• 四川大學(xué)華西醫(yī)院放射科（成都 610041）;

目的 綜合評述當(dāng)前各種磁共振成像（magnetic resonance imaging，MRI）技術(shù)在診斷肝臟纖維化中的應(yīng)用現(xiàn)狀。
方法 收集國內(nèi)、外最新相關(guān)文獻，總結(jié)各種MRI技術(shù)在肝臟纖維化中的應(yīng)用及研究進展。
結(jié)果 用于評價肝臟纖維化的MRI技術(shù)包括常規(guī)增強掃描、雙對比增強掃描和各種功能性MR技術(shù)。常規(guī)增強掃描可以觀察纖維化引起的肝臟形態(tài)學(xué)改變，對分級價值不大; 雙對比增強掃描能顯著提高肝臟纖維化的對比-噪聲比（contrast to noise ratio,CNR）; 各種功能性MR技術(shù)除了能診斷肝臟纖維化外，還能對其嚴重程度進行分級。
結(jié)論 MRI尤其是功能性MRI技術(shù)發(fā)展迅速，在肝臟纖維化診斷和嚴重程度評價中具有廣闊應(yīng)用前景。

引用本文： 劉曦嬌,宋彬. MRI技術(shù)評價肝臟纖維化的應(yīng)用進展. 中國普外基礎(chǔ)與臨床雜志, 2010, 17(3): 298-301. doi: 復(fù)制

1. Iredale JP. Models of liver fibrosis: exploring the dynamic nature of inflammation and repair in a solid organ [J]. J Clin Invest, 2007; 117(3): 539548.
2. 王瑾, 馬韻. 肝臟纖維化形式和逆轉(zhuǎn)的研究進展 [J]. 醫(yī)學(xué)研究雜志, 2009; 38(3): 8889.
3. Wallace K, Burt AD, Wright MC. Liver fibrosis [J]. Biochem J, 2008; 411(1): 118.
4. Afdhal NH, Nunes D. Evaluation of liver fibrosis: a concise review [J]. Am J Gastroenterol， 2004; 99(6): 11601174.
5. Sebastiani G, Alberti A. Non invasive fibrosis biomarkers reduce but not substitute the need for liver biopsy [J]. World J Gastroenterol, 2006; 12(23): 36823694.
6. Martin DR. Magnetic resonance imaging of diffuse liver diseases [J]. Top Magn Reson Imaging, 2002; 13(3): 151163.
7. Ito K, Mitchell DG, Siegelman ES. Cirrhosis: MR imaging features [J]. Magn Reson Imaging Clin N Am, 2002; 10(1): 7592.
8. Balci NC, Semelka RC. Contrast agents for MR imaging of the liver [J]. Radiol Clin North Am, 2005; 43(5): 887898.
9. Helmberger T, Semelka RC. New contrast agents for imaging the liver [J]. Magn Reson Imaging Clin N Am, 2001; 9(4): 745766.
10. 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.
11. HughesCassidy F, Chavez AD, Schlang A, et al. Superparamagnetic iron oxides and low molecular weight gadolinium chelates are synergistic for direct visualization of advanced liver fibrosis [J]. J Magn Reson Imaging, 2007; 26(3): 728737.
12. 湯翔寧, 朱文珍, 王承緣. 磁共振彈性成像原理及其應(yīng)用研究 [J]. 臨床放射學(xué)雜志， 2009; 28（2）： 282285.
13. 陽寧靜, 趙黎明, 宋彬. 肝纖維化的影像學(xué)評價及進展 [J]. 中國普外基礎(chǔ)與臨床雜志， 2008; 15（3）： 218222.
14. Rouvière O, Yin M, Dresner MA, et al. MR elastography of the liver: preliminary results [J]. Radiology, 2006; 240(2): 440448.
15. Yin M, Talwalkar JA, Glaser KJ, et al. Assessment of hepatic fibrosis with magnetic resonance elastography [J]. Clin Gastroenterol Hepatol, 2007; 5(10): 12071213.
16. Huwart L, Peeters F, Sinkus R, et al. Liver fibrosis: noninvasive assessment with MR elastography [J]. NMR Biomed, 2006; 19(2): 173179.
17. Faria SC, Ganesan K, Mwangi I, et al. MR imaging of liver fibrosis: current state of the art [J]. Radiographics, 2009; 29(6): 16151635.
18. Huwart L, Sempoux C, Vicaut E, et al. Magnetic resonance elastography for the noninvasive staging of liver fibrosis [J]. Gastroenterology, 2008; 135(1): 3240.
19. 譚延斌, 張敏鳴. 肝纖維化的MRI研究進展 [J]. 國際醫(yī)學(xué)放射學(xué)雜志, 2009; 32(2): 139142.
20. 王秋實, 鄒艷， 劉輝， 等. 肝纖維化MR彌散加權(quán)成像與病理的對照研究 [J]. 南方醫(yī)科大學(xué)學(xué)報, 2009; 29（10）： 19651968.
