Huang Yunlin, Sun Chao, Cheng Juan, Wang Ying, Qiu Yijie, Wang Shiwen, Wang Ming, Wei Li, Cheng Rui, Fan Jian-Gao, Dong Yi
Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, 1665 Kong Jiang Road, Shanghai, 200092, China.
Pediatr Radiol. 2025 Aug 1. doi: 10.1007/s00247-025-06349-5.
Metabolic dysfunction-associated steatotic liver disease is increasingly affecting younger populations. Ultrasound-derived fat fraction is a technique used in ultrasound to quantify liver fat content. The diagnostic performance of ultrasound-derived fat fraction in pediatric patients with metabolic dysfunction-associated steatotic liver disease is yet to be evaluated.
To evaluate the diagnostic performance of ultrasound-derived fat fraction measurement in detecting and grading hepatic steatosis in pediatric patients with metabolic dysfunction-associated steatotic liver disease.
In this prospective study, pediatric patients diagnosed with metabolic dysfunction-associated steatotic liver disease were enrolled. Six acquisitions of ultrasound-derived fat fraction were obtained. Taking magnetic resonance imaging (MRI)-proton density fat fraction as a reference standard, the area under the receiver operating characteristic curve (AUC) was performed to evaluate the diagnostic performance of ultrasound-derived fat fraction. Youden index was used to determine the cutoff value of ultrasound-derived fat fraction. Correlation coefficient and Bland-Altman plot were performed.
From April 2024 to March 2025, 32 patients (median age, 12 years; median body mass index, 29.7 kg/m) were included. The ultrasound-derived fat fraction values showed a positive correlation with MRI-proton density fat fraction (r = 0.72). The ultrasound-derived fat fraction values and MRI-proton density fat fraction had a mean bias of 3.3% (95% limits of agreement: -16.4, 23.1). Using MRI-proton density fat fractions ≥ 5%, ≥ 15%, and ≥ 25% as the reference standard for diagnosing hepatic steatosis grade ≥ S1, ≥ S2, and S3, the AUCs of ultrasound-derived fat fraction were 0.84, 0.88, and 0.88, with the cutoff values of 9.5%, 10.5%, and 12.8%, respectively.
Ultrasound-derived fat fraction demonstrates promising diagnostic performance for detecting and grading hepatic steatosis in pediatric patients with metabolic dysfunction-associated steatotic liver disease within this cohort.
代谢功能障碍相关脂肪性肝病正越来越多地影响年轻人群。超声衍生脂肪分数是一种在超声检查中用于量化肝脏脂肪含量的技术。超声衍生脂肪分数在患有代谢功能障碍相关脂肪性肝病的儿科患者中的诊断性能尚未得到评估。
评估超声衍生脂肪分数测量在诊断患有代谢功能障碍相关脂肪性肝病的儿科患者肝脂肪变性及分级中的诊断性能。
在这项前瞻性研究中，纳入了被诊断为代谢功能障碍相关脂肪性肝病的儿科患者。获取了六次超声衍生脂肪分数测量值。以磁共振成像（MRI）-质子密度脂肪分数作为参考标准，通过绘制受试者操作特征曲线（ROC）下面积（AUC）来评估超声衍生脂肪分数的诊断性能。采用约登指数确定超声衍生脂肪分数的临界值。进行了相关系数分析和布兰德-奥特曼图分析。
2024年4月至2025年3月，共纳入32例患者（中位年龄12岁；中位体重指数29.7kg/m²）。超声衍生脂肪分数值与MRI-质子密度脂肪分数呈正相关（r = 0.72）。超声衍生脂肪分数值与MRI-质子密度脂肪分数的平均偏差为3.3%（95%一致性界限：-16.4，23.1）。以MRI-质子密度脂肪分数≥5%、≥15%和≥25%作为诊断肝脂肪变性≥S1级、≥S2级和≥S3级的参考标准时，超声衍生脂肪分数的AUC分别为0.84、0.88和0.88，临界值分别为9.5%、10.5%和12.8%。
在该队列中，超声衍生脂肪分数在诊断患有代谢功能障碍相关脂肪性肝病的儿科患者肝脂肪变性及分级方面显示出良好的诊断性能。
