彌漫性肝臟實質疾病的CT和MRI評價_《中國普外基礎與臨床雜志》

作者：

陳錦秀 , 陳光文 , 宋彬

四川大學華西醫院放射科（成都 610041）;

關鍵詞：

彌漫性肝臟實質疾病多排螺旋CT 磁共振成像

視頻：

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的綜合評述當前多排螺旋CT（multi-detector row CT, MDCT）和各種磁共振成像（magnetic resonance imaging，MRI）技術在評價彌漫性肝臟實質疾病中的價值。
方法收集國內、外最新相關文獻，總結MDCT和各種MRI技術在評價各類彌漫性肝臟實質疾病中的應用及研究進展。結果彌漫性肝實質疾病種類繁多，分為儲存性、血管性及炎性疾病3大類。MDCT能夠較好地顯示肝臟彌漫性疾病的形態學變化，MRI尤其是MR功能成像除了反映形態學變化外，還能夠反映肝臟細胞代謝活動情況，從而為肝臟彌漫性疾病的診斷及療效評估提供定性和定量的信息。
結論影像學技術尤其是功能性MRI技術發展迅速，在彌漫性肝臟實質疾病的診斷和嚴重程度評價中具有較好的應用前景。

引用本文： 陳錦秀,陳光文,宋彬. 彌漫性肝臟實質疾病的CT和MRI評價. 中國普外基礎與臨床雜志, 2010, 17(2): 195-199. doi: 復制

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8.	Ros PR, Ji H. Special focus session: multisection (multidetector) CT: applications in the abdomen [J]. Radiographics， 2002; 22(3): 697700.
9.	Raptopoulos V, Karellas A, Bernstein J, et al. Value of dualenergy CT in differentiating focal fatty infiltration of the liver from lowdensity masses [J]. AJR Am J Roentgenol， 1991; 157(4): 721725.
10.	Hamer OW, Aguirre DA, Casola G, et al. Imaging features of perivascular fatty infiltration of the liver: initial observations [J]. Radiology， 2005; 237(1): 159169.
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13.	Levenson H, Greensite F, Hoefs J, et al. Fatty infiltration of the liver: quantification with phasecontrast MR imaging at 1.5 T vs biopsy [J]. AJR Am J Roentgenol， 1991; 156(2): 307312.
14.	KatzBrull R, Rofsky NM, Lenkinski RE. Breathhold abdominal and thoracic proton MR spectroscopy at 3 T [J]. Magn Reson Med， 2003; 50(3): 461467.
15.	Chmelík M, Schmid AI, Gruber S, et al. Threedimensional highresolution magnetic resonance spectroscopic imaging for absolute quantification of 31P metabolites in human liver [J]. Magn Reson Med， 2008; 60(4): 796802.
16.	Kim YK, Kim CS, Lee YH, et al. Comparison of superparamagnetic iron oxideenhanced and gadobenate dimeglumineenhanced dynamic MRI for detection of small hepatocellular carcinomas [J]. AJR Am J Roentgenol， 2004; 182(5): 12171223.
17.	王秋實, 郭啟勇, 梁長虹，等. MR彌散加權成像評價肝纖維化的初步實驗研究 [J]. 解剖學研究， 2007; 29(3): 212216.
18.	管生, 趙衛東, 周康榮，等. 磁共振彌散功能成像對肝臟早期彌漫性病變診斷價值的試驗研究 [J]. 中華肝病雜志， 2005; 13（7）: 524527.
19.	Xu L, Gao PY. “Palpation by imaging”： magnetic resonance elastography [J]. Chin Med Sci J， 2006; 21(4): 281286.
20.	Cobbold JF, Morin S, TaylorRobinson SD. Transient elastography for the assessment of chronic liver disease: ready for the clinic? [J]. World J Gastroenterology， 2007; 13(36): 47914797.
21.	Garbow JR, Lin X, Sakata N, et al. In vivo MRS measurement of liver lipid levels in mice [J]. J Lipid Res, 2004; 45(7): 13641371.
22.	Thomas EL, Hamilton G, Patel N, et al. Hepatic triglyceride content and its relation to body adiposity: a magnetic resonance imaging and proton magnetic resonance spectroscopy study [J]. Gut, 2005; 54(1): 122127.
23.	Szczepaniak LS, Nurenberg P, Leonard D, et al. Magnetic resonance spectroscopy to measure hepatic triglyceride content: prevalence of hepatic steatosis in the general population [J]. Am J Physiol Endocrinol Metab, 2005; 288(2): E462 E468.
24.	Alústiza JM, Artetxe J, Castiella A, et al. MR quantification of hepatic iron concentration [J]. Radiology， 2004; 230(2): 479484.
25.	Westphalen AC, Qayyum A, Yeh BM, et al. Liver fat: effect of hepatic iron deposition on evaluation with opposedphase MR imaging [J]. Radiology， 2007; 242(2): 450455.
26.	Gandon Y, Olivié D, Guyader D, et al. Noninvasive assessment of hepatic iron stores by MRI [J]. Lancet， 2004; 363(9406): 357362.
27.	Andrews NC. Disorders of iron metabolism [J]. N Engl J Med， 1999; 341（26）: 19861995.
28.	Horton KM, Bluemke DA, Hruban RH, et al. CT and MR imaging of benign hepatic and biliary tumors [J]. Radiographics， 1999; 19（2）: 431451.
29.	Lorigan JG, Charnsangavej C, Carrasco CH, et al. Atrophy with compensatory hypertrophy of the liver in hepatic neoplasms: radiographic findings [J]. AJR Am J Roentgenol， 1988; 150（6）: 12911295.
30.	Mathieu D, Vasile N, Menu Y, et al. BuddChiari syndrome: dynamic CT [J]. Radiology， 1987; 165（2）: 409413.
31.	Kawamoto S, Soyer PA, Fishman EK, et al. Nonneoplastic liver disease: evaluation with CT and MR imaging [J]. Radiographics， 1998; 18（4）: 827848.
32.	Proujansky R, Vinton N. Acute hepatitis [J]. Adolesc Med， 1995; 6（3）: 437446.
33.	Semelka RC, Kelekis NL, Sallah S, et al. Hepatosplenic fungal disease: diagnostic accuracy and spectrum of appearances on MR imaging [J]. AJR Am J Roentgenol， 1997; 169（5）: 13111316.
34.	Sallah S, Semelka RC, Wehbie R, et al. Hepatosplenic candidiasis in patients with acute leukaemia [J]. Br J Haematol， 1999; 106（3）: 697701.
35.	Thanos L, Zormpala A, Brountzos E, et al. Nodular hepatic and splenic sarcoidosis in a patient with normal chest radiograph [J]. Eur J Radiol， 2002; 41（1）: 1011.
36.	Sakai T, Maeda M, Takabatake M, et al. MR imaging of hepatosplenic sarcoidosis [J]. Radiat Med， 1995; 13（1）: 3941.

