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超声引导下衰减参数在计算机断层扫描诊断的脂肪肝患者肝脂肪变性检测及定量中的临床应用

Clinical Utility of Ultrasound-Guided Attenuation Parameter for the Detection and Quantification of Hepatic Steatosis in Patients with Fatty Liver Diagnosed by Computed Tomography.

作者信息

Iwashita Hideyuki, Shakado Satoshi, Yoshimaru Namiko, Tanaka Hitomi, Koto Fumika, Tanaka Takashi, Takata Kazuhide, Yokoyama Keiji, Yamaguchi Masashi, Irie Makoto, Hirai Fumihito

机构信息

Department of Gastroenterology and Medicine, Fukuoka University Nishijin Hospital, Fukuoka, Japan.

Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Fukuoka University, Fukuoka, Japan.

出版信息

Ultrasound Med Biol. 2022 Jul;48(7):1282-1289. doi: 10.1016/j.ultrasmedbio.2022.02.023. Epub 2022 Apr 6.

Abstract

This retrospective study was aimed (i) at elucidating the correlation between fatty liver diagnoses based on the plain computed tomography (CT) value and those based on the attenuation coefficient (AC) value determined with the ultrasound-guided attenuation parameter (UGAP) and (ii) at evaluating the diagnostic power of AC values. We included 125 patients who underwent blood tests, abdominal ultrasonography and abdominal CT at our department between April 2020 and March 2021. Hepatic fat infiltration was categorized as S0 (<5%), S1 (≥5 and 30<%), S2 (≥30 and <50%) or S3 (≥50%). The diagnostic ability of UGAP-determined AC was evaluated using receiver operating characteristic (ROC) curve analysis, and the correlation between AC value and fatty liver grade by CT value. The coefficient of correlation (r) between the AC value and plain CT value was -0.6188, indicating a moderate relationship. For diagnosing grade ≥S1 (n = 44), the area under the ROC curve (AUROC) was 0.8541, sensitivity 84.1%, specificity 81.5% and cutoff value 0.676 dB/cm/MHz. In diagnosing grade ≥S2 (n = 35), the AUROC was 0.8603, sensitivity 88.6%, specificity 81.1% and cutoff value 0.694 dB/cm/MHz. In diagnosing grade = S3 (n = 18), the AUROC was 0.9016, sensitivity 94.5%, specificity 81.9% and cutoff value, 0.704 dB/cm/MHz. The AC value is useful in diagnosing fatty liver.

摘要

本回顾性研究旨在

(i)阐明基于普通计算机断层扫描(CT)值的脂肪肝诊断与基于超声引导衰减参数(UGAP)测定的衰减系数(AC)值的脂肪肝诊断之间的相关性;(ii)评估AC值的诊断效能。我们纳入了2020年4月至2021年3月期间在我科接受血液检查、腹部超声检查和腹部CT检查的125例患者。肝脂肪浸润分为S0(<5%)、S1(≥5%且<30%)、S2(≥30%且<50%)或S3(≥50%)。采用受试者操作特征(ROC)曲线分析评估UGAP测定的AC的诊断能力,以及AC值与CT值所反映的脂肪肝分级之间的相关性。AC值与普通CT值之间的相关系数(r)为-0.6188,表明二者呈中等程度相关。对于诊断≥S1级(n = 44),ROC曲线下面积(AUROC)为0.8541,灵敏度为84.1%,特异度为81.5%,截断值为0.676 dB/cm/MHz。对于诊断≥S2级(n = 35),AUROC为0.860s3,灵敏度为88.6%,特异度为81.1%,截断值为0.694 dB/cm/MHz。对于诊断=S3级(n = 18),AUROC为0.9016,灵敏度为94.5%,特异度为81.9%,截断值为0.704 dB/cm/MHz。AC值在脂肪肝诊断中具有一定作用。

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