Jeon Sun Kyung, Joo Ijin, Kim So Yeon, Jang Jong Keon, Park Juil, Park Hee Sun, Lee Eun Sun, Lee Jeong Min
Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ultrasonography. 2021 Jan;40(1):136-146. doi: 10.14366/usg.20042. Epub 2020 May 9.
This study was aimed to investigate the value of quantitative ultrasound (US) parameters from radiofrequency (RF) data analysis for assessing hepatic steatosis, using controlled attenuation parameter (CAP)-based steatosis grades as the reference standard.
We analyzed 243 participants with both B-mode liver US with RF data acquisition and CAP measurements. On B-mode US images, hepatic steatosis was visually scored (0/1/2/3, none/mild/moderate/severe), and the hepatorenal index (HRI) was calculated. From the RF data analysis, the tissue scatter-distribution imaging parameter (TSI-p) and tissue attenuation imaging parameter (TAI-p) of the liver parenchyma were measured. US parameters were correlated with CAP-based steatosis grades (S0/1/2/3, none/mild/moderate/severe) and their diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis. Multivariate linear regression analysis was performed to identify determinants of TSI-p and TAI-p.
Participants were classified as having S0 (n=152), S1 (n=54), S2 (n=14), and S3 (n=23) on CAP measurements. TSI-p and TAI-p were significantly correlated with steatosis grades (ρ =0.593 and ρ=-0.617, P<0.001 for both). For predicting ≥S1, ≥S2, and S3, the areas under the ROC curves (AUCs) of TSI-p were 0.827/0.914/0.917; TAI-p, 0.844/0.914/0.909; visual scores, 0.659/0.778/0.794; and HRI, 0.629/0.751/0.759, respectively. TSI-p and TAI-p had significantly higher AUCs than did visual scores or HRI for ≥S1 or ≥S2 (P≤0.003). In the multivariate analysis, the transient elastography-based fibrosis grade (P=0.034) and steatosis grade (P<0.001) were independent determinants of TSI-p, while steatosis grade (P<0.001) was an independent determinant of TAI-p.
TSI-p and TAI-p derived from US RF data may be useful for detecting hepatic steatosis and assessing its severity.
本研究旨在以基于受控衰减参数（CAP）的脂肪变性分级作为参考标准，探讨通过射频（RF）数据分析获得的定量超声（US）参数在评估肝脂肪变性中的价值。
我们分析了243名同时接受B型肝脏超声检查并采集RF数据以及进行CAP测量的参与者。在B型超声图像上，对肝脂肪变性进行视觉评分（0/1/2/3，无/轻度/中度/重度），并计算肝肾指数（HRI）。通过RF数据分析，测量肝实质的组织散射分布成像参数（TSI-p）和组织衰减成像参数（TAI-p）。将超声参数与基于CAP的脂肪变性分级（S0/1/2/3，无/轻度/中度/重度）进行相关性分析，并使用受试者操作特征（ROC）曲线分析评估其诊断性能。进行多变量线性回归分析以确定TSI-p和TAI-p的决定因素。
根据CAP测量，参与者被分类为S0（n = 152）、S1（n = 54）、S2（n = 14）和S3（n = 23）。TSI-p和TAI-p与脂肪变性分级显著相关（ρ = 0.593和ρ = -0.617，两者P均<0.001）。对于预测≥S1、≥S2和S3，TSI-p的ROC曲线下面积（AUC）分别为0.827/0.914/0.917；TAI-p为0.844/0.914/0.909；视觉评分为0.659/0.778/0.794；HRI为0.629/0.751/0.759。对于≥S1或≥S2，TSI-p和TAI-p的AUC显著高于视觉评分或HRI（P≤0.003）。在多变量分析中，基于瞬时弹性成像的纤维化分级（P = 0.034）和脂肪变性分级（P<0.001）是TSI-p的独立决定因素，而脂肪变性分级（P<0.001）是TAI-p的独立决定因素。
从超声RF数据中得出的TSI-p和TAI-p可能有助于检测肝脂肪变性并评估其严重程度。
