衰减成像与控制衰减参数的诊断性能,以MRI为基的质子密度脂肪分数作为参考标准:一个前性的多中心研究
Takashi Nishimura1,2, Toshifumi Tada3, Tomoyuki Akita4
1Division of Hepatobiliary and Pancreatic Disease, Department of Gastroenterology, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Japan.
Journal of gastroenterology
|February 24, 2025
概括
与控制衰减参数 (CAP) 相比,衰减成像 (ATI) 是一种更有效的非侵入性工具,用于诊断肝肥胖症. 这项研究发现,ATI在肝脏脂肪积累的所有等级上都表现出卓越的诊断性能.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 医疗成像医学成像
- 诊断性超声波 超声波 超声波 超声波
背景情况:
- 肝硬化症诊断依赖于非侵入性方法,如减弱成像 (ATI) 和受控减弱参数 (CAP).
- 在诊断肝硬化时,ATI的临床实用性数据仍然有限.
- 基于磁共振成像的质子密度脂肪分数 (MRI-PDFF) 被确立为参考标准.
研究的目的:
- 为了比较ATI和CAP对肝硬化症的诊断准确度.
- 为了验证这些基于超声波的方法与MRI-PDFF对比.
- 评估各种患者子组的ATI和CAP的表现.
主要方法:
- 一项前性多中心研究,涉及562名患有慢性肝病的患者.
- 同时进行ATI,CAP和MRI-PDFF测量.
- CAP探针选择 (M或XL) 基于皮肤到肝脏的囊距离 (SCD).
- 通过MRI-PDFF定义的肝硬化等级是:S0 (<5.2%),S1 (5.2%-11.3%),S2 (11.3%-17.1%),S3 (≥17.1%). 肝硬化等级包括:S0 (<5.2%),S1 (5.2%-11.3%),S2 (11.3%-17.1%),S3 (≥17.1%). 肝硬化等级包括:
主要成果:
- 在各种患者层 (BMI,SCD,弹性图,纤维化指数) 中,ATI与MRI-PDFF的相关系数明显高于CAP.
- 在所有等级 (≥S1,≥S2,S3) 的肝肥胖症诊断中,ATI的曲线下面面积 (AUC) 值优于CAP.
- 具体来说,ATI的AUC分别为0.895 (≥S1),0.944 (≥S2) 和0.928 (S3),而CAP的AUC分别为0.845,0.881和0.860.
结论:
- 减弱成像 (ATI) 与受控减弱参数 (CAP) 相比,表现出肝肥胖症的诊断性能优越.
- ATI是一种临床上更有用的基于超声波的非侵入性方法,用于评估肝脏脂肪.
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