超声剪切波弹性成像和磁共振弹性成像对非酒精性脂肪性肝病肝脂肪变性分级的诊断性能比较

肝脏 ›› 2023, Vol. 28 ›› Issue (11): 1356-1358.

超声剪切波弹性成像和磁共振弹性成像对非酒精性脂肪性肝病肝脂肪变性分级的诊断性能比较

陈坛寿, 缪铃梅, 施增金

352100 福建宁德师范学院附属宁德市医院超声科(陈坛寿),急诊科(施增金);宁德市医疗基金保障中心(缪铃梅)

收稿日期:2023-03-28 出版日期:2023-11-30 发布日期:2024-03-03
通讯作者: 施增金,Email:aluckydog@139.com

Evaluation of ultrasonic shear wave vs. magnetic resonance elastography in diagnosing nonalcoholic fatty liver disease

CHEN Tan-shou¹, MIU Ling-mei³, SHI Zeng-jin²

1. Department of Ultrasound, Ningde Municipal Hospital of Ningde Normal University, Fujian 352100, China;
2. Emergency Department,Ningde Municipal Hospital of Ningde Normal University, Fujian 352100, China;
3. Ningde Medical Fund Guarantee Center, Fujian 352100, China

Received:2023-03-28 Online:2023-11-30 Published:2024-03-03
Contact: SHI Zeng-jin, Email: aluckydog@139.com

摘要/Abstract

摘要： 目的比较超声剪切波弹性成像(SWE)、磁共振弹性成像(MRE)对NAFLD肝脂肪变性分级的诊断性能。方法回顾性分析2019年10月至2022年4月在宁德市医院诊治的88例非酒精性脂肪性肝病患者的临床资料,依据病理检查结果进行肝脂肪变性分级。所有患者均行SWE、MRE检查,比较两种检查方法对NAFLD肝脂肪变性分级的诊断效能。结果 F0、F1、F2、F3的Emean值分别为(6.34±0.65)kPa、(8.08±1.22)kPa、(10.95±1.34)kPa、(14.25±2.02)kPa,ADC值分别为(1.25±0.18)10^-3 mm²/s、(1.14±0.13)10^-3 mm²/s、(1.04±0.09)10^-3 mm²/s、(0.92±0.05)10^-3 mm²/s。随着肝脂肪变性分级的增加,Emean值逐渐升高,ADC值逐渐降低,差异有统计学意义(P<0.05)。SWE诊断不同肝脂肪变性分级的AUC分别为0.855、0.823、0.841、0.827,MRE诊断不同肝脂肪变性分级的AUC分别为0.901、0.897、0.911、0.927。结论相较于SWE,MRE诊断NAFLD肝脂肪变性分级的诊断效能更优。

关键词: 非酒精性脂肪性肝病, 肝脂肪变性分级, 超声剪切波弹性成像, 磁共振弹性成像, 诊断效能

Abstract: Objective To compare the diagnostic efficacy of ultrasonic shear wave elastography (SWE) vs. magnetic resonance elastography (MRE) for hepatic steatosis in nonalcoholic fatty liver disease (NAFLD).Methods Clinical data from 88 patients diagnosed and treated for NAFLD between October 2019 to April 2022 in our hospital were retrospectively analyzed. Liver steatosis was categorized based on pathological findings. Both SWE and MRE were used to evaluate each patients, and their diagnostic performance in grading NAFLD liver steatosis was compared.Results For various liver steatosis grades, Emean values were (6.34 ± 0.65) kPa, (8.08 ± 1.22) kPa, (10.95 ± 1.34) kPa, and (14.25 ± 2.02) kPa, while ADC values were (1.25 ± 0.18) 10^-3 mm²/s, (1.14 ± 0.13) 10^-3 mm²/s, (1.04 ± 0.09) 10^-3 mm²/s, (0.92 ± 0.05) 10^-3 mm²/s, respectively. As liver steatosis grade escalated, there was a marked increase inn the Emean value and a corresponding decline in the ADC value, with these differences being statistically significant (P<0.05). In terms of diagnostic accuracy, the area under the curve(AUC) for SWE diagnosis across different liver steatosis grades was 0.855, 0.823, 0.841, 0.827. Conversely,for MRE diagnosis, the AUC values were 0.901, 0.897, 0.911, 0.927. Notably, the AUC for MRE diagnosis surpassed that of SWE for all hepatic steatosis grades.Conclusion MRE is more effective than SWE in diagnosing hepatic steatosis in NAFLD.