21. Koinuma M, Ohashi I, Hanafusa K, et al. Apparent diffusion coefficient measurements with diffusionweighted magnetic resonance imaging for evaluation of hepatic fibrosis [J]. J Magn Reson Imaging, 2005; 22(1): 8085.
22. Taouli B, Tolia AJ, Losada M, et al. Diffusionweighted MRI for quantification of liver fibrosis: preliminary experience [J]. AJR Am J Roentgenol, 2007; 189(4): 799806.
23. Lewin M, PoujolRobert A, Bolle PY, et al. Diffusionweighted magnetic resonance imaging for the assessment of fibrosis in chronic hepatitis C [J]. Hepatology, 2007; 46(3): 658665.
24. Boulanger Y, Amara M, Lepanto L, et al. Diffusionweighted MR imaging of the liver of hepatitis C patients [J]. NMR Biomed, 2003; 16(3): 132136.
25. Hollingsworth KG, Lomas DJ. Influence of perfusion on hepatic MR diffusion measurement [J]. NMR Biomed, 2006; 19(2): 231235.
26. Girometti R, Furlan A, Esposito G, et al. Relevance of bvalues in evaluating liver fibrosis: a study in healthy and cirrhotic subjects using two singleshot spinecho echoplanar diffusionweighted sequences [J]. J Magn Reson Imaging, 2008; 28(2): 411419.
27. Hagiwara M, Rusinek H, Lee VS, et al. Advanced liver fibrosis: diagnosis with 3D wholeliver perfusion MR imaging-initial experience [J]. Radiology, 2008; 246(3): 926934.
28. Kubo H, Harada M, Ishikawa M, et al. Hemodynamic changes with liver fibrosis measured by dynamic contrastenhanced MRI in the rat [J]. Magn Reson Med Sci, 2006; 5(2): 6571.
29. Miyazaki S, Yamazaki Y, Murase K. Error analysis of the quantification of hepatic perfusion using a dualinput singlecompartment model [J]. Phys Med Biol, 2008; 53(21): 59275946.
30. Orlacchio A, Bolacchi F, Angelico M, et al. In vivo, highfield, 3Tesla 1H MR spectroscopic assessment of liver fibrosis in HCVcorrelated chronic liver disease [J]. Radiol Med, 2008; 113(2): 289299.
31. 吳苾， 宋彬， 周翔平， 等. 慢性病毒性肝炎患者磁共振31P波譜與病理表現(xiàn)的關(guān)系 [J]. 中華肝臟病雜志, 2007; 15(5): 338341.
32. Noren B, Dahlqvist O, Lundberg P, et al. Separation of advanced from mild fibrosis in diffuse liver disease using 31P magnetic resonance spectroscopy [J]. Eur J Radiol, 2008; 66(2): 313320.
33. Noren B, Dahlqvist O, Lundberg P, et al. Separation of advanced from mild fibrosis in diffuse liver disease using 31P magnetic resonance spectroscopy [J]. Eur J Radiol, 2008; 66(2): 313320.
  1. 1. Iredale JP. Models of liver fibrosis: exploring the dynamic nature of inflammation and repair in a solid organ [J]. J Clin Invest, 2007; 117(3): 539548.
  2. 2. 王瑾, 馬韻. 肝臟纖維化形式和逆轉(zhuǎn)的研究進展 [J]. 醫(yī)學(xué)研究雜志, 2009; 38(3): 8889.
  3. 3. Wallace K, Burt AD, Wright MC. Liver fibrosis [J]. Biochem J, 2008; 411(1): 118.
  4. 4. Afdhal NH, Nunes D. Evaluation of liver fibrosis: a concise review [J]. Am J Gastroenterol， 2004; 99(6): 11601174.
  5. 5. Sebastiani G, Alberti A. Non invasive fibrosis biomarkers reduce but not substitute the need for liver biopsy [J]. World J Gastroenterol, 2006; 12(23): 36823694.
  6. 6. Martin DR. Magnetic resonance imaging of diffuse liver diseases [J]. Top Magn Reson Imaging, 2002; 13(3): 151163.
  7. 7. Ito K, Mitchell DG, Siegelman ES. Cirrhosis: MR imaging features [J]. Magn Reson Imaging Clin N Am, 2002; 10(1): 7592.
  8. 8. Balci NC, Semelka RC. Contrast agents for MR imaging of the liver [J]. Radiol Clin North Am, 2005; 43(5): 887898.
  9. 9. Helmberger T, Semelka RC. New contrast agents for imaging the liver [J]. Magn Reson Imaging Clin N Am, 2001; 9(4): 745766.
  10. 10. 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.
  11. 11. HughesCassidy F, Chavez AD, Schlang A, et al. Superparamagnetic iron oxides and low molecular weight gadolinium chelates are synergistic for direct visualization of advanced liver fibrosis [J]. J Magn Reson Imaging, 2007; 26(3): 728737.
