超声脂肪分数定量检测肝脂肪变性的可靠性研究

Quantitative assessment of hepatic steatosis:feasibility of ultrasound-derived fat fraction

目的:探讨超声脂肪分数(ultrasound-derived fat fraction,UDFF)定量检测成人肝脂肪变性的可行性。方法:前瞻性地收集2023年1—2月于上海交通大学医学院附属新华医院行健康检查的患者,并行UDFF检查。分别在患者的肝Ⅴ段和Ⅷ段进行3次UDFF测量,获得均值用于分析。自动测量皮肤距感兴趣区中央的深度。采用组内相关系数(intra-class correlation coefficient,ICC)、Bland-Altman图和Spearman相关检验评估UDFF技术的可重复性和再现性。结果:共纳入38例患者,UDFF值为6.5%(4.0%,15.6%)。脂肪肝患者的UDFF值为15.8%(8.4%,15.8%),显著高于无脂肪肝者的UDFF值4.0%(3.6%,4.9%)(P<0.001)。UDFF值与测量深度之间相关性中等(r=0.546,P<0.001)。自肝Ⅴ段和Ⅷ段获取的3次UDFF值一致性良好(ICC=0.882,95%CI 0.833~0.919)。肝Ⅴ段与Ⅷ段的UDFF值之间差异无统计学意义(P=0.697)。结论:UDFF技术作为无创、定量的检测技术,在肝脂肪变性的评估中具有较高的可靠性。

Objectives:To explore the feasibility of ultrasound-derived fat fraction(UDFF)measurement in adult patients in whom fatty liver was suspected.Methods:In this prospective study,participants were initially enrolled in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between January and February 2023 and received UDFF measurements.UDFF measurement was performed three times to obtain UDFF values from each imaging location(Ⅴhepatic segment andⅧhepatic segment)per participant,and the depth(skin-to-capsule distance)was automatically measured.The median of the acquired overall median UDFF values was used for statistical analysis.The Intra-class correlation coefficient(ICC),Spearman’s correlation test,and Bland-Altman plot were performed to assess the repeatability and reproducibility of UDFF measurement.Results:Totally,38 participants were included in this study,and the UDFF value of the participants was 6.5%(4.0%,15.6%).Participants with fatty liver had a UDFF value of 15.8%(9.6%,17.5%),significantly higher than that of participants without fatty liver,4.0%(3.6%,4.9%)(P<0.001).The UDFF values from the three times UDFF acquisitions obtained during each ultrasound examination showed excellent agreement(ICC=0.882,95%CI 0.833-0.919).The spearman correlation of UDFFs in different depths was moderate(r=0.546,P<0.001).No significant differences in UDFF values were found betweenⅤhepatic segment andⅧhepatic segment(P=0.697).Conclusion:UDFF is a feasibility non-invasive imaging tool for the detection of hepatic steatosis.