超声肝脏脂肪分数定量评估肝脏脂肪变性的临床研究

肝脏 ›› 2025, Vol. 30 ›› Issue (9): 1192-1194.

超声肝脏脂肪分数定量评估肝脏脂肪变性的临床研究

钱嵘, 张震, 王成晨, 郭明阳, 何沈岩, 陈慧冲, 涂娇, 陈婷婷, 刘婷, 裴峰

200052 上海解放军海军第905医院超声诊断科(钱嵘,张震,王成晨,郭明阳,何沈岩,陈慧冲,涂娇,陈婷婷,刘婷);201103 上海中国人民武装警察部队上海总队医院医学影像科(裴峰)

收稿日期:2025-03-15 出版日期:2025-09-30 发布日期:2025-11-05
通讯作者: 裴峰,Email:peifeng1968@sina.com
作者简介:共同第一作者:张震
基金资助:
上海市长宁区科委资助项目(CNKW2022Y61)

A clinical study on quantitative assessment of hepatic steatosis using ultrasound-derived fat fraction

QIAN Rong¹, ZHANG Zhen¹, WANG Cheng-chen¹, GUO Ming-yang¹, HE Shen-yan¹, CHEN Hui-chong¹, TU Jiao¹, CHEN Ting-ting¹, LIU Ting¹, PEI Feng²

1. Department of Ultrasound,The 905th Naval Hospital,Shanghai 200052,China;
2. Department of Medical Imaging, Shanghai General Hospital of The Chinese People's Armed Police Force, Shanghai 201103, China

Received:2025-03-15 Online:2025-09-30 Published:2025-11-05
Contact: PEI Feng,Email:peifeng1968@sina.com

摘要/Abstract

摘要： 目的探讨超声脂肪分数(UDFF)定量评估非酒精性脂肪肝(NAFLD)患者肝脏脂肪含量的临床价值。方法纳入2024年1月至12月解放军海军第905医院收治的NAFLD患者40例,另选同期健康志愿者18名。所有受试者先经常规超声检查,再分别检测其肝右叶受控衰减参数(CAP)及UDFF,比较两组CAP及UDFF的差异,分析UDFF和CAP的一致性及相关性。结果健康志愿组CAP为(223.16± 12.59)dB/m,UDFF为(4.69±1.27)%,均在正常范围,NAFLD组CAP为(258.49± 15.14)dB/m,UDFF为(14.75±2.87)%(P<0.05)。Pearson相关性分析显示,UDFF与CAP在评价肝脏脂肪变性时呈正相关(r=0.938,P<0.001)。Bland-Altman分析二者一致性显示,健康志愿组所有受检者均在95%置信区间内,NAFLD组有95%(38/40)的病例在置信区间内,表明两组受试者肝右叶UDFF和CAP值有良好的一致性。结论 UDFF为无创定量肝脏脂肪含量的检测技术,对评估非酒精性脂肪肝病有较高临床价值。

关键词: 超声脂肪分数, 肝脂肪变性, 非酒精性脂肪肝病, 受控衰减参数

Abstract: Objective To explore the clinical significance of ultrasound-derived fat fraction (UDFF) from the right lobe of liver for quantitatively assessing liver fat content of patients with non-alcoholic fatty liver disease (NAFLD). Methods Fifty-eight subjects were selected in this study and divided in Group A (normal control group:18 cases) and Group B (fatty liver group: 40 cases). All subjects first underwent conventional ultrasound examination, followed by measurements of the controlled attenuation parameter (CAP) and UDFF. The differences in CAP and UDFF between the two groups of patients were compared. The consistency and correlation between UDFF and CAP were analyzed. Results Group A had a CAP of (223.16 ± 12.59) dB/m and a UDFF of (4.69 ± 1.27)%, both within the normal range. Group B had a CAP of (258.49 ± 15.14) dB/m and a UDFF of (14.75 ± 2.87)%, both of which were significantly higher than those in Group A (P<0.05). Pearson correlation analysis showed that UDFF and CAP were positively correlated in assessing hepatic steatosis (r=0.938, P<0.001). Bland-Altman analysis of their agreement revealed that all subjects in Group A fell within the 95% confidence interval, while in Group B, 95% (38/40) of the cases were within the confidence interval, indicating a good consistency between UDFF and CAP values in the right liver lobes of patients in both groups. Conclusion UDFF is a non-invasive technique for quantitatively assessing liver fat content and holds significant clinical value in evaluating NAFLD.

Key words: Ultrasound-derived fat fraction, Hepatic steatosis, Non-alcoholic fatty liver disease, Controlled attenuation parameter

钱嵘, 张震, 王成晨, 郭明阳, 何沈岩, 陈慧冲, 涂娇, 陈婷婷, 刘婷, 裴峰. 超声肝脏脂肪分数定量评估肝脏脂肪变性的临床研究[J]. 肝脏, 2025, 30(9): 1192-1194.

QIAN Rong, ZHANG Zhen, WANG Cheng-chen, GUO Ming-yang, HE Shen-yan, CHEN Hui-chong, TU Jiao, CHEN Ting-ting, LIU Ting, PEI Feng. A clinical study on quantitative assessment of hepatic steatosis using ultrasound-derived fat fraction[J]. Chinese Hepatolgy, 2025, 30(9): 1192-1194.

