Department of Ultrasound, Second Affiliated Hospital of Zhejiang University, School of Medicine, #88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.
Department of Hepatology, Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
Abdom Radiol (NY). 2022 Feb;47(2):693-703. doi: 10.1007/s00261-021-03394-0. Epub 2021 Dec 27.
The purpose of this study was to evaluate the diagnostic performance of novel ultrasound technology normalized local variance (NLV) and the standard deviation of NLV (NLV-SD) using different ROIs for hepatic steatosis in patients with metabolic-associated fatty liver disease (MAFLD) and to identify the factors that influence the NLV value and NLV-SD value, using pathology results as the gold standard.
We prospectively enrolled 34 consecutive patients with suspected MAFLD who underwent percutaneous liver biopsy for evaluation of hepatic steatosis from June 2020 to December 2020. All patients underwent ultrasound and NLV examinations. NLV values and NLV-SD values were measured using different ROIs just before the liver biopsy procedure.
The distribution of hepatic steatosis grade on histopathology was 4/19/6/5 for none (< 5%)/ mild (5-33%)/ moderate (> 33-66%)/ and severe steatosis (> 66%), respectively. The NLV value with 50-mm-diameter ROI and NLV-SD value with 50-mm-diameter ROI showed a significant negative correlation with hepatic steatosis (spearman correlation coefficient: - 0.449, p = 0.008; - 0.471, p = 0.005). The AUROC of NLV (50 mm) for the detection of mild, moderate, and severe hepatic steatosis was 0.875, 0.735, and 0.583, respectively. The AUROC of NLV-SD (50 mm) for the detection of mild, moderate, and severe hepatic steatosis was 0.900, 0.745, and 0.603, respectively. NLV (50 mm) values and NLV-SD (50 mm) values between two readers showed excellent repeatability and the intraclass correlation coefficient (ICC) was 0.930 (p < 0.001) and 0.899 (p < 0.001). Hepatic steatosis was the only determinant factor for NLV value and NLV-SD value (p = 0.012, p = 0.038).
The NLV (50 mm) and NLV-SD (50 mm) provided good diagnostic performance in detecting the varying degrees of hepatic steatosis with great reproducibility. This study showed that the degree of steatosis was the only significant factor affecting the NLV value and NLV-SD value.
本研究旨在评估新型超声技术局部方差标准化（NLV）和 NLV 标准差（NLV-SD）的诊断性能，使用不同的 ROI 来评估代谢相关脂肪性肝病（MAFLD）患者的肝脂肪变性，并确定影响 NLV 值和 NLV-SD 值的因素，以病理学结果为金标准。
我们前瞻性纳入了 2020 年 6 月至 2020 年 12 月因 MAFLD 接受经皮肝活检评估肝脂肪变性的 34 例连续疑似 MAFLD 患者。所有患者均行超声和 NLV 检查。在肝活检前，使用不同的 ROI 测量 NLV 值和 NLV-SD 值。
肝脂肪变性程度的组织病理学分布分别为无脂肪变性（<5%）/轻度（5%-33%）/中度（>33%-66%）/重度（>66%），分别为 4/19/6/5 例。50mm 直径 ROI 的 NLV 值和 50mm 直径 ROI 的 NLV-SD 值与肝脂肪变性呈显著负相关（Spearman 相关系数：-0.449，p=0.008；-0.471，p=0.005）。NLV（50mm）检测轻度、中度和重度肝脂肪变性的 AUC 分别为 0.875、0.735 和 0.583。NLV-SD（50mm）检测轻度、中度和重度肝脂肪变性的 AUC 分别为 0.900、0.745 和 0.603。两位读者之间的 NLV（50mm）值和 NLV-SD（50mm）值显示出极好的可重复性，组内相关系数（ICC）分别为 0.930（p<0.001）和 0.899（p<0.001）。肝脂肪变性是唯一决定 NLV 值和 NLV-SD 值的因素（p=0.012，p=0.038）。
NLV（50mm）和 NLV-SD（50mm）在检测不同程度的肝脂肪变性方面具有良好的诊断性能，且具有很好的可重复性。本研究表明，脂肪变性程度是唯一显著影响 NLV 值和 NLV-SD 值的因素。