1. Clark JM, Diehl AM. Nonalcoholic fatty liver disease: an underrecognized cause of cryptogenic cirrhosis [J]. JAMA， 2003; 289（22）: 30003004.
2. Brunt EM. Nonalcoholic steatohepatitis: definition and pathology [J]. Semin Liver Dis， 2001; 21（1）: 316.
3. Bravo AA, Sheth SG, Chopra S. Liver biopsy [J]. N Engl J Med ， 2001; 344(7): 495500.
4. Siegelman ES, Mitchell DG, Semelka RC. Abdominal iron deposition: metabolism, MR findings, and clinical importance [J]. Radiology， 1996; 199（1）: 1322.
5. Adams P, Brissot P, Powell LW. EASL International Consensus Conference on Haemochromatosis [J]. J Hepatol， 2000; 33(3): 485504.
6. Brissot P, Bourel M, Herry D, et al. Assessment of liver iron content in 271 patients: a reevaluation of direct and indirect methods [J]. Gastroenterology， 1981; 80(3): 557565.
7. Abenoza P, Sibley RK. Farber’s disease: a fine structural study [J]. Ultrastruct Pathol， 1987; 11(4): 397403.
8. Ros PR, Ji H. Special focus session: multisection (multidetector) CT: applications in the abdomen [J]. Radiographics， 2002; 22(3): 697700.
9. Raptopoulos V, Karellas A, Bernstein J, et al. Value of dualenergy CT in differentiating focal fatty infiltration of the liver from lowdensity masses [J]. AJR Am J Roentgenol， 1991; 157(4): 721725.
10. Hamer OW, Aguirre DA, Casola G, et al. Imaging features of perivascular fatty infiltration of the liver: initial observations [J]. Radiology， 2005; 237(1): 159169.
11. Guyader D, Gandon Y, Deugnier Y, et al. Evaluation of computed tomography in the assessment of liver iron overload. A study of 46 cases of idiopathic hemochromatosis [J]. Gastroenterology， 1989; 97(3): 737743.
12. Howard JM, Ghent CN, Carey LS, et al. Diagnostic efficacy of hepatic computed tomography in the detection of body iron overload [J]. Gastroenterology， 1983; 84(2): 209215.
13. Levenson H, Greensite F, Hoefs J, et al. Fatty infiltration of the liver: quantification with phasecontrast MR imaging at 1.5 T vs biopsy [J]. AJR Am J Roentgenol， 1991; 156(2): 307312.
14. KatzBrull R, Rofsky NM, Lenkinski RE. Breathhold abdominal and thoracic proton MR spectroscopy at 3 T [J]. Magn Reson Med， 2003; 50(3): 461467.
15. Chmelík M, Schmid AI, Gruber S, et al. Threedimensional highresolution magnetic resonance spectroscopic imaging for absolute quantification of 31P metabolites in human liver [J]. Magn Reson Med， 2008; 60(4): 796802.
16. Kim YK, Kim CS, Lee YH, et al. Comparison of superparamagnetic iron oxideenhanced and gadobenate dimeglumineenhanced dynamic MRI for detection of small hepatocellular carcinomas [J]. AJR Am J Roentgenol， 2004; 182(5): 12171223.
17. 王秋實, 郭啟勇, 梁長虹，等. MR彌散加權成像評價肝纖維化的初步實驗研究 [J]. 解剖學研究， 2007; 29(3): 212216.
18. 管生, 趙衛東, 周康榮，等. 磁共振彌散功能成像對肝臟早期彌漫性病變診斷價值的試驗研究 [J]. 中華肝病雜志， 2005; 13（7）: 524527.
19. Xu L, Gao PY. “Palpation by imaging”： magnetic resonance elastography [J]. Chin Med Sci J， 2006; 21(4): 281286.
