Efficacy of B-mode ultrasound-based attenuation for the diagnosis of hepatic steatosis: a systematic review/meta-analysis.

Autor: Hirooka M; Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Tōon, Ehime, 791-0295, Japan. masashih@m.ehime-u.ac.jp., Koizumi Y; Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Tōon, Ehime, 791-0295, Japan., Sunago K; Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Tōon, Ehime, 791-0295, Japan., Nakamura Y; Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Tōon, Ehime, 791-0295, Japan., Hirooka K; Department of Gastroenterology and Metabology, National Hospital Organization Ehime Medical Center, Tōon, Japan., Watanabe T; Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Tōon, Ehime, 791-0295, Japan., Yoshida O; Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Tōon, Ehime, 791-0295, Japan., Tokumoto Y; Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Tōon, Ehime, 791-0295, Japan., Abe M; Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Tōon, Ehime, 791-0295, Japan., Hiasa Y; Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Tōon, Ehime, 791-0295, Japan.
Jazyk: angličtina
Zdroj: Journal of medical ultrasonics (2001) [J Med Ultrason (2001)] 2022 Apr; Vol. 49 (2), pp. 199-210. Date of Electronic Publication: 2022 Mar 03.
DOI: 10.1007/s10396-022-01196-5
Abstrakt: The accuracy of attenuation coefficients and B-mode ultrasound for distinguishing between S0 (healthy, < 5% fat) and S1-3 (steatosis ≥ 5%) livers compared to a controlled attenuation parameter is unclear. This meta-analysis aimed to comprehensively assess the diagnostic performance of B-mode ultrasound imaging for evaluating steatosis of ≥ 5%. We searched the PubMed, Embase, and Web of Science databases for studies on the accuracy of B-mode ultrasound for differentiating S0 from S1-3 in adults with chronic liver disease. A bivariate random-effects model was performed to estimate the pooled sensitivity, specificity, positive (PLR) and negative likelihood ratios (NLR), and diagnostic odds ratios (DORs). Subgroup analyses by attenuation coefficient, conventional B-mode ultrasound findings, and B-mode ultrasound findings without semi-quantification methods were performed. Liver steatosis was scored as follows: S0, < 5%; S1, 5-33%; S2, 33-66%; and S3, > 66%. Nineteen studies involving 3240 patients were analyzed. The pooled sensitivity and specificity of B-mode ultrasound for detecting S1 were 0.70 (95% confidence interval [CI], 0.63-0.77) and 0.86 (95% CI 0.82-0.89), respectively. The pooled PLR, NLR, and DOR were 4.90 (95% CI 3.69-6.51), 0.35 (95% CI 0.27- 0.44), and 14.1 (95% CI 8.7-23.0), respectively. The diagnostic accuracy was better in patients with attenuation coefficients (area under the curve [AUC], 0.89; sensitivity, 0.75; specificity, 0.86) than in those with conventional B-mode findings (AUC, 0.80; sensitivity, 0.59; specificity, 0.83). In particular, the diagnostic value was better when the attenuation coefficient guided by B-mode ultrasound was utilized. To screen patients with steatosis of ≥ 5%, attenuation coefficient should be used.
(© 2022. The Author(s), under exclusive licence to The Japan Society of Ultrasonics in Medicine.)
Databáze: MEDLINE
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