Controlled attenuation parameter for evaluating liver steatosis in chronic viral hepatitis

作     者：Giovanna Ferraioli Carmine Tinelli Raffaella Lissandrin Mabel Zicchetti Barbara Dal Bello Gaetano Filice Carlo Filice 

作者机构：Department of Infectious DiseasesFondazione IRCCS Policlinico San MatteoMedical School University of Pavia27100 PaviaItaly Clinical Epidemiology and Biometric UnitFondazione IRCCS Policlinico San Matteo27100 PaviaItaly Department of Pathology Fondazione IRCCS Policlinico San Matteo27100 PaviaItaly 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2014年第20卷第21期

页      面：6626-6631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] 100401[医学-流行病与卫生统计学] 10[医学] 

基　　金：Supported by Fibroscan device was made available for the study by Echosens(Paris France) 

主　　题：Liver steatosis Noninvasive techniques Controlled 

摘      要：AIM:To assess the performance of controlled attenuation parameter(CAP)in patients with chronic viral hepatitis.METHODS:CAP is a new technique that measures the attenuation in the liver of an ultrasound beam,which is directly related to lipid accumulation.Consecutive patients undergoing liver biopsy for chronic viral hepatitis were studied using the M probe of FibroScan device(Echosens,Paris,France).The device estimates liver st-eatosis in decibel per meter(dB/m).An expert operator performed all measurements.Steatosis was graded according to Kleiner’s classification.Pearson or Spearman rank coefficient was used to test correlation between two study variables.Linear regression was used for multivariate model to assess the association between CAP and other variables.Receiver operating characteristic curve analysis was performed to calculate area under the curve(AUROC)for S0 vs S1-S3 and S0-S1 vs S2-S3.RESULTS:115 subjects(85 males and 30 females)were prospectively studied.The mean values of CAP were 227.1±43.1 for S0;254.6±38.9 for S1;297.8±49.4 dB/m for S2-S3.In univariate analysis CAP showed a significant correlation with age,body mass index(BMI),degree of steatosis,and cholesterol.Multivariate regression analysis confirmed the correlation with the degree of steatosis[coefficient,1.2(0.60-1.83);P10-5]and BMI[coefficient,4.1(0.5-7.8);P=0.03]but not with all other variables.Optimal cutoff values for S≥1 and S≥2 were 219 dB/m[AUROC,0.76(0.67-0.84);sensitivity,91.1%(78.8-97.5);specificity,51.6%(38.7-64.2);positive predictive value,56.9%(44.7-68.6);negative predictive value,89.2%(74.3-97.0);positive likelihood ratio,1.88(1.4-2.5);negative likelihood ratio,0.17(0.07-0.5)]and 296 dB/m[AUROC,0.82(0.74-0.89);sensitivity,60.0%(32.3-83.7);specificity,91.5%(83.9-96.3);positive predictive value,52.9%(27.8-77.0);negative predictive value,93.5%(86.3-97.6);positive likelihood ratio,7.05(3.2-15.4);negative likelihood ratio,0.44(0.2-0.8)],respectively.CONCLUSION:Controlled attenuation parameter could be a useful tool in the clinical management of patients with chronic viral hepatitis for detecting liver steatosis.