Department of Radiology, Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2024 Oct;65(10):602-610. doi: 10.3349/ymj.2023.0440.
This study aimed to investigate the effect of respiratory motion on hepatic steatosis quantification using ultrasound attenuation imaging (ATI) or ultrasound-guided attenuation parameter (UGAP) in pediatric patients.
Pediatric patients (aged ≤18 years) who underwent liver ultrasonography (US) with ATI or UGAP between May 2022 and February 2023 were included retrospectively. Median, interquartile range (IQR), and IQR/median values were calculated in both free-breathing (FB) and breath-holding (BH) states. Subjects were divided into normal and fatty liver groups according to grayscale US. Wilcoxon signed rank test, intraclass correlation coefficient (ICC), and linear regression test were used.
A total of 83 patients (M:F=46:37, median age 10 years, range 6-17 years) was included, with 55 patients in the ATI group and 28 patients in the UGAP group. The measured values of ATI and UGAP were not significantly different between FB and BH. The ICC values between FB and BH states were 0.950 [95% confidence interval (CI) 0.916-0.971] for median ATI and 0.786 (95% CI 0.591-0.894) for median UGAP. FB and BH status did not significantly affect the median ATI and UGAP (=0.852, 0.531, respectively). The IQR/median value showed a significant association with age only in the FB status of the normal group using ATI (β= -0.014, =0.042).
Respiratory motion does not significantly affect the measurement of ATI or UGAP. Median ATI value showed excellent agreement in FB and BH status, while UGAP showed good agreement. Younger age may affect measurement variability in FB status of the normal group using ATI.
本研究旨在探讨呼吸运动对超声衰减成像（ATI）或超声引导衰减参数（UGAP）在儿科患者肝脏脂肪定量中的影响。
回顾性纳入 2022 年 5 月至 2023 年 2 月期间接受超声衰减成像（ATI）或超声引导衰减参数（UGAP）肝超声检查的儿科患者（年龄≤18 岁）。在自由呼吸（FB）和屏气（BH）状态下计算中位数、四分位距（IQR）和 IQR/中位数。根据灰阶超声将受试者分为正常肝和脂肪肝组。采用 Wilcoxon 符号秩检验、组内相关系数（ICC）和线性回归检验。
共纳入 83 例患者（男：女=46:37，中位年龄 10 岁，范围 6-17 岁），其中 ATI 组 55 例，UGAP 组 28 例。FB 和 BH 状态下 ATI 和 UGAP 的测量值无显著差异。FB 和 BH 状态下的 ICC 值分别为 0.950（95%置信区间 0.916-0.971）和 0.786（95%置信区间 0.591-0.894）。FB 和 BH 状态对中位 ATI 和 UGAP 无显著影响（=0.852，0.531）。IQR/中位数仅与 ATI 正常组的 FB 状态下的年龄呈显著相关（β=-0.014，=0.042）。
呼吸运动对 ATI 或 UGAP 的测量无显著影响。中位 ATI 值在 FB 和 BH 状态下具有极好的一致性，而 UGAP 则具有良好的一致性。在 ATI 的 FB 状态下，年龄较小可能会影响正常组的测量变异性。
