OBJECTIVE:To study the diagnostic value of real-time ultrasound shear wave elastography (US-SWE) in evaluating the histological stages of nonalcoholic fatty liver disease (NAFLD) in a rabbit model. MATERIALS AND METHODS:Twenty-one 8-week-old rabbits were fed a high-fat, high-cholesterol diet (experimental groups), and seven rabbits were fed a standard diet (control group). All rabbits underwent real-time US-SWE at various time points to document the histological stages of NAFLD. We categorized the histological stages as normal, NAFL, borderline nonalcoholic steatohepatitis (NASH), and NASH. We measured the elastic modulus of the liver parenchyma and analyzed the diagnostic efficacy of real-time US-SWE using the area under receiver operating characteristic curve (AUC) for the four histological stages. RESULTS:The mean, minimum, and maximum elastic modulus increase for NAFL, borderline NASH, and NASH. For the mean, minimum, and maximum elastic modulus, AUCs are 0.891 (95% confidence interval [CI]: 0.716–0.977), 0.867 (95% CI: 0.686–0.965), and 0.789(95% CI:0.594–0.919) for differentiating normal liver from liver with NAFLD, respectively; AUCs are 0.846 (95% CI: 0.660–0.954), 0.818 (95% CI: 0.627–0.937), and 0.797(95% CI:0.627–0.913) for differentiating normal liver or liver with NAFL from liver with borderline NASH or NASH, respectively; AUCs are 0.889 (95% CI: 0.713–0.976), 0.787 (95% CI: 0.591–0.918), and 0.895 (95% CI:0.720–0.978) for differentiating liver with NASH from liver with borderline NASH or normal liver, respectively. CONCLUSIONS:Real-time US-SWE is an accurate, noninvasive technique for evaluating the histological stages of NAFLD by measuring liver stiffness. We recommend using the mean elastic modulus to differentiate the histological stages, with the minimum and maximum elastic modulus as valuable complements.

中文翻译：

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用于评估非酒精性脂肪肝的实时超声剪切波弹性成像多参数的诊断性能：兔模型。

目的：研究实时超声剪切波弹性成像（US-SWE）在兔模型中评估非酒精性脂肪性肝病（NAFLD）组织学分期的诊断价值。材料与方法：21只8周龄兔饲喂高脂肪、高胆固醇饲料（实验组），7只兔饲喂标准饲料（对照组）。所有兔子在不同时间点接受实时 US-SWE 以记录 NAFLD 的组织学阶段。我们将组织学分期分为正常、NAFL、临界非酒精性脂肪性肝炎 (NASH) 和 NASH。我们测量了肝实质的弹性模量，并使用四个组织学阶段的受试者工作特征曲线下面积 (AUC) 分析了实时 US-SWE 的诊断功效。结果：平均值、最小值、NAFL、临界 NASH 和 NASH 的最大弹性模量增加。对于平均、最小和最大弹性模量，AUC 为 0.891（95% 置信区间 [CI]：0.716–0.977）、0.867（95% CI：0.686–0.965）和 0.789（95% CI：0.594–0.919）分别用于区分正常肝脏和 NAFLD 肝脏；AUC 为 0.846（95% CI：0.660-0.954）、0.818（95% CI：0.627-0.937）和 0.797（95% CI：0.627-0.913）用于区分正常肝脏或带有线型 NASH 的肝脏或有边界的 NASH ， 分别; AUC 分别为 0.889（95% CI：0.713-0.976）、0.787（95% CI：0.591-0.918）和 0.895（95% CI：0.720-0.978）用于区分患有 NASH 的肝脏与具有临界 NASH 的肝脏或正常肝脏. 结论：实时 US-SWE 是准确的，通过测量肝脏硬度来评估 NAFLD 组织学阶段的无创技术。我们建议使用平均弹性模量来区分组织学阶段，最小和最大弹性模量作为有价值的补充。