期刊
LIVER INTERNATIONAL
卷 32, 期 6, 页码 902-910出版社
WILEY
DOI: 10.1111/j.1478-3231.2012.02781.x
关键词
biopsy; elastography; fatty liver; steatosis
资金
- Echosens (Paris, France)
- Canadian Institutes of Health Research
- Alberta Innovates - Health Solutions
- KNS Canada
Background Accurate tools for the noninvasive detection of hepatic steatosis are needed. The Controlled Attenuation Parameter (CAP) specifically targets liver steatosis using a process based on transient elastography. Methods Patients with chronic liver disease and body mass index (BMI) =28kg/m2 underwent biopsy and liver stiffness measurement (LSM) with simultaneous CAP determination using the FibroScan (R) M probe. The performance of the CAP for diagnosing steatosis compared with biopsy was assessed using areas under receiver operating characteristic curves (AUROC). Results A total of 153 patients were included: 69% were male, median BMI was 32kg/m2; 47% had nonalcoholic fatty liver disease (NAFLD); and 65% had significant (=10%) steatosis. The CAP was significantly correlated with the percentage of steatosis (?=0.47) and steatosis grade (?=0.51; both P<0.00005). The median CAP was higher among patients with significant steatosis (317 [IQR 284339] vs. 250 [227279] dB/m with <10% steatosis; P<0.0005) and the AUROC for this outcome was 0.81 (95% CI 0.740.88). At a cut-off of 283 dB/m, the CAP was 76% sensitive, 79% specific, and had positive and negative predictive values of 87% and 64%, respectively. CAP performance was not influenced by measurement variability, but was higher in patients with mild (F0-F1) fibrosis (AUROC 0.89 vs. 0.72 with F2-F4; P=0.03). The AUROCs of the CAP for =5%, >33% and >66% steatosis were 0.79, 0.76 and 0.70, respectively. Conclusions The CAP is a promising tool for the noninvasive detection of hepatic steatosis. Advantages of CAP include its ease of measurement, operator-independence and simultaneous availability with LSM for fibrosis assessment.
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