Key words: Nonalcoholic fatty liver disease, Classification of hepatic steatosis, Ultrasonic shear wave elastography, Magnetic resonance elastography, Diagnostic performance

陈坛寿, 缪铃梅, 施增金. 超声剪切波弹性成像和磁共振弹性成像对非酒精性脂肪性肝病肝脂肪变性分级的诊断性能比较[J]. 肝脏, 2023, 28(11): 1356-1358.

CHEN Tan-shou, MIU Ling-mei, SHI Zeng-jin. Evaluation of ultrasonic shear wave vs. magnetic resonance elastography in diagnosing nonalcoholic fatty liver disease[J]. Chinese Hepatolgy, 2023, 28(11): 1356-1358.

参考文献

[1] 陆伦根, 曲颖. 非酒精性脂肪性肝病的诊断与评估. 中华消化杂志, 2020, 40(9): 584-587.
[2] Linares I, Hamar M, Selzner N, et al. Steatosis in liver transplantation: current limitations and future strategies. Transplantation, 2019, 103(1): 78-90.
[3] Sande J A, Verjee S, Vinayak S, et al. Ultrasound shear wave elastography and liver fibrosis: A prospective multicenter study. World J Hepatol, 2017, 9(1): 38-47.
[4] Lefebvre T, Wartelle-Bladou C, Wong P, et al. Prospective comparison of transient, point shear wave, and magnetic resonance elastography for staging liver fibrosis. Eur Radiol, 2019, 29(12): 6477-6488.
[5] Gu J, Liu S, Du S, et al. Diagnostic value of MRI-PDFF for hepatic steatosis in patients with non-alcoholic fatty liver disease: a meta-analysis. Eur Radiol, 2019, 29(7): 3564-3573.
[6] 中华医学会肝病学分会脂肪肝和酒精性肝病学组. 非酒精性脂肪性肝病诊疗指南(2010年修订版). 中华肝脏病杂志, 2010, 18(3): 163-166.
[7] Loomba R, Friedman S L, Shulman G I. Mechanisms and disease consequences of nonalcoholic fatty liver disease. Cell, 2021, 184(10): 2537-2564.
[8] 郭芸蕾, 阮骊韬, 党莹, 等. 实时剪切波弹性成像技术测量肝脾硬度联合肝脂肪变性指数在诊断脂肪肝中的应用价值研究. 中国临床医学影像杂志, 2019, 30(6): 416-420.
[9] Huang Z, Zhou J, Lu X, et al. How does liver steatosis affect diagnostic performance of 2D-SWE. SSI: assessment from aspects of steatosis degree and pathological types. Eur Radiol, 2021, 31(5): 3207-3215.
[10] Dorosti M, Heidarloo A J, Bakhshimoghaddam F, et al. Whole-grain consumption and its effects on hepatic steatosis and liver enzymes in patients with non-alcoholic fatty liver disease: a randomised controlled clinical trial. Brit J Nutr, 2020, 123(3): 328-336.
[11] 王敏, 石喻, 郭启勇. 磁共振弹性成像评价肝脏疾病的研究进展. 中国医科大学学报, 2019, 48(9): 841-844.
[12] Makhija N, Vikram NK, Srivastava DN, et al. Role of diffusion-weighted magnetic resonance imaging in the diagnosis and grading of hepatic steatosis in patients with non-alcoholic fatty liver disease: comparison with ultrasonography and magnetic resonance spectroscopy. J Clin Exp Hepatol, 2021, 11(6): 654-660.
[13] Jia WR, Luo T, Dong YJ, et al. Breast elasticity imaging techniques: comparison of strain elastography and shear-wave elastography in the same population. Ultrasound Med Biol, 2021, 47(1): 104-113.
[14] Palmeri ML, Milkowski A, Barr R, et al. Radiological society of North America/quantitative imaging biomarker alliance shear wave speed bias quantification in elastic and viscoelastic phantoms. J Ultras Med, 2021, 40(3): 569-581.
[15] Zhang L, Long X, Nijiati M, et al. Tumor stiffness measured by 3D magnetic resonance elastography can help predict the aggressiveness of endometrial carcinoma: preliminary findings. Cancer Imaging, 2021, 21(1): 1-10.