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Received:June 28, 2024 Published Online:February 20, 2025
Received:June 28, 2024 Published Online:February 20, 2025
中文摘要: 目的 探讨超声衰减成像对儿童代谢功能障碍相关性脂肪肝病（MAFLD）的诊断价值。方法 选取南京医科大学第四附属医院2023年1月至2024年6月就诊的伴MAFLD的超重及肥胖儿童110例作为研究对象，另随机选取同期40例正常儿童作为对照组。所有儿童均接受二维超声及衰减成像检查，记录身高与体重，计算身体质量指数（BMI）,记录衰减系数（AC）。按照二维超声检查结果，将MAFLD组脂肪肝分为轻、中、重度三个亚组，比较对照组与MAFLD组间BMI及AC的差异，分析超声衰减成像对儿童MAFLD的诊断价值。结果 MAFLD组BMI高于对照组［(25.81±3.48)kg/m2 vs (18.63±1.76)kg/m2, t=16.38，P＜0.01］。轻度、中度、重度MAFLD的BMI分别为(23.63±1.24)、(26.56±1.80)、(30.69±4.14) kg/m2，组间比较差异有统计学意义（F=54.11， P＜0.01）。MAFLD组AC高于对照组［(0.68±0.05)dB/（cm·MHz） vs (0.48±0.05)dB/（cm·MHz）, t=15.53， P＜0.01］。轻度、中度、重度MAFLD的AC分别为(0.62±0.07)、(0.75±0.05)、(0.89±0.05)dB/（cm·MHz），组间比较差异有统计学意义（F=164.06，P＜0.01）。AC与超声分级结果呈正相关(r=0.921, P＜0.05)，与BMI呈正相关(r=0.829, P＜0.05),超声分级结果与BMI呈正相关(r=0.801, P＜0.05)。AC诊断轻、中、重度MAFLD的曲线下面积分别为0.941、0.933、0.975。结论 超声衰减成像能够定量且无创评估儿童MAFLD的肝脏脂肪浸润程度，与二维超声相比，AC与BMI相关性更高，可作为MAFLD早期精准无创的评价指标。
中文关键词: 代谢功能障碍相关性脂肪肝病 衰减成像 衰减系数 超重及肥胖儿童 身体质量指数
Abstract:Objective To evaluate the diagnostic value of ultrasound attenuated imaging in children with metabolic-dysfunction-associated fatty liver disease (MAFLD). Methods A total of 110 overweight and obese children with MAFLD who visited the Fourth Affiliated Hospital of Nanjing Medical University from January 2023 to June 2024 were selected as the study subjects, along with 40 randomly selected healthy children as the control group. All children underwent two-dimensional ultrasound and attenuation imaging examinations. Height, weight, body mass index (BMI), and attenuation coefficient (AC) were recorded. Based on the results of two-dimensional ultrasound, the fatty liver in the MAFLD group was classified into mild, moderate, and severe subgroups. Differences in BMI and AC between the control group and the MAFLD group were compared, and the diagnostic value of ultrasound attenuation imaging for childhood MAFLD was analyzed. Results The BMI of the MAFLD group was higher than that of the control group ［(25.81±3.48)kg/m2 vs (18.63±1.76)kg/m2, t=16.38,P＜0.01］. The BMI values for mild, moderate, and severe MAFLD were (23.63±1.24), (26.56±1.80), and (30.69±4.14)kg/m2, respectively, with significant differences among the groups (F=54.11, P＜0.01). The AC of the MAFLD group was higher than that of the control group ［(0.68±0.05)dB/(cm·MHz) vs (0.48±0.05)dB/(cm·MHz), t= 15.53,P＜0.01］. The AC values for mild, moderate, and severe MAFLD were (0.62±0.07), (0.75±0.05), and (0.89±0.05)dB/(cm·MHz), respectively, with significant differences among the groups (F= 164.06, P＜0.01). AC showed a positive correlation with ultrasound grading results (r=0.921, P＜0.05), and was also positively correlated with BMI (r=0.829, P＜0.05). Ultrasound grading results were positively correlated with BMI (r=0.801, P＜0.05). The area under the curve (AUC) for diagnosing mild, moderate, and severe MAFLD using AC was 0.941, 0.933, and 0.975, respectively. Conclusion Ultrasound attenuation imaging can quantitatively and non-invasively assess the degree of hepatic fat infiltration in children with MAFLD. Compared with two-dimensional ultrasound, AC shows a stronger correlation with BMI, and can serve as an early, precise, and non-invasive evaluation indicator for MAFLD.
keywords: Metabolic-dysfunction-associated fatty liver disease Attenuated imaging Attenuation coefficients Overweight/obese children Body mass index
文章编号： 中图分类号：R589.2 文献标志码：A
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