Non-invasive diagnosis of non-alcoholic steatohepatitis by ultrasound attenuation imaging and two-dimensional shear wave elastography

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K08400
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53010:Gastroenterology-related
• Research Institution: Iwate Medical University
• Principal Investigator: Kuroda Hidekatsu 岩手医科大学, 医学部, 特任准教授 (70382596)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: NASH / NAFLD / 2D-SWE / UGAP

Outline of Final Research Achievements

We investigated the usefulness of combining 2D-SWE and the ultrasound-guided attenuation parameter (UGAP) for assessing the risk of progressive NASH. This prospective study included 202 patients with NAFLD who underwent 2D-SWE, UGAP, and liver biopsy (LB) on the same day. Patients were grouped according to liver stiffness (LS) and the attenuation coefficient (AC): A, low LS/low AC; B, low LS/high AC; C, high LS/low AC; and D, high LS/high AC. The percentages of progressive NASH in Groups A, B, C, and D were 0.0%, 7.7%, 35.7%, and 50.0%, respectively (P<0.001). The prediction model was established as logit (p) = 0.541 × LS (kPa) + 7.79 × AC (dB/cm/MHz) - 8.40, with AUROC, sensitivity, and specificity values of 0.83, 80.9%, and 74.6%, respectively. Combined assessment by 2D-SWE and UGAP is useful for risk stratification of progressive NASH and may be convenient for evaluating the necessity of specialist referral and LB.

Free Research Field

消化器疾患

Academic Significance and Societal Importance of the Research Achievements

NAFLD/NASHは世界中で患者数が急増し、そのエンドステージである肝硬変や肝細胞癌は今日臨床現場での大きな脅威となっている。膨大な患者数のNAFLDから、予後の悪い線維化進展例やNASHを効率よく囲い込むことは極めて重要な臨床的課題である。我々は、NAFLDの肝線維化診断における2D-SWEの有用性、肝脂肪化診断におけるUGAPの有用性を者の併用によりNASHならびにprogressive NASH の効率的な層別化が可能で、高精度なprogressive NASH診断予測モデルの構築に成功した。本成果は、肝生検適応や治療方針の判断への応用も期待される。