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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 40 Issue 1
Jan.  2024
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Article Navigation >  Journal of Clinical Hepatology  > 2024  >  40(1): 46-51

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

DOI: 10.12449/JCH240109
  • 1.

    Department of Medical Imaging，Affiliated Hospital of Yan’an University，Yan’an，Shaanxi 716000，China

  • 2.

    Department of Nuclear Medicine，Xi’an International Medical Center Hospital，Xi’an 710100，China

Research funding:

Science and Technology Research and Development Project of Yan’an (2018KS-11)

More Information
  • Corresponding author: ZHANG Wei， 304180598@qq.com （ORCID： 0009-0009-2951-1115）
  • Received Date: 2023-04-20
  • Accepted Date: 2023-05-06
  • Published Date: 2024-01-23
    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.

     

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    • References(21)
  • [1]
    Polaris Observatory Collaborators. Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study[J]. Lancet Gastroenterol Hepatol, 2018, 3( 6): 383- 403. DOI: 10.1016/S2468-1253(18)30056-6.
    [2]
    ZHOU WW, HUANG J, PAN FM. Research progress in epidemiological characteristics and therapeutic drugs of chronic hepatitis B[J]. J Changchun Univ Chin Med, 2022, 38( 12): 1420- 1424. DOI: 10.13463/j.cnki.cczyy.2022.12.028.

    周薇薇, 黄俊, 潘发明. 慢性乙型肝炎流行病学特点和治疗药物研究进展[J]. 长春中医药大学学报, 2022, 38( 12): 1420- 1424. DOI: 10.13463/j.cnki.cczyy.2022.12.028.
    [3]
    RINELLA ME, NEUSCHWANDER-TETRI BA, SIDDIQUI MS, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease[J]. Hepatology, 2023, 77( 5): 1797- 1835. DOI: 10.1097/HEP.0000000000000323.
    [4]
    LEE YB, HA Y, CHON YE, et al. Association between hepatic steatosis and the development of hepatocellular carcinoma in patients with chronic hepatitis B[J]. Clin Mol Hepatol, 2019, 25( 1): 52- 64. DOI: 10.3350/cmh.2018.0040.
    [5]
    SHIHA G, IBRAHIM A, HELMY A, et al. Asian-Pacific Association for the Study of the Liver(APASL) consensus guidelines on invasive and non-invasive assessment of hepatic fibrosis: a 2016 update[J]. Hepatol Int, 2017, 11( 1): 1- 30. DOI: 10.1007/s12072-016-9760-3.
    [6]
    ROGIER J, ROULLET S, CORNÉLIS F, et al. Noninvasive assessment of macrovesicular liver steatosis in cadaveric donors based on computed tomography liver-to-spleen attenuation ratio[J]. Liver Transpl, 2015, 21( 5): 690- 695. DOI: 10.1002/lt.24105.
    [7]
    FERRAIOLI G. Quantitative assessment of liver steatosis using ultrasound controlled attenuation parameter(Echosens)[J]. J Med Ultrason(2001), 2021, 48( 4): 489- 495. DOI: 10.1007/s10396-021-01106-1.
    [8]
    Committee of Hepatology, Chinese Research Hospital Association, Fatty Liver Expert Committee, Chinese Medical Doctor Association, National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, et al. Expert recommendations on standardized diagnosis and treatment for fatty liver disease(2019 revised edition)[J]. J Clin Hepatol, 2019, 35( 11): 2426- 2430. DOI: 10.3969/j.issn.1001-5256.2019.11.007.

    中国研究型医院学会肝病专业委员会, 中国医师协会脂肪性肝病专家委员会, 中华医学会肝病学分会脂肪肝与酒精性肝病学组, 等. 脂肪性肝病诊疗规范化的专家建议(2019年修订版)[J]. 临床肝胆病杂志, 2019, 35( 11): 2426- 2430. DOI: 10.3969/j.issn.1001-5256.2019.11.007.
    [9]
    TAMAKI N, AJMERA V, LOOMBA R. Non-invasive methods for imaging hepatic steatosis and their clinical importance in NAFLD[J]. Nat Rev Endocrinol, 2022, 18( 1): 55- 66. DOI: 10.1038/s41574-021-00584-0.
    [10]
    DULAI PS, SIRLIN CB, LOOMBA R. MRI and MRE for non-invasive quantitative assessment of hepatic steatosis and fibrosis in NAFLD and NASH: Clinical trials to clinical practice[J]. J Hepatol, 2016, 65( 5): 1006- 1016. DOI: 10.1016/j.jhep.2016.06.005.
    [11]
    National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association, Fatty Liver Expert Committee, Chinese Medical Doctor Association. Guidelines of prevention and treatment for nonalcoholic fatty liver disease: A 2018 update[J]. J Clin Hepatol, 2018, 34( 5): 947- 957. DOI: 10.3969/j.issn.1001-5256.2018.05.007.

