Huang Yun-Lin, Sun Chao, Wang Ying, Cheng Juan, Wang Shi-Wen, Wei Li, Lu Xiu-Yun, Cheng Rui, Wang Ming, Fan Jian-Gao, Dong Yi
Department of Ultrasound, Zhongshan Hospital Fudan University, Shanghai, China.
Center for Fatty Liver Disease, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China.
Ultrasonography. 2025 Mar;44(2):134-144. doi: 10.14366/usg.24204. Epub 2024 Dec 19.
This study assessed the performance of the ultrasound-guided attenuation parameter (UGAP) in diagnosing and grading hepatic steatosis in patients with metabolic dysfunctionassociated steatotic liver disease (MASLD). Magnetic resonance imaging proton density fat fraction (MRI-PDFF) served as the reference standard.
Patients with hepatic steatosis were enrolled in this prospective study and underwent UGAP measurements. MRI-PDFF values of ≥5%, ≥15%, and ≥25% were used as references for the diagnosis of steatosis grades ≥S1, ≥S2, and S3, respectively. Spearman correlation coefficients and area under the receiver operating characteristic curves (AUCs) were calculated.
Between July 2023 and June 2024, the study included 88 patients (median age, 40 years; interquartile range [IQR], 36 to 46 years), of whom 54.5% (48/88) were men and 45.5% (40/88) were women. Steatosis grades exhibited the following distribution: 22.7% (20/88) had S0, 50.0% (44/88) had S1, 21.6% (19/88) had S2, and 5.7% (5/88) had S3. The success rate for UGAP measurements was 100%. The median UGAP value was 0.74 dB/cm/MHz (IQR, 0.65 to 0.82 dB/ cm/MHz), and UGAP values were positively correlated with MRI-PDFF (r=0.77, P<0.001). The AUCs of UGAP for the diagnoses of ≥S1, ≥S2, and S3 steatosis were 0.91, 0.90, and 0.88, respectively. In the subgroup analysis, 98.4% (60/61) of patients had valid controlled attenuation parameter (CAP) values. UGAP measurements were positively correlated with CAP values (r=0.65, P<0.001).
Using MRI-PDFF as the reference standard, UGAP demonstrates good diagnostic performance in the detection and grading of hepatic steatosis in patients with MASLD.
本研究评估了超声引导下衰减参数（UGAP）在诊断代谢功能障碍相关脂肪性肝病（MASLD）患者肝脂肪变性及对其进行分级中的性能。磁共振成像质子密度脂肪分数（MRI-PDFF）作为参考标准。
肝脂肪变性患者纳入本前瞻性研究并接受UGAP测量。MRI-PDFF值≥5%、≥15%和≥25%分别用作诊断脂肪变性分级≥S1、≥S2和S3的参考标准。计算Spearman相关系数和受试者操作特征曲线下面积（AUC）。
2023年7月至2024年6月期间，该研究纳入88例患者（中位年龄40岁；四分位间距[IQR]，36至46岁），其中54.5%（48/88）为男性，45.5%（40/88）为女性。脂肪变性分级分布如下：22.7%（20/88）为S0，50.0%（44/88）为S1，21.6%（19/88）为S2，5.7%（5/88）为S3。UGAP测量成功率为100%。UGAP中位值为0.74 dB/cm/MHz（IQR，0.65至0.82 dB/cm/MHz），UGAP值与MRI-PDFF呈正相关（r = 0.77，P < 0.001）。UGAP诊断≥S1、≥S2和S3脂肪变性的AUC分别为0.91、0.90和0.88。在亚组分析中，98.4%（60/61）的患者有有效的受控衰减参数（CAP）值。UGAP测量与CAP值呈正相关（r = 0.65，P < 0.001）。
以MRI-PDFF作为参考标准，UGAP在MASLD患者肝脂肪变性的检测和分级中表现出良好的诊断性能。
