摘要
目的探讨超声声衰减成像(ATI)技术诊断代谢相关性脂肪肝(MAFLD)的临床价值,分析其影响因素。方法前瞻性选取我院体检科、肝病科、内分泌科招募的122例受试者,分为健康志愿者31例(正常对照组)和MAFLD患者91例(MAFLD组),所有受试者均行腹部二维超声、ATI、受控衰减成像(CAP)及血清学检查,比较两组各参数的差异。以CAP检查结果为标准,绘制受试者工作特征(ROC)曲线分析ATI诊断不同程度脂肪肝的效能;分析ATI所测衰减系数(AC)值与CAP值、二维超声分级的相关性及各临床资料对AC值的影响。结果MAFLD组与正常对照组体质量指数、甘油三酯、谷丙转氨酶、谷草转氨酶、二维超声分级比较,差异均有统计学意义(均P<0.05)。MAFLD组AC值为(0.79±0.11)dB·cm^(-1)·MHz^(-1),高于正常对照组[(0.58±0.45)dB·cm^(-1)·MHz^(-1)],且AC值随着脂肪肝程度的增加逐渐增大,差异均有统计学意义(均P<0.05)。ROC曲线分析显示,AC值诊断≥S1、≥S2、≥S3级脂肪肝的截断值分别为0.64、0.70、0.79 dB·cm^(-1)·MHz^(-1),灵敏度分别为89.7%、80.6%、100%,特异度分别为90.3%、69.0%、87.1%,曲线下面积分别为0.959、0.799、0.965。Pearson相关性分析显示,AC值与CAP值、二维超声分级均呈正相关(r=0.940、0.851,均P<0.01);多元线性回归分析显示,AC值与二维超声分级、CAP值均呈线性正相关。结论ATI技术对MAFLD的诊断及其分级具有良好的效能,AC值变化仅与脂肪肝程度相关。
Objective To investigate the clinical value of ultrasound attenuation imaging(ATI)in the diagnosis of metabolic-associated fatty liver disease(MAFLD),and to analyze its influence factors.Methods One hundred and twenty-two subjects were recruited from the department of physical examination,department of hepatology,and department of endocrinology of our hospital were selected and divided into 31 healthy volunteers(normal control group)and 91 patients with MAFLD(MAFLD group).All subjects underwent abdominal two-dimensional ultrasound,ATI,controlled attenuation parameter(CAP)and serological examinations,the differences in each parameter between the two groups were compared.Taking the results of CAP as standard,the efficacy of ATI in diagnosing different degrees of fatty liver was analyzed by receiver operating characteristic(ROC)curve.The correlation between the attenuation coefficient(AC)value measured by ATI and CAP value,two-dimensional ultrasound grading and the influence of clinical data on AC value were analyzed.Results The differences in body mass index,triglyceride,alanine aminotransferase,glutamic oxaloacetic transaminase,two-dimensional ultrasound grading between MAFLD group and normal control group were statistically significant(all P<0.05).The AC value of MAFLD group was(0.79±0.11)dB·cm^(-1)·MHz^(-1),which was higher than that of the normal control group[(0.58±0.45)dB·cm^(-1)·MHz^(-1)].The AC value increased with the increasing of fatty liver degree,and the differences were statistically significant(all P<0.05).ROC curve analysis showed that the cut-off value of AC value for diagnosing fatty liver of grades≥S1,≥S2,≥S3 were 0.64,0.70,0.79 dB·cm^(-1)·MHz^(-1),respectively,with sensitivities of 89.7%,80.6%and 100%,and specificities of 90.3%,69.0%and 87.1%,respectively.The area under the curve were 0.959,0.799 and 0.965,respectively.Pearson correlation analysis showed that AC value was positively correlated with CAP value and two-dimensional ultrasound grading(r=0.940,0.851,both P<0.01),multiple linear regression analysis showed that there was linear positive correlation between AC value and two-dimensional ultrasound grading,CAP value.Conclusion ATI can be used to diagnose MAFLD and grade it effectively,AC value is only related to the degree of fatty liver.
作者
王丹
龙富立
连溯
伍业冬
李坚
彭子明
莫秋艳
田丽玲
陆斌
刘雪玲
WANG Dan;LONG Fuli;LIAN Su;WU Yedong;LI Jian;PENG Ziming;MO Qiuyan;TIAN Liling;LU Bin;LIU Xueling(Department of Ultrasound,the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,Nanning 530023,China;不详)
出处
《临床超声医学杂志》
CSCD
2023年第1期8-12,共5页
Journal of Clinical Ultrasound in Medicine
基金
国家自然科学基金项目(81760844)
广西自然科学基金项目(2020GXNSFAA297098)
广西医疗卫生适宜技术开发与推广应用项目(S2019022)
广西壮族自治区中医药管理局自筹课题(GZZC2019056)
广西中医药大学校级面上项目(2019MS028)。
关键词
超声检查
声衰减成像
代谢相关性脂肪肝
受控衰减成像
定量诊断
Ultrasonography
Attenuation imaging
Metabolic-associated fatty liver disease
Controlled attenuation parameter
Quantitative diagnosis
