MRI-PDFF、FibroTouch和FAST评分对NAFLD患者发生NASH的诊断效能

肝脏 ›› 2026, Vol. 31 ›› Issue (1): 71-74.

MRI-PDFF、FibroTouch和FAST评分对NAFLD患者发生NASH的诊断效能

马志强, 詹浩辉, 梁燕, 刘晶晶

471000 洛阳河南科技大学第二附属医院消化内科(马志强,梁燕,刘晶晶),医学影像中心(詹浩辉)

收稿日期:2025-01-12 出版日期:2026-01-31 发布日期:2026-03-30
基金资助:
河南省医学科技攻关计划联合共建项目(LHGJ20240533)

Efficacy of MRI-PDFF, FibroTouch, and FAST score in diagnosing the occurrence of NASH in patients with NAFLD

MA Zhi-qiang¹, ZHAN Hao-hui², LIANG Yan¹, LIU Jing-jing¹

1. Department of Gastroenterology, the Second Affiliated Hospital of Henan University of Science and Technology, Luoyang 471000, China;
2. Medical Imaging Center, the Second Affiliated Hospital of Henan University of Science and Technology, Luoyang 471000, China

Received:2025-01-12 Online:2026-01-31 Published:2026-03-30

摘要/Abstract

摘要： 目的探究磁共振质子密度脂肪分数(MRI-PDFF)、肝脏瞬时弹性检测(FibroTouch)和FAST评分诊断非酒精性脂肪肝病(NAFLD)患者发生非酒精性脂肪性肝炎(NASH)的效能。方法选取2019年3月到2024年3月河南科技大学第二附属医院诊治的91例NAFLD患者,根据是否发生NASH分为非NASH组(n=65)、NASH组(n=26),根据是否为高危NASH分为非高危组(n=80)、高危NASH组(n=11)。均接受MRI-PDFF检测、肝脏组织病理学检查及FAST检测,采用FibroScan行肝脏硬度(LSM)、受控衰减参数(CAP)检测。Logistic多因素回归分析NAFLD患者发生NASH的影响因素。以受试者工作特征曲线下面积(AUC)分析NAFLD患者发生NASH的诊断效能。结果 NASH组的LSM为(9.6±2.3)kPa,FAST评分为0.5±0.2,显著高于非NASH组的(7.1±1.2)kPa和0.3±0.1,差异有统计学意义(t=5.263、4.862,均P<0.01)。高危NASH组的LSM(10.2±2.6)kPa和FAST评分为0.5±0.2,显著高于非高危组(6.6±1.3)kPa和0.2±0.1(t=4.515、4.892,均P<0.05)。Logistic分析表明,LSM、FAST评分是NAFLD患者发生NASH的影响因素。LSM、FAST评分联合诊断的AUC为0.978、灵敏度90.0%、特异度98.0%,显著优于各指标单独诊断。结论 LSM与FAST评分对NAFLD患者发生NASH具有良好的诊断效能,且两者联合的诊断效能更高。

关键词: 磁共振质子密度脂肪分数, 肝脏瞬时弹性检测, FAST评分, 非酒精性脂肪肝病

Abstract: Objective To investigate the efficacy of magnetic resonance imaging proton density fat fraction (MRI-PDFF), FibroTouch, and Fatty Liver Index based on Aspartate Aminotransferase and Total Bilirubin (FAST) score in diagnosing nonalcoholic steatohepatitis (NASH) in patients with nonalcoholic fatty liver disease (NAFLD). Methods A total of 91 patients with non-alcoholic fatty liver disease (NAFLD) admitted to the Second Affiliated Hospital of Henan University of Science and Technology from March 2019 to March 2024 were selected. According to whether non-alcoholic steatohepatitis (NASH) occurred or not, they were divided into the non-NASH group (n=65) and the NASH group (n=26). Based on the presence of high-risk NASH, they were divided into the non-high-risk group (n=80) and the high-risk NASH group (n=11). All patients underwent MRI-PDFF measurements, liver histopathological examination, and FAST score assessment. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were obtained by FibroScan. Logistic regression analysis was performed, and receiver operating characteristic (ROC) curves were constructed to analyze the diagnostic efficacy for NASH in NAFLD patients. Results The LSM [(9.6±2.3) kPa] and FAST score (0.5±0.2) in the NASH group were significantly higher than those in the non-NASH group [(7.1±1.2) kPa and (0.3±0.1)kPa], respectively with P<0.05. The LSM [(10.2±2.6) kPa] and FAST score (0.5±0.2) in the high-risk NASH group were significantly higher than those in the non-high-risk group [(6.6±1.3) kPa and (0.2±0.1)kPa], P<0.05. Logistic regression analysis indicated that LSM and FAST scores were influencing factors for the development of NASH in NAFLD patients (P<0.05). The ROC curve analysis showed that the combined diagnostic AUC value for LSM and FAST scores was 0.978, with a sensitivity of 90.0% and a specificity of 98.0%, which was significantly better than the diagnosis using each indicator alone. Conclusion Fibrotouch-derived LSM and FAST scores have good diagnostic efficacy for patients with NASH, and their combination enhances the diagnostic efficacy.

Key words: MRI-PDFF, FibroTouch, FAST score, Nonalcoholic fatty liver disease (NAFLD)

马志强, 詹浩辉, 梁燕, 刘晶晶. MRI-PDFF、FibroTouch和FAST评分对NAFLD患者发生NASH的诊断效能[J]. 肝脏, 2026, 31(1): 71-74.

MA Zhi-qiang, ZHAN Hao-hui, LIANG Yan, LIU Jing-jing. Efficacy of MRI-PDFF, FibroTouch, and FAST score in diagnosing the occurrence of NASH in patients with NAFLD[J]. Chinese Hepatolgy, 2026, 31(1): 71-74.

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