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椎旁肌影像学参数改变与非酒精性脂肪肝的相关性。

Association between paravertebral muscle radiological parameter alterations and non-alcoholic fatty liver disease.

机构信息

Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.

Philips Healthcare, Shanghai, China.

出版信息

Abdom Radiol (NY). 2024 Jul;49(7):2250-2261. doi: 10.1007/s00261-024-04352-2. Epub 2024 May 27.

DOI:10.1007/s00261-024-04352-2
PMID:38801559
Abstract

PURPOSE

To assess changes in laboratory indices, paravertebral muscle (PVM) fat infiltration and multi b-value DWI parameters and their potential correlation with NAFLD.

METHODS

This retrospective analysis included 178 patients with histopathologically confirmed NAFLD, incluiding 76 with non-alcoholic steatohepatitis (NASH). Differences in PVM fat infiltration ratio (FIR), DWI parameters, and laboratory indices were compared between two groups. The correlation between FIR and NAFLD activity score (NAS) was also analysed. Binary logistic regression was used to identify the independent risk factors for NASH. The clinical utility of PVM fat infiltration, DWI parameters, and laboratory indices for diagnosing NASH in patients with NAFLD was evaluated using receiver operating characteristic (ROC) curves.

RESULTS

The FIRs at the L2 and L3 levels were significantly higher in the with NASH group than those in the without NASH group. The heterogeneity index (α) and perfusion fraction (f) values at the L3 level of PVM were lower in the with NASH group. Moreover, the FIR at the L3 level was positively correlated with NAS. FIR at the L3 level was an independent risk factor for NASH along with alanine aminotransferase level. The area under the ROC curve (AUC) using L3 level PVM radiological parameters and laboratory indices for diagnosing NASH in patients with NAFLD was significantly higher than that using the degree of PVM fat infiltration, DWI parameters, or laboratory indices alone.

CONCLUSIONS

Radiological parameters of the PVM were correlated with NAFLD. An integrated curve combining PVM radiological parameters may help distinguish NASH from NAFLD, thereby offering novel insights into the diagnosis of NASH.

摘要

目的

评估实验室指标、椎旁肌(PVM)脂肪浸润和多 b 值 DWI 参数的变化及其与非酒精性脂肪性肝病(NAFLD)的潜在相关性。

方法

本回顾性分析纳入了 178 例经组织病理学证实的 NAFLD 患者,其中 76 例为非酒精性脂肪性肝炎(NASH)患者。比较两组间椎旁肌脂肪浸润率(FIR)、DWI 参数和实验室指标的差异。分析 FIR 与 NAFLD 活动评分(NAS)的相关性。采用二元逻辑回归分析确定 NASH 的独立危险因素。采用受试者工作特征(ROC)曲线评估 PVM 脂肪浸润、DWI 参数和实验室指标对诊断 NAFLD 患者 NASH 的临床应用价值。

结果

NASH 组 L2 和 L3 水平的 FIR 明显高于无 NASH 组。NASH 组 PVM 在 L3 水平的异质性指数(α)和灌注分数(f)值较低。此外,L3 水平的 FIR 与 NAS 呈正相关。L3 水平的 FIR 是 NASH 的独立危险因素,同时还与丙氨酸氨基转移酶水平相关。使用 L3 水平 PVM 影像学参数和实验室指标诊断 NAFLD 患者 NASH 的 ROC 曲线下面积(AUC)明显高于单独使用 PVM 脂肪浸润程度、DWI 参数或实验室指标的 AUC。

结论

PVM 的影像学参数与 NAFLD 相关。综合 PVM 影像学参数的曲线可能有助于区分 NASH 与 NAFLD,从而为 NASH 的诊断提供新的见解。

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