OBJECTIVES The primary aim of this study was to investigate the value of attenuation imaging (ATI), a novel ultrasound technique for detection of steatosis, by comparing the results to that obtained with controlled attenuation parameter (CAP) and by using MRI-derived proton density fat fraction (PDFF) as reference standard. METHODS From March to November 2018, 114 consecutive adult subjects potentially at risk of steatosis and 15 healthy controls were enrolled. Each subject underwent ATI and CAP assessment on the same day. MRI-PDFF was performed within a week. RESULTS The prevalence of steatosis, as defined by MRI-PDFF ≥ 5%, was 70.7%. There was a high correlation of ATI with MRI-PDFF (r = 0.81, P < 0.0001). The correlation of CAP with MRI-PDFF and with ATI, respectively, was moderate (r = 0.65, P < 0.0001 and r = 0.61, P < 0.0001). The correlation of ATI or CAP with PDFF was not affected by age, gender, or body mass index. Area under the receiver operating characteristics of ATI and CAP, respectively, were 0.91 (0.84-0.95; P < 0.0001) and 0.85 (0.77-0.91; P < 0.0001) for detecting S > 0 steatosis (MRI-PDFF ≥ 5%); 0.95 (0.89-0.98; P < 0.0001) and 0.88 (0.81-0.93; P < 0.0001) for detecting S > 1 steatosis (MRI-PDFF ≥ 16.3%). The cutoffs of ATI and CAP, respectively, were 0.63 dB/cm/MHz and 258 dB/m for detecting S > 0 liver steatosis; 0.72 dB/cm/MHz and 304 dB/m for detecting S > 1 steatosis. ATI performed better than CAP, and this improvement was statistically significant for S > 1 (P = 0.04). DISCUSSION This study shows that, in patients with no fibrosis/mild fibrosis, ATI is a very promising tool for the noninvasive assessment of steatosis.

中文翻译：

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使用基于超声波的新技术检测肝脂肪变性：使用MRI衍生的质子密度脂肪分数作为金标准的先导研究。

目的本研究的主要目的是将衰减成像（ATI）的价值（一种用于检测脂肪变性的新型超声技术）与通过控制衰减参数（CAP）获得的结果进行比较，以及使用MRI衍生的质子密度来研究其价值。脂肪分数（PDFF）作为参考标准。方法从2018年3月至2018年11月，纳入114名可能有脂肪变性风险的连续成年受试者和15名健康对照者。每个受试者在同一天接受ATI和CAP评估。一周内进行了MRI-PDFF。结果MRI-PDFF≥5％定义的脂肪变性率为70.7％。ATI与MRI-PDFF有高度相关性（r = 0.81，P <0.0001）。CAP与MRI-PDFF和ATI的相关性是中等的（r = 0.65，P <0.0001和r = 0.61，P <0.0001）。ATI或CAP与PDFF的相关性不受年龄，性别或体重指数的影响。用于检测S> 0脂肪变性（MRI-PDFF≥5％）的接收器的ATI和CAP操作特性区域分别为0.91（0.84-0.95; P <0.0001）和0.85（0.77-0.91; P <0.0001）; 0.95（0.89-0.98; P <0.0001）和0.88（0.81-0.93; P <0.0001）用于检测S> 1脂肪变性（MRI-PDFF≥16.3％）。用于检测S> 0肝脂肪变性的ATI和CAP的截止分别为0.63 dB / cm / MHz和258 dB / m。0.72 dB / cm / MHz和304 dB / m用于检测S> 1脂肪变性。ATI的性能优于CAP，并且对于S> 1（P = 0.04），这种改善具有统计学意义。讨论本研究表明，对于没有纤维化/轻度纤维化的患者，ATI是一种非常有前途的无创性评估脂肪变性的工具。