroenterol, 2006; 12(8): 1292-1295.
11. Blomley MJ, Lim AK, Harvey CJ, et al. Liver microbubble transit time compared with histology and Child-Pugh score in diffuse liver disease: a cross sectional study [Ｊ]. Gut, 2003; 52(8): 1188-1193.
12. Lim AK, Taylor-Robinson SD, Patel N, et al. Hepatic vein transit times using a microbubble agent can predict disease severity non-invasively in patients with hepatitis C [Ｊ]. Gut, 2005; 54(1): 128-133.
13. 罗小华, 宋彬, 陈卫霞. 慢性乙型肝炎CT表现与病情程度的关系 [Ｊ]. 中华肝脏病杂志, 2005; 13（3）: 190-193.
14. 童隆正, 王新光, 贺文. 关于CT图像肝纤维化评定标准的研究 [Ｊ]. 医疗设备信息, 2001; 12(16): 9-11.
15. 宋彬. CT灌注成像的原理、技术及在腹部影像诊断中的应用 [Ｊ]. 中国普外基础与临床杂志, 2004; 11(2): 171-174.
16. 吴苾, 宋彬. 影像学新技术在消化系统的临床应用 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(2): 222-229.
17. 江利, 杨建勇, 杨旭峰, 等. 肝脏CT灌注成像技术及其在肝硬化中的初步应用 [Ｊ]. 临床放射学杂志, 2004; 23(3): 214-217.
18. Guan S, Zhao WD, Zhou KR, et al. CT perfusion at early stage of hepatic diffuse disease [Ｊ]. World J Gastroenterol, 2005; 11(22): 3465-3467.
19. 上海市肝纤维化课题协作组. 肝纤维化的CT、 MR 诊断初步探讨 [Ｊ]. 上海医学, 2002; 25（4）: 210-213.
20. Ito K, Mitchell DG, Hann HW, et al. Viral-induced cirrhosis: grading of severity using MR imaging [Ｊ]. AJR Am J Roentgenol, 1999; 173(3): 591-596.
21. 陈克敏, 钟亮, 柴维敏，等. 肝纤维化门脉血流的磁共振相位对比法测定 [Ｊ]. 临床放射学杂志, 2001; 20(1): 53-55.
22. Aguirre DA, Behling CA, Alpert E, et al. Liver fibrosis: noninvasive diagnosis with double contrast material-enhanced MR imaging [Ｊ]. Radiology, 2006; 239(2): 425-437.
23. 王秋实, 郭启勇, 梁长虹, 等. MR弥散加权成像评价肝纤维化的初步实验研究 [Ｊ].解剖学研究, 2007; 29(3): 212-216.
24. 管生, 赵卫东, 周康荣, 等. 磁共振功能弥散成像对肝脏早期弥漫性病变诊断价值的实验研究 [Ｊ]. 中华肝脏病杂志, 2005; 13（7）: 524-527.
25. 沈文, 尹建忠, 张龙江, 等. 肝纤维化和肝硬化的MR扩散成像及与病理对照、CT灌注参数的相关性研究 [Ｊ]. 临床放射学杂志, 2007; 26(10): 1000-1004.
26. Aubé C, Racineux PX, Lebigot J, et al. Diagnosis and quantification of hepatic fibrosis with diffusion weighted MR imaging: preliminary results [Ｊ]. J Radiol, 2004; 85(3): 301-306.
27. 吴苾, 宋彬, 杨洋. 肝脏31P-MR波谱成像的临床应用 [Ｊ]. 中国普外基础与临床杂志, 2005; 12(6): 624-627.
28. 崔恩铭, 谭理连, 李志铭, 等. 健康成人肝脏31P-MR 波谱研究 [Ｊ]. 放射学实践, 2007; 22（11）: 1189-1192.
29. 崔恩铭, 谭理连, 李志铭, 等. 慢性乙型肝炎患者31P MRS 与血清肝功能相关性研究 [Ｊ]. 中国临床医学影像杂志, 2007; 18（11）: 789-792.
30. 张艺军, 郭玉峰, 周怀琪, 等. 1HMRS在定性诊断乙肝后早期肝硬化中的初步研究 [Ｊ]. 现代生物医学进展, 2007; 7（7）: 1061-1064.
31. Xu L, Gao PY. “Palpation by imaging”: magnetic resonance elastography [Ｊ]. Chin Med Sci J, 2006; 21(4): 281-286.
32. Cobbold JF, Morin S, Taylor-Robinson SD. Transient elastography for the assessment of chronic liver disease: ready for the clinic [Ｊ]. World J Gastroenterol, 2007; 13(36): 4791-4797.
33. Foucher J, Chanteloup E, Vergniol J, et al. Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective study [Ｊ]. Gut, 2006; 55(3): 403-408.
34. Moreno-Otero R, Trapero-Marugan M, Mendoza J. Liver fibrosis assessment by transient elastography in hepatitis C patients with normal alanine aminotransferase [Ｊ]. Gut, 2006; 55(7): 1055-1056.
35. Takeda T, Yasuda T, Nakayama Y, et al. Usefulness of noninvasive transient elastography for assessment of liver fibrosis stage in chronic hepatitis C [Ｊ]. World J Gastroenterol, 2006; 12(48): 7768-7773.
36. Fraquelli M, Rigamonti C, Casazza G, et al. Reproducibility of transient elastography in the evaluation of liver fibrosis in patients with chronic liver disease [Ｊ]. Gut, 2007; 56(7): 968-973.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Assessing Liver Fibrosis with Non-Invasive Methods

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