FibroTouch©和CT定量检查诊断脂肪肝人群NASH效能研究*

doi:10.3969/j.issn.1672-5069.2025.02.010

Abstract

Abstract: Objective The aim of this study was to investigate diagnostic performance of controlled attenuation parameter (CAP), liver stiffness measurement (LSM) and total adipose tissue (TAT) in screening patients with nonalcoholic steatohepatitis (NASH) from individuals with nonalcoholic fatty liver diseases (NAFLD). Methods 150 patients with NAFLD were enrolled in our hospital between January 2022 and January 2024, and all underwent liver biopsy. CAP and LSM were determined by FibroTouch^©, and quantitative TAT and ratio of liver/spleen CT value were obtained by CT scan. The diagnosis consistency between FibroTouch^© and CT scan and liver biopsy was analyzed by Kappa values. Area under receiver operating characteristic (ROC) curves (AUC) was applied to evaluate diagnostic efficacy. Results Liver histo-pathological examination found simple fatty liver (SFL) in 109 cases and NASH in 41 cases in our series; taking pathological diagnosis as golden standard, the good diagnostic consistence was found between FibroTouch^© or CT quantitative scan (Kappa=0.743, or Kappa=0.684), with sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 87.8%, 89.9%, 89.3%, 76.6% and 95.2%, or 85.4%, 87.2%, 86.7%, 71.4% and 94.1%; CAP, LSM and TAT in patients with NASH were (303.5±12.7)db/m, (11.1±2.9)kPa and (473.1±80.5)cm², all significantly higher than [(269.4±17.2)db/m, (6.4±1.6)kPa and (358.1±72.0)cm², respectively, P＜0.05], while ratio of liver/spleen CT value was (0.4±0.1), much lower than [(0.8±0.2), P＜0.05] in patients with SFL; ROC analysis showed the AUCs were 0.861, 0.864, 0.803 and 0.851, all with a satisfactory diagnostic efficacy (P＜0.05), when CAP, LSM, ratio of liver/spleen CT value and TAT were applied to predict NASH from individuals with NAFLD. Conclusion FibroTouch^© and CT quantitative scan both have certain diagnostic performance in assessing NASH in population of NAFLD, and warrants further clinical investigation.

Key words: Nonalcoholic fatty liver disease, Nonalcoholic steatohepatitis, Controlled attenuation parameter, Liver stiffness measurement, Total adipose tissue, Diagnosis

Wang Xiaoyan, Cui Wenxing, Chen Chao. Controlled attenuation parameter, liver stiffness measurement and total adipose tissue in screening patients with nonalcoholic steatohepatitis[J]. Journal of Practical Hepatology, 2025, 28(2): 198-201.

References

[1] Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology, 2023, 77(5):1797-1835.
[2] Duell PB, Welty FK, Miller M, et al. Nonalcoholic fatty liver disease and cardiovascular risk: a scientific statement from the american heart association. Arterioscler Thromb Vasc Biol, 2022, 42(6):e168-e185.
[3] El-Kassas M, Cabezas J, Coz PI, et al. Nonalcoholic fatty liver disease: current global burden. Semin Liver Dis, 2022, 42(3):401-412.
[4] Leung PB, Davis AM, Kumar S. Diagnosis and management of nonalcoholic fatty liver disease. JAMA, 2023, 330(17):1687-1688.
[5] Kjaergaard M, Lindvig KP, Hansen CD, et al. Hepatorenal index by b-mode ratio versus imaging and fatty liver index to diagnose steatosis in alcohol-related and nonalcoholic fatty liver disease. J Ultrasound Med, 2023, 42(2):487-496.
[6] 郭萌,郭琦,张峰.超声瞬时弹性成像检测受控衰减参数评估非酒精性脂肪性肝病患者肝脂肪变程度价值研究.实用肝脏病杂志,2024,27(2):189-192.
[7] Cao Q, Yan C, Han X, et al. Quantitative evaluation of nonalcoholic fatty liver in rat by material decomposition techniques using rapid-switching dual energy CT. Acad Radiol, 2022, 29(6):e91-e97.
[8] 中华医学会肝病学分会脂肪肝和酒精性肝病学组,中国医师协会脂肪肝专家委员会.非酒精性脂肪性肝病防治指南 (2018年版).实用肝脏病杂志,2018,21(2):177-186.
[9] Teng ML, Ng CH, Huang DQ, et al. Global incidence and prevalence of nonalcoholic fatty liver disease. Clin Mol Hepatol, 2023, 29(Suppl):S32-S42.
[10] Tokushige K, Ikejima K, Ono M, et al. Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis 2020. J Gastroenterol, 2021, 56(11):951-963.
[11] 何方平.我国NAFLD慢病管理实践现状和建议.实用肝脏病杂志,2023,26(4):460-462.
[12] Avramovski P, Lazarevski M, Avramovska M, et al. Prunus mume extract and choline treatment in patients with non-alcoholic fatty liver disease estimated by b-mode ultrasonography and hepatorenal index. Caspian J Intern Med, 2024, 15(1):161-171.
[13] Argalia G, Ventura C, Tosi N, et al. Comparison of point shear wave elastography and transient elastography in the evaluation of patients with NAFLD. Radiol Med, 2022, 127(5):571-576.
[14] Qu Y, Song YY, Chen CW, et al. Diagnosticperformance of FibroTouch ultrasound attenuation parameter and liver stiffness measurement in assessing hepatic steatosis and fibrosis in patients with nonalcoholic fatty liver disease. Clin Transl Gastroenterol, 2021, 12(4):e00323.
[15] 张昕,郭悦,杨军.瞬时弹性成像测定肝脾硬度值评估乙型肝炎肝硬化患者食管静脉曲张初步研究.实用肝脏病杂志,2021,24(1):95-98.
[16] Cheng X, Zhao K, Zha X, et al. Opportunistic screening using low-dose CT and the prevalence of osteoporosis in China: a nationwide, multicenter study. J Bone Miner Res, 2021, 36(3):427-435.
[17] Greco F, Beomonte Zobel B, Mallio CA. Impact of quantitative computed tomography-based analysis of abdominal adipose tissue in patients with lymphoma. Hematol Rep, 2023, 15(3):474-482.
[18] Dichtel LE, Tabari A, Mercaldo ND, et al. CT Texture analysis in nonalcoholic fatty liver disease (NAFLD). J Clin Exp Hepatol, 2023, 13(5):760-766.
[19] Starekova J, Hernando D, Pickhardt PJ, et al. Quantification of liver fat content with ct and mri: state of the art. Radiology, 2021, 301(2):250-262.
[20] Karlas T, Petroff D, Sasso M, et al. Individual patient data meta-analysis of controlled attenuation parameter (CAP) technology for assessing steatosis. J Hepatol, 2017, 66(5):1022-1030.
[21] Shen F, Zheng RD, Mi YQ, et al. Controlled attenuation parameter for non-invasive assessment of hepatic steatosis in Chinese patients. World J Gastroenterol, 2014, 20(16):4702-4711.
[22] Andrade P, Rodrigues S, Rodrigues-Pinto E, et al. Diagnostic accuracy of controlled attenuation parameter for detecting hepatic steatosis in patients with chronic liver disease. GE Port J Gastroenterol, 2017, 24(4):161-168.
[23] de Lédinghen V, Vergniol J, Capdepont M, et al. Controlled attenuation parameter (CAP) for the diagnosis of steatosis: a prospective study of 5323 examinations. J Hepatol, 2014, 60(5):1026-31.

Controlled attenuation parameter, liver stiffness measurement and total adipose tissue in screening patients with nonalcoholic steatohepatitis

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