CAJ | 학술논문

肝纤维化程度的不断进展直接影响到患者的治疗方案及预后。早期诊断肝纤维化分级并进行动态监测是目前临床急需的技术。无创诊断技术能避免或减少肝活组织检查来早期识别肝纤维化，并能进行动态监测，有着重要的临床应用价值。但因各种局限性也使其应用受到限制。肝脏弹性仪器不同型号探头的使用、脂肪衰减量的检测（CAP系统）、脾脏硬度检测、超声影像引导下的肝脏硬度检测以及通过肝脏弹性检测早期预测原发性肝癌等无创诊断技术已在临床研究中实践。为了更好地理解和应用这些诊断模型，针对目前无创诊断肝纤维化在临床研究的进展以及其局限性进行探讨。
간섬유화정도적불단진전직접영향도환자적치료방안급예후。조기진단간섬유화분급병진행동태감측시목전림상급수적기술。무창진단기술능피면혹감소간활조직검사래조기식별간섬유화，병능진행동태감측，유착중요적림상응용개치。단인각충국한성야사기응용수도한제。간장탄성의기불동형호탐두적사용、지방쇠감량적검측（CAP계통）、비장경도검측、초성영상인도하적간장경도검측이급통과간장탄성검측조기예측원발성간암등무창진단기술이재림상연구중실천。위료경호지리해화응용저사진단모형，침대목전무창진단간섬유화재림상연구적진전이급기국한성진행탐토。
The progression of liver fibrosis directly affects treatment options and prognosis.Early diagnosis and classification of liver fibrosis and dynamic monitoring are clinically needed.Noninvasive diagnostic techniques can avoid or reduce liver biopsy to enable early identifica-tion of liver fibrosis and to dynamically monitor the progression of fibrosis.But various limitations have restricted its application.Noninvasive diagnostic techniques,such as liver transient elastography using the different probe mode,controlled attenuation parameter,spleen stiffness measurement,ultrasound-based transient elastography for the early prediction of hepatic fibrosis,and risk assessment of hepatitis B virus-related hepatocellular carcinoma,have been applied in clinical studies.In order to better understand and apply these diagnostic models,the progress in clinical studies of noninvasive diagnosis of liver fibrosis,as well as the limitations,is reviewed.