| 摘要: |
| 【摘要】目的 探讨超声衰减成像（ATI）技术无创诊断代谢相关性脂肪肝（MAFLD）的临床价值及其影响因素。方法 自我院体检科、肝病科、内分泌科招募受试者122例进行前瞻性研究，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，比较上述两组上述指标的差异。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与CAP、ATI与二维超声分级诊断脂肪肝的相关性及各临床资料对衰减系数（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，高于健康对照组（0.58±0.45）dB·cm-1·MHz-1，且AC值随着脂肪肝程度的增加而逐渐增大，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%。相干性分析显示，ATI与CAP、ATI与二维超声分级在诊断MAFLD方面表现呈正相关（r=0.940、0.851，均P＜0.0001）；多元线性回归分析显示，AC值的变化不受临床资料的影响，仅与脂肪肝程度相关。结论 ATI技术在诊断MAFLD及其程度分级方面具有良好的诊断效能，并与CAP、二维超声分级显著相关，且AC值变化不受临床参数的影响，仅与脂肪肝程度相关。 |
| 关键词: 超声检查 声衰减成像 代谢相关性脂肪肝 定量诊断 受控衰减成像 |
| DOI： |
| 投稿时间：2022-05-11修订日期：2022-11-14 |
| 基金项目:国家自然科学基金（81760844）；广西自然科学基金（2020GXNSFAA297098）；广西中医药适宜技术开发与推广项目（GZSY21-22）；广西自治区中医药局自筹课题（GZZC2019056）;广西中医药大学校级面上项目（2019MS028） |
|
| Clinical value and influencing factors of acoustic attenuation imaging in the diagnosis of metabolic fatty liver |
| Wang Dan,Long Fuli,Lian Su,Wu Yedong,Li Jian,Peng Ziming,Mo Qiuyan,Tian Liling,Lu Bin,Liu Xueling |
| (The First Affifiliated Hospital of Guangxi University of Traditional Chinese Medicine) |
| Abstract: |
| Abstract: Objective To explore the clinical value and influencing factors of noninvasive ultrasound attenuation imaging (ATI) in the diagnosis of metabolic fatty liver disease (MAFLD).Methods 122 subjects were recruited from the physical examination department, hepatology department and endocrinology department of our hospital for a prospective study. They were divided into 31 healthy volunteers (normal control group) and 91 patients with MAFLD (MAFLD group). All subjects were examined by abdominal two-dimensional ultrasound, ATI, controlled attenuation imaging (CAP) and serology. The differences of the above indicators between the two groups were compared. Based on the results of CAP examination, the ROC curve of subjects was drawn to analyze the efficacy of ATI in the diagnosis of fatty liver at different levels, and the correlation between ATI and CAP, ATI and two-dimensional ultrasound grading in the diagnosis of fatty liver, as well as the influence of various clinical data on the attenuation coefficient (AC) value.Results There were significant differences in body mass index, triglyceride, alanine aminotransferase and glutamic oxaloacetic transaminase between MAFLD group and normal control group (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 healthy control group (0.58 ± 0.45) dB · cm-1 · MHz-1. The AC value increased with the increase of fatty liver degree, and the difference was statistically significant (all P＜0.05). ROC curve analysis showed that the cutoff value of AC value in diagnosis of ≥ S1, ≥ S2, ≥ S3 fatty liver was 0.64, 0.70, 0.79 dB · cm-1 · MHz-1, the sensitivity was 89.7%, 80.6%, 100%, and the specificity was 90.3%, 69.0%, 87.1%, respectively. Coherence analysis showed that ATI was positively correlated with CAP, ATI with two-dimensional ultrasound grading in the diagnosis of MAFLD (r=0.940, 0.851, all P＜0.0001); Multivariate linear regression analysis showed that the change of AC value was not affected by clinical data, but only related to the degree of fatty liver. Conclusion ATI technology has good diagnostic efficacy in diagnosing MAFLD and its degree grading, and is significantly related to CAP and two-dimensional ultrasound grading, and the change of AC value is not affected by clinical parameters, but only related to the degree of fatty liver. |
| Key words: Ultrasonic examination Attenuation imaging Metabolic-associated fatty liver disease Quantitative diagnosis Controlled attenuation parameter |
