为在 hemochromatosis 的肝纤维变性预言的非侵略的方法: 一个步骤在远处

• 作者: Agustin Castiella Eva Zapata José M Alústiza
• 来源期刊: 世界肝病学杂志：英文版（电子版）
• 学科: 医学
• 关键词: HEMOCHROMATOSIS Iron OVERLOAD Liver FIBROSIS NON-INVASIVE Magnetic resonance imaging Ultrasound ELASTOGRAPHY
• 年，卷（期）: 2010,（7）
• 页码范围: 251-255
• 页数: 5页
• 分类号: R285

摘要

Advances in recent years in the understanding of, and the genetic diagnosis of hereditary hemochromatosis (HH) have changed the approach to iron overload he-reditary diseases. The ability to use a radiologic tool (MRI) that accurately provides liver iron concentration determination, and the presence of non-invasive sero-logic markers for fibrosis prediction (ser um ferritin, platelet count, transaminases, etc), have diminished the need for liver biopsy for diagnosis and prognosis of this disease. Consequently, the role of liv er biopsy in iron metabolism disorders is changing. Furthermore, the irruption of transient elastography to assess liver stiffness, and, more recently, the ability to determine liver f ibrosis by means of MRI elastography will change this role even more, with a potential drastic decline in hepatic biopsies in years to come. This review will provide a brief summary of the different non-invasive methods available nowadays for diagnosis and prognosis in HH, and point out potential new techniques that could come about in the next years for fibrosis prediction, thus avoiding the need for liver biopsy in a greater number of patients. It is possible that liver biopsy will remain useful for the diagnosis of associated diseases, where other non-invasive means are not po-ssible, or for those rare cases displaying discrepancies between radiological and biochemical markers.