超声衰减成像无创诊断肝脏脂肪变性的价值  

Clinical value of ultrasound attenuation imaging in noninvasive diagnosis of hepatic steatosis

作　　者：王丹 连溯[1] 龙富立[2] 伍业冬[1] 莫秋艳 彭子明 梁春燕 周庆锋 陆斌[4] 刘雪玲[1] WANG Dan;LIAN Shuo;LONG Fuli;WU Yedong;MO Qiuyan;PENG Ziming;LIANG Chunyan;ZHOU Qingfeng;LU Bin;LIU Xueling(Department of Ultrasound,First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanjing 530023,China)

机构地区：[1]广西中医药大学第一附属医院超声科,广西南宁530023 [2]广西中医药大学第一附属医院肝病科,广西南宁530023 [3]广西中医药大学第一附属医院科研部,广西南宁530023 [4]广西中医药大学第一附属医院体检中心,广西南宁530023

出　　处：《中国中西医结合影像学杂志》2023年第5期531-535,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金(81760844);广西壮族自治区中医药局自筹课题(GZZC2019056);广西医疗卫生适宜技术开发与推广项目(S2019022);广西中医药大学校级面上项目(2019MS028);广西壮族自治区卫健委自筹课题(Z20200741,Z-A20230913)。

摘　　要：目的:探讨超声衰减成像(ATI)诊断不同程度肝脏脂肪变性的价值。方法:招募145例受试者进行前瞻性研究,以受控衰减成像(CAP)为参考标准,分析衰减系数值(ATI值)与受控衰减参数值(CAP值)的相关性,以及ATI诊断不同程度肝脏脂肪变性的效能。结果:ATI值与CAP值呈强正相关(r=0.915,P<0.000 1)。ATI值随肝脏脂肪变性程度的增加而增加,不同程度肝脏脂肪变性ATI值比较,差异均有统计学意义(均P<0.001)。以CAP作为参考标准,ATI诊断≥S1、≥S2、S3级肝脏脂肪变性的最佳阳性界值分别0.62、0.68、0.79 dB·cm^(-1)·MHz^(-1)。结论:ATI可无创定量诊断肝脏脂肪变性,有较高的诊断效能,且ATI值与CAP值呈强相关性。Objective:To investigate the value of the ultrasound attenuation imaging(ATI)technique for diagnosing different degrees of liver steatosis.Methods:A total of 145 subjects were recruited for a prospective study.Using controlled attenuation imaging(CAP)as reference standard,the correlation between ATI value and CAP value was analyzed,and the efficacy of ATI in diagnosing different degrees of hepatic steatosis was analyzed.Results:A strong positive correlation was demonstrated between ATI value and CAP value(r=0.915,P<0.0001).The mean value of ATI increased with the degree of liver steatosis,and the difference in the mean value of ATI between different degrees of liver steatosis was statistically significant(P<0.001).Using CAP as a reference standard,the best positive predictive values of ATI for diagnosing≥S1,≥S2,and S3 were 0.62,0.68,and 0.79 dB·cm-1·MHz-1,respectively.Conclusions:ATI is a good noninvasive quantitative diagnostic method of hepatic steatosis.It is highly efficient in the diagnosis of steatosis and has a strong correlation with CAP.

关 键 词：衰减成像 受控衰减成像 肝脏脂肪变性 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.5[医药卫生—诊断学]