Chen Fei, An Jingjing, Deng Long, Wang Jing, He Ruiling
Department of Ultrasound, The First Hospital of Lanzhou University, Lanzhou, 730000, China.
Department of Ultrasound, Donggang Branch the First Hospital of Lanzhou University, Lanzhou, 730000, China.
BMC Med Imaging. 2025 Jan 7;25(1):10. doi: 10.1186/s12880-024-01549-1.
US tools to quantify hepatic steatosis have recently been made clinically available by different manufacturers, but comparative data on their consistency are lacking.
US tools to quantify hepatic steatosis have recently been made clinically available by different manufacturers, but comparative data on their consistency are lacking. The aim of our study was to compare the diagnostic consistency for evaluating hepatic steatosis by two different US techniques, hepatorenal index by B-mode Ratio and attenuation coefficient by attenuation imaging (ATI).
Patients with suspicion or previously diagnosed of metabolic dysfunction-associated steatotic liver disease (MASLD) who attended fatty liver consulting room from June 2023 to September 2023 were prospectively recruited. Patients underwent two different US techniques of B-mode Ratio and ATI, and laboratory test were collected. According to previously proposed cut-off values, B-mode Ratio ≥ 1.22, 1.42, 1.54, and ATI ≥ 0.62, 0.70, and 0.78 dB/cm/MH were used for assessing of mild, moderate, and severe hepatic steatosis, respectively. Kappa consistency test was used to evaluate the consistency of hepatic steatosis.
A total of 62 patients were enrolled, including 44 males (71.0%) with an age of (41 ± 13) years and a body mass index of (27.0 ± 3.5) kg/m. In the hyperlipidemia group, the B-mode Ratio and ATI were significantly higher than those in the non-hyperlipidemia group, with values of 1.68 ± 0.39 vs. 1.28 ± 0.35 (p = 0.001) and 0.74 ± 0.12 dB/cm/MH vs. 0.64 ± 0.11 dB/cm/MH (p = 0.005), respectively. The correlation coefficient between B-mode Ratio and ATI was 0.732 (p < 0.001). Using B-mode Ratio and ATI as diagnostic criteria for MASLD, the proportion of patients with MASLD was 79% and 82%, respectively. The Kappa coefficient for assessing MASLD was 0.90 (p < 0.001). Furthermore, these two different US techniques were used for grading hepatic steatosis, with no, mild, moderate, and severe steatosis accounting for 21%, 18%, 13%, and 48%, as well as 18%, 29%, 22%, and 31%, respectively. The linear weighted Kappa coefficient for staging hepatic steatosis was 0.78 (95% confidence interval: 0.68-0.87, p < 0.001).
The non-invasive methods of two different US techniques based on B-mode Ratio and ATI have good consistency for evaluating hepatic steatosis, and can be used for large-scale community screening.
美国用于量化肝脂肪变性的工具最近已由不同制造商投入临床使用，但缺乏关于它们一致性的比较数据。
美国用于量化肝脂肪变性的工具最近已由不同制造商投入临床使用，但缺乏关于它们一致性的比较数据。我们研究的目的是比较两种不同超声技术评估肝脂肪变性的诊断一致性，即B模式比值法测定肝肾指数和衰减成像（ATI）测量衰减系数。
前瞻性招募2023年6月至2023年9月在脂肪肝咨询室就诊的疑似或先前诊断为代谢功能障碍相关脂肪性肝病（MASLD）的患者。患者接受了B模式比值法和ATI这两种不同的超声技术检查，并收集了实验室检查结果。根据先前提出的临界值，B模式比值≥1.22、1.42、1.54，以及ATI≥0.62、0.70和0.78dB/cm/MH分别用于评估轻度、中度和重度肝脂肪变性。采用Kappa一致性检验评估肝脂肪变性的一致性。
共纳入62例患者，其中男性44例（71.0%），年龄（41±13）岁，体重指数（27.0±3.5）kg/m²。高脂血症组的B模式比值和ATI显著高于非高脂血症组，分别为1.68±0.39 vs. 1.28±0.35（p = 0.001）和0.74±0.12dB/cm/MH vs. 0.64±0.11dB/cm/MH（p = 0.005）。B模式比值与ATI的相关系数为0.732（p < 0.001）。以B模式比值和ATI作为MASLD的诊断标准，MASLD患者的比例分别为79%和82%。评估MASLD的Kappa系数为0.90（p < 0.001）。此外，这两种不同的超声技术用于肝脂肪变性分级，无、轻度、中度和重度脂肪变性分别占21%、18%、13%和48%，以及18%、29%、22%和31%。肝脂肪变性分期的线性加权Kappa系数为0.78（95%置信区间：0.68 - 0.87，p < 0.001）。
基于B模式比值法和ATI的两种不同超声技术的非侵入性方法在评估肝脂肪变性方面具有良好的一致性，可用于大规模社区筛查。
