热声超声评估肝脏脂肪变性——一种诊断MASLD的新方法
Thermoacoustic Ultrasound Assessment of Liver Steatosis-A Novel Approach for MASLD Diagnosis.
摘要(中文译文)
代谢功能障碍相关脂肪性肝病（MASLD）是一场全球健康危机，但当前的诊断手段有限。肝活检具有侵入性，磁共振成像-质子密度脂肪分数（MRI-PDFF）费用高昂，而定量超声方法准确性较低，尤其是在高体重指数（BMI）患者中。本研究介绍了一种新型热声（TA）方法，该方法基于组织电导率生成超声信号，其中瘦组织（富含水分和电解质）比脂肪组织吸收更多射频（RF）能量，从而为脂肪提供直接的分子对比。：一项前瞻性、横断面可行性研究在40名疑似脂肪性肝病受试者中，将新型热声脂肪分数（TAFF）评分与参考标准MRI-PDFF进行了比较。采用Bland-Altman分析、Deming回归和二分类性能进行检验。为确定系统稳定性，一项专门的重测信度与再现性（R&R）研究（N = 14）使用由双向随机效应方差分析模型得出的组内相关系数（ICC）评估了操作者间和操作者内一致性。TAFF估计值与MRI-PDFF呈显著相关（r = 0.89），平均绝对误差为3.04%脂肪分数。分类性能较高，在12%脂肪分数阈值下受试者工作特征曲线下面积（AUROC）为0.92，在20%脂肪分数阈值下为0.99。R&R研究证实了稳健的稳定性（组内相关系数 = 0.89），操作者间平均差异可忽略不计，为0.36%。估计误差与BMI或其他体型测量指标无统计学显著相关性。：这些发现支持热声学作为一种准确、非侵入性、即时检测解决方案的潜力，可作为新的影像生物标志物。通过在整个MASLD谱系中提供与MRI-PDFF密切一致的预测值，TAFF可以补充当前可用的超声方法，以解决MRI在MASLD评估、诊断和监测中的成本和可及性限制。
Abstract
: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a global health crisis, but current diagnostics are limited. Liver biopsy is invasive, magnetic resonance imaging-proton density fat fraction (MRI-PDFF) is expensive, and quantitative ultrasound methods are low-accuracy, especially in patients with a high body mass index (BMI). This study introduces a novel thermo-acoustic (TA) method that generates ultrasound signals based on tissue electrical conductivity, where lean tissue (high in water and electrolytes) absorbs more radio-frequency (RF) energy than fatty tissue, providing a direct molecular contrast for fat. : A prospective, cross-sectional feasibility study compared a new thermo-acoustic fat fraction (TAFF) score with the reference standard MRI-PDFF in 40 subjects with suspected fatty liver disease. Bland-Altman analysis, Deming regression, and Binary classification performance were tested. To establish system stability, a dedicated Repeatability and Reproducibility (R&R) study (N = 14) evaluated inter-operator and intra-operator consistency using an Intraclass Correlation Coefficient (ICC) derived from a two-way random-effects ANOVA model. TAFF estimates demonstrated a substantial correlation (r = 0.89) with MRI-PDFF and an average absolute error of 3.04% fat fraction. Classification performance was high, with an Area Under the Receiver Operating Characteristic Curve (AUROC) of 0.92 at the 12% fat fraction threshold and 0.99 at the 20% fat fraction threshold. The R&R study confirmed robust stability (intraclass correlation = 0.89) and a negligible mean inter-operator difference of 0.36%. Estimation errors showed no statistically significant correlation with BMI or other body habitus measurements. : These findings support thermoacoustics' potential as an accurate, non-invasive, point-of-care solution that can serve as a new imaging biomarker. By providing predictive values closely aligned with MRI-PDFF across the full MASLD spectrum, TAFF can complement currently available ultrasound methods to address the cost and access constraints of MRI for the assessment, diagnosis, and monitoring of MASLD.
如何引用
AMA
Jang Hwan Cho, Christopher M Bull, Michael Thornton, Jing Gao, Jonathan M Rubin, Idan Steinberg. Thermoacoustic Ultrasound Assessment of Liver Steatosis-A Novel Approach for MASLD Diagnosis.. Diagnostics (Basel, Switzerland). 2026; doi:10.3390/diagnostics16050804.
APA
Jang Hwan Cho, Christopher M Bull, Michael Thornton, Jing Gao, Jonathan M Rubin, Idan Steinberg (2026). Thermoacoustic Ultrasound Assessment of Liver Steatosis-A Novel Approach for MASLD Diagnosis.. Diagnostics (Basel, Switzerland). https://doi.org/10.3390/diagnostics16050804
GB/T 7714
Jang Hwan Cho, Christopher M Bull, Michael Thornton, Jing Gao, Jonathan M Rubin, Idan Steinberg. Thermoacoustic Ultrasound Assessment of Liver Steatosis-A Novel Approach for MASLD Diagnosis.[J]. Diagnostics (Basel, Switzerland), 2026 doi:10.3390/diagnostics16050804.
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