Seo Duck Min, Lee Sang Min, Park Ji Won, Kim Min-Jeong, Ha Hong Il, Park Sun-Young, Lee Kwanseop
Department of Radiology, Hallym University Sacred Heart Hospital, Anyang, Korea.
Department of Radiology, CHA University Gangnam Medical Center, Seoul, Korea.
Ultrasonography. 2023 Apr;42(2):227-237. doi: 10.14366/usg.22122. Epub 2022 Oct 31.
This retrospective study aimed to determine the number of times the ultrasound-guided attenuation parameter (UGAP) should be measured during the evaluation of hepatic steatosis.
Patients with suspected nonalcoholic fatty liver disease who underwent two UGAP repetition protocols (six-repetition [UGAP_6] and 12-repetition [UGAP_12]) and measurement of the controlled attenuation parameter (CAP) using transient elastography between October 2020 and June 2021 were enrolled. The mean attenuation coefficient (AC), interquartile range (IQR)/median, and coefficient of variance (CV) of the two repetition protocols were compared using the paired t test. Moreover, the diagnostic performances of UGAP_6 and UGAP_12 were compared using the area under the receiver operating characteristic (AUROC) curve, considering the CAP value as a reference standard.
The study included 160 patients (100 men; mean age, 50.9 years). There were no significant differences between UGAP_6 and UGAP_12 (0.731±0.116 dB/cm/MHz vs. 0.734±0.113 dB/cm/MHz, P=0.156) and mean CV (7.6±0.3% vs. 8.0±0.3%, P=0.062). However, the mean IQR/median of UGAP_6 was significantly lower than that of UGAP_12 (8.9%±6.0% vs. 9.8%±5.2%, P=0.012). In diagnosing the hepatic steatosis stage, UGAP_6 and UGAP_12 yielded comparable AUROCs (≥S1, 0.908 vs. 0.897, P=0.466; ≥S2, 0.883 vs. 0.897, P=0.126; S3, 0.832 vs. 0.834, P=0.799).
UGAP had high diagnostic performance in diagnosing hepatic steatosis, regardless of the number of repetitions (six repetitions vs. 12 repetitions), with maintained reliability. Therefore, six UGAP measurements seem sufficient for evaluating hepatic steatosis using UGAP.
本回顾性研究旨在确定在评估肝脂肪变性过程中超声引导下衰减参数（UGAP）的测量次数。
纳入2020年10月至2021年6月期间接受两种UGAP重复方案（六次重复[UGAP_6]和十二次重复[UGAP_12]）并使用瞬时弹性成像测量受控衰减参数（CAP）的疑似非酒精性脂肪性肝病患者。使用配对t检验比较两种重复方案的平均衰减系数（AC）、四分位数间距（IQR）/中位数和变异系数（CV）。此外，以CAP值作为参考标准，使用受试者操作特征曲线下面积（AUROC）比较UGAP_6和UGAP_12的诊断性能。
该研究纳入了160例患者（100名男性；平均年龄50.9岁）。UGAP_6和UGAP_12之间的AC无显著差异（0.731±0.116 dB/cm/MHz对0.734±0.113 dB/cm/MHz，P = 0.156），平均CV也无显著差异（7.6±0.3%对8.0±0.3%，P = 0.062）。然而，UGAP_6的平均IQR/中位数显著低于UGAP_12（8.9%±6.0%对9.8%±5.2%，P = 0.012）。在诊断肝脂肪变性阶段时，UGAP_6和UGAP_12产生了相当的AUROC（≥S1，0.908对0.897，P = 0.466；≥S2，0.883对0.897，P = 0.126；S3，0.832对0.834，P = 0.799）。
无论重复次数（六次重复对十二次重复）如何，UGAP在诊断肝脂肪变性方面具有较高的诊断性能，且可靠性保持不变。因此，对于使用UGAP评估肝脂肪变性而言，六次UGAP测量似乎就足够了。
