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慢性乙型肝炎患者肝脂肪变性分析及控制衰减参数用于肝脂肪变性分级的分析

Analysis of liver steatosis analysis and controlled attenuation parameter for grading liver steatosis in patients with chronic hepatitis B.

作者信息

Ren Xinping, Xia Shujun, Zhang Lu, Li Ruokun, Zhou Wei, Ji Ri, Zhou Jianqiao, Tian Jingyan, Zhan Weiwei

机构信息

Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.

Department of Ultrasound, Wuxi Branch of Ruijin Hospital, Wuxi, China.

出版信息

Quant Imaging Med Surg. 2021 Feb;11(2):571-578. doi: 10.21037/qims-19-1091.

Abstract

BACKGROUND

Chronic hepatitis B is the most common chronic liver disease in China. For patients with chronic hepatitis B, steatosis increases the risk of cirrhosis and hepatocellular carcinoma. This study aimed to analyze and compare the clinical value of a newly developed ultrasound attenuation parameter, liver steatosis analysis (LiSA), acquired by Hepatus (Mindray, China), and controlled attenuation parameter (CAP), a widely used ultrasound attenuation parameter acquired by FibroScan (Echosens, France), for grading liver steatosis in patients with chronic hepatitis B infection.

METHODS

A total of 203 patients were divided into two groups according to liver fat content validated by liver biopsy: group 1 (liver fat content <10%) and group 2 (liver fat content ≥10%). All patients underwent LiSA and CAP examinations. Receiver operating characteristic (ROC) curves were calculated for the two ultrasound attenuation tools.

RESULTS

Both LiSA and CAP successfully discriminated between patients in group 1 and group 2. ROC curves showed that both tools had good diagnostic ability (AUC: >0.7) for steatosis ≥10%, and the performance of LiSA was significantly better than CAP (AUC: 0.859 0.801, P=0.048). Using optimal cut-off points, LiSA had specificity and sensitivity of 96.23% and 76.08%, respectively, for the diagnosis of steatosis ≥10%, compared to 91.53% and 72.10%, respectively, for CAP.

CONCLUSIONS

LiSA and CAP are extremely efficient tools for assessing liver steatosis, even at a low grade. Both parameters are non-invasive, inexpensive, and easy to use, and can provide immediate results with high sensitivity.

摘要

背景

慢性乙型肝炎是中国最常见的慢性肝病。对于慢性乙型肝炎患者,脂肪变性会增加肝硬化和肝细胞癌的风险。本研究旨在分析和比较一种新开发的超声衰减参数——肝脏脂肪变性分析(LiSA),由迈瑞公司(中国)的Hepatus设备获取,以及受控衰减参数(CAP),一种广泛使用的超声衰减参数,由法国Echosens公司的FibroScan设备获取,用于评估慢性乙型肝炎感染患者的肝脏脂肪变性分级的临床价值。

方法

根据肝活检验证的肝脏脂肪含量,将203例患者分为两组:第1组(肝脏脂肪含量<10%)和第2组(肝脏脂肪含量≥10%)。所有患者均接受LiSA和CAP检查。计算两种超声衰减工具的受试者操作特征(ROC)曲线。

结果

LiSA和CAP均成功区分了第1组和第2组患者。ROC曲线显示,两种工具对脂肪变性≥10%均具有良好的诊断能力(AUC:>0.7),且LiSA的性能显著优于CAP(AUC:0.859对0.801,P = 0.048)。使用最佳截断点时,LiSA诊断脂肪变性≥10%的特异性和敏感性分别为96.23%和76.08%,而CAP分别为91.53%和72.10%。

结论

LiSA和CAP是评估肝脏脂肪变性的高效工具,即使是轻度脂肪变性。这两个参数均为非侵入性、廉价且易于使用,能够提供高灵敏度的即时结果。

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