摘要
目的探讨超声声衰减成像(ATI)对代谢相关脂肪性肝病脂肪变性程度诊断及分级的应用价值。资料与方法回顾性选取2021年10月—2022年3月在华北理工大学附属医院行肝脏灰阶超声、ATI检查及MRI上腹部成像m Dixon序列扫查者161例,以m Dixon技术测量的肝脏质子密度脂肪分数(PDFF)分级为参照,分析不同程度肝脂肪变性患者的声衰减系数(AC)及其与临床指标间的相关性,采用受试者工作特征曲线评估ATI对不同程度脂肪肝的诊断效能。结果根据MRI-PDFF分级,S0级、S1级、S2级与S3级脂肪肝的AC值分别为(0.58±0.05)、(0.66±0.05)、(0.78±0.05)及(0.89±0.04)dB/cmoMHz,不同程度脂肪肝分级AC值比较,差异有统计学意义(F=133.819,P<0.05)。AC值与PDFF脂肪肝分级呈高度正相关(r=0.913,P<0.05),与体重指数、腰围呈中度正相关(r=0.553、0.524,P均<0.05),与三酰甘油、空腹血糖、皮肤肝包膜距离、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇呈低度正相关(r=0.390、0.300、0.298、0.291、0.189、0.170,P均<0.05)。ATI诊断各级别脂肪肝的阳性分界值分别为:S1级及以上0.642d B/cmoMHz[曲线下面积(AUC)0.951,敏感度90.1%,特异度92.5%],S2级及以上0.724 dB/cmoMHz(AUC 0.980,敏感度95.9%,特异度95.5%),S3级及以上0.830 dB/cmoMHz(AUC 0.987,敏感度94.1%,特异度93.7%)。结论ATI可对代谢相关脂肪性肝病脂肪变性程度进行分级诊断;AC值与PDFF脂肪肝分级、体重指数、腰围、皮肤肝包膜距离以及空腹血糖等实验室指标具有一定的相关性。
Purpose To explore the clinical value of attenuation imaging(ATI)in the diagnosis and grading of steatosis in metabolic dyfunction-associated fatty liver disease(MAFLD).Materials and Methods A total of 161 patients were retrospectively selected from October 2021 to March 2022 in the Affiliated Hospital of North China University of Science and Technology underwent gray-scale ultrasound,ATI and MRI mDixon sequence scanning of the liver.Taking the liver proton density fat fraction(PDFF)measured by mDixon technology as the reference,the attenuation coefficient(AC)of patients with different degrees of hepatic steatosis and its correlation with clinical indexes were analyzed,and the diagnostic efficacy of ATI for different degrees of liver steatosis was further evaluated by receiver operator characteristic curve.Results According to MRI-PDFF classification,the AC values of S0,S1,S2 and S3 fatty liver were(0.58±0.05),(0.66±0.05),(0.78±0.05),(0.89±0.04)dB/cmoMHz,respectively.There was significant difference in AC values among different degrees of fatty liver classification(F=133.819,P<0.05).AC value was highly positively correlated with PDFF fatty liver grade(r=0.913,P<0.05),and moderately positively correlated with body mass index and waist circumference(r=0.553,0.524,P<0.05).There were low positive correlations with triglyceride,fasting blood glucose,skin and liver envelope distance,total cholesterol,low density lipoprotein cholesterol and high density lipoprotein cholesterol(r=0.390,0.300,0.298,0.291,0.189,0.170,all P<0.05).The positive cut-off values of ATI for diagnosis of fatty liver at all levels were:class S1 and above 0.642 dB/cmoMHz[area under the curve(AUC)0.951,sensitivity 90.1%,specificity 92.5%],class S2 and above 0.724 dB/cmoMHz(AUC 0.980,sensitivity 95.9%,specificity 95.5%).0.830 dB/cmoMHz for grade S3 and above(area under the curve was 0.987,sensitivity was 94.1%,specificity was 93.7%).Conclusion ATI can be used to grade and diagnose the degree of steatosis in metabolism-related fatty liver disease.A
作者
林颖鑫
孟健
冯蕾
张树华
LIN Yingxin;MENG Jian;FENG Lei;ZHANG Shuhua(Department of Ultrasonography,the Affiliated Hospital of North China University of Technology,Tangshan 063000,China;不详)
出处
《中国医学影像学杂志》
CSCD
北大核心
2023年第10期1080-1084,1102,共6页
Chinese Journal of Medical Imaging
关键词
代谢相关脂肪性肝病
超声声衰减成像
肝脏质子密度脂肪分数
磁共振成像
诊断
鉴别
Metabolic dyfunction-associated fatty liver disease
Attenuation imaging
Protondensity fatfraction
Magnetic resonance imaging
Diagnosis,differential
