Yun Kyu Lee, Dong Hyeon Lee, Sae Kyung Joo, Heejoon Jang, Young Ho So, Siwon Jang, Dong Ho Lee, Jeong Hwan Park, Mee Soo Chang, Won Kim
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This study compared the diagnostic performances of combi-elastography and vibration-controlled transient elastography (VCTE) for identifying hepatic steatosis, fibrosis, and high-risk MASH.</p><p><strong>Methods: </strong>Participants who underwent combi-elastography, VCTE, and liver biopsy were selected from a prospective cohort of patients with clinically suspected MASLD. Combi-elastography-related parameters were acquired, and their performances were evaluated using area under the receiver-operating characteristic curve (AUROC) analysis.</p><p><strong>Results: </strong>A total of 212 participants were included. The diagnostic performance for hepatic steatosis of the attenuation coefficient adjusted by covariates from combi-elastography was comparable to that of the controlled attenuation parameter measured by VCTE (AUROC, 0.85 vs 0.85; p=0.925). 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引用次数: 0
摘要
背景/目的:联合弹性成像是一种基于 B 型超声波的方法,其中同时使用两种弹性成像模式来评估代谢功能障碍相关性脂肪性肝病(MASLD)。然而,联合弹性成像在诊断代谢功能障碍相关性脂肪性肝炎(MASH)和确定纤维化严重程度方面的性能尚不明确。本研究比较了联合弹性成像和振动控制瞬态弹性成像(VCTE)在鉴别肝脂肪变性、肝纤维化和高危MASH方面的诊断性能:从临床疑似 MASLD 患者的前瞻性队列中挑选出接受联合弹性成像、VCTE 和肝活检的参与者。研究人员获取了联合弹性成像相关参数,并通过受体运行特征曲线下面积(AUROC)分析对这些参数的性能进行了评估:结果:共纳入 212 名参与者。经联合弹性成像的协变量调整后的衰减系数对肝脏脂肪变性的诊断性能与 VCTE 测量的受控衰减参数相当(AUROC,0.85 vs 0.85;p=0.925)。经协变量调整后,联合弹性成像得出的纤维化指数在诊断明显纤维化方面的性能与 VCTE 测量的肝脏硬度相当(AUROC,0.77 vs 0.80;p=0.573)。在诊断MASLD参与者中的高风险MASH时,经协变量调整后的联合弹性成像活动指数与FibroScan-天门冬氨酸氨基转移酶评分相当(AUROC,0.72 vs 0.74;p=0.792):结论:在评估MASLD组织学时,联合弹性成像的性能与VCTE相似。
Combi-Elastography versus Transient Elastography for Assessing the Histological Severity of Metabolic Dysfunction-Associated Steatotic Liver Disease.
Background/aims: Combi-elastography is a B-mode ultrasound-based method in which two elastography modalities are utilized simultaneously to assess metabolic dysfunction-associated steatotic liver disease (MASLD). However, the performance of combi-elastography for diagnosing metabolic dysfunction-associated steatohepatitis (MASH) and determining fibrosis severity is unclear. This study compared the diagnostic performances of combi-elastography and vibration-controlled transient elastography (VCTE) for identifying hepatic steatosis, fibrosis, and high-risk MASH.
Methods: Participants who underwent combi-elastography, VCTE, and liver biopsy were selected from a prospective cohort of patients with clinically suspected MASLD. Combi-elastography-related parameters were acquired, and their performances were evaluated using area under the receiver-operating characteristic curve (AUROC) analysis.
Results: A total of 212 participants were included. The diagnostic performance for hepatic steatosis of the attenuation coefficient adjusted by covariates from combi-elastography was comparable to that of the controlled attenuation parameter measured by VCTE (AUROC, 0.85 vs 0.85; p=0.925). The performance of the combi-elastography-derived fibrosis index adjusted by covariates for diagnosing significant fibrosis was comparable to that of liver stiffness measured by VCTE (AUROC, 0.77 vs 0.80; p=0.573). The activity index from combi-elastography adjusted by covariates was equivalent to the FibroScan-aspartate aminotransferase score in diagnosing high-risk MASH among participants with MASLD (AUROC, 0.72 vs 0.74; p=0.792).
Conclusions: The performance of combi-elastography is similar to that of VCTE when evaluating histology of MASLD.
期刊介绍:
Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut and Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology.
Gut and Liver is jointly owned and operated by 8 affiliated societies in the field of gastroenterology, namely: the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, the Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, the Korean Pancreatobiliary Association, and the Korean Society of Gastrointestinal Cancer.