Fujiwara Yudai, Kuroda Hidekatsu, Abe Tamami, Ishida Kazuyuki, Oguri Takuma, Noguchi Sachiyo, Sugai Tamotsu, Kamiyama Naohisa, Takikawa Yasuhiro
Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan.
Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan.
Ultrasound Med Biol. 2018 Nov;44(11):2223-2232. doi: 10.1016/j.ultrasmedbio.2018.06.017. Epub 2018 Aug 2.
The purpose of our study was to evaluate the diagnostic accuracy of the ultrasound-guided attenuation parameter (UGAP) for the detection of hepatic steatosis in comparison with the controlled attenuation parameter (CAP), using histopathology as the reference standard. We prospectively analyzed 163 consecutive chronic liver disease patients who underwent UGAP, CAP, computed tomography and a liver biopsy on the same day between April 2016 and July 2017. Radiofrequency signals corresponding to the images were compensated by the reference signal previously measured from the uniform phantom with known attenuation (0.44 dB/cm/MHz). The attenuation coefficient was calculated from the signals' decay slope. The median attenuation coefficient values in patients with S0 (n = 62), S1 (n = 63), S2 (n = 23) and S3 grade (n = 15) were 0.485, 0.560, 0.660 and 0.720, respectively. Significant correlations were found between attenuation coefficient and percentage steatosis, CAP values and liver-to-spleen computed tomography attenuation ratio (p < 0.001). The areas under the receiver operating characteristic curve of UGAP for identifying ≥S1, ≥S2 and ≥S3 were 0.900, 0.953 and 0.959, respectively, which were significantly better than the results obtained with CAP for identifying ≥S2 and ≥S3. In conclusion, UGAP had high diagnostic accuracy for detecting hepatic steatosis in patients with chronic liver disease.
本研究的目的是，以组织病理学为参考标准，评估超声引导下衰减参数（UGAP）检测肝脂肪变性的诊断准确性，并与受控衰减参数（CAP）进行比较。我们前瞻性分析了2016年4月至2017年7月期间连续163例同日接受UGAP、CAP、计算机断层扫描和肝活检的慢性肝病患者。对应图像的射频信号由先前从已知衰减（0.44 dB/cm/MHz）的均匀体模测量的参考信号进行补偿。根据信号的衰减斜率计算衰减系数。S0级（n = 62）、S1级（n = 63）、S2级（n = 23）和S3级（n = 15）患者的衰减系数中值分别为0.485、0.560、0.660和0.720。衰减系数与脂肪变性百分比、CAP值和肝脾计算机断层扫描衰减比之间存在显著相关性（p < 0.001）。UGAP用于识别≥S1、≥S2和≥S3的受试者工作特征曲线下面积分别为0.900、0.953和0.959，显著优于CAP用于识别≥S2和≥S3的结果。总之，UGAP对检测慢性肝病患者的肝脂肪变性具有较高的诊断准确性。
