Transient Elastography (Fibrotouch) Quantitative Evaluation Of Nonalcoholic Fatty Liver Disease In Clinical Research

ObjectiveTo explore the clinical application value of transient elastography(FibroTouch) inthe diagnosis of nonalcoholic fatty liver: To evaluate the differences of fatattenuation parameter and liver stiffness measurement between case group andnormal controls;To evaluate the consistency and correlation of fat attenuationparameter and ultrasonic classification result about fatty liver;To research therelationship between the liver stiffness(the degree of fibrosis)with age,fat attenuationparameter.To research the linear relationship between BMI and fat attenuationparameter.Methods1.167patients with NAFLD and183healthy patients fulfilling the2010criteriaGuidelines for the Diagnosis and Management of Non-alcoholic Fatty Liver Diseasewere selected. The male to female ratio were2.3:1,1:1.2, NAFLD group in themajority with male (P <0.01), average age was42.3±42.3years,47.0±10.3yearsold.Questionnaire survey was conducted for all subjects (see annex A), physicalexamination, biochemical tests.And record each participants’ age, sex, body massindex, etc.2. Of all the subjects with FibroTouch check and record each patient fat attenuationparameter values and effective detection of liver stiffness measurement.3. Of all subjects are conducted by the same skilled operators abdominal ultrasound,liver B ultrasonic image, and according to the Chinese medical association branch ofhepatology fatty liver and alcoholic liver disease group2010revision of thenonalcoholic fatty liver disease diagnosis and treatment guidelines in the fatty liverultrasonic classification standard all patients were divided into mild, moderate andsevere, record test results.4.Use statistical methods to carry on comparative analysis to study data: to evaluatethe differences of fat attenuation parameter and liver stiffness measurementbetween case group and normal controls;To evaluate the consistency and correlationof fat attenuation parameter and ultrasonic classification result about fatty liver;To research the relationship between the liver stiffness(the degree of fibrosis) with age,fatattenuation parameter.To research the linear relationship between BMI and fatattenuation parameter.Results①167cases of NAFLD patients and183cases of control group, with102cases inpatients with NAFLD mild fatty liver (male66, female,36cases),55cases ofmoderate fatty liver (male43cases, female12),10cases of severe fatty liver disease(male8cases, female2).Control group,183cases (male183, female98).Case groupand control group in the sex ratio were2.3:1,1:1.2,the average age was42.3±42.3years, respectively,47.0±10.3years old.BMI: cases:26.4±2.7kg/m2, the controlgroup:22.6±2.2kg/m2;②Fat attenuation parameters of NAFLD group is significantly higher than the controlgroup (282.5±35.8dB/m to226.9±22.2dB/m, P <0.05);Liver stiffness value ofNAFLD group is significantly higher than control group (4.7±1.4kpa to4.0±1.0kpa, P <0.05);③Using Pearson correlation analysis test, it shows that FibroTouch and ultrasound infatty liver test at0.01level has significant correlation, the correlation coefficient is0.797;④FibroTouch diagnosis of mild, moderate and severe fatty liver AUC were0.908(95%CI,0.877to0.938),0.933(95%CI,0.906to0.960),0.944(95%CI,0.913to0.913).FibroTouch of mild, moderate and severe fatty liver best cutoff valuerespectively:239dB/dB/m,266.5m,292.5dB/m;⑤Wireless relationship between age,fat attenuation parameters and liver stiffnessmeasurement;⑥Fatty attenuation parameter linear correlation with BMI， Y=10.920+9.935*BMI.Conclusion①FibroTouch and ultrasound in the diagnosis of nonalcoholic fatty liver disease hassignificant correlation, The AUROC of FibroTouch different for different degree offatty liver diagnosis. ②FibroTouch can be used for noninvasive diagnosis of fatty liver disease, not onlythe quantitative diagnosis of fatty liver, liver stiffness can be detected at the same time;③The attenuation parameter and fat liver stiffness value NAFLD group were greaterthan the control group;④With the increase of age, attenuation parameter, the liver stiffness measurementdidn’t increase.There is no linear correlation between any two;⑤Fat attenuation parameter linear correlation with BMI.