受控衰减参数评估慢性乙肝患者肝脏脂肪变性的准确性及误诊分析

doi:10.7517/issn.1674-0475.230711

影像科学与光化学 ›› 2023, Vol. 41 ›› Issue (6): 290-295.DOI: 10.7517/issn.1674-0475.230711

受控衰减参数评估慢性乙肝患者肝脏脂肪变性的准确性及误诊分析

鲁景楠¹, 王改莲², 温雅¹, 沙文霞²

1. 延安大学附属医院影像科, 陕西延安 716000;
2. 延安市第二人民医院影像科, 陕西延安 716000

收稿日期:2023-07-24 出版日期:2023-11-23 发布日期:2023-12-14
通讯作者: 沙文霞

Analysis of Accuracy and Misdiagnosis of Controlled Attenuation Parameter in Evaluating Hepatic Steatosis in Patients with Chronic Hepatitis B

LU Jingnan¹, WANG Gailian², WEN Ya¹, SHA Wenxia²

1. Department of Medical Imaging, Yan'an University Affiliated Hospital, Yan'an 716000, Shanxi, P. R. China;
2. Department of Medical Imaging, Yan'an Second People's Hospital, Yan'an 716000, Shanxi, P. R. China

Received:2023-07-24 Online:2023-11-23 Published:2023-12-14

摘要/Abstract

摘要： 探讨受控衰减参数（CAP）评估慢性乙型肝炎肝脏脂肪变性的准确性，并分析影响CAP诊断准确性的因素。回顾性收集215例慢性乙型肝炎患者的临床资料，使用受试者操作特征（ROC）曲线分析CAP的诊断性能，并获得CAP评估不同程度肝脏脂肪变性的最佳截断值，以区分不同程度的肝脏脂肪变性。对CAP和磁共振质子密度脂肪分数（MRI-PDFF）评估肝脏脂肪变性阶段的不一致性进行分析。使用Logistic回归分析CAP误诊的风险因素。结果显示，在整个研究人群中，CAP诊断有无脂肪变性、轻度脂肪变性和中重度脂肪变性均具有良好的诊断效能。根据CAP和MRI-PDFF诊断脂肪变性阶段的不一致性，将患者分为诊断一致性组和诊断不一致性组。Logistic回归结果显示，年龄和BMI是CAP误诊的独立危险因素。CAP评估慢性乙型肝炎肝脏脂肪变性虽然有一定的误诊率，但仍具有良好的诊断准确性。

关键词: 慢性乙型肝炎, 肝脏脂肪变性, 受控衰减参数, 磁共振质子密度脂肪分数, 影响因素

Abstract: To explore the accuracy of controlled attenuation parameter (CAP) in assessing liver steatosis in chronic hepatitis B, and to analyze factors affecting the diagnostic accuracy of CAP. The clinical data of 215 patients with chronic hepatitis B were retrospectively collected, the diagnostic performance of CAP was analyzed using the receiver operating characteristic (ROC) curve, and the optimal cutoff value of CAP to evaluate different degrees of hepatic steatosis was obtained to distinguish different degrees of hepatic steatosis. To analyze the inconsistency between CAP and magnetic resonance proton density fat fraction (MRI-PDFF) in assessing the stage of hepatic steatosis. Logistic regression was used to analyze risk factors for CAP misdiagnosis. The results showed that in the entire study population, CAP had good diagnostic performance in diagnosing steatosis with or without steatosis, mild steatosis, and moderate to severe steatosis. According to the inconsistency in the diagnosis of steatosis stage between CAP and MRI-PDFF, patients were divided into a diagnostic consistency group and a diagnostic inconsistency group.Logistic regression results showed that age and BMI were independent risk factors for misdiagnosis of CAP. Although CAP has a certain misdiagnosis rate in assessing hepatic steatosis in chronic hepatitis B, it still has good diagnostic accuracy.

Key words: chronic hepatitis B, hepatic steatosis, controlled attenuation parameter, magnetic resonance imaging estimated proton density fat fraction, influencing factor

鲁景楠, 王改莲, 温雅, 沙文霞. 受控衰减参数评估慢性乙肝患者肝脏脂肪变性的准确性及误诊分析[J]. 影像科学与光化学, 2023, 41(6): 290-295.

LU Jingnan, WANG Gailian, WEN Ya, SHA Wenxia. Analysis of Accuracy and Misdiagnosis of Controlled Attenuation Parameter in Evaluating Hepatic Steatosis in Patients with Chronic Hepatitis B[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2023, 41(6): 290-295.

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受控衰减参数评估慢性乙肝患者肝脏脂肪变性的准确性及误诊分析

Analysis of Accuracy and Misdiagnosis of Controlled Attenuation Parameter in Evaluating Hepatic Steatosis in Patients with Chronic Hepatitis B

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