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Quantitative ultrasound radiofrequency data analysis for the assessment of hepatic steatosis using the controlled attenuation parameter as a reference standard

Ultrasonography 2021년 40권 1호 p.136 ~ 146
전선경, 주이진, 김소연, 장종건, 박주일, 박희선, 이은선, 이정민,
소속 상세정보
전선경 ( Jeon Sun-Kyung ) - Seoul National University College of Medicine Seoul National University Hospital Department of Radiology
주이진 ( Joo I-Jin ) - Seoul National University College of Medicine Seoul National University Hospital Department of Radiology
김소연 ( Kim So-Yeon ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
장종건 ( Jang Jong-Keon ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
박주일 ( Park Ju-Il ) - Seoul National University College of Medicine Seoul National University Hospital Department of Radiology
박희선 ( Park Hee-Sun ) - Konkuk University School of Medicine Department of Radiology
이은선 ( Lee Eun-Sun ) - Chung-Ang University College of Medicine Chung-Ang University Hospital Department of Radiology
이정민 ( Lee Jeong-Min ) - Seoul National University College of Medicine Seoul National University Hospital Department of Radiology

Abstract


Purpose: This study was aimed to investigate the value of quantitative ultrasound (US) parameters from radiofrequency (RF) data analysis for assessing hepatic steatosis, using controlled attenuation parameter (CAP)-based steatosis grades as the reference standard.

Methods: We analyzed 243 participants with both B-mode liver US with RF data acquisition and CAP measurements. On B-mode US images, hepatic steatosis was visually scored (0/1/2/3, none/mild/moderate/severe), and the hepatorenal index (HRI) was calculated. From the RF data analysis, the tissue scatter-distribution imaging parameter (TSI-p) and tissue attenuation imaging parameter (TAI-p) of the liver parenchyma were measured. US parameters were correlated with CAP-based steatosis grades (S0/1/2/3, none/mild/moderate/severe) and their diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis. Multivariate linear regression analysis was performed to identify determinants of TSI-p and TAI-p.

Results: Participants were classified as having S0 (n=152), S1 (n=54), S2 (n=14), and S3 (n=23) on CAP measurements. TSI-p and TAI-p were significantly correlated with steatosis grades (ρ =0.593 and ρ=-0.617, P<0.001 for both). For predicting ≥S1, ≥S2, and S3, the areas under the ROC curves (AUCs) of TSI-p were 0.827/0.914/0.917; TAI-p, 0.844/0.914/0.909; visual scores, 0.659/0.778/0.794; and HRI, 0.629/0.751/0.759, respectively. TSI-p and TAI-p had significantly higher AUCs than did visual scores or HRI for ≥S1 or ≥S2 (P≤0.003). In the multivariate analysis, the transient elastography-based fibrosis grade (P=0.034) and steatosis grade (P<0.001) were independent determinants of TSI-p, while steatosis grade (P<0.001) was an independent determinant of TAI-p.

Conclusion: TSI-p and TAI-p derived from US RF data may be useful for detecting hepatic steatosis and assessing its severity.

키워드

Ultrasonography; Liver; Fatty liver

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