中华肝脏病杂志最新文献

Gadoxetate disodium (Gd-EOB-DTPA), as a hepatocyte-specific MRI contrast agent, plays a key role in the early-stage diagnosis, differential diagnosis, and treatment evaluation of liver diseases. Gd-EOB-DTPA-enhanced MRI has been recommended as a first-line imaging diagnostic method for the diagnosis of liver lesions by clinical guidelines in many countries and regions. However, there is currently a lack of standardized management consensus to guide the clinical practice of Gd-EOB-DTPA-enhanced MRI examinations. Therefore, there is an urgent need to establish a scientifically based, full-process management protocol to improve image quality and professional standards and ensure the effectiveness of examinations. The "Expert Consensus on Standardized Management of Gadoxetate Disodium-Enhanced MRI Examinations (version 2026)" integrates the latest evidence-based data and clinical experience to standardize the entire process-from contrast agent storage management, pre-examination assessment and preparation, and operational coordination during the examination to post-examination observation guidance. In addition, it aims to enhance the professional competence and emergency response level of radiology medical personnel, thereby improving patient compliance, diminishing the incidence rate of adverse events, and providing a scientific and reliable clinical practice basis for the standardized implementation and technical promotion of Gd-EOB-DTPA-enhanced MRI examination in clinical practice.

Liver nodules are one of the common and complex clinical conditions, with certain ones developing into malignant lesions, hence significantly affecting patient prognosis. The detection rate of liver nodules has significantly improved with advances in modern imaging technology; however, there is still a lack of unified guidance on their diagnosis, treatment, and management. The "Expert Consensus on the Diagnosis, Treatment, and Management of Liver Nodules (version 2026)" systematically summarizes and standardizes aspects of liver nodules, including definition, classification, screening, diagnosis, treatment, and follow-up, through multidisciplinary collaboration based on the latest domestic and international research findings and expert clinical experience. This article emphasizes the importance of multidimensional assessment for liver nodules, including quantity, size, liver imaging reports, classification in data management systems, and pathological type. The implementation of individualized screening in high-risk populations is recommended at least once every six months starting at age 40, while for those with liver cirrhosis, malignant liver nodules, or a family history of liver cancer, screening should begin at age 30. The diagnostic strategy integrates systematic medical history, physical examination, imaging, and the detection of multiple serum marker collections. The usage of scoring models such as aMAP, GALAD, and GAAD highlights the diagnostic value of liver pathology and advocates a multidisciplinary team approach for risk assessment. Treatment plans emphasize individualization and involve etiological treatment, surgical therapy, interventional therapy, radiotherapy and systemic therapy. The aim of this consensus is to standardize the diagnosis and treatment of liver nodules, enhance precision, implement graded management, enable early differentiation between benign and malignant liver nodules, and improve patient prognosis.

With the rapid development of systemic therapy for primary hepatocellular carcinoma, how to scientifically formulate subsequent treatment strategies following first-line treatment failure has become a key issue that urgently needs to be addressed in clinical practice. In this context, developing a consensus on standardized second-line drugs that corresponds with the characteristics of patients and clinical practice in China is of significant practical importance. This consensus is based on high-level evidence-based medicine, combined with the experience of multidisciplinary experts in China, proposing unified evaluation criteria and stratified treatment recommendations for core issues such as disease progression assessment, drug resistance evaluation, and timing of switching therapy following failure of targeted therapy, immune checkpoint inhibitors, and combination therapy. In addition, it advocates for evidence-based, individualized treatment decisions that balance efficacy and safety profile, with the aim of promoting the standardization and homogenization of second-line drugs for hepatocellular carcinoma in our country, thereby providing authoritative guidance for clinical practice and effectively improving and benefiting patients' long-term survival and quality of life.