超声脂肪分数定量评估肥胖人群肝脏脂肪变性的临床价值

Clinical value of ultrasound-derived fat fraction in the quantitative assessment of hepatic steatosis in obese population

目的探讨超声脂肪分数(UDFF)定量评估肥胖人群肝脏脂肪变性的临床应用价值。方法选取经我院肝脏组织病理结果确诊的肥胖脂肪肝患者70例,其中S1级25例(S1级组),S2级20例(S2级组),S3级25例(S3级组)。应用超声获取各组皮肤到感兴趣区中心的测量深度和UDFF值,并比较其差异。由两名医师分别测量患者UDFF值,记录UDFF值的中位数进行操作者间的一致性分析,分析UDFF值与病理分级、临床资料及测量深度的相关性。绘制受试者工作特征(ROC)曲线分析UDFF值对不同程度肝脏脂肪变性的诊断效能。结果S1、S2、S3级组UDFF值分别为17.08%±7.15%、24.80%±5.22%、28.48%±5.22%,差异有统计学意义(P<0.05);各组测量深度比较差异无统计学意义。操作者间测量S1、S2、S3级组UDFF值的组内相关系数分别为0.809、0.777、0.759(均P<0.01),一致性均较好。相关性分析显示,UDFF值与病理分级、测量深度均呈中度正相关(r=0.638、0.313,均P<0.01),与体质量指数、腰围均呈低度正相关(r=0.236、0.248,均P<0.05)。ROC曲线分析显示,UDFF值诊断≥S2级、≥S3级肝脏脂肪变性的曲线下面积分别为0.86、0.82,其对应的灵敏度分别为91.1%、88.0%,特异度分别为72.0%、68.9%。结论UDFF在定量评估肥胖人群肝脏脂肪变性中具有较好的临床应用价值。

Objective To investigate the clinical application value of ultrasound-derived fat fraction(UDFF)in the quantitative assessment of hepatic steatosis in obese population.Methods A total of 70 obese patients with fatty liver confirmed by pathological results of liver tissue in our hospital were selected,including 25 cases of S1 grade(S1 grade group),20 cases of S2 grade(S2 grade group),and 25 cases of S3 grade(S3 grade group).The depth from the skin to the center of the region of interest and UDFF value were obtained by ultrasound,and the differences were compared.Two physicians independently measured the UDFF value,and the median values were recorded for inter-operator consistency analysis.The correlation between UDFF value and pathological grading,clinical data and measurement depth was analyzed.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of UDFF value for different degrees of hepatic steatosis.Results The UDFF value in S1,S2,and S3 grade groups were 17.08%±7.15%,24.80%±5.22%,and 28.48%±5.22%,respectively.And the differences was statistically significant(P<0.05).There was no significant difference in measurement depth among the groups.The inter-operator intraclass correlation coefficients for the measurement of UDFF value in S1,S2,and S3 groups were 0.809,0.777,and 0.759,respectively(all P<0.01),indicating good consistency.Correlation analysis showed that the UDFF value was moderately positively correlated with the pathological grading and measurement depth(r=0.638,0.313,both P<0.01),while weakly positively correlated with body mass index and waist circumference(r=0.236,0.248,both P<0.05).ROC curve analysis showed that the area under curve of UDFF value in diagnosing≥S2 and≥S3 grade hepatic steatosis were 0.86,0.82,with sensitivities of 91.1%,88.0%,and specificities of 72.0%and 68.9%,respectively.Conclusion UDFF has good clinical application value in the quantitative assessmemt of hepatic steatosis in obese population.