Validity of real time ultrasound in the diagnosis of hepatic steatosis: a prospective study.
Validity of real time ultrasound in the diagnosis of hepatic steatosis: a prospective study.
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DOI：
10.1016/j.jhep.2009.09.001
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发表时间：
2009-12
影响因子：
25.7
通讯作者：
McCullough AJ
中科院分区：
文献类型：
--
作者：
Dasarathy S;Dasarathy J;Khiyami A;Joseph R;Lopez R;McCullough AJ
超声用于筛查肝脂肪变性，这是美国最常见的肝脏疾病。然而，很少有研究前瞻性地评价超声诊断肝脂肪变性的准确性。因此，在接受肝活检的连续患者中进行了一项双盲前瞻性研究，以评价超声诊断肝脂肪变性的准确性。由一名对临床诊断不知情的研究者在活检前进行真实的超声检查。由一位对临床指征或超声检查结果不知情的病理学家对肝活检进行审查。在研究的73例连续患者中，46例（63%）在活检中发现任何严重程度的大泡性脂肪变性，51例（69.9%）发现微泡性脂肪。超声医师对任何程度的大泡性肝脂肪变性的总体印象的敏感性为60.9%，特异性为100%。当脂肪含量≥ 20%时，敏感性可达100%，特异性可达90%。脂肪的悬韧带分布并没有改变超声诊断的准确性。超声诊断微泡性脂肪的敏感性为43%，特异性为73%。超声上回声增强与门静脉模糊相结合诊断脂肪肝的敏感性最高。结合超声检查结果的真实的实时超声检查具有较高的特异性，但当脂肪含量低于≥ 20%时，低估了肝脏脂肪变性的患病率。
Ultrasound is used to screen for hepatic steatosis, the most common liver disease in the United States. However, few studies have prospectively evaluated the accuracy of ultrasound to diagnose hepatic steatosis. Therefore, a double blinded prospective study was performed in consecutive patients undergoing liver biopsy to evaluate the accuracy of ultrasound to diagnose hepatic steatosis. Real time ultrasound was performed just prior to the biopsy by a single investigator masked to the clinical diagnosis. The liver biopsy was reviewed by a pathologist masked to the clinical indication or sonographic findings Of 73 consecutive patients studied,macrovesicular steatosis of any severity on biopsy was found in 46 (63%) and micro vesicular fat found in 51 (69.9%). The overall impression of the sonographer for the presence of macrovesicular hepatic steatosis of any degree had a sensitivity of 60.9% and a specificity of 100%. The sensitivity increased to 100% and the specificity to 90% when there was ≥ 20% of fat. The zonular distribution of the fat did not alter the diagnostic accuracy of ultrasound. Ultrasound had a poor yield in the diagnosis of microvesicular fat with an overall sensitivity of 43% and a specificity of 73%. The combination of increased echogenicity and portal vein blurring on ultrasound had the greatest sensitivity in the diagnosis of hepatic steatosis. Real time ultrasound using a combination of sonographic findings has a high specificity but underestimates the prevalence of hepatic steatosis when there is less than ≥ 20% fat.
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影响因子：
2.9
作者：
Fishbein, M;Castro, F;Stevens, WR
通讯作者：
Stevens, WR
影响因子：
1.3
作者：
FORSBERG, L;FLOREN, CH;PRYTZ, H
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PRYTZ, H
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作者：
Mathiesen, UL;Franzén, LE;Bodemar, G
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作者：
Strauss, Simon;Gavish, Ella;Katsnelson, Ludmila
通讯作者：
Katsnelson, Ludmila
影响因子：
2.6
作者：
DAVIES, RJ;SAVERYMUTTU, SH;JOSEPH, AEA
通讯作者：
JOSEPH, AEA