声速匹配应用于脂肪肝定量的初步研究
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摘要
目的:初步研究应用声速匹配技术对脂肪肝进行无创定量诊断的可行性。方法:纳入受试者32例,应用声速匹配技术测定肝右叶区域内声速值,按照传统超声诊断分为脂肪肝组和非脂肪肝组,比较两组受试者的声速值。根据血脂测试结果,将受试者分为高脂血症组和非高脂血症组,比较其声速值,并检验血脂指标与ZSI的相关性。通过ROC曲线检验该技术的准确性。结果:脂肪肝组声速显著低于非脂肪肝组(P=0.000)。高脂血症组的声速显著低于非高脂血症组声速(P=0.027)。声速与甘油三酯无相关性(r=-0.098,P=0.594),与总胆固醇呈负相关(P=0.036,r=0.470)。声速诊断脂肪肝的ROC曲线下面积为0.94,诊断临界值为18 m/s,敏感度84.2%[95%CI(60.4%,96.6%)],特异度为100%[95%CI(75.3%,100%)]。结论:声速匹配技术可以通过声速测定准确定量诊断脂肪肝,并且与高脂血症具有相关性。
Objective:To assess the feasibility of applying sound velocity matching technique to noninvasively quantifying of the severity of fatty liver.Method:Thirty-two subjects were recruited and the sound velocity matching technique was used to measure their values of sound velocity in the right lobe of liver.According to the traditional ultrasonic diagnosis,the patients were divided into the fatty liver group and the non-fatty liver group to compare their values of sound velocity.According to the results of blood lipid test,the subjects were divided into the hyperlipidemia group and the non-hyperlipidemia group to compare their values of sound velocity and also can test the correlation between serum lipid index and zone speed index(ZSI).And the receiver operating characteristic curve analysis was performed to assess the accuracy of this technology.Result:The sound velocity of fatty liver group was significantly lower than that of non-fatty liver group(P=0.000).The sound velocity of hyperlipidemia group was significantly lower than that of non-hyperlipidemia group(P=0.027).The results showed that sound velocity did not correlate significantly with triglyceride(r=-0.098,P=0.594);and sound velocity was negatively correlated with total cholesterol(P=0.036,r=0.470).The area under ROC curve was 0.94,the diagnostic threshold was 18 m/s,the sensitivity was 84.2%[95%CI(60.4%,96.6%)],and the specificity was 100%[95%CI(75.3%,100%).Conclusion:The sound velocity matching technique can diagnose fatty liver accurately and quantitatively by sound velocity measurement,and it is correlated with hyperlipidemia.
Objective:To assess the feasibility of applying sound velocity matching technique to noninvasively quantifying of the severity of fatty liver.Method:Thirty-two subjects were recruited and the sound velocity matching technique was used to measure their values of sound velocity in the right lobe of liver.According to the traditional ultrasonic diagnosis,the patients were divided into the fatty liver group and the non-fatty liver group to compare their values of sound velocity.According to the results of blood lipid test,the subjects were divided into the hyperlipidemia group and the non-hyperlipidemia group to compare their values of sound velocity and also can test the correlation between serum lipid index and zone speed index(ZSI).And the receiver operating characteristic curve analysis was performed to assess the accuracy of this technology.Result:The sound velocity of fatty liver group was significantly lower than that of non-fatty liver group(P=0.000).The sound velocity of hyperlipidemia group was significantly lower than that of non-hyperlipidemia group(P=0.027).The results showed that sound velocity did not correlate significantly with triglyceride(r=-0.098,P=0.594);and sound velocity was negatively correlated with total cholesterol(P=0.036,r=0.470).The area under ROC curve was 0.94,the diagnostic threshold was 18 m/s,the sensitivity was 84.2%[95%CI(60.4%,96.6%)],and the specificity was 100%[95%CI(75.3%,100%).Conclusion:The sound velocity matching technique can diagnose fatty liver accurately and quantitatively by sound velocity measurement,and it is correlated with hyperlipidemia.
