临床肝胆病杂志2024，Vol.40Issue(1)：46-51,6.DOI:10.12449/JCH240109
肝/脾CT值、受控衰减参数(CAP)和磁共振质子密度脂肪分数(MRI-PDFF)在慢性乙型肝炎脂肪变性患者中的应用价值
Application value of liver/spleen CT value,controlled attenuation parameter,and magnetic resonance imaging-proton density fat fraction in chronic hepatitis B patients with hepatic steatosis
摘要
Abstract
Objective To investigate the application value of liver/spleen CT value(CTL/S),controlled attenuation parameter(CAP),and magnetic resonance imaging-proton density fat fraction(MRI-PDFF)in chronic hepatitis B(CHB)patients with hepatic steatosis.Methods A retrospective analysis was performed for the clinical data of 213 CHB patients who underwent liver CT,CAP,and MRI-PDFF examinations in Affiliated Hospital of Yan'an University from October 2018 to December 2022.According to MRI-PDFF,the 213 patients were divided into CHB group with 111 patients(MRI-PDFF<5%)and CHB+hepatic steatosis group with 102 patients(MRI-PDFF≥5%),among whom there were 69 patients with mild hepatic steatosis and 33 patients with moderate to severe hepatic steatosis.The independent-samples t test was used for comparison of normally distributed continuous data between groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups.The Bland-Altman plot was used to evaluate the consistency in MRI-PDFF measurement between two physicians.The Spearman's correlation coefficient was used to analyze the correlation between CTL/S and MRI-PDFF and between CAP and MRI-PDFF.The receiver operating characteristic(ROC)curve was plotted and the area under the ROC curve(AUC)was calculated to investigate the value of CTL/S and CAP in the diagnosis of different degrees of hepatic steatosis,and the DeLong test was used to compare the AUCs of the two radiological examinations.Results MRI-PDFF had relatively high repeatability and stability in CHB patients.There is a significant negative correlation between CTL/S and MRI-PDFF(r=-0.800,P<0.001)and a significant positive correlation between CAP and MRI-PDFF(r=0.692,P<0.001).Both CTL/S and CAP had a relatively high accuracy in the diagnosis of hepatic steatosis in CHB patients,with an AUC of 0.951 and 0.902,respectively,and CTL/S had a better accuracy than CAP(P<0.05).In the diagnosis of mild and moderate-to-severe hepatic steatosis,CTL/S had an AUC of 0.921 and 0.895,respectively,and CAP had an AUC of 0.859 and 0.825,respectively,suggesting that CTL/S had a slightly higher diagnostic efficiency than CAP.Conclusion MRI-PDFF has high repeatability and stability in CHB patients,and CTL/S and CAP have a high diagnostic value for different degrees of hepatic steatosis in CHB patients.关键词
乙型肝炎,慢性/脂肪肝/诊断Key words
Hepatitis B,Chronic/Fatty Liver/Diagnosis引用本文复制引用
鲁景楠,李岩松,温雅,王雄慧,屈兆宇,李建龙,张炜..肝/脾CT值、受控衰减参数(CAP)和磁共振质子密度脂肪分数(MRI-PDFF)在慢性乙型肝炎脂肪变性患者中的应用价值[J].临床肝胆病杂志,2024,40(1):46-51,6.基金项目
延安市科学技术研究发展计划项目(2018KS-11) Science and Technology Research and Development Project of Yan'an(2018KS-11) （2018KS-11）