/ 推荐

参考文献

[1] Younossi Z M, Golabi P, Paik J M,et al. The global epidemiology of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: a systematic review[J]. Hepatology. 2023,77(4):1335-1347.
[2] Anstee Q M, Reeves H L, Kotsiliti E,et al. From NASH to HCC: current concepts and future challenges[J]. Nat Rev Gastroenterol Hepatol. 2019,16(7):411-428.
[3] Ballestri S, Zona S, Targher G, et al. Nonalcoholic fatty liver disease is associated with an almost twofold increased risk of incident type 2 diabetes and metabolic syndrome. Evidence from a systematic review and meta-analysis[J]. J Gastroenterol Hepatol. 2016 ,31(5):936-944.
[4] Sporea I, Bâldea V, Lupusoru R, et al. Quantification of steatosis and fibrosis using a new system implemented in an ultrasound machine[J]. Med Ultrason. 2020,22(3):265-271.
[5] Mikolasevic I, Domislovic V, Klapan M, et al. Accuracy of controlled attenuation parameter and liver stiffness measurement in patients with non-alcoholic fatty liver disease[J]. Ultrasound Med Biol. 2021,47(3):428-437.
[6] Ferraioli G, Kumar V, Ozturk A, et al. US Attenuation for liver fat quantification: an AIUM-RSNA QIBA pulse-echo quantitative ultrasound initiative[J]. Radiology. 2022 ,302(3):495-506.
[7] 韩佳豪,李嘉,沈会明,等.超声衍生脂肪分数对代谢异常相关脂肪性肝病的诊断效能[J].中华超声影像学杂志,2024,33(8):703-711.
[8] Dillman J R, Thapaliya S, Tkach J A, et al. Quantification of hepatic steatosis by ultrasound: prospective comparison with MRI proton density fat fraction as reference standard[J]. AJR Am J Roentgenol. 2022,219(5):784-791.
[9] Zeng K Y, Bao W Y, Wang Y H, et al. Non-invasive evaluation of liver steatosis with imaging modalities: new techniques and applications[J]. World J Gastroenterol, 2023,29(17):2534-2550.
[10] Zalcman M, Barth R A, Rubesova E. Real-time ultrasound-derived fat fraction in pediatric population: feasibility validation with MR-PDFF[J]. Pediatr Radiol. 2023,53(12):2466-2475.
[11] Ferraioli G, Berzigotti A, Barr R G, et al. Quantification of liver fat content with ultrasound: a WFUMB position paper[J]. Ultrasound Med Biol. 2021,47(10):2803-2820.

[1]	杨宪碧, 黄卫东, 黄英. SWE及UAP参数评估肥胖青少年非酒精性脂肪性肝病肝脂肪变的临床价值[J]. 肝脏, 2025, 30(4): 542-547.
[2]	李雨蓉, 钟昌明, 王杰. 无创评分预测肝脂肪变性的优势与不足[J]. 肝脏, 2024, 29(3): 260-262.
[3]	栗雯霏, 张捷, 栗建辉. 影像技术对非酒精性脂肪肝的评价[J]. 肝脏, 2023, 28(7): 875-880.
[4]	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.
[5]	王铁钢, 李小明, 朱丹阳. 不同肝组织学特征非肥胖型NAFLD患者磁共振质子密度脂肪分数表现[J]. 肝脏, 2022, 27(5): 573-575.
[6]	魏建东, 苟小军, 陈远卓, 施巍. 非酒精性脂肪性肝病合并2型糖尿病患者脂肪受控衰减参数及肝脏硬度值的变化[J]. 肝脏, 2022, 27(3): 355-357.
[7]	辜雪莲, 李俊峰, 毛小荣. 肠道菌群在非酒精性脂肪性肝病中的研究进展[J]. 肝脏, 2021, 26(12): 1418-1420.
[8]	张进, 张海. FibroScan技术联合血清骨钙素在绝经后女性非酒精性脂肪性肝病患者中的应用[J]. 肝脏, 2020, 25(9): 975-977.
[9]	宋旭光, 何玉冰. 瞬时弹性成像在NAFLD患者肝纤维化和脂肪变性检测中的临床应用[J]. 肝脏, 2020, 25(5): 536-538.
[10]	张荣, 陈婧, 黄江涛, 吕海龙, 杨一邨, 王浩斌, 张抒. 对氧磷酶-1 参与调控非酒精性脂肪肝脂质代谢与胰岛素抵抗作用及机制[J]. 肝脏, 2020, 25(2): 149-154.
[11]	邹琳, 李铁岩, 佘会元. IGF1和IGFBP3在非酒精性脂肪性肝病病程中的表达变化[J]. 肝脏, 2019, 24(5): 521-525.
[12]	牛蕊. 慢性乙型肝炎患者病毒相关指标与肝脂肪变性的相关性研究[J]. 肝脏, 2019, 24(4): 421-423.
[13]	叶丽华, 王萌之, 陈佳, 杨雅, 齐亚雄, 钱冬斌, 杨中原, 陈韬. 慢性乙型肝炎患者长期抗病毒治疗LSM和CAP值的变化及临床意义[J]. 肝脏, 2019, 24(12): 1412-1414.
[14]	张明芳, 郝凯峰, 仲广生, 陈秀春. 非酒精性脂肪性肝病与乳腺癌的相关性研究[J]. 肝脏, 2019, 24(11): 1293-1295.
[15]	张程亮,贺雯茜,徐艳娇,常慕君,向东,杨金玉,刘东. 果糖诱导非酒精性脂肪性肝病小鼠动物模型的构建和评价[J]. 肝脏, 2017, 22(8): 700-704.