比较不同的肝脂肪变性诊断方法：最佳诊断工具是什么？
Comparing Different Methods for the Diagnosis of Liver Steatosis: What Are the Best Diagnostic Tools?
作者信息
Chopinet Sophie, Lopez Olivier, Brustlein Sophie, Uzel Antoine, Moyon Anais, Varlet Isabelle, Balasse Laure, Kober Frank, Bobot Mickaël, Bernard Monique, Haffner Aurélie, Sdika Michaël, Montcel Bruno, Guillet Benjamin, Vidal Vincent, Grégoire Emilie, Hardwigsen Jean, Brige Pauline
机构信息
Department of Digestive Surgery and Liver Transplantation, Hôpital la Timone, AP-HM, 13005 Marseille, France.
Aix Marseille Université, LIIE, 13007 Marseille, France.
出版信息
Diagnostics (Basel). 2024 Oct 16;14(20):2292. doi: 10.3390/diagnostics14202292.
BACKGROUND
Due to the ongoing organ shortage, marginal grafts with steatosis are more frequently used in liver transplantation, leading to higher occurrences of graft dysfunction. A histological analysis is the gold standard for the quantification of liver steatosis (LS), but has its drawbacks: it is an invasive method that varies from one pathologist to another and is not available in every hospital at the time of organ procurement. This study aimed to compare non-invasive diagnostic tools to a histological analysis for the quantification of liver steatosis.
METHODS
Male C57BL6J mice were fed with a methioninecholine-deficient (MCD) diet for 14 days or 28 days to induce LS, and were compared to a control group of animals fed with a normal diet. The following non-invasive techniques were performed and compared to the histological quantification of liver steatosis: magnetic resonance spectroscopy (MRS), CARS microscopy, Tc MIBI SPECT imaging, and a new near-infrared spectrometer (NIR-SG1).
RESULTS
After 28 days on the MCD diet, an evaluation of LS showed ≥30% macrovesicular steatosis. High correlations were found between the NIR-SG1 and the blinded pathologist analysis (R = 0.945) ( = 0.001), and between the CARS microscopy (R = 0.801 ( < 0.001); MRS, R = 0.898 ( < 0.001)) and the blinded pathologist analysis. The ROC curve analysis showed that the area under the curve (AUC) was 1 for both the NIR-SG1 and MRS ( = 0.021 and < 0.001, respectively), while the AUC = 0.910 for the Oil Red O stain ( < 0.001) and the AUC = 0.865 for the CARS microscopy ( < 0.001). The AUC for the Tc MIBI SPECT was 0.640 ( = 0.013), and this was a less discriminating technique for LS quantification.
CONCLUSIONS
The best-performing non-invasive methods for LS quantification are MRS, CARS microscopy, and the NIR-SG1. The NIR-SG1 is particularly appropriate for clinical practice and needs to be validated by clinical studies on liver grafts.
背景
由于持续存在的器官短缺问题，脂肪变性的边缘性移植物在肝移植中使用得越来越频繁，导致移植物功能障碍的发生率更高。组织学分析是肝脂肪变性（LS）定量的金标准，但有其缺点：它是一种侵入性方法，不同病理学家的结果存在差异，且在器官获取时并非每家医院都能进行。本研究旨在比较非侵入性诊断工具与组织学分析对肝脂肪变性进行定量。
方法
雄性C57BL6J小鼠喂食蛋氨酸胆碱缺乏（MCD）饮食14天或28天以诱导LS，并与喂食正常饮食的动物对照组进行比较。进行了以下非侵入性技术，并与肝脂肪变性的组织学定量进行比较：磁共振波谱（MRS）、相干反斯托克斯拉曼散射显微镜（CARS显微镜）、锝甲氧异腈单光子发射计算机断层扫描（Tc MIBI SPECT）成像和一种新型近红外光谱仪（NIR-SG1）。
结果
在MCD饮食28天后，对LS的评估显示大泡性脂肪变性≥30%。在NIR-SG1与不知情的病理学家分析之间（R = 0.945）（P = 0.001），以及在CARS显微镜（R = 0.801（P < 0.001）；MRS，R = 0.898（P < 0.001））与不知情的病理学家分析之间发现了高度相关性。ROC曲线分析表明，NIR-SG1和MRS的曲线下面积（AUC）均为1（分别为P = 0.021和P < 0.001），而油红O染色的AUC = 0.910（P < 0.001），CARS显微镜的AUC = 0.865（P < 0.001）。Tc MIBI SPECT的AUC为0.640（P = 0.013），这是一种对LS定量区分能力较差的技术。
结论
用于LS定量的性能最佳的非侵入性方法是MRS、CARS显微镜和NIR-SG1。NIR-SG1特别适用于临床实践，需要通过肝移植物的临床研究进行验证。
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