超声肝肾指数和磁共振成像质子密度脂肪分数技术在诊断肝脂肪变性中的可靠性，以磁共振波谱为参考标准。

Reliability of ultrasound hepatorenal index and magnetic resonance imaging proton density fat fraction techniques in the diagnosis of hepatic steatosis, with magnetic resonance spectroscopy as the reference standard.

机构信息

Department of Diagnostic Radiology and Nuclear Medicine, Gunma University, Graduate School of Medicine, Maebashi, Gunma, Japan.

Department of Radiology, Gunma University Hospital, Maebashi, Gunma, Japan.

出版信息

PLoS One. 2021 Aug 12;16(8):e0255768. doi: 10.1371/journal.pone.0255768. eCollection 2021.

DOI:10.1371/journal.pone.0255768

PMID:34383812

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8360521/

Abstract

PURPOSE

To evaluate the reliability of ultrasound hepatorenal index (US-HRI) and magnetic resonance imaging proton density fat fraction (MRI-PDFF) techniques in the diagnosis of hepatic steatosis, with magnetic resonance spectroscopy proton density fat fraction (MRS-PDFF) as the reference standard.

MATERIALS AND METHODS

Fifty-two adult volunteers (30 men, 22 women; age, 31.5 ± 6.5 years) who had no history of kidney disease or viral/alcoholic hepatitis were recruited to undergo abdominal US, MRI, and MRS examinations. US-HRI was calculated from the average of three pairs of regions of interest (ROIs) measurements placed in the liver parenchyma and right renal cortex. On MRI, the six-point Dixon technique was employed for calculating proton density fat fraction (MRI-PDFF). An MRS sequence with a typical voxel size of 27 ml was chosen to estimate MRS-PDFF as the gold standard. The data were evaluated using Pearson's correlation coefficient and receiver operating characteristic (ROC) curves.

RESULTS

The Pearson correlation coefficients of US-HRI and MRI-PDFF with MRS-PDFF were 0.38 (p = 0.005) and 0.95 (p<0.001), respectively. If MRS-PDFF ≥5.56% was defined as the gold standard of fatty liver disease, the areas under the curve (AUCs), cut-off values, sensitivities and specificities of US-HRI and MRI-PDFF were 0.74, 1.54, 50%, 91.7% and 0.99, 2.75%, 100%, 88.9%, respectively. The intraclass correlation coefficients (ICCs) of US-HRI and MRI-PDFF were 0.70 and 0.85.

CONCLUSION

MRI-PDFF was more reliable than US-HRI in diagnosing hepatic steatosis.

摘要

目的

评估超声肝肾指数（US-HRI）和磁共振成像质子密度脂肪分数（MRI-PDFF）技术在诊断肝脂肪变性中的可靠性，以磁共振波谱质子密度脂肪分数（MRS-PDFF）为参考标准。

材料与方法

招募了 52 名成年志愿者（30 名男性，22 名女性；年龄 31.5±6.5 岁），他们均无肾脏疾病或病毒性/酒精性肝炎病史，接受了腹部超声、磁共振和 MRS 检查。US-HRI 是通过在肝实质和右肾皮质的三个 ROI 测量值的平均值计算得出的。在 MRI 上，采用六点 Dixon 技术计算质子密度脂肪分数（MRI-PDFF）。选择具有典型体素大小为 27ml 的 MRS 序列来估计 MRS-PDFF 作为金标准。使用 Pearson 相关系数和受试者工作特征（ROC）曲线对数据进行评估。

结果

US-HRI 和 MRI-PDFF 与 MRS-PDFF 的 Pearson 相关系数分别为 0.38（p=0.005）和 0.95（p<0.001）。如果 MRS-PDFF≥5.56%定义为脂肪肝疾病的金标准，则 US-HRI 和 MRI-PDFF 的曲线下面积（AUCs）、截断值、敏感度和特异度分别为 0.74、1.54、50%、91.7%和 0.99、2.75%、100%、88.9%。US-HRI 和 MRI-PDFF 的组内相关系数（ICCs）分别为 0.70 和 0.85。