A prospective comparative assessment of the accuracy of the FibroScan in evaluating liver steatosis.
A prospective comparative assessment of the accuracy of the FibroScan in evaluating liver steatosis.
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DOI：
10.1371/journal.pone.0182784
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Park S
中科院分区：
文献类型：
--
作者：
Jun BG;Park WY;Park EJ;Jang JY;Jeong SW;Lee SH;Kim SG;Cha SW;Kim YS;Cho YD;Kim HS;Kim BS;Jin SY;Park S
最近的研究已经证明了FibroScan®设备在诊断肝脏脂肪变性方面的实用性，但其有用性尚未得到彻底评估。我们研究了受控衰减参数（CAP）在检测和定量肝脏脂肪变性中的作用。对79例接受肝活检、FibroScan检查、超声检查和肝脂肪变性指数（HSI）的慢性肝病患者进行了前瞻性分析。通过FibroScan设备、超声检查和HSI测量的脂肪变性的存在和程度与肝活检组织的结果进行比较。肝活检结果与CAP检测肝脂肪变性的kappa（κ）指数检验结果基本一致（κCAP = 0.77，P<0.001; κ超声= 0.60，P<0.001; κHSI = 0.47，P<0.001）。CAP、超声检查和HSI的受试者工作特征曲线下面积（AUROC）分别为0.899 [95%置信区间（CI）= 0.826-0.972）]、0.859（95% CI = 0.779-0.939）和0.766（95% CI = 0.655-0.877）。区分正常和肝脂肪变性的最佳CAP截止值为247 dB/m，其敏感性和特异性分别为91.9%和85.7%，阳性预测值为85.0%，阴性预测值为92.3%。在检测脂肪变性方面，CAP产生的结果与肝活检结果高度一致。因此，CAP是一种无创和可靠的工具，用于评估肝脏脂肪变性，即使在早期阶段。
Recent studies have demonstrated the utility of the FibroScan® device in diagnosing liver steatosis, but its usefulness has not been thoroughly appraised. We investigated the usefulness of the controlled attenuation parameter (CAP) in detecting and quantifying liver steatosis. A prospective analysis was applied to 79 chronic liver disease patients who underwent a liver biopsy, a FibroScan investigation, ultrasonography, and hepatic steatosis index (HSI). The presence and degree of steatosis as measured by the FibroScan device, ultrasonography and HSI were compared with the results for the liver biopsy tissue. There was substantial concordance between the liver biopsy results and the CAP as evaluated by the kappa (κ) index test for detecting liver steatosis (κCAP = 0.77, P<0.001; κultrasonography = 0.60, P<0.001; κHSI = 0.47, P<0.001). The areas under the receiver operating characteristic curve (AUROCs) of the CAP, ultrasonography, and HSI were 0.899 [95% confidence interval (CI) = 0.826–0.972)], 0.859 (95% CI = 0.779–0.939), and 0.766 (95% CI = 0.655–0.877), respectively. The optimal CAP cutoff value for differentiating between normal and hepatic steatosis was 247 dB/m, which produced sensitivity and specificity values of 91.9% and 85.7%, respectively, as well as a positive predictive value of 85.0% and a negative predictive value of 92.3%. The CAP produces results that are highly concordant with those of a liver biopsy in detecting steatosis. Therefore, the CAP is a noninvasive and reliable tool for evaluating liver steatosis, even in the early stages.
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