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Correlation of the grade of hepatic steatosis between controlled attenuation parameter and ultrasound in patients with fatty liver: a multi-center retrospective cohort study

Korean Journal of Internal Medicine 2020년 35권 6호 p.1346 ~ 1353
유정주, 유양재, 문우람, 김승업, 정승원, 박하나, 박민규, 장재영, 박수연, 김범경, 박준용, 김도영, 안상훈, 한광협, 김상균, 김영석, 김지훈, 연종은, 변관수,
소속 상세정보
유정주 ( Yoo Jeong-Ju ) - Soonchunhyang University Bucheon Hospital Department of Internal Medicine
유양재 ( Yoo Yang-Jae ) - Korea University College of Medicine Department of Internal Medicine
문우람 ( Moon Woo-Ram ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine
김승업 ( Kim Seung-Up ) - Yonsei University College of Medicine Department of Internal Medicine
정승원 ( Jeong Soung-Won ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine
박하나 ( Park Ha-Na ) - CHA University CHA Bundang Medical Center Department of Internal Medicine
박민규 ( Park Min-Gyu ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine
장재영 ( Jang Jae-Young ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine
박수연 ( Park Su-Yeon ) - Soonchunhyang University Seoul Hospital Department of Biostatistics
김범경 ( Kim Beom-Kyung ) - Yonsei University College of Medicine Department of Internal Medicine
박준용 ( Park Jun-Yong ) - Yonsei University College of Medicine Department of Internal Medicine
김도영 ( Kim Do-Young ) - Yonsei University College of Medicine Department of Internal Medicine
안상훈 ( Ahn Sang-Hoon ) - Yonsei University College of Medicine Department of Internal Medicine
한광협 ( Han Kwang-Hyub ) - Yonsei University College of Medicine Department of Internal Medicine
김상균 ( Kim Sang-Gyune ) - Soonchunhyang University Bucheon Hospital Department of Internal Medicine
김영석 ( Kim Young-Seok ) - Soonchunhyang University Bucheon Hospital Department of Internal Medicine
김지훈 ( Kim Ji-Hoon ) - Korea University College of Medicine Department of Internal Medicine
연종은 ( Yeon Jong-Eun ) - Korea University College of Medicine Department of Internal Medicine
변관수 ( Byun Kwan-Soo ) - Korea University College of Medicine Department of Internal Medicine

Abstract


Background/Aims: The controlled attenuation parameter (CAP), based on transient elastography, is widely used for noninvasive assessment of the degree of hepatic steatosis (HS). We investigated the correlation of the degree HS between CAP and ultrasound (US) in patients with HS.

Methods: In total, 986 patients with US-based HS who underwent transient elastography within 1 month were evaluated. The US-based grade of HS was categorized as mild (grade 1), moderate (grade 2), or severe (grade 3).

Results: The CAP was significantly correlated with the US-based grade of HS (r = 0.458, p < 0.001). The median CAP value of each US-based HS grade showed a positive correlation with grade (271.1, 303.7, and 326.7 dB/m for grades 1, 2, and 3). In a multivariate analysis, the US-based HS grade, body mass index, serum albumin, alanine aminotransferase, and total cholesterol, and liver stiffness were all significantly correlated with the CAP value (all p < 0.05). The areas under the receiver operating characteristic curves for grade 2 to 3 and grade 3 HS were 0.749 (95% confidence interval [CI], 0.714 to 0.784) and 0.738 (95% CI, 0.704 to 0.772). The optimal cut-off CAP values to maximize the sum of the sensitivity and specificity for grade 2 to 3 and grade 3 HS were 284.5 dB/m (sensitivity 78.6%, specificity 61.7%) and 298.5 dB/m (sensitivity 84.6%, specificity 55.6%).

Conclusions: The correlation of the degree of HS between CAP and US was significantly high in patients with HS, and the optimal cut-off CAP values for grade 2 to 3 and grade 3 HS were 284.5 and 298.5 dB/m.

키워드

Fatty liver; Elasticity imaging techniques; Ultrasonography

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