用于诊断肝脂肪变性的 M 及 XL 探头，能否使用相同的受控衰减参数截断值？
Can the same controlled attenuation parameter cut-offs be used for M and XL probes for diagnosing hepatic steatosis?
机构信息
Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Institute of Digestive Disease, The Chinese University of Hong Kong, Sha Tin, Hong Kong.
出版信息
J Gastroenterol Hepatol. 2018 Oct;33(10):1787-1794. doi: 10.1111/jgh.14150. Epub 2018 May 7.
BACKGROUND AND AIM
There are limited studies on controlled attenuation parameter (CAP) using Fibroscan XL probe for the diagnosis of hepatic steatosis grade. The aim of this study was to determine whether previously defined optimal cut-offs for CAP using the M probe could be applied for the XL probe.
METHODS
Adult patients with chronic liver disease who had a liver biopsy and examination with both the M and XL probes were included. Previously defined optimal cut-offs for CAP using the M probe were used for the diagnosis of steatosis grades ≥S1, ≥S2, and S3 (248, 268, and 280 dB/m, respectively).
RESULTS
Data for 180 patients were analyzed (mean age 53.7 ± 10.8 years; central obesity 84.5%; non-alcoholic fatty liver disease 86.7%). The distribution of steatosis grades was S0, 9.4%; S1, 28.3%; S2, 43.9%, and S3, 18.3%. The sensitivity, specificity, positive predictive value, and negative predictive value of CAP using the M/XL probe for the diagnosis of steatosis grade ≥S1 was 93.9%/93.3%, 58.8%/58.8%, 95.6%/95.6%, and 50.0%/47.6%, respectively. These values were 94.6%/94.6%, 41.2%/44.1%, 72.6%/73.6%, and 82.4%/83.3%, respectively, for ≥S2, and 87.9%/87.9%, 27.2%/27.9%, 21.3%/21.5%, and 90.9%/91.1%, respectively, for S3.
CONCLUSION
The same cut-off values for CAP may be used for the M and XL probes for the diagnosis of hepatic steatosis grade.
背景与目的
使用 Fibroscan XL 探头进行受控衰减参数 (CAP) 检测诊断肝脂肪变程度的研究较少。本研究旨在确定先前使用 M 探头定义的 CAP 最佳截断值是否可应用于 XL 探头。
方法
纳入接受肝脏活检且同时接受 M 和 XL 探头检查的慢性肝病成年患者。采用先前使用 M 探头定义的 CAP 最佳截断值，分别诊断脂肪变程度≥S1、≥S2 和 S3（248、268 和 280dB/m）。
结果
共分析了 180 例患者的数据（平均年龄 53.7±10.8 岁；中心性肥胖 84.5%；非酒精性脂肪性肝病 86.7%）。脂肪变程度分布为 S0 9.4%、S1 28.3%、S2 43.9%和 S3 18.3%。使用 M/XL 探头诊断脂肪变程度≥S1 的 CAP 的敏感性、特异性、阳性预测值和阴性预测值分别为 93.9%/93.3%、58.8%/58.8%、95.6%/95.6%和 50.0%/47.6%。这些值分别为≥S2 时的 94.6%/94.6%、41.2%/44.1%、72.6%/73.6%和 82.4%/83.3%，S3 时的 87.9%/87.9%、27.2%/27.9%、21.3%/21.5%和 90.9%/91.1%。
结论
M 和 XL 探头用于诊断肝脂肪变程度时，CAP 的相同截断值可能适用。
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