Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan.
Eur Radiol. 2021 May;31(5):3216-3225. doi: 10.1007/s00330-020-07391-7. Epub 2020 Oct 30.
Hepatic steatosis has become a considerable concern in the pediatric population. The objective of this study was to evaluate the feasibility of using ultrasound Nakagami imaging to produce a parametric image for analyzing the echo amplitude distribution to assess pediatric hepatic steatosis.
A total of 68 pediatric participants were enrolled in healthy control (n = 26) and study groups (n = 42). Raw data from ultrasound imaging were acquired for each participant analysis using AmCAD-US, a software approved by the US Food and Drug Administration for ultrasound Nakagami imaging. The Nakagami parameters were compared with the hepatic steatosis index (HSI) and the steatosis grade (G0: HSI < 30; G1: 30 ≤ HSI < 36; G2: 36 ≤ HSI < 41.6; G3: 41.6 ≤ HSI < 43; G4: HSI ≥ 43) using correlation analysis, one-way analysis of variance (ANOVA), and receiver operating characteristic (ROC) curve analysis.
The Nakagami parameter increased from 0.53 ± 0.13 to 0.82 ± 0.05 with increasing severity of hepatic steatosis from G0 to G4 and were significantly different between the different grades of hepatic steatosis (p < .05). The areas under the ROC curves were 0.96, 0.92, 0.85, and 0.82 for diagnosing hepatic steatosis ≥ G1, ≥ G2, ≥ G3, and ≥ G4, respectively.
The Nakagami parameter value quantifies changes in the echo amplitude distribution of ultrasound backscattered signals caused by fatty infiltration, providing a novel, noninvasive, and effective data analysis technique to detect pediatric hepatic steatosis.
• Ultrasound Nakagami imaging enabled quantification of the echo amplitude distribution for tissue characterization. • The Nakagami parameter increased with the increasing severity of pediatric hepatic steatosis. • The Nakagami parameter demonstrated promising diagnostic performance in evaluating pediatric hepatic steatosis.
肝脂肪变性在儿科人群中已成为一个相当关注的问题。本研究的目的是评估超声 Nakagami 成像产生参数图像来分析回波幅度分布以评估小儿肝脂肪变性的可行性。
共有 68 名儿科参与者被纳入健康对照组（n=26）和研究组（n=42）。使用 AmCAD-US 软件对每个参与者的超声成像原始数据进行分析，该软件已获得美国食品和药物管理局批准用于超声 Nakagami 成像。使用相关性分析、单因素方差分析（ANOVA）和受试者工作特征（ROC）曲线分析比较 Nakagami 参数与肝脂肪变性指数（HSI）和脂肪变性等级（G0：HSI<30；G1：30≤HSI<36；G2：36≤HSI<41.6；G3：41.6≤HSI<43；G4：HSI≥43）。
随着肝脂肪变性从 G0 到 G4 严重程度的增加，Nakagami 参数从 0.53±0.13 增加到 0.82±0.05，并且不同肝脂肪变性等级之间的差异具有统计学意义（p<0.05）。ROC 曲线下面积分别为 0.96、0.92、0.85 和 0.82，用于诊断肝脂肪变性≥G1、≥G2、≥G3 和≥G4。
Nakagami 参数值量化了脂肪浸润引起的超声背散射信号回波幅度分布的变化，为检测小儿肝脂肪变性提供了一种新颖、无创且有效的数据分析技术。
•超声 Nakagami 成像使组织特征的回波幅度分布量化成为可能。•Nakagami 参数随着小儿肝脂肪变性严重程度的增加而增加。•Nakagami 参数在评估小儿肝脂肪变性方面具有有前景的诊断性能。
