Tada Toshifumi, Kumada Takashi, Toyoda Hidenori, Yasuda Satoshi, Sone Yasuhiro, Hashinokuchi Shinichi, Ogawa Sadanobu, Oguri Takuma, Kamiyama Naohisa, Chuma Makoto, Akita Tomoyuki, Tanaka Junko
Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
Department of Diagnostic Radiology, Ogaki Municipal Hospital, Ogaki, Japan.
Hepatol Res. 2020 Feb;50(2):190-198. doi: 10.1111/hepr.13442. Epub 2019 Dec 29.
Recently, a new method has been developed to diagnose hepatic steatosis with attenuation coefficients based on the ultrasound-guided attenuation parameter (UGAP). We investigated whether fibrosis identified by hepatic stiffness measurements based on magnetic resonance elastography (MRE) affects attenuation coefficient measurement using UGAP for the evaluation of hepatic steatosis.
A total of 608 patients with chronic liver disease were analyzed. Correlations between magnetic resonance imaging-determined proton density fat fraction (PDFF) or MRE value and attenuation coefficients were evaluated. In addition, the interaction between hepatic fibrosis and the attenuation coefficient was analyzed.
The correlation coefficient (r) between PDFF values and attenuation coefficient values was 0.724, indicating a strong relationship. Conversely, the r between MRE values and attenuation coefficient values was -0.187, indicating almost no relationship. In the multiple regression assessment of the effect of PDFF and MRE on the attenuation coefficient based on UGAP, the P-values for PDFF, MRE, and PDFF × MRE were < 0.001, 0.277, and 0.903, respectively. In patients with non-alcoholic fatty liver disease (n = 169), the r between PDFF values and attenuation coefficient values was 0.695, indicating a moderate relationship. Conversely, the r between MRE values and attenuation coefficient values was -0.068, indicating almost no relationship. In the multiple regression assessment of the effect of PDFF and MRE on the attenuation coefficient based on UGAP, the P-values for PDFF, MRE, and PDFF × MRE were <0.001, 0.948, and 0.706, respectively.
UGAP-determined attenuation coefficient was weakly affected by liver stiffness, an indicator of hepatic fibrosis.
最近，已开发出一种基于超声引导衰减参数（UGAP）利用衰减系数诊断肝脂肪变性的新方法。我们研究了基于磁共振弹性成像（MRE）的肝脏硬度测量所识别的纤维化是否会影响使用UGAP进行的衰减系数测量，以评估肝脂肪变性。
共分析了608例慢性肝病患者。评估磁共振成像测定的质子密度脂肪分数（PDFF）或MRE值与衰减系数之间的相关性。此外，分析了肝纤维化与衰减系数之间的相互作用。
PDFF值与衰减系数值之间的相关系数（r）为0.724，表明存在强相关性。相反，MRE值与衰减系数值之间的r为-0.187，表明几乎没有相关性。在基于UGAP对PDFF和MRE对衰减系数影响的多元回归评估中，PDFF、MRE和PDFF×MRE的P值分别为<0.001、0.277和0.903。在非酒精性脂肪性肝病患者（n = 169）中，PDFF值与衰减系数值之间的r为0.695，表明存在中度相关性。相反，MRE值与衰减系数值之间的r为-0.068，表明几乎没有相关性。在基于UGAP对PDFF和MRE对衰减系数影响的多元回归评估中，PDFF、MRE和PDFF×MRE的P值分别为<0.001、0.948和0.706。
UGAP测定的衰减系数受肝纤维化指标肝脏硬度的影响较弱。
