Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Gastroenterology, Baoshan Branch, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Dig Dis. 2023 Dec;24(12):691-701. doi: 10.1111/1751-2980.13242. Epub 2023 Dec 22.
To estimate the performance of the FibroTouch-based ultrasound attenuation parameter (UAP) for assessing hepatic steatosis in nonalcoholic fatty liver disease (NAFLD), with magnetic resonance imaging proton density fat fraction (MRI-PDFF) as the reference standard.
This prospective, cross-sectional study included 275 individuals in the training group and 110 individuals in the validation group, all of whom completed a standardized research visit, laboratory tests, MRI-PDFF, and UAP measurements over 1 month. Pearson correlation coefficient and Bland-Altman analysis were used to assess the agreement between UAP and MRI-PDFF for the detection of hepatic steatosis. The diagnostic value of UAP was evaluated by the area under the receiver operating characteristic (ROC) curve (AUROC). Confounding factors to UAP performance were identified by ROC curves and regression analyses.
The AUROC of UAP for detecting MRI-PDFF at ≥5%, ≥10%, and ≥20% were 0.95 (95% confidence interval [CI] 0.92-0.97), 0.86 (95% CI 0.81-0.90), and 0.90 (95% CI 0.86-0.93), respectively, and their optimal thresholds were 259, 274, and 295 dB/m, respectively. The UAP measurements had higher diagnostic accuracy in participants with lower waist circumference (≤90 cm for men and ≤80 cm for women) compared to those with higher waist circumference (AUROC values: 0.97 vs 0.84, P < 0.05). Bland-Altman analysis showed good agreement between UAP and MRI-PDFF (bias 0.00021). According to established regression analyses, hepatic steatosis could be accurately diagnosed using UAP estimation.
FibroTouch-UAP has a high diagnostic potential for hepatic steatosis in NAFLD patients and helps clinical assessment and monitoring.
利用磁共振成像质子密度脂肪分数（MRI-PDFF）作为参考标准，评估基于 FibroTouch 的超声衰减参数（UAP）在评估非酒精性脂肪性肝病（NAFLD）患者肝脂肪变性中的性能。
这项前瞻性、横断面研究纳入了 275 名训练组患者和 110 名验证组患者，所有患者均在 1 个月内完成了标准化的研究访问、实验室检查、MRI-PDFF 和 UAP 测量。采用 Pearson 相关系数和 Bland-Altman 分析评估 UAP 与 MRI-PDFF 检测肝脂肪变性的一致性。通过受试者工作特征（ROC）曲线下面积（AUROC）评估 UAP 的诊断价值。通过 ROC 曲线和回归分析确定影响 UAP 性能的混杂因素。
UAP 检测 MRI-PDFF≥5%、≥10%和≥20%的 AUROC 分别为 0.95（95%置信区间[CI]0.92-0.97）、0.86（95% CI 0.81-0.90）和 0.90（95% CI 0.86-0.93），其最佳截断值分别为 259、274 和 295 dB/m。在腰围较小（男性≤90 cm，女性≤80 cm）的患者中，UAP 测量具有更高的诊断准确性（AUROC 值：0.97 与 0.84，P<0.05）。Bland-Altman 分析显示 UAP 与 MRI-PDFF 之间具有良好的一致性（偏差 0.00021）。根据既定的回归分析，使用 UAP 估计可以准确诊断肝脂肪变性。
FibroTouch-UAP 对 NAFLD 患者肝脂肪变性具有较高的诊断潜力，有助于临床评估和监测。
