超声衍生脂肪分数对代谢异常相关脂肪性肝病的诊断效能  

Performance of ultrasound derived fat fraction on diagnosing metabolic dysfunction associated steatotic liver disease

作　　者：韩佳豪 李嘉[1] 沈会明[1] 宋丹蕾 王萍萍 高瑞霞 Han Jiahao;Li Jia;Shen Huiming;Song Danlei;Wang Pingping;Gao Ruixia(Department of Ultrasound,Zhongda Hospital Southeast University,Nanjing 210009,China)

机构地区：[1]东南大学附属中大医院超声医学科,南京210009

出　　处：《中华超声影像学杂志》2024年第8期703-711,共9页Chinese Journal of Ultrasonography

基　　金：南京市卫生科技发展项目(YKK21275)。

摘　　要：目的探讨超声衍生脂肪分数(UDFF)测量肝脂肪变性程度与磁共振质子密度脂肪分数(MRI PDFF)间的一致性,及其诊断代谢异常相关脂肪性肝病(MASLD)的能力。方法前瞻性纳入2023年11月至2024年2月于东南大学附属中大医院住院治疗需行腹部超声检查的患者107例以及招募的健康志愿者125例,使用UDFF及MRI PDFF分别测量患者肝脂肪变性程度,使用Spearman相关性分析及Bland-Altman图检验UDFF及MRI PDFF测值的一致性,使用ROC曲线检验UDFF对MASLD的诊断能力。结果在本研究入组人群中,相较于无肝脂肪变性受检者,MASLD患者体质指数(BMI)、腰臀比、糖尿病患病率、血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰转移酶(GGT)、三酰甘油水平以及UDFF测值更高(均P<0.05)。UDFF测量的肝脂肪变性程度与MRI PDFF测量结果呈强相关[ρ=0.873(95%CI=0.837~0.901),P<0.001]。UDFF诊断MASLD的ROC曲线下面积(AUC)为0.983(95%CI=0.956~0.995,P<0.001),最佳诊断阈值为≥6%,其诊断能力优于基于二维超声的半定量分级以及超声衰减参数(P<0.001)。结论UDFF测量的肝脂肪变性程度与MRI PDFF的测量结果一致性较好,并且对MASLD具有很好的诊断能力,可以作为测量肝脂肪变性程度及诊断MASLD的可靠影像学手段。Objective To investigate the agreement of ultrasound derived fat fraction(UDFF)with magnetic resonance imaging proton density fat fraction(MRI PDFF)on evaluating hepatic steatosis,and the performance of UDFF on diagnosing metabolic dysfunction associated steatotic liver disease(MASLD).Methods One hundred and twenty-five volunteers and one hundred and seven inpatients who underwent abdominal ultrasound examination in Zhongda Hospital Southeast University from November 2023 to February 2024 were prospectively enrolled.UDFF and MRI PDFF were applied to evaluate hepatic steatosis.Spearman correlation test and Bland-Altman plot were applied to analyze the agreement of UDFF and MRI PDFF.Receiver operating characteristic curve(ROC)was applied to calculate the performance of UDFF on diagnosing MASLD.Results In our participants,compared to individuals without hepatic steatosis,patients with MASLD had higher body mass index(BMI),waist-to-hip ratio,prevalence of diabetes mellitus,levels of alanine transaminase(ALT),aspertate aminotransferase(AST),alkaline phosphatase(ALP),γ-glutamyl transpeptidase(GGT),triglyceride,and UDFF(all P<0.05).The percentage of hepatic steatosis measured by UDFF and MRI PDFF was strongly correlated[ρ=0.873(95%CI=0.837-0.901),P<0.001].UDFF performed excellent for diagnosing MASLD with an area under the curve(AUC)of 0.983(95%CI=0.956-0.995,P<0.001),and was better than semi-quantitative assessment based on two-dimensional ultrasound as well as ultrasound attenuation parameter.The optimal cut off value of UDFF to diagnose MASLD was≥6%.Conclusions The percentage of hepatic steatosis measured by UDFF and MRI PDFF agrees with each other,and UDFF obtains an excellent performance on diagnosing MASLD,so that UDFF should be considered a reliable imaging technique for quantitively evaluating hepatic steatosis and diagnosing MASLD.

关 键 词：超声检查 超声衍生脂肪分数 代谢异常相关脂肪性肝病 肝脂肪变性 

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]