  12. 12. 湯翔寧, 朱文珍, 王承緣. 磁共振彈性成像原理及其應(yīng)用研究 [J]. 臨床放射學(xué)雜志， 2009; 28（2）： 282285.
  13. 13. 陽寧靜, 趙黎明, 宋彬. 肝纖維化的影像學(xué)評價及進展 [J]. 中國普外基礎(chǔ)與臨床雜志， 2008; 15（3）： 218222.
  14. 14. Rouvière O, Yin M, Dresner MA, et al. MR elastography of the liver: preliminary results [J]. Radiology, 2006; 240(2): 440448.
  15. 15. Yin M, Talwalkar JA, Glaser KJ, et al. Assessment of hepatic fibrosis with magnetic resonance elastography [J]. Clin Gastroenterol Hepatol, 2007; 5(10): 12071213.
  16. 16. Huwart L, Peeters F, Sinkus R, et al. Liver fibrosis: noninvasive assessment with MR elastography [J]. NMR Biomed, 2006; 19(2): 173179.
  17. 17. Faria SC, Ganesan K, Mwangi I, et al. MR imaging of liver fibrosis: current state of the art [J]. Radiographics, 2009; 29(6): 16151635.
  18. 18. Huwart L, Sempoux C, Vicaut E, et al. Magnetic resonance elastography for the noninvasive staging of liver fibrosis [J]. Gastroenterology, 2008; 135(1): 3240.
  19. 19. 譚延斌, 張敏鳴. 肝纖維化的MRI研究進展 [J]. 國際醫(yī)學(xué)放射學(xué)雜志, 2009; 32(2): 139142.
  20. 20. 王秋實, 鄒艷， 劉輝， 等. 肝纖維化MR彌散加權(quán)成像與病理的對照研究 [J]. 南方醫(yī)科大學(xué)學(xué)報, 2009; 29（10）： 19651968.
  21. 21. Koinuma M, Ohashi I, Hanafusa K, et al. Apparent diffusion coefficient measurements with diffusionweighted magnetic resonance imaging for evaluation of hepatic fibrosis [J]. J Magn Reson Imaging, 2005; 22(1): 8085.
  22. 22. Taouli B, Tolia AJ, Losada M, et al. Diffusionweighted MRI for quantification of liver fibrosis: preliminary experience [J]. AJR Am J Roentgenol, 2007; 189(4): 799806.
  23. 23. Lewin M, PoujolRobert A, Bolle PY, et al. Diffusionweighted magnetic resonance imaging for the assessment of fibrosis in chronic hepatitis C [J]. Hepatology, 2007; 46(3): 658665.
  24. 24. Boulanger Y, Amara M, Lepanto L, et al. Diffusionweighted MR imaging of the liver of hepatitis C patients [J]. NMR Biomed, 2003; 16(3): 132136.
  25. 25. Hollingsworth KG, Lomas DJ. Influence of perfusion on hepatic MR diffusion measurement [J]. NMR Biomed, 2006; 19(2): 231235.
  26. 26. Girometti R, Furlan A, Esposito G, et al. Relevance of bvalues in evaluating liver fibrosis: a study in healthy and cirrhotic subjects using two singleshot spinecho echoplanar diffusionweighted sequences [J]. J Magn Reson Imaging, 2008; 28(2): 411419.
  27. 27. Hagiwara M, Rusinek H, Lee VS, et al. Advanced liver fibrosis: diagnosis with 3D wholeliver perfusion MR imaging-initial experience [J]. Radiology, 2008; 246(3): 926934.
  28. 28. Kubo H, Harada M, Ishikawa M, et al. Hemodynamic changes with liver fibrosis measured by dynamic contrastenhanced MRI in the rat [J]. Magn Reson Med Sci, 2006; 5(2): 6571.
  29. 29. Miyazaki S, Yamazaki Y, Murase K. Error analysis of the quantification of hepatic perfusion using a dualinput singlecompartment model [J]. Phys Med Biol, 2008; 53(21): 59275946.
  30. 30. Orlacchio A, Bolacchi F, Angelico M, et al. In vivo, highfield, 3Tesla 1H MR spectroscopic assessment of liver fibrosis in HCVcorrelated chronic liver disease [J]. Radiol Med, 2008; 113(2): 289299.
  31. 31. 吳苾， 宋彬， 周翔平， 等. 慢性病毒性肝炎患者磁共振31P波譜與病理表現(xiàn)的關(guān)系 [J]. 中華肝臟病雜志, 2007; 15(5): 338341.
  32. 32. Noren B, Dahlqvist O, Lundberg P, et al. Separation of advanced from mild fibrosis in diffuse liver disease using 31P magnetic resonance spectroscopy [J]. Eur J Radiol, 2008; 66(2): 313320.
  33. 33. Noren B, Dahlqvist O, Lundberg P, et al. Separation of advanced from mild fibrosis in diffuse liver disease using 31P magnetic resonance spectroscopy [J]. Eur J Radiol, 2008; 66(2): 313320.