引文
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[7]Sakitani K,Enooku K,Kubo H,et al.Clinical characteristics of patients with diabetes mellitus and fatty liver diagnosed by liver/spleen Hounsfield units on CT scan[J].J Int Med Res,2017,45(3):1208-1220.
[8]Permutt Z,Le T A,Peterson M R,et al.Correlation between liver histology and novel magnetic resonance imaging in adult patients with nonalcoholic fatty liver disease-MRI accurately quantifies hepatic steatosis in NAFLD[J].Aliment Pharmacol Ther,2012,36(1):22-29.
[9]Zhang B,Ding F,Chen T,et al.Ultrasound hepatic/renal ratio and hepatic attenuation rate for quantifying liver fat content[J].World JGastronenterol,2014,20(47):17985-17992.
[10]Li Q,Dhyani M,Grajo J R,et al.Current status of imaging in nonalcoholic fatty liver disease[J].World J Hepatol,2018,10(8):530-542.
[11]Kim K B,Kim C W.Quantification of Hepatorenal Index for ComputerAided Fatty Liver Classification with Self-Organizing Map and Fuzzy Stretching from Ultrasonography[J].Biomed Res Int,2015,2015:535894.
[12]Erdogmus B,Tamer A,Buyukkaya R,et al.Portal vein hemodynamics in patients with non-alcoholic fatty liver disease[J].Tohoku J Exp Med,2008,215(1):89-93.
[2]Ballestri S,Lonardo A,Bonapace S,et al.Risk of cardiovascular,cardiac and arrhythmic complications in patients with non-alcoholic fatty liver disease[J].World J Gastroenterol,2014,20(7):1724-1745.
[3]Brouwers M C,van Greevenbroek M M,Bilderbeek-Beckers M A,et al.Fatty liver-based identification of two distinct hypertriglyceridemic subgroups in familial combined hyperlipidemia[J].Metabolism,2007,56(10):1311-1317.
[4]Ng R,Wu H,Xiao H,et al.Inhibition of microRNA-24 expression in liver prevents hepatic lipid accumulation and hyperlipidemia[J].Hepatology,2014,60(2):554-564.
[5]Mikolasevic I,Orlic L,Franjic N,et al.Transient elastography(FibroScan?)with controlled attenuation parameter in the assessment of liver steatosis and fibrosis in patients with nonalcoholic fatty liver disease-Where do we stand[J].World J Gastroenterol,2016,22(32):7236-7251.
[6]Boozari B,Potthoff A,Mederacke I,et al.Evaluation of sound speed for detection of liver fibrosis:prospective comparison with transient dynamic elastography and histology[J].J Ultrasound Med,2010,29(11):1581-1588.
[7]Sakitani K,Enooku K,Kubo H,et al.Clinical characteristics of patients with diabetes mellitus and fatty liver diagnosed by liver/spleen Hounsfield units on CT scan[J].J Int Med Res,2017,45(3):1208-1220.
[8]Permutt Z,Le T A,Peterson M R,et al.Correlation between liver histology and novel magnetic resonance imaging in adult patients with nonalcoholic fatty liver disease-MRI accurately quantifies hepatic steatosis in NAFLD[J].Aliment Pharmacol Ther,2012,36(1):22-29.
[9]Zhang B,Ding F,Chen T,et al.Ultrasound hepatic/renal ratio and hepatic attenuation rate for quantifying liver fat content[J].World JGastronenterol,2014,20(47):17985-17992.
[10]Li Q,Dhyani M,Grajo J R,et al.Current status of imaging in nonalcoholic fatty liver disease[J].World J Hepatol,2018,10(8):530-542.
[11]Kim K B,Kim C W.Quantification of Hepatorenal Index for ComputerAided Fatty Liver Classification with Self-Organizing Map and Fuzzy Stretching from Ultrasonography[J].Biomed Res Int,2015,2015:535894.
[12]Erdogmus B,Tamer A,Buyukkaya R,et al.Portal vein hemodynamics in patients with non-alcoholic fatty liver disease[J].Tohoku J Exp Med,2008,215(1):89-93.