Accuracy of non-invasive liver stiffness measurement and steatosis quantification in patients with severe and morbid obesity

作     者：Magdalena Eilenberg Petra Munda Judith Stift Felix BLanger Gerhard Prager Michael Trauner Katharina Staufer 

作者机构：Division of General SurgeryDepartment of SurgeryMedical University of ViennaViennaAustria Department of Visceral Surgery and MedicineInselspitalUniversity Hospital BernBernSwitzerland Division of Gastroenterology&HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria Clinical Institute of PathologyMedical University of ViennaViennaAustria Division of TransplantationDepartment of SurgeryMedical University of ViennaViennaAustria 

出 版 物：《Hepatobiliary Surgery and Nutrition》 (肝胆外科与营养（英文）)

年 卷 期：2021年第10卷第5期

页      面：610-622,I0004-I0007页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Transient elastography controlled attenuation parameter(CAP™) FibroScan-AST score(FAST score) obesity non-alcoholic fatty liver disease(NAFLD) 

摘      要：Background:Vibration controlled transient elastography(VCTE)and controlled attenuation parameter(CAP™)have shown reliable performance predicting fibrosis and steatosis in normal-to overweight patients but have not been validated in severe to morbid *** study aimed at determining the accuracy of VCTE,CAP™and the composite score FibroScan-AST(FAST)in patients with a body mass index(BMI)of≥35 kg/m^(2).Methods:Patients scheduled for bariatric-metabolic surgery underwent preoperative VCTE/CAP™measurement,and intraoperative liver *** feasibility and accuracy of VCTE,CAP™and the composite score FAST were retrospectively analysed to evaluate fibrosis,steatosis and active fibrotic non-alcoholic steatohepatitis[NASH+non-alcoholic fatty liver disease(NAFLD)activity score≥4+fibrosis grade≥2]using per protocol(PP)and intent to diagnose(ITD)***:In total,170 patients(median BMI 44.4 kg/m²)were included in the *** biopsy showed NASH,simple steatosis,and normal livers in 60.6%(n=103),28.8%(n=49),and 10.6%(n=18),*** and CAP™delivered reliable results in 90.6%(n=154/170)and 90.5%(n=134/148).The AUC(PP)of VCTE,CAP™,and FAST were 0.687(≥F2),0.786(≥F3),0.703(≥S2),0.738(S3),and 0.780(active fibrotic NASH).The AUC increased to 0.742(≥F2),0.842(≥F3),0.712(≥S2),0.780(S3),and 0.836(active fibrotic NASH)in patients below the median BMI of 44.4 kg/m².Conclusions:VCTE,CAP™and FAST show acceptable accuracy for the detection of fibrosis,steatosis and NASH in a real-life cohort of patients with *** improves in patients with a BMI44.4 kg/m^(2).