Clinical Value Of Sound Attenuation Imaging In Quantitative Diagnosis Of Metabolic Associated Fatty Liver Disease

Objective : To investigate the clinical value of sound attenuation imaging(ATI)in quantifying the diagnosis of metabolic associated fatty liver disease(MAFLD).Methods:295 MAFLD patients who visited the Department of Gastroenterology and Hepatology Clinic of the First Hospital of China Medical University from August 2020 to November 2022 were divided into light,medium and heavy groups by Fibro Touch(FT)examination,and underwent ultrasound attenuation imaging(ATI)examination on the same day.30 healthy people were added for the same two tests to join the study.The correlation between the attenuation coefficient value(AC)measured by ATI and the controlled attenuation parameter(CAP)measured by FT was determined by using the FT test results as the reference standard,and the diagnostic efficacy of ATI technology for fatty liver was evaluated by using the subject working curve.Results:1.There were statistically significant differences in age,sex,BMI,WHR,AC,liver-skin distance,GGT,ALT,AST,TG,UA among the groups with different grades of MAFLD(P<0.05).2.AC,age,BMI,WHR,liver-skin distance,GGT,ALT,AST,TG,UA,GLU and MAFLD were correlated(P<0.05).3.The areas under the ROC curves of the MAFLD grades ≥ mild,≥ moderate and ≥ severe determined by the CAP value corresponding to ATI were 0.944,0.951 and 0.964,the sensitivities were 83.7%,89.0%,93.8%,and the specificities were 96.7%,96.7%,94.7%,88.3%.The optimal diagnostic thresholds were 0.62 d B/cm/MHz for mild,0.70 d B/cm/MHz for moderate,and0.86 d B/cm/MHz for severe.4.Correlation analysis showed that AC was correlated with age,BMI,liver-skin distance,ALT,TG,UA,and GLU of MAFLD patients(P<0.05).5.Multiple linear regression analysis showed that the AC value was only linearly positively correlated with the CAP value(β=0.835,P<0.001).Conclusions:1.Ultrasound ATI and CAP have a high consistency in the diagnosis of MAFLD.2.Ultrasonic ATI technology has good diagnostic performance for different degrees of hepatic steatosis,and it is a reliable tool for quantitative grading of MAFLD.3.The optimal diagnostic threshold for AC obtained through ROC curve analysis is0.62 d B/cm/MHz for mild,0.70 d B/cm/MHz for moderate,and 0.86 d B/cm/MHz for severe cases.4.The AC value is affected by the degree of hepatic steatosis,but not affected by age,BMI,WHR,liver-skin distance,GLU,GGT,ALT,AST,ALP,TG,TC,and UA.