Ultrasound-Guided Attenuation Parameter May Replace B-mode Ultrasound in Diagnosing Nonalcoholic Fatty Liver Disease

doi:10.37015/AUDT.2023.220037

Abstract

Abstract:

Objective: To compare the diagnostic sensitivity and consistency of ultrasound-guided attenuation parameter (UGAP) with B-mode ultrasound in nonalcoholic fatty liver disease (NAFLD) patients, and explored their correlation with clinical indicators.
Methods: Patients suspected of NAFLD from July to November 2021 were enrolled in this prospective study. After performing the B-mode ultrasound and UGAP examination, all patients were divided into four groups according to the grade of NAFLD obtained by two modalities, respectively. The diagnostic agreement of the two modalities were evaluated, and the diagnostic sensitivity was compared by the McNemar test. The correlation between clinical indicators and the attenuation coefficient (AC) of UGAP was analyzed by linear regression.
Results: The intraclass correlation coefficient of UGAP was 0.958 (95%CI: 0.943,0.970), while the kappa value of B-mode ultrasound grading was 0.799 (95%CI: 0.686, 0.912). The diagnostic sensitivity of UGAP was higher than that of B-mode ultrasound (99.0% vs. 32%, P < 0.001). BMI and TG can be distinguished in different grades of NAFLD diagnosed by B-mode ultrasound, while BMI, ALT, HDL, and Apo A can be distinguished in different grades of NAFLD diagnosed by UGAP. BMI (r = 0.502, P < 0.001), ALT (r = 0. 396, P < 0.001), TG (r = 0.418, P < 0.001), HDL (r = -0. 359, P < 0.001) and Apo A (r = -0.228, P = 0.020) were linearly correlated with the AC value of UGAP.
Conclusions: Compared with the B-mode ultrasound, UGAP had a higher sensitivity and consistency in diagnosing NAFLD, and correlated well with some laboratory indicators, which may be more valuable in screening and diagnosis of NAFLD.

Key words: Nonalcoholic fatty liver disease; Ultrasonography; Diagnostic imaging

Bo Jiang, MD, Yiman Du, MD, Xiang Fei, MD, Jianing Zhu, MD, Lianhua Zhu, MD, Qiuyang Li, MD, Yukun Luo, MD, PhD. Ultrasound-Guided Attenuation Parameter May Replace B-mode Ultrasound in Diagnosing Nonalcoholic Fatty Liver Disease. Advanced Ultrasound in Diagnosis and Therapy, 2023, 7(3): 260-266.

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Parameters	Value
Number	103
Sex (male/female) ^ζ	72/31
Age (years)	54.47 ± 13.22
Body mass index (kg/m²)	25.27 ± 3.89
Blood platelet count (10⁹/L)	236.43 ± 79.28
Alanine aminotransferase (U/L) ^*	17.40 (12.10, 25.70)
Aspartate aminotransferase (IU/L)	18.90 ± 9.14
Albumin (g/L)	41.60 ± 3.88
low-density lipoprotein cholesterol (mmol/L)	2.55 ± 0.78
high-density lipoprotein cholesterol (mmol/L) ^*	1.01 (0.87, 1.33)
triglycerides (mmol/L) ^*	1.36 (0.95, 1.85)
total cholesterol (mmol/L)	4.24 ± 0.98
glycated serum protein (µmol/L)	175.42 ± 44.63
apolipoprotein A (g/L)	1.27 ± 0.25
apolipoprotein B (g/L)	0.76 ± 0.18