20. Cobbold JF, Morin S, TaylorRobinson SD. Transient elastography for the assessment of chronic liver disease: ready for the clinic? [J]. World J Gastroenterology， 2007; 13(36): 47914797.
21. Garbow JR, Lin X, Sakata N, et al. In vivo MRS measurement of liver lipid levels in mice [J]. J Lipid Res, 2004; 45(7): 13641371.
22. Thomas EL, Hamilton G, Patel N, et al. Hepatic triglyceride content and its relation to body adiposity: a magnetic resonance imaging and proton magnetic resonance spectroscopy study [J]. Gut, 2005; 54(1): 122127.
23. Szczepaniak LS, Nurenberg P, Leonard D, et al. Magnetic resonance spectroscopy to measure hepatic triglyceride content: prevalence of hepatic steatosis in the general population [J]. Am J Physiol Endocrinol Metab, 2005; 288(2): E462 E468.
24. Alústiza JM, Artetxe J, Castiella A, et al. MR quantification of hepatic iron concentration [J]. Radiology， 2004; 230(2): 479484.
25. Westphalen AC, Qayyum A, Yeh BM, et al. Liver fat: effect of hepatic iron deposition on evaluation with opposedphase MR imaging [J]. Radiology， 2007; 242(2): 450455.
26. Gandon Y, Olivié D, Guyader D, et al. Noninvasive assessment of hepatic iron stores by MRI [J]. Lancet， 2004; 363(9406): 357362.
27. Andrews NC. Disorders of iron metabolism [J]. N Engl J Med， 1999; 341（26）: 19861995.
28. Horton KM, Bluemke DA, Hruban RH, et al. CT and MR imaging of benign hepatic and biliary tumors [J]. Radiographics， 1999; 19（2）: 431451.
29. Lorigan JG, Charnsangavej C, Carrasco CH, et al. Atrophy with compensatory hypertrophy of the liver in hepatic neoplasms: radiographic findings [J]. AJR Am J Roentgenol， 1988; 150（6）: 12911295.
30. Mathieu D, Vasile N, Menu Y, et al. BuddChiari syndrome: dynamic CT [J]. Radiology， 1987; 165（2）: 409413.
31. Kawamoto S, Soyer PA, Fishman EK, et al. Nonneoplastic liver disease: evaluation with CT and MR imaging [J]. Radiographics， 1998; 18（4）: 827848.
32. Proujansky R, Vinton N. Acute hepatitis [J]. Adolesc Med， 1995; 6（3）: 437446.
33. Semelka RC, Kelekis NL, Sallah S, et al. Hepatosplenic fungal disease: diagnostic accuracy and spectrum of appearances on MR imaging [J]. AJR Am J Roentgenol， 1997; 169（5）: 13111316.
34. Sallah S, Semelka RC, Wehbie R, et al. Hepatosplenic candidiasis in patients with acute leukaemia [J]. Br J Haematol， 1999; 106（3）: 697701.
35. Thanos L, Zormpala A, Brountzos E, et al. Nodular hepatic and splenic sarcoidosis in a patient with normal chest radiograph [J]. Eur J Radiol， 2002; 41（1）: 1011.
36. Sakai T, Maeda M, Takabatake M, et al. MR imaging of hepatosplenic sarcoidosis [J]. Radiat Med， 1995; 13（1）: 3941.

《中國普外基礎與臨床雜志》

彌漫性肝臟實質疾病的CT和MRI評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

《中國普外基礎與臨床雜志》

彌漫性肝臟實質疾病的CT和MRI評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料