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. 2021 Jul 16;5(8):947-952.
doi: 10.1002/jgh3.12615. eCollection 2021 Aug.

The ultrasound-guided attenuation parameter is useful in quantification of hepatic steatosis in non-alcoholic fatty liver disease

Yu Ogino  1 , Noritaka Wakui  1 , Hidenari Nagai  1 , Yoshinori Igarashi  1
Affiliations

The ultrasound-guided attenuation parameter is useful in quantification of hepatic steatosis in non-alcoholic fatty liver disease

Yu Ogino et al. JGH Open. .

Abstract

Aim: To determine the utility of the ultrasound-guided attenuation parameter (UGAP) for quantifying hepatic steatosis in non-alcoholic fatty liver disease (NAFLD).

Methods: Subjects were 84 patients with NAFLD (53 men, 31 women; mean age 54 [20-81] years) who underwent liver biopsy and ultrasonography using a GE LOGIQ E9 system and C1-6 probe at our hospital between 2017 and 2020. B-Mode imaging of segment V in the liver was acquired and echo attenuation was assessed using UGAP. Steatosis score (S0: <5%; S1: 5%-33%; S2: 34%-66%; S3: ≥67%) from liver specimens was compared with the attenuation coefficient (AC; dB/cm/MHz) using UGAP.

Results: Steatosis score was S0 for 9 patients, S1 for 40, S2 for 21, and S3 for 14. AC by steatosis score was 0.52 ± 0.07, 0.63 ± 0.07, 0.74 ± 0.06, and 0.78 ± 0.06 dB/cm/MHz for S0, S1, S2, and S3, respectively. AC by UGAP differed significantly between S0 and S1, S0 and S2, S0 and S3, S1 and S2, and S1 and S3 (all P < 0.01), demonstrating a significant increase with steatosis score. Receiver operating characteristic analysis showed good diagnostic performance of UGAP for patients with steatosis score ≥1, ≥2, and ≥3 (AUROC = 0.94, 0.95, and 0.88, respectively). Liver fat content (%) from liver specimens and AC (r = 0.81, P < 0.01) showed a significant positive correlation.

Conclusion: UGAP is useful for quantifying hepatic steatosis in patients with NAFLD.

Keywords: attenuation imaging; hepatic steatosis; non‐alcoholic fatty liver disease; ultrasonography.

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Figures

Figure 1
Figure 1
Correlation between attenuation coefficient (AC) values and steatosis score. By steatosis score, the AC value was 0.52 ± 0.07 for S0, 0.63 ± 0.0 for S1, 0.74 ± 0.06 for S2, and 0.78 ± 0.06 for S3. Multiple comparison tests showed a significant difference between S0 and S1, S0 and S2, S0 and S3, S1 and S2, and S1 and S3 (all P < 0.01), demonstrating that AC increased significantly with the progression of steatosis.
Figure 2
Figure 2
Diagnostic performance of attenuation coefficient (AC) values for liver steatosis score. By steatosis score, the cutoff value and area under receiver operating characteristic curve were respectively (a) 0.60 and 0.94 for S0 and ≥ S1, (b) 0.71 and 0.95 for S0–1 and ≥ S2, and (c) 0.72 and 0.88 for S0–S2 and ≥ S3. The sensitivity and specificity of AC values were respectively 86.7 and 88.9% for ≥S1 cases, 85.7 and 91.8% for ≥S2 cases, and 85.7 and 80.0% for ≥S3 cases.
Figure 3
Figure 3
Correlation between attenuation coefficient (AC) values and liver fat content (LFC) (%). There was a significant positive correlation between LFC (%) obtained by liver biopsy and AC values (r = 0.81, P < 0.01).
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