Ultrasound-estimated hepatorenal index: diagnostic performance and interobserver agreement for pediatric liver fat quantification.

IF 2.1 3区医学 Q2 PEDIATRICS Pediatric Radiology Pub Date : 2024-09-01 Epub Date: 2024-08-13 DOI:10.1007/s00247-024-06021-4

Farid Hajibonabi, Erica L Riedesel, Susan D Taylor, Leann E Linam, Adina L Alazraki, Chao Zhang, Geetika Khanna

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Abstract

Background: Semiquantitative and quantitative sonographic techniques have the potential for screening and surveillance of children at risk of nonalcoholic fatty liver disease.

Objective: To determine diagnostic performance and interobserver agreement of hepatorenal index (HRI) for pediatric ultrasound-based liver fat quantification.

Materials and methods: In an institutional review board (IRB)-approved retrospective study (April 2014 to April 2023), children (< 18 years) with clinically performed magnetic resonance imaging (MRI) scans for liver fat quantification were assessed. Inclusion criteria required availability of abdominal ultrasound within 3 months of quantitative MRI. Three blinded readers subjectively assessed for sonographic hepatic steatosis and calculated HRI. MRI proton density fat fraction (PDFF) was the reference standard. Interobserver agreement, correlation with PDFF, and optimal HRI (using ROC analysis) values were analyzed. The significance level was set at p < 0.05.

Results: A total of 41 patients (25 male) with median (interquartile range (IQR)) age of 13 (10-15) years were included. Median (IQR) MRI PDFF was 11.30% (2.70-17.95%). Hepatic steatosis distribution by MRI PDFF included grade 0 (34%), grade 1 (15%), grade 2 (22%), and grade 3 (29%) patients. Intraclass correlation coefficient for HRI among the three readers was 0.61 (95% CI 0.43-0.75) (p < 0.001). Moderate correlation was observed between manually estimated HRI and PDFF for each reader (r = 0.62, 0.67, and 0.67; p < 0.001). Optimal HRI cutoff was found to be 1.99 to diagnose hepatic steatosis (sensitivity 89%, specificity 93%). Median (IQR) HRI for each MRI grade of hepatic steatosis (0-4) was as follows: 1.2 (1.1-1.5), 2.6 (1.1-3.3), 3.6 (2.6-5.4), 5.6 (2.6-10.9), respectively (p < 0.001).

Conclusion: Ultrasound-estimated HRI has moderate interobserver agreement and moderate correlation with MRI-derived PDFF. HRI of 1.99 maximizes accuracy for identifying pediatric liver fat.

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超声波估算的肝肾指数：小儿肝脏脂肪定量的诊断性能和观察者之间的一致性。

背景：半定量和定量超声技术可用于筛查和监测有非酒精性脂肪肝风险的儿童：目的：确定小儿超声肝脏脂肪定量的诊断性能和肝肾指数（HRI）的观察者间一致性：在一项经机构审查委员会（IRB）批准的回顾性研究中（2014 年 4 月至 2023 年 4 月），儿童（结果：41 名患者（25 名男性）接受了超声检查：共纳入 41 名患者（25 名男性），中位数（四分位数间距，IQR）年龄为 13（10-15）岁。MRI PDFF 中位数（IQR）为 11.30% (2.70-17.95%)。肝脏脂肪变性在磁共振成像 PDFF 中的分布包括 0 级（34%）、1 级（15%）、2 级（22%）和 3 级（29%）患者。三位读片者的 HRI 级内相关系数为 0.61（95% CI 0.43-0.75）（P 结论：HRI 级内相关系数为 0.61（95% CI 0.43-0.75））：超声估计的 HRI 与 MRI 导出的 PDFF 具有中等程度的观察者间一致性和中等程度的相关性。1.99的HRI可最大限度地提高识别小儿肝脏脂肪的准确性。

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来源期刊

Pediatric Radiology 医学-核医学

CiteScore

4.40

自引率

17.40%

发文量

300

审稿时长

3-6 weeks

期刊介绍： Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.