The clinical value of controlled attenuation parameter for the noninvasive assessment of liver steatosis

Autor:	Marta Di Gregorio, Elisabetta Above, Annalisa De Silvestri, Giovanna Ferraioli, Gianluigi Poma, Carlo Filice, Raffaella Lissandrin, Carolina Dellafiore, Laura Maiocchi, Carmine Tinelli, Renato Maserati
Rok vydání:	2016
Předmět:	Adult Liver Cirrhosis Male medicine.medical_specialty Population Severity of Illness Index Gastroenterology Body Mass Index 03 medical and health sciences Liver disease 0302 clinical medicine Internal medicine medicine Humans education Aged education.field_of_study Hepatology business.industry Ultrasound Fatty liver Gold standard (test) Middle Aged medicine.disease Fatty Liver Cross-Sectional Studies Italy Liver ROC Curve Area Under Curve 030220 oncology & carcinogenesis Elasticity Imaging Techniques Female 030211 gastroenterology & hepatology Steatosis Transient elastography business Viral hepatitis
Zdroj:	Liver International. 36:1860-1866
ISSN:	1478-3223
DOI:	10.1111/liv.13207
Popis:	Background & aims Ultrasound is the imaging modality most widely utilized in the general population for diagnostic purposes. Controlled attenuation parameter is a novel noninvasive method for assessing steatosis. Our aim was to investigate whether the clinical value of controlled attenuation parameter in patients referred for abdominal ultrasound examinations is affected by liver fibrosis. Methods Consecutive patients referred for abdominal ultrasound examinations were enrolled. Controlled attenuation parameter and liver stiffness were assessed with the FibroScan (Echosens, France). Liver fibrosis was staged according to published cutoffs of liver stiffness measurements. Pearson's or Spearman's rank correlation coefficient was used to test the association between two study variables. Optimal cutoff of controlled attenuation parameter for diagnosing liver steatosis (S≥2) was 256 dB/m. The diagnostic performance and accuracy of dichotomized controlled attenuation parameter, ultrasound and body mass index were analysed using the imperfect gold standard methodology. Results A total of 726 subjects (464 males and 262 females) were studied. Five hundred and eight-nine (81.1%) patients were affected by chronic viral hepatitis. Correlation of controlled attenuation parameter with ultrasound score was 0.48 and 0.57 in patients with and without chronic viral hepatitis respectively. In patients with chronic viral hepatitis, ultrasound, dichotomized controlled attenuation parameter and body mass index showed performance of 58.2%, 82.3% and 46.7%, respectively, whereas in patients without chronic viral hepatitis, the performance was 86.4%, 68.6% and 48.6% respectively. Conclusions In patients with chronic viral hepatitis and advanced liver fibrosis, controlled attenuation parameter performs better than ultrasound for assessing liver steatosis, whereas in patients without viral hepatitis and with nonsignificant liver disease ultrasound shows the best performance.
Databáze:	OpenAIRE
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