Optimal threshold of controlled attenuation parameter with MRI-PDFF as the gold standard for the detection of hepatic steatosis.
Optimal threshold of controlled attenuation parameter with MRI-PDFF as the gold standard for the detection of hepatic steatosis.
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DOI：
10.1002/hep.29639
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发表时间：
2018-04
期刊：
影响因子：
--
通讯作者：
Loomba R
中科院分区：
文献类型：
--
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
在非酒精性脂肪性肝病（NAFLD）中，使用M探头和XL探头检测肝脂肪变性的受控衰减参数（CAP）的最佳阈值尚不明确。磁共振成像质子密度脂肪分数（MRI - PDFF）是一种检测肝脂肪变性存在的准确且精密的方法，且优于CAP。因此，本研究的目的是评估CAP在检测由MRI - PDFF≥5%所定义的肝脂肪变性时的诊断准确性和最佳阈值。这项横断面研究纳入了119名成年人（59%为女性），这些人是在加州大学圣地亚哥分校NAFLD研究中心6个月内前瞻性招募的，包括患有和未患有NAFLD的患者，他们在有指征时接受了MRI - PDFF检查以及使用M探头或XL探头进行的CAP检查。平均（±标准差）年龄和体重指数分别为52.4（±15.2）岁和29.9（±5.5）kg/m²。NAFLD（MRI - PDFF≥5%）和MRI - PDFF≥10%的患病率分别为70.6%和47.1%。CAP检测MRI - PDFF≥5%的受试者工作特征曲线下面积（AUROC）在288 dB/m的截断点为0.80（95%置信区间：0.70 - 0.90），检测MRI - PDFF≥10%的AUROC在306 dB/m的截断点为0.87（95%置信区间：0.80 - 0.94）。当按CAP的四分位距（IQR）分层时，我们观察到低于中位数（30 dB/m）的IQR与高于中位数的IQR相比，具有稳健的AUROC（[0.92，95%置信区间：0.85 - 1.00]对比[0.70，95%置信区间：0.56 - 0.85]，p值 = 0.0117），并且这些差异具有统计学和临床意义。
肝脂肪变性（MRI - PDFF≥5%）存在时CAP的截断点为288 dB/m。当CAP的IQR <30 dB/m时，CAP检测肝脂肪变性的诊断准确性更可靠。这些新的数据对CAP在NAFLD评估中的临床应用具有重要意义。
The optimal threshold of controlled attenuation parameter (CAP) for the detection of hepatic steatosis using both M and XL probe is unknown in nonalcoholic fatty liver disease (NAFLD). Magnetic resonance imaging proton-density-fat-fraction (MRI-PDFF) is an accurate and precise method to detect presence of hepatic steatosis and is better than CAP. Thus, the aim of this study was to evaluate the diagnostic accuracy and the optimal threshold of CAP for the detection of hepatic steatosis as defined by MRI-PDFF ≥ 5%. This cross-sectional study included 119 adults (59% women), prospectively recruited with and without NAFLD who underwent MRI-PDFF and CAP using either M probe or XL probe when indicated within a six-month period at the NAFLD Research Center, UCSD. Mean (±standard deviation) age and BMI were 52.4 (±15.2) years and 29.9 (±5.5) kg/m2, respectively. The prevalence of NAFLD (MRI-PDFF≥5%) and MRI-PDFF≥ 10% was 70.6% and 47.1%, respectively. The area under the ROC (AUROC) of CAP for the detection of MRI-PDFF ≥ 5% was 0.80 (95%CI:0.70–0.90) at the cut-point of 288 dB/m and of MRI-PDFF ≥10% was 0.87 (95%CI:0.80–0.94) at the cut-point of 306 dB/m. When stratified by IQR of CAP, we observed that an IQR below median (30 dB/m) had a robust AUROC compared to IQR above median ([0.92, 95%CI:0.85-1.00] vs. [0.70, 95%CI:0.56-0.85], p-value=0.0117), and these differences were statistically and clinically significant. The cut-point of CAP for presence of hepatic steatosis (MRI-PDFF ≥ 5%) was 288 dB/m. The diagnostic accuracy of CAP for the detection of hepatic steatosis is more reliable when IQR of CAP is <30 dB/m. These novel data have implications for clinical utility of CAP in the assessment of 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
影响因子：
25.7
作者：
Dulai PS;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
影响因子：
15.9
作者：
Caussy, Cyrielle;Soni, Meera;Loomba, Rohit
通讯作者：
Loomba, Rohit
影响因子：
7.6
作者：
Doycheva I;Cui J;Nguyen P;Costa EA;Hooker J;Hofflich H;Bettencourt R;Brouha S;Sirlin CB;Loomba R
通讯作者：
Loomba R