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Controlled attenuation parameter measured using transient elastography for the noninvasive assessment of macrovesicular steatosis in potential living liver donors

Ultrasonography 2022년 41권 1호 p.164 ~ 170
이선영, 김경원, 김소연, 서니은, 송기원, 이승규,
소속 상세정보
이선영 ( Lee Sun-Young ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
김경원 ( Kim Kyoung-Won ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
김소연 ( Kim So-Yeon ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
서니은 ( Seo Ni-Eun ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
송기원 ( Song Gi-Won ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
이승규 ( Lee Sung-Gyu ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery

Abstract


Purpose: This study aimed to determine the diagnostic performance of the controlled attenuation parameter (CAP) measured using transient elastography (TE) for assessing macrovesicular steatosis (MaS) in potential living liver donors using same-day biopsy as a reference standard.

Methods: This retrospective study included 204 living liver donor candidates who underwent TE and liver biopsy on the same day between July 2013 and June 2014. The histologic degree of MaS was determined. The area under the receiver operating characteristic curve (AUROC) was used to evaluate the performance of CAP for diagnosing MaS of >10%, and the optimal cutoff value was identified using the maximal Youden index.

Results: Based on liver biopsy, 185 subjects had MaS of ≤10% and 19 had MaS of >10%. The CAP value was significantly correlated with the percentage of MaS on liver biopsy (r=0.635, P<0.001), and the median CAP value was significantly higher in subjects with MaS of >10% than in those with MaS of ≤10% (300 dB/m vs. 209 dB/m, P<0.001). The AUROC for diagnosing MaS of >10% by CAP was 0.938 (95% confidence interval, 0.896 to 0.967), and a CAP of >259 dB/m yielded a sensitivity of 84.2% and a specificity of 92.4%.

Conclusion: The CAP measured using TE was significantly correlated with MaS and accurately detected substantial MaS in potential living liver donors. The CAP is a promising tool for the noninvasive diagnosis of MaS and may be used to screen unsuitable living liver donor candidates.

키워드

Controlled attenuation parameter; Transient elastography; Macrovesicular steatosis; Liver biopsy; Living donors

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