Abstract：
OBJECTIVE: Noninvasive evaluation of metabolic dysfunction-associated fatty liver disease (MAFLD) using ultrasonography holds significant clinical value. The associations between ultrasound (US)-based parameters and the pathological spectra remain unclear and controversial. This study aims to investigate the associations thoroughly.
METHODS: The participants with MAFLD undergoing liver biopsy and multiparametric ultrasonography were prospectively recruited from December 2020 to September 2022. Three US-based parameters, namely attenuation coefficient (AC), liver stiffness (LS) and dispersion slope (DS) were obtained. The relationship between these parameters and steatosis grades, inflammation grades and fibrosis stages was examined.
RESULTS: In this study with 116 participants, AC values significantly differed across distinct steatosis grades (p < 0.001), while DS and LS values varied among inflammation grades (p < 0.001) and fibrosis stages (p < 0.001). The area under the receiver operating characteristic curves (AUCs) of AC ranged from 0.82 to 0.84 for differentiating steatosis grades, while AUCs of LS ranged from 0.62 to 0.76 for distinguishing inflammation grades and 0.83-0.95 for discerning fibrosis stages. AUCs for DS ranged from 0.79 to 0.81 in discriminating inflammation grades and 0.80-0.88 for differentiating fibrosis stages. Subgroup analysis revealed that LS demonstrated different trends in inflammation grade but consistent trends in fibrosis stage across subgroups, whereas DS showed consistent trends for both inflammation grade and fibrosis stage across all subgroups.
CONCLUSIONS: AC values indicate the degree of hepatic steatosis but not inflammation or fibrosis. LS values are determined only by fibrosis stage and are not associated with inflammation grades. DS values are associated with both fibrosis and inflammation grades.
METHODS: The participants with MAFLD undergoing liver biopsy and multiparametric ultrasonography were prospectively recruited from December 2020 to September 2022. Three US-based parameters, namely attenuation coefficient (AC), liver stiffness (LS) and dispersion slope (DS) were obtained. The relationship between these parameters and steatosis grades, inflammation grades and fibrosis stages was examined.
RESULTS: In this study with 116 participants, AC values significantly differed across distinct steatosis grades (p < 0.001), while DS and LS values varied among inflammation grades (p < 0.001) and fibrosis stages (p < 0.001). The area under the receiver operating characteristic curves (AUCs) of AC ranged from 0.82 to 0.84 for differentiating steatosis grades, while AUCs of LS ranged from 0.62 to 0.76 for distinguishing inflammation grades and 0.83-0.95 for discerning fibrosis stages. AUCs for DS ranged from 0.79 to 0.81 in discriminating inflammation grades and 0.80-0.88 for differentiating fibrosis stages. Subgroup analysis revealed that LS demonstrated different trends in inflammation grade but consistent trends in fibrosis stage across subgroups, whereas DS showed consistent trends for both inflammation grade and fibrosis stage across all subgroups.
CONCLUSIONS: AC values indicate the degree of hepatic steatosis but not inflammation or fibrosis. LS values are determined only by fibrosis stage and are not associated with inflammation grades. DS values are associated with both fibrosis and inflammation grades.
摘要：
目的：使用超声对代谢功能障碍相关的脂肪肝（MAFLD）进行无创性评估具有重要的临床价值。基于超声（US）的参数与病理光谱之间的关联仍不清楚且存在争议。本研究旨在彻底调查这些关联。
方法：2020年12月至2022年9月前瞻性招募接受肝活检和多参数超声检查的MAFLD患者。三个基于美国的参数，即衰减系数(AC)，获得肝脏硬度（LS）和分散斜率（DS）。这些参数与脂肪变性等级之间的关系，检查炎症等级和纤维化分期。
结果：在这项有116名参与者的研究中，不同脂肪变性等级的AC值显着不同（p<0.001），而DS和LS值在炎症等级（p<0.001）和纤维化分期（p<0.001）之间有所不同。AC的接收器工作特征曲线（AUC）下的面积范围为0.82至0.84，用于区分脂肪变性等级。而LS的AUC范围为0.62至0.76，用于区分炎症等级，用于区分纤维化分期为0.83-0.95。DS的AUC在区分炎症等级方面为0.79至0.81，在区分纤维化分期方面为0.80-0.88。亚组分析显示，LS表现出不同的炎症分级趋势，但不同亚组的纤维化分期趋势一致。而DS在所有亚组的炎症分级和纤维化阶段均显示一致的趋势.
结论：AC值表示肝脏脂肪变性的程度，而不是炎症或纤维化。LS值仅由纤维化阶段确定，与炎症等级无关。DS值与纤维化和炎症等级相关。
方法：2020年12月至2022年9月前瞻性招募接受肝活检和多参数超声检查的MAFLD患者。三个基于美国的参数，即衰减系数(AC)，获得肝脏硬度（LS）和分散斜率（DS）。这些参数与脂肪变性等级之间的关系，检查炎症等级和纤维化分期。
结果：在这项有116名参与者的研究中，不同脂肪变性等级的AC值显着不同（p<0.001），而DS和LS值在炎症等级（p<0.001）和纤维化分期（p<0.001）之间有所不同。AC的接收器工作特征曲线（AUC）下的面积范围为0.82至0.84，用于区分脂肪变性等级。而LS的AUC范围为0.62至0.76，用于区分炎症等级，用于区分纤维化分期为0.83-0.95。DS的AUC在区分炎症等级方面为0.79至0.81，在区分纤维化分期方面为0.80-0.88。亚组分析显示，LS表现出不同的炎症分级趋势，但不同亚组的纤维化分期趋势一致。而DS在所有亚组的炎症分级和纤维化阶段均显示一致的趋势.
结论：AC值表示肝脏脂肪变性的程度，而不是炎症或纤维化。LS值仅由纤维化阶段确定，与炎症等级无关。DS值与纤维化和炎症等级相关。
