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Accuracy of the ultrasound attenuation coefficient for the evaluation of hepatic steatosis: a systematic review and meta-analysis of prospective studies

Ultrasonography 2022년 41권 1호 p.83 ~ 92
장종건, 최상현, 이지성, 김소연, 이승수, 김경원,
소속 상세정보
장종건 ( Jang Jong-Keon ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
최상현 ( Choi Sang-Hyun ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
이지성 ( Lee Ji-Sung ) - University of Ulsan College of Medicine Asan Medical Center Department of Clinical Epidemiology and Biostatistics
김소연 ( Kim So-Yeon ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
이승수 ( Lee Seung-Soo ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
김경원 ( Kim Kyung-Won ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology

Abstract


Purpose: The accurate detection and quantification of hepatic steatosis using a noninvasive method are important for the management of nonalcoholic fatty liver disease. We performed a systematic review and meta-analysis of the accuracy of the ultrasound-measured attenuation coefficient (AC) in the evaluation of hepatic steatosis.

Methods: The PubMed, Embase, and Cochrane databases were searched for prospective studies reporting the diagnostic accuracy of AC for assessing hepatic steatosis. The meta-analytic pooled sensitivity and specificity of AC for any grade of steatosis (S≥1) and advanced steatosis (S≥2) were estimated using a bivariate random-effects model. Meta-regression analysis was conducted to investigate the causes of heterogeneity among studies.

Results: Thirteen studies including 1,509 patients were identified. The pooled sensitivity and specificity of AC for S≥1 were 76% (95% confidence interval [CI], 73% to 80%; I2=43%) and 84% (95% CI, 77% to 89%; I2=74%), respectively, while for S≥2 they were 87% (95% CI, 83% to 91%; I2=0%) and 79% (95% CI, 75% to 83%; I2=59%), respectively. Study heterogeneity was associated with body mass index (BMI) and the prevalence of steatosis or significant fibrosis.

Conclusion: AC can be clinically useful for assessing hepatic steatosis, with good overall diagnostic performance. The data reported in the published literature differed according to BMI and the prevalence of steatosis or significant fibrosis, and careful interpretation with consideration of these factors might be needed.

키워드

Liver; Steatosis; Nonalcoholic fatty liver disease; Ultrasound; Diagnostic imaging; Meta-analysis

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