We evaluated the diagnostic accuracy of the controlled attenuation parameter (CAP) and liver stiffness measurements (LSM) measured with either an M or XL probe against liver biopsy (LB) in patients with non-alcoholic fatty liver disease (NAFLD). This study was a cross-sectional prospective study that included 179 NAFLD patients. With a cutoff value for CAP ≥345, we can exclude significant steatosis in 87% (79.4%–92.5%) of our population. With respect to the LSM, the highest accuracy was obtained for F ≥ F3 (area under the receiver operating characteristic curve [AUROC] = 0.98) and F = F4 (AUROC = 0.98). In a multivariable linear regression model, significant predictors influencing LSM were fibrosis stage (β = 2.6, p < 0.001) as a positive predictor and lobular inflammation (β = –0.68, p = 0.04) as a negative predictor, without significant influence after adjustment for CAP and probe type. We found that CAP is a satisfactory method for excluding advanced steatosis, while LSM is a good non-invasive marker for the exclusion of fibrosis.

我们评估了控制衰减参数 (CAP) 和肝脏硬度测量 (LSM) 的诊断准确性，该测量使用 M 或 XL 探针对非酒精性脂肪性肝病 (NAFLD) 患者进行肝活检 (LB)。这项研究是一项横断面前瞻性研究，包括 179 名 NAFLD 患者。使用 CAP ≥345 的临界值，我们可以排除 87% (79.4%–92.5%) 人群的显着脂肪变性。对于 LSM，F ≥ F3（接受者操作特征曲线下面积 [AUROC] = 0.98）和 F = F4（AUROC = 0.98）获得了最高准确度。在多变量线性回归模型中，影响 LSM 的重要预测因子是纤维化阶段（β = 2.6，p < 0.001）作为阳性预测因子和小叶炎症（β = –0.68，p = 0.04) 作为负面预测因子，在调整 CAP 和探针类型后没有显着影响。我们发现 CAP 是一种令人满意的排除晚期脂肪变性的方法，而 LSM 是一种很好的排除纤维化的非侵入性标志物。