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