Application value of liver and spleen stiffness measured by real-time shear wave elastography combined with hepatic steatosis index in diagnosis of hepatic steatosis
GUO Yun-lei, RUAN Li-tao, DANG Ying, BAI Xiao-fang, CHEN Hong, WANG Xiang, LI Ning, LI Yue-jiao
The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
Abstract：Objective: To study the application value of liver and spleen stiffness measured by real-time shear wave elastography(SWE) combined with hepatic steatosis index(HSI) to diagnosis the severity of hepatic steatosis in non-alcoholic fatty liver disease(NAFLD). Methods: Patients who met the inclusion criteria and treated at the First Affiliated Hospital of Xi’an Jiaotong University from January 2017 to June 2018 were included. Referring to the upper abdominal CT scan results, we divided the included patients into four groups as: control group and mild, moderate, severe fatty liver groups. Comparing liver stiffness(LS) and spleen stiffness(SS) measured by SWE and HSI between groups was performed. Calculate the ROC curves of single and joint indicators for diagnosis hepatic steatosis. Results: LS, SS and HSI were all significantly different among groups(P<0.05). After comparing between any two means, we found LS, SS and HSI have poor ability to identify adjacent levels of fatty liver. So we just calculated the ROC curves for diagnosing moderate to severe fatty liver. The area under the ROC curves(AUROC) were 0.895±0.030, 0.730±0.041 and 0.788±0.036(P<0.05) respectively. The critical values were 7.35 kPa, 23.65 kPa and 36.32 respectively. Finally, we calculated the joint indicators’ ROC curves. The AUROC of LS+HSI was 0.904±0.028(P<0.05), the sensitivity was 88.3% and the specificity was 87.0%. The AUROC of SS+HSI was 0.824±0.033(P<0.05), the sensitivity was 75.0% and the specificity was 77.2%. Conclusion: LS and SS measured by SWE combine with HSI can accurately detect moderate to severe NAFLD. LS+HSI had the highest diagnostic performance than others with a good clinical value.
郭芸蕾，阮骊韬，党 莹，白晓芳，陈 红，王 翔，李 宁，李岳礁. 实时剪切波弹性成像技术测量肝脾硬度联合肝脂肪变性指数在诊断脂肪肝中的应用价值研究[J]. 中国临床医学影像杂志, 2019, 30(6): 416-420.
GUO Yun-lei, RUAN Li-tao, DANG Ying, BAI Xiao-fang, CHEN Hong, WANG Xiang, LI Ning, LI Yue-jiao. Application value of liver and spleen stiffness measured by real-time shear wave elastography combined with hepatic steatosis index in diagnosis of hepatic steatosis. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(6): 416-420.
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