Abstract
PurposeThe purpose of this study was to evaluate the diagnostic performance of novel ultrasound technology normalized local variance (NLV) and the standard deviation of NLV (NLV-SD) using different ROIs for hepatic steatosis in patients with metabolic-associated fatty liver disease (MAFLD) and to identify the factors that influence the NLV value and NLV-SD value, using pathology results as the gold standard.MethodsWe prospectively enrolled 34 consecutive patients with suspected MAFLD who underwent percutaneous liver biopsy for evaluation of hepatic steatosis from June 2020 to December 2020. All patients underwent ultrasound and NLV examinations. NLV values and NLV-SD values were measured using different ROIs just before the liver biopsy procedure.ResultsThe distribution of hepatic steatosis grade on histopathology was 4/19/6/5 for none (< 5%)/ mild (5–33%)/ moderate (> 33–66%)/ and severe steatosis (> 66%), respectively. The NLV value with 50-mm-diameter ROI and NLV-SD value with 50-mm-diameter ROI showed a significant negative correlation with hepatic steatosis (spearman correlation coefficient: − 0.449, p = 0.008; − 0.471, p = 0.005). The AUROC of NLV (50 mm) for the detection of mild, moderate, and severe hepatic steatosis was 0.875, 0.735, and 0.583, respectively. The AUROC of NLV-SD (50 mm) for the detection of mild, moderate, and severe hepatic steatosis was 0.900, 0.745, and 0.603, respectively. NLV (50 mm) values and NLV-SD (50 mm) values between two readers showed excellent repeatability and the intraclass correlation coefficient (ICC) was 0.930 (p < 0.001) and 0.899 (p < 0.001). Hepatic steatosis was the only determinant factor for NLV value and NLV-SD value (p = 0.012, p = 0.038).ConclusionThe NLV (50 mm) and NLV-SD (50 mm) provided good diagnostic performance in detecting the varying degrees of hepatic steatosis with great reproducibility. This study showed that the degree of steatosis was the only significant factor affecting the NLV value and NLV-SD value.
Highlights
Hepatic steatosis is characterized as abnormal accumulation of triglycerides (≥ 5%) in the liver [1]
normalized local variance (NLV) examination prior to liver biopsy was performed. 12 patients with chronic hepatitis B were excluded from the study and our final study population comprised a total of 34 patients
The results showed that the NLV (50 mm) values and NLVSD (50 mm) values were significantly different among the patients with different grades of hepatic steatosis
Summary
Hepatic steatosis is characterized as abnormal accumulation of triglycerides (≥ 5%) in the liver [1]. Hepatic steatosis is a common histopathological feature of metabolic-associated fatty liver disease (MAFLD), alcoholic liver disease (ALD), chronic hepatitis B (CHB), and chronic hepatic C (CHC) infections [2]. Etiological factors which associated with fatty liver included diabetes, hepatitis, and drug toxicity [2]. Metabolic-associated fatty liver disease (MAFLD), formerly known as non-alcoholic fatty liver disease (NAFLD),. Advanced fibrosis is still the strongest predictor of mortality in MAFLD patients [7, 8], the risk of disease progression and liver-related mortality in the early stages of the disease is increasing [9]. Monitoring hepatic steatosis is of great significance in the early diagnosis, treatment, and follow-up of MAFLD patients
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