Non-invasive assessment of hepatic steatosis: Prospective comparison of the accuracy of imaging examinations
Non-invasive assessment of hepatic steatosis: Prospective comparison of the accuracy of imaging examinations
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DOI：
10.1016/j.jhep.2010.01.008
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发表时间：
2010-04-01
影响因子：
25.7
通讯作者：
Yu, Eun Sil
中科院分区：
文献类型：
--
作者：
Lee, Seung Soo;Park, Seong Ho;Yu, Eun Sil
背景和目的：尽管越来越多地使用各种影像学检查来无创评估肝脂肪变性（HS），但它们的相对准确性尚不清楚。本研究的目的是前瞻性比较计算机断层扫描 (CT)、双梯度回波磁共振成像 (DGE-MRI)、质子磁共振波谱 (H-1-MRS) 和超声检查 (US) 对 HS 的诊断和定量评估的准确性。方法：总共 161 名连续的潜在活体肝脏捐献者接受了 US（由两名独立放射科医生 US1 和 US2 执行）、CT、DGE-MRI、H-1-MRS 和肝脏检查。同日进行活检。以HS的组织学程度为参考标准，比较US1、US2、CT、DGE-MRI和H-1-MRS对HS≥5%和HS≥30%的诊断性能，并比较CT、DGE-MRI和H-1-MRS对HS定量估计的准确性。结果：DGE-MRI和H-1-MRS对HS的诊断明显优于CT和US >= 5%。 DGE-MRI 表现出比其他检查诊断 HS >= 30% 的准确率更高的趋势。在最佳截止值下，DGE-MRI 的交叉验证敏感性和特异性对于诊断 HS >= 5% 分别为 76.7% 和 87.1%，对于诊断 HS >= 30% 分别为 90.9% 和 94%。影像学检查估计的 HS 程度与 HS 组织学程度之间经过交叉验证的 Bland-Altman 95% 一致限，DGE-MRI 的一致性最窄，为 -12.7% 至 12.7%。结论：在 CT、DGE-MRI、H-1-MRS 和 US 中，DGE-MRI 是诊断和定量估计 HS 最准确的方法。因此，DGE-MRI可能是HS无创评估的首选影像学检查。 (c) 2010 年欧洲肝脏研究协会。由 Elsevier B.V. 出版。保留所有权利。
Background & Aims: Despite increasing use of various imaging examinations for non-invasive assessment of hepatic steatosis (HS), their relative accuracy is unknown. The objective of this study is to prospectively compare the accuracy of computed tomography (CT), dual gradient echo magnetic resonance imaging (DGE-MRI), proton magnetic resonance spectroscopy (H-1-MRS), and ultrasonography (US) for the diagnosis and quantitative estimation of HS.Methods: A total of 161 consecutive potential living liver donors underwent US (performed by two independent radiologists, US1 and US2), CT, DGE-MRI, H-1-MRS, and liver biopsy on the same day. Using the histologic degree of HS as the reference standard, we compared the diagnostic performance of US1, US2, CT, DGE-MRI, and H-1-MRS for diagnosing HS >= 5% and HS >= 30% and compared the accuracy of CT, DGE-MRI, and H-1-MRS in the quantitative estimation of HS.Results: DGE-MRI and H-1-MRS significantly outperformed CT and US for the diagnosis of HS >= 5%. DGE-MRI showed a tendency of higher accuracy than the other examinations for diagnosing HS >= 30%. The cross-validated sensitivity and specificity of DGE-MRI at the optimal cut-off were 76.7% and 87.1%, respectively, for diagnosing HS >= 5% and 90.9% and 94%, respectively, for diagnosing HS >= 30%. The cross-validated Bland-Altman 95% limits of agreement between the estimated degree of HS on imaging examinations and the histologic degree of HS, were the narrowest with DGE-MRI, yielding -12.7% to 12.7%.Conclusions: Among CT, DGE-MRI, H-1-MRS, and US, DGE-MRI is the most accurate method for the diagnosis and quantitative estimation of HS. Therefore, DGE-MRI may be the preferred imaging examination for the non-invasive assessment of HS. (c) 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.