FibroTouch与B超、CT对脂肪肝的诊断价值比较

李静波; 刘姝; 温博; 高楠; 王炳元

doi:10.3969/j.issn.1001-5256.2016.03.011

FibroTouch与B超、CT对脂肪肝的诊断价值比较

DOI: 10.3969/j.issn.1001-5256.2016.03.011

中国医科大学附属第一医院老年消化科

详细信息

中图分类号: R575.5
计量
- 文章访问数: 2729
- HTML全文浏览量: 83
- PDF下载量: 463
- 被引次数: 0
出版历程
- 收稿日期: 2015-08-08
- 出版日期: 2016-03-20

Clinical significance of Fibro Touch,ultrasound,and computed tomography in diagnosis of fatty liver disease: a comparative analysis

Department of Geriatric Medicine,The First Affiliated Hospital of China Medical University

摘要

摘要:
目的探讨影像引导瞬时弹性成像系统Fibro Touch脂肪衰减参数（FAP）对脂肪肝诊断的意义。方法以2014年1月-12月在中国医科大学附属第一医院体检的1080例体检者为研究对象,统计所有人员的肝脏FAP、肝脏彩超结果和肝脏CT平扫肝/脾CT比值。计量资料组间比较采用Kruskal-Wallis H检验,采用Kappa一致性系数和ROC曲线比较FAP与肝脏彩超结果和肝脏CT平扫肝/脾CT比值诊断脂肪肝的一致性及其诊断价值。结果通过肝脏B超诊断脂肪肝阴性336例（31.11%）,阳性744例（68.89%）;参照B超结果,Fibro Touch的敏感性及特异性分别为80.5%和75.3%。通过肝脏CT诊断脂肪肝阴性（0级）821例（76.02%）、阳性259例,其中轻度（1级）216例、中度（2级）34例、重度（3级）9例;参照CT结果,Fibro Touch的敏感性及特异性分别为95.4%和47.0%,B超的敏感性及特异性分别为93.1%和36.8%。Fibro Touch诊断脂肪肝结果与B超有较高的一致性（kappa系数=0.597,P<0.0001）;与CT的一致性较低（...
- 脂肪肝 /
- 弹性成像技术 /
- B超 /
- CT
Abstract:
Objective To investigate the clinical significance of image- guided transient elastography Fibro Touch with fat attenuation parameter( FAP) in the diagnosis of fatty liver disease. Methods A total of 1080 persons who underwent physical examination in The First Affiliated Hospital of China Medical University from January to December,2014 were enrolled,and liver FAP,the results of color Doppler ultrasound for the liver,and liver / spleen CT ratio on computed tomography( CT) scan for the liver were collected and analyzed. The Kruskal- Wallis H test was applied for comparison of continuous data between groups,and the Kappa consistency coefficient and receiver operating characteristic curve were used to investigate the consistency between FAP and the results of color Doppler ultrasound for the liver or liver / spleen CT ratio on CT scan for the liver in the diagnosis of fatty liver disease and their diagnostic values. Results Liver ultrasound found 336 patients( 31. 11%) without fatty liver disease and 744 patients( 68. 89%) with fatty liver disease; with reference to the results of ultrasound,the sensitivity and specificity of Fibro Touch were 80. 5% and 75. 3%,respectively. Liver CT found 821 patients( 76. 02%)without fatty liver disease( grade 0) and 259 patients with fatty liver disease,among whom 216 had mild fatty liver disease( grade 1),34 had moderate fatty liver disease( grade 2),and 9 had severe fatty liver disease( grade 3); with reference to the results of liver CT,the sensitivity and specificity of Fibro Touch were 95. 4% and 47. 0%,respectively,and the sensitivity and specificity of ultrasound were 93. 1%and 36. 8%,respectively. As for the diagnosis of fatty liver disease,the results of Fibro Touch had a higher consistency with ultrasound results( Kappa coefficient = 0. 597,P < 0. 0001),and a lower consistency with CT results( Kappa coefficient = 0. 113,P < 0. 0001). Conclusion Fibro Touch has the advantages of high accuracy,easy operation,noninvasiveness,and low cost,and therefore it is a promising imaging method for the diagnosis of fatty liver disease.
- fatty liver /
- elasticity imaging technigues /
- ultrasonic B /
- computed tomography

HTML全文

参考文献(26)

[1]FAN JG.Epidemiology of alcoholic and nonalcoholic fatty liver disease in China[J].J Gastroenterol Hepatol,2013,28(Suppl 1):11-17.

[2]FESTI D,SCHIUMERINI R,MARZI L,et al.Review article:the diagnosis of non-alcoholic fatty liver disease-availability and accuracy of non-invasive methods[J].Aliment Pharmacol Ther,2013,37(4):392-400.

[3]ANSTEE QM,TARGHER G,DAY CP.Progression of NAFLD to diabetes mellitus,cardiovascular disease or cirrhosis[J].Nat Rev Gastroenterol Hepatol,2013,10(6):330-344.

[4]European Association for the study of the Liver.EASL clinical practical guidelines:management of alcoholic liver disease[J].J Hepatol,2012,57(2):399-420.

