非侵襲性影像檢查對於肝纖維化的診斷與影響

10.6666/ClinMed.201910_84(4).0113

李承翰；許朝偉

肝纖維化（liver fibrosis） ； 纖維化掃描（fibroscan） ； 彈性造影（elastography）

臨床醫學月刊

84卷4期（2019 / 10 / 25）

683 - 691

繁體中文

肝纖維化程度的評估，對於慢性肝炎的診療是非常重要的。造成肝纖維化最常見的原因有：慢性B型肝炎、慢性C型肝炎、酒精性肝炎甚至脂肪肝。肝臟纖維化主要是由於肝組織的破壞，接著由疤痕組織（scar tissue）取代而形成。肝生檢是評估肝纖維化的黃金準則，然其侵襲性和取樣誤差一直是存在的問題，隨著影像檢查技術的進步，用以探測肝纖維化的方法也隨之增加，包含：傳統超音波、顯影劑超音波（contrast-enhanced ultrasound，CEUS）、電腦斷層、核磁共振影像，此外更有肝臟彈性造影檢查（liver elastography examinations），是利用原有的超音波或核磁共振影像為基底，專門針對肝纖維化的新一代檢查，其原理跟檢查的方式將回在本文中介紹，隨著各種非侵襲性的檢查正在逐漸發展成熟並且投入臨床應用，希望能夠帶給慢性肝炎患者更多元診療的選擇。

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