Prospective, Same-Day, Direct Comparison of Controlled Attenuation Parameter With the M vs the XL Probe in Patients With Nonalcoholic Fatty Liver Disease, Using Magnetic Resonance Imaging-Proton Density Fat Fraction as the Standard.
Prospective, Same-Day, Direct Comparison of Controlled Attenuation Parameter With the M vs the XL Probe in Patients With Nonalcoholic Fatty Liver Disease, Using Magnetic Resonance Imaging-Proton Density Fat Fraction as the Standard.
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DOI：
10.1016/j.cgh.2019.11.060
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发表时间：
2020-07
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据报道，在检测肝脂肪变性时，使用M探头的受控衰减参数（CAP）测量值低于XL探头。然而，在非酒精性脂肪性肝病（NAFLD）患者中，尚未对M探头和XL探头的CAP进行直接比较。我们以磁共振成像质子密度脂肪分数（MRI - PDFF）为标准，比较了M探头和XL探头的CAP在肝脏脂肪含量定量方面的情况。
我们在2017年11月至2018年11月期间，在一个研究中心对100名患有和未患有NAFLD的成年人（平均体重指数[BMI]为30.6 ± 4.7 kg/m²）进行了一项前瞻性研究。在同一天使用M探头和XL探头对这些患者进行CAP评估，然后测量MRI - PDFF作为参考标准。结果指标为肝脏脂肪变性的存在（定义为MRI - PDFF≥5%）以及肝脏脂肪含量≥10%（定义为MRI - PDFF≥10%）。我们进行了受试者工作特征曲线下面积（AUROC）分析，以评估每种探头的CAP在检测肝脏脂肪变性（MRI - PDFF≥5%）和肝脏脂肪含量≥10%时的诊断准确性。
在研究参与者中，68%的患者MRI - PDFF为5%或更高，48%的患者MRI - PDFF为10%或更高。M探头测量的平均CAP（310 ± 62 dB/m）显著低于X探头（317 ± 63 dB/m）（P = -0.07）。当BMI＜30 kg/m²的参与者使用M探头，BMI≥30 kg/m²的参与者使用XL探头，且MRI - PDFF高于5%时，M探头测量的CAP（312 ± 51.4 dB/m）仍然显著低于XL探头（345 ± 47.6 dB/m）（P = -0.035）。检测MRI - PDFF≥5%时，M探头的CAP最佳阈值为294 dB/m，XL探头为307 dB/m。检测MRI - PDFF≥10%时，M探头的CAP最佳阈值为311 dB/m，XL探头为322 dB/m。仅对于XL探头，四分位间距低于30 dB/m的CAP测量值在检测MRI - PDFF≥5%时的AUROC（0.97；95%置信区间，0.80 - 1.00）低于四分位间距高于30 dB/m的CAP测量值（AUROC，0.82；95%置信区间，0.71 - 0.90）（P = 0.0129）。
在以MRI - PDFF为标准，对使用M探头和XL探头的CAP进行分析时，我们发现与XL探头相比，M探头对CAP值的量化偏低，且与BMI无关。在解读NAFLD患者的CAP数据时，应考虑探头的类型。
Controlled attenuation parameter (CAP) measurements using M probe have been reported to be lower than those of the XL-probe in detection of hepatic steatosis. However, there has been no direct comparison of CAP with the M vs the XL probe in patients with nonalcoholic fatty liver disease (NAFLD). We compared CAP with the M vs the XL probe for quantification of hepatic fat content, using magnetic resonance imaging proton density fat fraction (MRI-PDFF) as the standard. We performed a prospective study of 100 adults (mean body mass index [BMI], 30.6 ± 4.7 kg/m2) with and without NAFLD, assessed by CAP with the M probe and XL probe on the same day, at a single research center, from November 2017 through November 2018. We then measured the MRI-PDFF as the reference standard. Outcomes were presence of hepatic steatosis, defined as MRI-PDFF ≥ 5%, and detection of hepatic fat content ≥ 10%, defined as MRI-PDFF ≥ 10%. We performed area under the receiver operating characteristic curve (AUROC) analyses to assess the diagnostic accuracy of CAP for each probe in detection of hepatic steatosis (MRI-PDFF ≥ 5%) and of hepatic fat content ≥ 10%. Of the study participants, 68% had an MRI-PDFF of 5% or more and 48% had an MRI-PDFF of 10% or more. The mean CAP measured by the M probe (310 ± 62 db/m) was significantly lower than by the X probe (317 ± 63 db/m) (P = −007). When M probe was used in participants with BMIs <30 kg/ m2 and XL probe in participants with BMIs ≥30 kg/m2, the CAP measured by the M probe (312 ± 51.4 db/m) remained significantly lower than that of the XL probe (345 ± 47.6 db/m) (P =−0035.), when the MRI-PDFF was above 5%. The optimal threshold of CAP for the detection of MRI-PDFF≥5%, was 294 db/mwith the M probe and 307 db/mwith the XL probe. The optimal threshold of CAP for the detection of MRI-PDFF ≥ 10%, was 311 db/m with the M probe and 322 db/m with the XL probe. For only the XL probe, CAP measurements with an interquartile range below 30 dB/m detected an MRI-PDFF≥5% with a lower AUROC (0.97; 95% CI, 0.80–1.00) than CAP measurements with an interquartile range above 30 dB/m (AUROC, 0.82; 95% CI, 0.71–0.90) (P = .0129). In an analysis of the same patients using CAP with the M probe and XL probe, with MRI-PDFF as the standard, we found that the M probe under-quantifies CAP values compared with the XL probe, independent of BMI. The type of probe should be considered when interpreting CAP data from patients with NAFLD.
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DOI：
10.1002/hep.26455
发表时间：
2013-12
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Noureddin M;Lam J;Peterson MR;Middleton M;Hamilton G;Le TA;Bettencourt R;Changchien C;Brenner DA;Sirlin C;Loomba R
通讯作者：
Loomba R
DOI：
10.1002/hep.29639
发表时间：
2018-04
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Caussy C;Alquiraish MH;Nguyen P;Hernandez C;Cepin S;Fortney LE;Ajmera V;Bettencourt R;Collier S;Hooker J;Sy E;Rizo E;Richards L;Sirlin CB;Loomba R
通讯作者：
Loomba R
影响因子：
7.6
作者：
Permutt Z;Le TA;Peterson MR;Seki E;Brenner DA;Sirlin C;Loomba R
通讯作者：
Loomba R
DOI：
10.1002/hep.29797
发表时间：
2018-08
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Caussy C;Reeder SB;Sirlin CB;Loomba R
通讯作者：
Loomba R
影响因子：
24.5
作者：
Caussy, Cyrielle;Ajmera, Veeral H.;Loomba, Rohit
通讯作者：
Loomba, Rohit