Diagnostic Echotomography SA, Kifissia.
Liver Unit Euroclinic, Athens, Greece.
Ultrasound Q. 2022 Jun 1;38(2):124-132. doi: 10.1097/RUQ.0000000000000605.
Nonalcoholic fatty liver disease (NAFLD) is the most widespread chronic liver disease type in the Western countries. Ultrasound (US) is used for NAFLD and hepatic steatosis (HS) grading. The most popular US method for NAFLD assessment is the hepatorenal index (HRI), but because of its limitations, other noninvasive methods have been developed. The Resona 7 US system has recently incorporated an US attenuation-related quantitative feature, liver ultrasound attenuation (LiSA), for HS estimation. The purpose of this study is to compare LiSA's and HRI's performance on NAFLD assessment.
A total of 159 NAFLD patients having a magnetic resonance imaging-proton density fat fraction (MRI-PDFF) examination were examined by 2 radiologists, who performed LiSA and HRI measurements in the liver. Correlation of LiSA's and HRI's measurements with MRI-PDFF values was calculated through Pearson correlation coefficient (PCC). To further investigate the performance of LiSA and HRI, optimum cutoffs, provided by the literature, were used to correspond HS grades to MRI-PDFF results. Moreover, a receiver operating characteristic (ROC) analysis on LiSA measurements and steatosis grades was performed.
Magnetic resonance imaging-PDFF was better correlated with LiSA (PCC = 0.80) than HRI (PCC = 0.67). Receiver operating characteristic analysis showed better performance range for LiSA (77.8%-91.8%) than for HRI (72.8%-85.4%) on all HS grades for all studies used for corresponding MRI-PDFF values to HS grades.
The results indicate that LiSA is more accurate than HRI in HS differentiation and can lead to more accurate grading of HS on NAFLD patients.
非酒精性脂肪性肝病（NAFLD）是西方国家最常见的慢性肝病类型。超声（US）用于 NAFLD 和肝脂肪变性（HS）分级。NAFLD 评估最常用的 US 方法是肝肾指数（HRI），但由于其局限性，已经开发了其他非侵入性方法。Resona 7 US 系统最近纳入了一种与 US 衰减相关的定量特征，即肝超声衰减（LiSA），用于 HS 估计。本研究的目的是比较 LiSA 和 HRI 在 NAFLD 评估中的性能。
对 159 名经磁共振成像质子密度脂肪分数（MRI-PDFF）检查的 NAFLD 患者进行了研究，两名放射科医生对肝脏进行了 LiSA 和 HRI 测量。通过 Pearson 相关系数（PCC）计算 LiSA 和 HRI 测量值与 MRI-PDFF 值的相关性。为了进一步研究 LiSA 和 HRI 的性能，使用文献提供的最佳截止值将 HS 等级与 MRI-PDFF 结果相对应。此外，还对 LiSA 测量值和脂肪变性等级进行了接收者操作特征（ROC）分析。
MRI-PDFF 与 LiSA 的相关性更好（PCC=0.80），而不是 HRI（PCC=0.67）。ROC 分析显示，对于所有研究中用于对应 MRI-PDFF 值到 HS 等级的所有 HS 等级，LiSA 的性能范围更好（77.8%-91.8%），而 HRI 的性能范围更好（72.8%-85.4%）。
结果表明，LiSA 在 HS 分化方面比 HRI 更准确，可以更准确地对 NAFLD 患者的 HS 进行分级。
