超声来源的脂肪分数诊断代谢相关脂肪性肝病应用研究

doi:10.3969/j.issn.1672-5069.2025.04.019

摘要/Abstract

摘要： 目的探讨超声来源的脂肪分数(UDFF)诊断代谢相关脂肪性肝病(MAFLD)的效能。方法 2023年10月～12月我院诊治的可疑脂肪肝患者54例,均同日接受MRI质子密度脂肪分数序列(MRI-PDFF)检查和UDFF检查。应用组内相关系数(ICC)比较两种诊断方法的一致性,应用受试者工作特征曲线(ROC)下面积(AUC)评估UDFF诊断MAFLD的效能。结果经MRI-PDFF检查,诊断无脂肪肝者16例,轻度脂肪肝者28例,中度脂肪肝者3例和重度脂肪肝者7例;10例中重度脂肪肝组UDFF为20.5(15.8,28.0) %,显著高于28例轻度脂肪肝组【13.0(11.0,17.0)%,P＜0.01】或16例无脂肪肝【5.5(4.0,7.0)%, P＜0.01】;MRI-PDFF与UDFF诊断的组内相关系数为0.808,提示一致性良好;UDFF值诊断MAFLD的截断点为8.0%,其AUC为0.979(P<0.001),敏感性为97.4%,特异性为93.8%,诊断中重度MAFLD的截断点为14.0%,其AUC为0.908(P<0.001),敏感性为91.7%,特异性为79.6%;本文轻中重脂肪肝组超声检测的点剪切波成像(pSWE)或杨氏模量值无显著性差异(P>0.05)。结论 UDFF诊断MAFLD效能高,达到MRI-PDFF的诊断水平,而临床广泛应用的pSWE的诊断价值还需要验证。

Abstract: Objective The purpose of this study was to investigate diagnostic performance of ultrasound-derived fat fraction (UDFF) in patients with metabolic associated fatty liver disease (MAFLD). Methods 54 allegedpatients with fatty liver were encountered in our hospital between October and December 2023, and all received MRI proton density fat fraction sequence (MRI-PDFF) and UDFF examination simultaneously. Intragroup correlation coefficient (ICC) was conducted to compare the consistency, and area underreceiver operating characteristic curve (AUC) was applied to assess the diagnostic efficacy. Results Based onMRI-PDFF results, non-fatty liver was found in 16 cases, mild fatty liver in 28 cases, moderate fatty liver in 3 cases and severe fatty liver in 7 cases; UDFF in 10 patients with moderate/severe fatty liver was 20.5(15.8, 28.0) %, much higher than [13.0(11.0,17.0)%, P＜0.01] in 28 patients with mild fatty liver or [5.5(4.0,7.0)%, P＜0.01] in 16 persons without fatty liver; ICC between MRI-PDFF and UDFF was 0.808,presenting as satisfactory diagnostic consistency; AUC in diagnosing MAFLD by UDFF was 0.987 (P<0.001), when the cut-off value was set as 8.0%,with the sensitivity (Se) of 97.4%, and the specificity (Sp) of 93.8%, and the AUC in diagnosing moderate/severe fatty liver was 0.908(P<0.001), when the cut-off value was set as 14.0%, with Se of 91.7% and Sp of 79.6%; our study didn't found difference of point shear wave elastography (pSWE) among individuals with or without fatty liver(P>0.05). Conclusion We recommendUDFF for diagnosis of metabolic associated fatty liver disease as its excellent efficacy, while the application of pSWE still needs multiple center validation.

Key words: Metabolic associated fatty liver disease, MRI proton density fat fraction sequence, Ultrasonic-derived fat fraction, Diagnosis

韩煜东, 张杰, 章文瑾, 何年安. 超声来源的脂肪分数诊断代谢相关脂肪性肝病应用研究[J]. 实用肝脏病杂志, 2025, 28(4): 553-556.

Han Yudong, Zhang Je, Zhang Wenjin, et al. Application of ultrasound-derived fat fraction in the diagnosis of metabolic associated fatty liver disease: a preliminary study[J]. Journal of Practical Hepatology, 2025, 28(4): 553-556.

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