Bae Jae Seok, Lee Dong Ho, Suh Kyung-Suk, Kim Haeryoung, Lee Kyung Bun, Lee Jae Young, Han Joon Koo
Department of Radiology, Seoul National University Hospital, Seoul, Korea.
Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
Ultrasonography. 2022 Apr;41(2):344-354. doi: 10.14366/usg.21150. Epub 2021 Oct 25.
The present study compared the performance of computed tomography (CT), magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF), controlled attenuation parameter (CAP), grayscale ultrasonography (US), and attenuation imaging (ATI) for the diagnosis of hepatic steatosis (HS).
In total, 120 prospectively recruited patients who underwent hepatic resection between June 2018 and June 2020 were retrospectively analyzed. CT, MRI-PDFF, CAP, grayscale US, and ATI were performed within 3 months before surgery. Diagnostic performance for HS ≥5% and HS >33% was compared using the area under the curve (AUC) of receiver operating characteristic curves. Histopathologic examinations served as the reference standard for the degree of HS.
For detecting HS ≥5%, MRI-PDFF (AUC, 0.946) significantly outperformed CT, CAP and grayscale US (AUC, 0.807, 0.829, and 0.761, respectively) (P<0.01 for all). ATI (AUC, 0.892) was the second-best modality and significantly outperformed grayscale US (P=0.001). In pairwise comparisons, there were no significant differences between the AUC of ATI and the values of MRI-PDFF, CT, or CAP (P=0.133, P=0.063, and P=0.150, respectively). For detecting HS >33%, all the modalities provided good diagnostic performance without significant differences (AUC, 0.887-0.947; P>0.05 for all).
For detecting HS ≥5%, MRI-PDFF was the best imaging modality, while ATI outperformed grayscale US. For detecting HS >33%, all five imaging tools demonstrated good diagnostic performance.
本研究比较了计算机断层扫描(CT)、磁共振成像衍生的质子密度脂肪分数(MRI-PDFF)、受控衰减参数(CAP)、灰阶超声检查(US)和衰减成像(ATI)在诊断肝脂肪变性(HS)方面的性能。
回顾性分析了2018年6月至2020年6月期间前瞻性招募的120例行肝切除术的患者。在手术前3个月内进行CT、MRI-PDFF、CAP、灰阶US和ATI检查。使用受试者操作特征曲线的曲线下面积(AUC)比较HS≥5%和HS>33%的诊断性能。组织病理学检查作为HS程度的参考标准。
对于检测HS≥5%,MRI-PDFF(AUC,0.946)显著优于CT、CAP和灰阶US(AUC分别为0.807、0.829和0.761)(所有P<0.01)。ATI(AUC,0.892)是第二好的检查方法,显著优于灰阶US(P=0.001)。在两两比较中,ATI的AUC与MRI-PDFF、CT或CAP的值之间无显著差异(分别为P=0.133、P=0.063和P=0.150)。对于检测HS>33%,所有检查方法均具有良好的诊断性能,无显著差异(AUC,0.887-0.947;所有P>0.05)。
对于检测HS≥5%,MRI-PDFF是最佳成像方法,而ATI优于灰阶US。对于检测HS>33%,所有五种成像工具均显示出良好的诊断性能。