    中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会. 非酒精性脂肪性肝病防治指南(2018年更新版)[J]. 临床肝胆病杂志, 2018, 34( 5): 947- 957. DOI: 10.3969/j.issn.1001-5256.2018.05.007.
    [12]
    YE J, WU Y, LI F, et al. Effect of orlistat on liver fat content in patients with nonalcoholic fatty liver disease with obesity: assessment using magnetic resonance imaging-derived proton density fat fraction[J]. Therap Adv Gastroenterol, 2019, 12: 1756284819879047. DOI: 10.1177/1756284819879047.
    [13]
    YANG M, WEI L. Impact of NAFLD on the outcome of patients with chronic hepatitis B in Asia[J]. Liver Int, 2022, 42( 9): 1981- 1990. DOI: 10.1111/liv.15252.
    [14]
    CASTERA L, FRIEDRICH-RUST M, LOOMBA R. Noninvasive assessment of liver disease in patients with nonalcoholic fatty liver disease[J]. Gastroenterology, 2019, 156( 5): 1264- 1281.e4. DOI: 10.1053/j.gastro.2018.12.036.
    [15]
    PARK CC, NGUYEN P, HERNANDEZ C, et al. Magnetic resonance elastography vs transient elastography in detection of fibrosis and noninvasive measurement of steatosis in patients with biopsy-proven nonalcoholic fatty liver disease[J]. Gastroenterology, 2017, 152( 3): 598- 607.e2. DOI: 10.1053/j.gastro.2016.10.026.
    [16]
    LEE SS, PARK SH. Radiologic evaluation of nonalcoholic fatty liver disease[J]. World J Gastroenterol, 2014, 20( 23): 7392- 7402. DOI: 10.3748/wjg.v20.i23.7392.
    [17]
    ZHONG L, CHEN JJ, CHEN J, et al. Nonalcoholic fatty liver disease: quantitative assessment of liver fat content by computed tomography, magnetic resonance imaging and proton magnetic resonance spectroscopy[J]. J Dig Dis, 2009, 10( 4): 315- 320. DOI: 10.1111/j.1751-2980.2009.00402.x.
    [18]
    CHEN S, HUANG ZH. Advances in quantitative imaging evaluation of non-alcoholic fatty liver disease[J]. J New Clin Medicine, 2018, 11( 12): 1283- 1286. DOI: 10.3969/j.issn.1674-3806.2018.12.32.

    陈松, 黄泽和. 非酒精性脂肪肝病的影像学定量评估研究进展[J]. 中国临床新医学, 2018, 11( 12): 1283- 1286. DOI: 10.3969/j.issn.1674-3806.2018.12.32.
    [19]
    KARLAS T, PETROFF D, SASSO M, et al. Individual patient data meta-analysis of controlled attenuation parameter(CAP) technology for assessing steatosis[J]. J Hepatol, 2017, 66( 5): 1022- 1030. DOI: 10.1016/j.jhep.2016.12.022.
    [20]
    NOGAMI A, YONEDA M, IWAKI M, et al. Non-invasive imaging biomarkers for liver steatosis in non-alcoholic fatty liver disease: present and future[J]. Clin Mol Hepatol, 2023, 29( Suppl): S123- S135. DOI: 10.3350/cmh.2022.0357.
    [21]
    MA YN, LIU JC. Research progress in the noninvasive quantitative diagnosis of hepatic steatosis using controlled attenuation parameters[J]. Chin J Gastroenterol Hepatol, 2020, 29( 11): 1309- 1312. DOI: 10.3969/j.issn.1006-5709.2020.11.023.

    马亚楠, 刘近春. 受控衰减参数无创定量诊断肝脂肪变性的研究进展[J]. 胃肠病学和肝病学杂志, 2020, 29( 11): 1309- 1312. DOI: 10.3969/j.issn.1006-5709.2020.11.023.
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