健康筛查项目中定量超声检查对肝脂肪变性的诊断性能：一项前瞻性单中心研究。
Diagnostic performance of quantitative ultrasonography for hepatic steatosis in a health screening program: a prospective single-center study.
作者信息
Pyo Jeung Hui, Cho Soo Jin, Choi Sung Chul, Jee Jae Hwan, Yun Jeeyeong, Hwang Jeong Ah, Park Goeun, Kim Kyunga, Kang Wonseok, Kang Mira, Byun Young Hye
机构信息
Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
出版信息
Ultrasonography. 2024 Jul;43(4):250-262. doi: 10.14366/usg.24040. Epub 2024 May 29.
PURPOSE
This study compared the diagnostic performance of quantitative ultrasonography (QUS) with that of conventional ultrasonography (US) in assessing hepatic steatosis among individuals undergoing health screening using magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) as the reference standard.
METHODS
This single-center prospective study enrolled 427 participants who underwent abdominal MRI and US. Measurements included the attenuation coefficient in tissue attenuation imaging (TAI) and the scatter-distribution coefficient in tissue scatter-distribution imaging (TSI). The correlation between QUS and MRI-PDFF was evaluated. The diagnostic capabilities of QUS, conventional B-mode US, and their combined models for detecting hepatic fat content of ≥5% (MRI-PDFF ≥5%) and ≥10% (MRI-PDFF ≥10%) were compared by analyzing the areas under the receiver operating characteristic curves. Additionally, clinical risk factors influencing the diagnostic performance of QUS were identified using multivariate linear regression analyses.
RESULTS
TAI and TSI were strongly correlated with MRI-PDFF (r=0.759 and r=0.802, respectively; both P<0.001) and demonstrated good diagnostic performance in detecting and grading hepatic steatosis. The combination of QUS and B-mode US resulted in the highest areas under the ROC curve (AUCs) (0.947 and 0.975 for detecting hepatic fat content of ≥5% and ≥10%, respectively; both P<0.05), compared to TAI, TSI, or B-mode US alone (AUCs: 0.887, 0.910, 0.878 for ≥5% and 0.951, 0.922, 0.875 for ≥10%, respectively). The independent determinants of QUS included skinliver capsule distance (β=7.134), hepatic fibrosis (β=4.808), alanine aminotransferase (β=0.202), triglyceride levels (β=0.027), and diabetes mellitus (β=3.710).
CONCLUSION
QUS is a useful and effective screening tool for detecting and grading hepatic steatosis during health checkups.
目的
本研究比较了定量超声（QUS）与传统超声（US）在以磁共振成像衍生的质子密度脂肪分数（MRI-PDFF）作为参考标准评估健康筛查个体肝脂肪变性方面的诊断性能。
方法
这项单中心前瞻性研究纳入了427名接受腹部MRI和US检查的参与者。测量包括组织衰减成像（TAI）中的衰减系数和组织散射分布成像（TSI）中的散射分布系数。评估了QUS与MRI-PDFF之间的相关性。通过分析受试者操作特征曲线下面积，比较了QUS、传统B型超声及其联合模型检测肝脂肪含量≥5%（MRI-PDFF≥5%）和≥10%（MRI-PDFF≥10%）的诊断能力。此外，使用多变量线性回归分析确定影响QUS诊断性能的临床危险因素。
结果
TAI和TSI与MRI-PDFF密切相关（分别为r = 0.759和r = 0.802；均P<0.001），并在检测和分级肝脂肪变性方面表现出良好的诊断性能。与单独的TAI、TSI或B型超声相比，QUS和B型超声的联合在ROC曲线下面积最高（检测肝脂肪含量≥5%和≥10%时的AUC分别为0.947和0.975；均P<0.05）（≥5%时单独的AUC分别为0.887、0.910、0.878，≥10%时分别为0.951、0.922、0.875）。QUS的独立决定因素包括皮肤-肝包膜距离（β = 7.134）、肝纤维化（β = 4.808）、丙氨酸氨基转移酶（β = 0.202）、甘油三酯水平（β = 0.027）和糖尿病（β = 3.710）。
结论
QUS是健康体检中检测和分级肝脂肪变性的一种有用且有效的筛查工具。
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