Медицинская литература. Новинки

 

 

 

 

 

 

Обзор международных клинических рекомендаций и результатов клинических исследований по диагностике гепатоцеллюлярного рака за 2014-2020 годы

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Цель. Анализ международных клинических рекомендаций и данных клинических исследований, посвященных диагностике гепатоцеллюлярного рака, демонстрация возможностей МРТ с гепатоспецифическим контрастным средством и оценка диагностических преимуществ метода по сравнению с УЗИ, КТ и МРТ с внеклеточными контрастными препаратами. Материал и методы. Проведен поиск научных публикаций и клинических рекомендаций в информационно-аналитической системе PubMed за 2014-2020 гг. по ключевым словам: “HCC” (гепатоцеллюлярный рак), “US” (УЗИ), “СТ” (КТ), “MRI” (МРТ), “gadoxetic acid” (гадоксетовая кислота). Отобраны резюме 331 статьи. После исключения исследований, посвященных техническим аспектам и описанию отдельных клинических наблюдений, а также анализа полного текста статей были отобраны 32 публикации. Результаты. Представленный обзор продемонстрировал диагностические преимущества МРТ с гепатоспецифическим контрастным средством, а также широкий спектр ее применения на всех этапах оказания помощи пациенту с гепатоцеллюлярным раком. Заключение. Несмотря на существующее многообразие методов диагностики гепатоцеллюлярного рака, передовым направлением в настоящее время является МРТ с гадоксетовой кислотой. Высокая диагностическая эффективность гадоксетовой кислоты позволяет увеличить точность исследования и в конечном итоге выбрать оптимальную тактику ведения пациента.

Ключевые слова:
печень, гепатоцеллюлярный рак, МРТ, КТ, УЗИ, гадоксетовая кислота, диспластические узлы, liver, hepatocellular carcinoma, MRI, CT, ultrasound, gadoxetic acid, dysplastic nodes

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The review of international clinical guidelines and clinical trial results for the diagnosis of hepatocellular cancer (HCC) for the period 2014-2020

The purpose of this publication is to analyze international clinical guidelines and clinical trial data on the diagnosis of hepatocellular carcinoma and demonstrate the possibilities of using MRI with hepatobiliary magnetic resonance contrast agent. As well as an evaluation its diagnostic advantages in comparison with other diagnostic methods such as ultrasound, CT and MRI with extracellular contrast agents. Material and methods. Abstracts of 331 scientific articles for the period 2014-2020 were selected in the PubMed information and analytical system for the keywords: “hepatocellular carcinoma”, “US”, “CT”, “MRI”, “gadoxetic acid”. Articles about technical aspects and clinical cases were excluded. After the analysis of full-text articles, 32 pub lications were selected. Results. The presented review has demonstrated the diagnostic advantages of MRI with hepatobiliary magnetic resonance contrast agents and a wide range of its application at all stages of care for a patient with hepatocellular carcinoma. Conclusion. Despite the existing variety of methods for diagnosing hepatocellular carcinoma, the leading direction in this area is currently MRI with gadoxetic acid. The high diagnostic efficiency of gadoxetic acid makes it possible to increase the accuracy of the imaging and to choose the optimal management for each patient.

Keywords:
печень, гепатоцеллюлярный рак, МРТ, КТ, УЗИ, гадоксетовая кислота, диспластические узлы, liver, hepatocellular carcinoma, MRI, CT, ultrasound, gadoxetic acid, dysplastic nodes