一种用于识别非酒精性脂肪性肝炎的新型定量超声技术。

A novel quantitative ultrasound technique for identifying non-alcoholic steatohepatitis.

机构信息

Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China.

出版信息

Liver Int. 2022 Jan;42(1):80-91. doi: 10.1111/liv.15064. Epub 2021 Sep 30.

DOI:10.1111/liv.15064

PMID:34564946

Abstract

BACKGROUND AND AIMS

There remains a need to develop a non-invasive, accurate and easy-to-use tool to identify patients with non-alcoholic steatohepatitis (NASH). Successful clinical and preclinical applications demonstrate the ability of quantitative ultrasound (QUS) techniques to improve medical diagnostics. We aimed to develop and validate a diagnostic tool, based on QUS analysis, for identifying NASH.

METHODS

A total of 259 Chinese individuals with biopsy-proven non-alcoholic fatty liver disease (NAFLD) were enrolled in the study. The histological spectrum of NAFLD was classified according to the NASH clinical research network scoring system. Radiofrequency (RF) data, raw data of iLivTouch, was acquired for further QUS analysis. The least absolute shrinkage and selection operator (LASSO) method was used to select the most useful predictive features.

RESULTS

Eighteen candidate RF parameters were reduced to two significant parameters by shrinking the regression coefficients with the LASSO method. We built a novel QUS score based on these two parameters, and this QUS score showed good discriminatory capacity and calibration for identifying NASH both in the training set (area under the ROC curve [AUROC]: 0.798, 95% confidence interval [CI] 0.731-0.865; Hosmer-Lemeshow test, P = .755) and in the validation set (AUROC: 0.816, 95% CI 0.725-0.906; Hosmer-Lemeshow test, P = .397). Subgroup analysis showed that the QUS score performed well in different subgroups.

CONCLUSIONS

The QUS score, which was developed from QUS, provides a novel, non-invasive and practical way for identifying NASH.

摘要

背景与目的

仍然需要开发一种非侵入性、准确且易于使用的工具来识别非酒精性脂肪性肝炎（NASH）患者。成功的临床和临床前应用证明，定量超声（QUS）技术有能力改善医学诊断。我们旨在开发和验证一种基于 QUS 分析的诊断工具，用于识别 NASH。

方法

共纳入 259 名经活检证实的非酒精性脂肪性肝病（NAFLD）的中国个体。根据 NASH 临床研究网络评分系统对 NAFLD 的组织学谱进行分类。获取射频（RF）数据，即 iLivTouch 的原始数据，以进行进一步的 QUS 分析。最小绝对收缩和选择算子（LASSO）方法用于选择最有用的预测特征。

结果

通过 LASSO 方法收缩回归系数，将 18 个候选 RF 参数减少到 2 个有意义的参数。我们基于这两个参数建立了一个新的 QUS 评分，该 QUS 评分在训练集（ROC 曲线下面积 [AUROC]：0.798，95%置信区间 [CI] 0.731-0.865；Hosmer-Lemeshow 检验，P=0.755）和验证集（AUROC：0.816，95%CI 0.725-0.906；Hosmer-Lemeshow 检验，P=0.397）中均显示出良好的鉴别能力和校准能力。亚组分析显示，QUS 评分在不同亚组中表现良好。