Division of Hepatogastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Taiwan, ROC.
Division of Endocrinology & Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Taiwan, ROC.
J Formos Med Assoc. 2017 Nov;116(11):852-861. doi: 10.1016/j.jfma.2017.08.010. Epub 2017 Sep 6.
BACKGROUND/PURPOSE: Controlled attenuation parameter (CAP) is a method for measuring steatosis based on FibroScan. Despite observer dependency, ultrasound (US) robustly diagnoses moderate and severe steatosis. Here, we aimed to evaluate the correlation of CAP with US-identified steatosis in real-world clinical practice.
CAP and US were performed for 1554 chronic liver disease (CLD) patients. CAP was performed by two technicians, and US was performed by 30 hepatologists. The performance of the CAP as compared with the US results was assessed using the area under the receiver operating characteristic curve (AUROC).
532 (34.2%) of the patients had hepatitis C virus (HCV) infection, 723 (46.5%) of the patients had hepatitis B virus (HBV) infection, and the rest were patients with metabolic risk factors. CAP values were significantly correlated with the steatosis grades identified by US for all the patients (ρ = 0.497, P < 0.001), for the HBV-infected patients (ρ = 0.495, P < 0.001), for the HCV-infected patients (ρ = 0.343, P < 0.001), and for the patients with metabolic risk factors (ρ = 0.515, P < 0.001). Using CAP, the AUROC values were 0.759, 0.795, 0.715, and 0.716 for ≥moderate steatosis identified by US in, respectively, all the patients, the HBV-infected patients, the HCV-infected patients, and the patients with metabolic risk factors. The AUROC values were 0.791, 0.868, 0.807 and 0.701 for severe steatosis identified by US in, respectively, all the patients, the HBV-infected patients, the HCV-infected patients, and the patients with metabolic risk factors.
CAP values were well correlated with the steatosis grades assessed by US in real-world clinical practice.
背景/目的：受控衰减参数（CAP）是一种基于 FibroScan 测量脂肪变性的方法。尽管存在观察者依赖性，但超声（US）可可靠地诊断中重度脂肪变性。在此，我们旨在评估 CAP 与真实临床实践中 US 诊断的脂肪变性之间的相关性。
对 1554 例慢性肝病（CLD）患者进行 CAP 和 US 检查。CAP 由两名技术员进行，US 由 30 名肝病专家进行。使用受试者工作特征曲线（AUROC）下面积评估 CAP 与 US 结果的相关性。
532 例（34.2%）患者感染丙型肝炎病毒（HCV），723 例（46.5%）患者感染乙型肝炎病毒（HBV），其余为代谢危险因素患者。CAP 值与所有患者的 US 确定的脂肪变性程度显著相关（ρ=0.497，P<0.001），与 HBV 感染患者（ρ=0.495，P<0.001）、HCV 感染患者（ρ=0.343，P<0.001）和代谢危险因素患者（ρ=0.515，P<0.001）。使用 CAP，在所有患者、HBV 感染患者、HCV 感染患者和代谢危险因素患者中，US 确定的≥中度脂肪变性的 AUROC 值分别为 0.759、0.795、0.715 和 0.716。在所有患者、HBV 感染患者、HCV 感染患者和代谢危险因素患者中，US 确定的重度脂肪变性的 AUROC 值分别为 0.791、0.868、0.807 和 0.701。
在真实临床实践中，CAP 值与 US 评估的脂肪变性程度具有良好的相关性。
