Oeda Satoshi, Inoue Kaori, Isoda Hiroshi, Hirai Kenji, Takahashi Hirokazu
Liver Center, Saga University Hospital, Japan.
Department of Laboratory Medicine, Saga University Hospital, Japan.
Intern Med. 2025 Apr 15;64(8):1143-1149. doi: 10.2169/internalmedicine.4128-24. Epub 2024 Sep 18.
Objective Recent developments in ultrasound elastography (UE) and ultrasound attenuation imaging (UA) have enabled the detection of advanced liver fibrosis and steatosis in patients with steatotic liver disease (SLD), which is prevalent worldwide. In patients with SLD, the presence of advanced liver fibrosis determines the risk of hepatocarcinogenesis, and UE and UA are expected to play important roles in liver cancer surveillance. We conducted a questionnaire survey among medical facilities in Saga Prefecture regarding the actual status of awareness and implementation of UE and UA. Methods A 16-item questionnaire was sent to 275 facilities that employed members of the Liver Cancer Control Medical Association in Saga Prefecture. The response rate was 56% (153 facilities), and data from 142 facilities were analyzed after excluding 11 facilities. Results The most common facilities were outpatient clinics (60%) followed by hospitals with ≥100 beds (14%). In 48% of the facilities, an average of 10-49 abdominal ultrasound examinations were performed monthly. The rates of recognition that UE and UA are useful for fibrosis and steatosis were 65% (92/142) and 41% (58/142), respectively. The actual availability of UE and UA in facilities with ultrasound machines was 21% (30/142) and 12% (17/142), respectively; UE and UA were used in 90% (27/30) and 88% (15/17) of these facilities, respectively. Conclusion Even among medical facilities in Saga Prefecture that are active in liver cancer surveillance, awareness of UE and UA is not high. The availability of UE and UA may be inadequate, considering the high prevalence of SLD.
目的 超声弹性成像(UE)和超声衰减成像(UA)的最新进展已能够检测出脂肪性肝病(SLD)患者的晚期肝纤维化和脂肪变性,SLD在全球范围内普遍存在。在SLD患者中,晚期肝纤维化的存在决定了肝癌发生的风险,预计UE和UA在肝癌监测中发挥重要作用。我们针对佐贺县医疗机构中UE和UA的认知及应用实际情况进行了问卷调查。方法 向佐贺县肝癌防治医学协会成员所在的275家医疗机构发送了一份包含16个项目的问卷。回复率为56%(153家机构),排除11家机构后,对142家机构的数据进行了分析。结果 最常见的机构是门诊诊所(60%),其次是拥有≥100张床位的医院(14%)。48%的机构每月平均进行10 - 49次腹部超声检查。认为UE和UA对纤维化和脂肪变性有用的比例分别为65%(92/142)和41%(58/142)。配备超声设备的机构中UE和UA的实际可用率分别为21%(30/142)和12%(17/142);在这些机构中,分别有90%(27/30)和88%(15/17)使用了UE和UA。结论 即使在佐贺县积极开展肝癌监测的医疗机构中,对UE和UA的认知也不高。考虑到SLD的高患病率,UE和UA的可用率可能不足。