| Project/Area Number |
16K09371
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Gastroenterology
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| Research Institution | Iwate Medical University |
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Principal Investigator |
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| Project Period (FY) |
2016-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥3,250,000 (Direct Cost: ¥2,500,000、Indirect Cost: ¥750,000)
Fiscal Year 2018: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2017: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2016: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
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| Keywords | NASH / 肝線維化 / 肝脂肪化 / 超音波エラストグラフィ / 超音波減衰イメージング / NAFLD / 超音波 / エラストグラフィー / 組織性状診断 / UGAP / エラストグラフィ / テクスチャ解析 |
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| Outline of Final Research Achievements |
We analyzed 133 NAFLD patients. 2D-shear wave elastography (SWE), Ultrasound-guided attenuation parameter (UGAP), and liver biopsy were performed at our institution. The Liver stiffness (LS) of each fibrosis stage was F0/F1/F2/F3/F4：5.6/6.3/7.8/9.4/14.9 (kPa), respectively, demonstrating a stepwise increase with increasing severity of liver fibrosis (p<0.0001). Attenuation coefficient (AC) of in each steatosis grade was S0/S1/S2/S3：0.43/0.57/0.68/0.72 (dB/cm/MHz), respectively, demonstrating a stepwise increase with increasing severity of liver steatosis (p<0.0001). By multiple logistic regression analysis, P＝1/(1＋e-λ)，λ=0.478×LS+20.242×AC-14.196 were calculated, which form a calculated composite score for the diagnosis of NASH. The AUROC of this scoring model for predicting NASH was 0.889. Non-invasive ultrasound evaluation using 2D-SWE and UGAP may estimate liver fibrosis and steatosis, and which developed a new scoring system for detecting NASH accurately.
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| Academic Significance and Societal Importance of the Research Achievements |
超音波を駆使し、エラストグラフィと減衰イメージングの2つのモダリティの長所を活かすことで、NASHの組織性状変化をリアルタイムかつ低侵襲に定量化する試みは、これまでにない新しい技術開発の基盤となり独創性が高い。また、本研究が臨床応用されれば、低侵襲、低コストで繰り返し可能な超音波検査がNASH診断の主軸となり、肝生検をする事なくNASHの早期拾い上げや早期治療導入が可能で、スクリーニングへの応用、超音波診断技術の標準化など臨床的価値が非常に高い。さらには、超音波画像のテクスチャ解析は、コンピュータ支援画像診断技術の最先端を担う手法であり、独創性や創造性の高い研究と考える。
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