Yagobian Shiva D, Dasyam Navya, Minervini Marta, Tublin Mitchell, Behari Jaideep, Furlan Alessandro
University of Pittsburgh School of Medicine, Pittsburgh, PA.
UPMC Department of Radiology, Pittsburgh, PA.
Ultrasound Q. 2024 Dec 23;41(1). doi: 10.1097/RUQ.0000000000000702. eCollection 2025 Mar 1.
The purpose of this study is to investigate the diagnostic accuracy of a new noninvasive imaging technique, ultrasound-guided attenuation parameter (UGAP), in diagnosing hepatic steatosis. This single-center retrospective study included 81 UGAP studies performed to guide therapy between July 2022 and June 2023 at a large academic medical center. Patients with either liver biopsy or Magnetic resonance-based proton-density fat fraction (MRI-PDFF) within 12 months of US-UGAP imaging, irrespective of order, were included. Patient demographics, body mass index, liver function tests, UGAP values, MRI-PDFF values, and liver biopsy results were obtained from a review of the medical records. Presence of steatosis was defined as PDFF >5.2% or >5% of hepatocytes with steatosis at pathology. Area under the ROC curve (AUROC) was used to measure UGAP accuracy for the detection of hepatic steatosis with statistical significance P < 0.05. There was a significant positive correlation between UGAP and MRI-PDFF (r = 0.463; P < 0.001; confidence interval [CI]: 0.220;0.651). The AUROC to differentiate absence of steatosis (n = 21) from presence of steatosis (n = 32) for UGAP with MRI as the gold standard was 0.760 (P < 0.001; CI: 0.623;0.867). A UGAP value >0.66 had 78% sensitivity and 67% specificity to identify steatosis presence on MRI-PDFF. The AUROC to differentiate absence of steatosis (n = 11) from presence of steatosis (n = 21) for UGAP with pathology as the gold standard was 0.894 (P < 0.001; CI: 0.734;0.974). A UGAP value >0.57 had 100% sensitivity and 64% specificity to identify steatosis presence at pathology. UGAP is an accurate measure for detecting the presence of hepatic steatosis and may be a noninvasive method for metabolic dysfunction-associated steatotic liver disease diagnosis and follow-up.
本研究的目的是调查一种新的非侵入性成像技术——超声引导衰减参数（UGAP）在诊断肝脂肪变性方面的诊断准确性。这项单中心回顾性研究纳入了2022年7月至2023年6月期间在一家大型学术医疗中心进行的81项用于指导治疗的UGAP研究。纳入在US-UGAP成像后12个月内进行肝活检或基于磁共振的质子密度脂肪分数（MRI-PDFF）检查的患者，检查顺序不限。通过查阅病历获取患者的人口统计学信息、体重指数、肝功能检查结果、UGAP值、MRI-PDFF值和肝活检结果。脂肪变性的存在定义为PDFF>5.2%或病理检查时脂肪变性的肝细胞>5%。采用ROC曲线下面积（AUROC）来衡量UGAP检测肝脂肪变性的准确性，统计学显著性P<0.05。UGAP与MRI-PDFF之间存在显著正相关（r=0.463；P<0.001；置信区间[CI]：0.220；0.651）。以MRI为金标准，UGAP区分无脂肪变性（n=21）和有脂肪变性（n=32）的AUROC为0.760（P<0.001；CI：0.623；0.867）。UGAP值>0.66时，识别MRI-PDFF上脂肪变性存在的灵敏度为78%，特异度为67%。以病理为金标准，UGAP区分无脂肪变性（n=11）和有脂肪变性（n=21）的AUROC为0.894（P<0.001；CI：0.734；0.974）。UGAP值>0.57时，识别病理检查时脂肪变性存在的灵敏度为100%，特异度为64%。UGAP是检测肝脂肪变性存在的一种准确方法，可能是一种用于代谢功能障碍相关脂肪性肝病诊断和随访的非侵入性方法。
