基于MRI图像评估肝脂肪变性时衰减测量与受控衰减参数的比较

Comparison Between Attenuation Measurement and the Controlled Attenuation Parameter for the Assessment of Hepatic Steatosis Based on MRI Images.

作者信息

Gotoh Tatsuya, Kumada Takashi, Ogawa Sadanobu, Niwa Fumihiko, Toyoda Hidenori, Hirooka Masashi, Koizumi Yohei, Hiasa Yoichi, Akita Tomoyuki, Tanaka Junko, Shimizu Masahito

机构信息

Department of Imaging Diagnosis, Ogaki Municipal Hospital, Ogaki, Japan.

Department of Nursing, Faculty of Nursing, Gifu Kyoritsu University, Ogaki, Japan.

出版信息

Liver Int. 2025 Jan;45(1):e16210. doi: 10.1111/liv.16210.

DOI:10.1111/liv.16210

PMID:39673700

Abstract

BACKGROUND AND AIMS

This study prospectively compared the diagnostic accuracies of the improved Attenuation Measurement (iATT) algorithm and the Controlled Attenuation Parameter (CAP) and assessed the interchangeability of iATT with magnetic resonance imaging-derived proton density fat fraction (MRI-derived PDFF).

METHODS

Patients with chronic liver disease were prospectively enrolled and underwent iATT, CAP and MRI-derived PDFF measurements for hepatic steatosis evaluation. According to MRI-derived PDFF values, steatosis grades were categorised as steatosis (S)0 (< 5.2%), S1 (≥ 5.2%, < 11.3%), S2 (≥ 11.3%, < 17.1%) and S3 (≥ 17.1%). Correlation coefficients (CCs) were determined, diagnostic performances were compared by the area under the receiver operating characteristic curve (AUROC) and agreement was evaluated using the calculated percentage error (PE) and expected limit of agreement (LOA).

RESULTS

A total of 414 patients (median age 64 years, 203 females) were evaluated. The CC between iATT and MRI-derived PDFF was 0.727 (95% confidence interval [CI] 0.678-0.770), which was higher than that between CAP and MRI-derived PDFF at 0.615 (95% CI 0.551-0.672) (p < 0.001). The AUROCs of iATT for ≥ S1, ≥ S2 and ≥ S3 were 0.901 (95% CI 0.870-0.931), 0.878 (95% CI 0.846-0.910) and 0.839 (95% CI 0.794-0.883), respectively. The diagnostic performances of iATT for ≥ S1 and ≥ S2 showed significantly higher AUROCs than those of CAP (p < 0.001, p = 0.036, respectively). The calculated PE and the expected LOA for CAP and iATT were 38.94% and 22.66% and 32.94% and 30.03%, respectively.

CONCLUSIONS

iATT was superior to CAP and comparable to MRI-derived PDFF in assessing hepatic steatosis.

TRIAL REGISTRATION

This study was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN000047411).

摘要

背景与目的

本研究前瞻性地比较了改良衰减测量（iATT）算法与受控衰减参数（CAP）的诊断准确性，并评估了iATT与磁共振成像衍生的质子密度脂肪分数（MRI衍生的PDFF）的互换性。

方法

前瞻性纳入慢性肝病患者，对其进行iATT、CAP测量以及MRI衍生的PDFF测量以评估肝脂肪变性。根据MRI衍生的PDFF值，将脂肪变性分级为脂肪变性（S）0（<5.2%）、S1（≥5.2%，<11.3%）、S2（≥11.3%，<17.1%）和S3（≥17.1%）。确定相关系数（CCs），通过受试者操作特征曲线下面积（AUROC）比较诊断性能，并使用计算出的百分比误差（PE）和预期一致性界限（LOA）评估一致性。

结果

共评估了414例患者（中位年龄64岁，女性203例）。iATT与MRI衍生的PDFF之间的CC为0.727（95%置信区间[CI]0.678 - 0.770），高于CAP与MRI衍生的PDFF之间的CC（0.615，95%CI 0.551 - 0.672）（p<0.001）。iATT对于≥S1、≥S2和≥S3的AUROC分别为0.901（95%CI 0.870 - 0.931）、0.878（95%CI 0.846 - 0.910）和0.839（95%CI 0.794 - 0.883）。iATT对于≥S1和≥S2的诊断性能显示出比CAP显著更高的AUROC（分别为p<0.001，p = 0.036）。计算得出的CAP和iATT的PE以及预期LOA分别为38.94%和22.66%以及32.94%和30.03%。