[5]Expert Committee on the Diagnosis and Management of Fatty Liver Disease,Chinese Medical Association.Recommendation for the standardization of diagnosis and treatment of fatty liver disease[J].J Clin Hepatol,2013,29(9):652-655.(in Chinese)中国医师协会脂肪性肝病专家委员会.脂肪性肝病诊疗规范化的专家建议[J].临床肝胆病杂志,2013,29(9):652-655.

[6]NASCIMBENI F,PAIS R,BELLENTANI S,et al.From NAFLD in clinical practice to answers from guidelines[J].J Hepatol,2013,59(4):859-871.

[7]CASTERRA L,VILGRAIN V,ANGULO P.Noinvasive evaluation of NAFLD[J].Nat Rev Gastroenterol Hepatol,2013,10(11):666-675.

[8]KHOV N,SHARMA A,RILEY TR.Bedside ultrasound in the diagnosis of nonalcoholic fatty liver disease[J].World J Gastroenterol,2014,20(22):6821-6825.

[9]MYERS RP,POLLETT A,KIRSCH R,et al.Controlled attenuation parameter(CAP):a noninvasive method for the detection of hepatic steatosis based on transient elastography[J].Liver Int,2012,32(6):902-910.

[10]CHAN WK,NIK MUSTAPHA NR,MAHADEVA S.Controlled attenuation parameter for the detection and quantification of hepatic steatosis in non-alcoholic fatty liver disease[J].J Gastroenterol Hepatol,2014,29(7):1470-1476.

[11]CHON YE,JUNG KS,KIM SU,et al.Controlled attenuation parameter(CAP)for detection of hepatic steatosis in patients with chronic liver diseases:a prospective study of a native Korean population[J].Liver Int,2014,34(1):102-109.

[12] SASSO M,TENGHER-BARNA I,ZIOL M,et al.Novel controlled attenuation parameter for noninvasive assessment of steatosis using Fibroscan:validation in chronic hepatitis C[J].J Viral Hepat,2012,19(4):244-253.

[13]SCAGLIONI F,CICCIA S,MARION M,et al.ASH and NASH[J].Dig Dis,2011,29(2):202-210.

[14] VERNON G,BARANOVA A,YOUNOSIS ZM.Systematic review:the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults[J].Aliment Pharmacol Ther,2011,34(3):274-285.

[15]WANG FS,FAN JG,ZHANG Z,et al.The global burden of liver disease:the major impact of China[J].Hepatology,2014,60(6):2099-2108.

[16]HU X,HUANG Y,BAO Z,et al.Prevalence and factors associated with nonalcoholic fatty liver disease in Shanghai work-units[J].BMC Gastroenterol,2012,12(35):123.

[17]CARVALHANA S,LEITO J,ALVES AC,et al.How good is controlled attenuation parameter and fatty liver index for assessing liver steatosis in general population:correlation with ultrasound[J].Liver Int,2014,34(6):e111-e117.

[18]FERRAIOLI G,TINELLI C,LISSANDRIN R,et al.Controlled attenuation parameter for evaluating liver steatosis in chronic viral hepatitis[J].World J Gastroenterol,2014,20(21):6626-6631.

[19]KUMAR M,RASTOGI A,SINGH T,et al.Controlled attenuation parameter for non-invasive assessment of hepatic steatosis:does etiology affect performance?[J].J Gastroenterol Hepatol,2013,28(7):1194-1201.

[20]SCHWEZER NF,SPRINGER F,SCHRAML C,et al.Noninvasive assessment and quantification of liver steatosis by ultrasound,computed tomography and magnetic resonance[J].J Hepatol,2009,51(3):433-445.

[21]MEHTA SR,THOMAS EL,BELL JD,et al.Noninvasive means of measuring hepatic fat content[J].World J Gastroenterol,2008,13(22):3476-3483.

[22]ZEB I,LI D,NASIR KG,et al.Computed tomography scans in the evaluation of fatty liver disease in a population based study:the multi-ethnic study of atherosclerosis[J].Acad Radiol,2012,19(7):811-818.

[23] MYERS RP,POLLETT A,KIRSCH R,et al.Controlled attenuation parameter(CAP):a noninvasive method for the detection of hepatic steatosis based on transient elastography[J].Liver Int,2012,32(6):902-910.

[24]SHEN Y,ZHANG J,CAI H,et al.Identifying patients with chronic hepatitis B at high risk of type 2 diabetes mellitus:a cross-sectional study with pair-matched controls[J].BMC Gastroenterology,2015,15(1):32.

[25]PARK SK,SEO MH,SHIN HC,et al.Clinical availability of nonalcoholic fatty liver disease as an early predictor of type 2 diabetes mellitus in Korean men:5-year prospective cohort study[J].Hepatology,2013,57(4):1378-1383.

[26]de LEDINGHEN V,VERGNIOL J,FOUCHER J,et al.Non-invasive diagnosis of liver steatosis using controlled attenuation parameter(CAP)and transient elastography[J].Liver Int,2012,32(6):911-918.

施引文献

资源附件(0)

访问统计