Rocky Vista University, Ivins, Utah, USA.
J Ultrasound Med. 2022 Mar;41(3):699-711. doi: 10.1002/jum.15751. Epub 2021 May 13.
The aim of the study was to test inter-observer and intra-observer reliability of measuring multiparametric ultrasound in adult livers.
We prospectively measured shear wave velocity (SWV, m/s), shear wave dispersion slope (SWD, m/s/kHz), attenuation coefficient (ATI, dB/cm/MHz), normalized local variance (NLV), and echo intensity ratio of liver to kidney (L/K ratio) in 21 adults who underwent liver magnetic resonance imaging-proton density fat fraction (MRI-PDFF). Intraclass correlation coefficient and 95% Bland-Altman limits of agreement (95% LOA) were used to analyze intra- and inter-observer reproducibility.
Based on liver MRI-PDFF, 21 participants (8 men and 13 women, mean age 55 years) were divided into group 1 (11 normal livers, MRI-PDFF <5%) and group 2 (10 steatotic livers, MRI-PDFF ≥5%). ICCs for intra-observer repeatability and inter-observer reproducibility in measuring multiple ultrasound parameters in both normal and steatotic livers were above 0.75. However, 95% confidence interval for measuring SWD in all livers and L/K ratio in normal livers was 0.38-0.90 and 0.47-0.91, respectively. Differences in SWV, SWD, ATI, NLV, L/K ratio, and MRI-PDFF between participants with and without hepatic steatosis were significant (p < .05), whereas serum biomarkers and body mass index were not (p > .05), based on a two-tailed t-test.
The results suggest that the repeatability and reproducibility for measuring liver SWV, ATI, and NLV are moderate to excellent, while those for SWD and L/K ratio are poor. Standardized machine settings, scanning protocols, and operator training are suggested in performing multiparametric ultrasound of the liver.
本研究旨在测试成人肝脏中多参数超声测量的观察者间和观察者内可靠性。
我们前瞻性地测量了 21 名接受肝脏磁共振成像-质子密度脂肪分数（MRI-PDFF）检查的成年人的剪切波速度（SWV，m/s）、剪切波频散斜率（SWD，m/s/kHz）、衰减系数（ATI，dB/cm/MHz）、局部方差归一化（NLV）和肝脏与肾脏的回声强度比（L/K 比值）。采用组内相关系数和 95% Bland-Altman 一致性界限（95% LOA）分析观察者内和观察者间的可重复性。
根据肝脏 MRI-PDFF，21 名参与者（8 名男性和 13 名女性，平均年龄 55 岁）分为 1 组（11 个正常肝脏，MRI-PDFF <5%）和 2 组（10 个脂肪变性肝脏，MRI-PDFF ≥5%）。在正常和脂肪变性肝脏中，多次测量超声参数的观察者内重复性和观察者间再现性的 ICC 均大于 0.75。然而，所有肝脏测量 SWD 的 95%置信区间和正常肝脏的 L/K 比值分别为 0.38-0.90 和 0.47-0.91。基于双侧 t 检验，患有和不患有肝脂肪变性的参与者之间的 SWV、SWD、ATI、NLV、L/K 比值和 MRI-PDFF 差异具有统计学意义（p<0.05），而血清生物标志物和体重指数则没有差异（p>0.05）。
结果表明，测量肝脏 SWV、ATI 和 NLV 的重复性和再现性为中等至良好，而 SWD 和 L/K 比值的重复性和再现性较差。建议在进行肝脏多参数超声检查时采用标准化的机器设置、扫描方案和操作人员培训。
