| MethodRetrospective review of 322 normal-ALT lean NAFLD patients(BMI<24kg/m~2),who were diagnosed by abdomen ultrasound.The clinical data were collected from July 2015 to January 2018 in the Department of Gastroenterology of China-Japan Union Hospital of Jilin University.According to different FibroScan CAP values,the subjects were divided into two groups:CAP NAFLD group(CAP?238dB/m)and CAP non-NAFLD group(CAP<238dB/m);according to different CT liver/spleen density ratios,the subjects were divided into two groups:CT NAFLD group(ratio?1)and CT non-NAFLD group(ratio>1).Factors influencing the assessment of NAFLD by FibroScan and CT were explored.In addition,analyzed the difference ofcoincidence rates betweenFibroScan,CT and ultrasound with different LSM values(LSM<7.9kPa group,7.9?LSM<9.8kPa group,LSM?9.8kPa group).To explore the timing of different non-invasive methods usage in different stages of NAFLD,and provide the basis for the assessment of disease severity.Results1.From the subjects of this study,it can be found that there were47.52%patients whose CAP value did not meet the diagnosis of fatty liver,and 67.70%patients whose CT liver/spleen density ratio did not meet the diagnosis of fatty liver among the patients who were diagnosed with fatty liver by abdominal ultrasound.2.The baseline characteristics of group CAP NAFLD and CAP non-NAFLD group showed that there were significant differences between two groups in age,LSM,TG level,CHOL level,LDL-C level,TBIL level and DBIL level,and the difference was statistically significant.The baseline characteristics of CT NAFLD group and CT non-NAFLD group showed that there were significant differences between the two groups in age and TG level,and the difference was statistically significant.3.For patients with NAFLD with different LSM values,compared the coincidence rate between FibroScan CAP value and ultrasound,the result showed that the LSM<7.9 group was significantly different from LSM>9.8 groups,and it had statistical significance.however,there was no statistical difference between CT liver/spleen density ratio and ultrasound.4.For different LSM values,compared the difference of the positive rate of NAFLD diagnosed by two or more examination methods.The results showed that when LSM<9.8kPa,the CAP NAFLD group was significantly different from the CT NAFLD group,and the CT NAFLD group was significantly different from the CAP and/or CT NAFLD group,and it had statistical significance.When LSM>9.8kPa,the CAP NAFLD group was significantly different the CAP and/or CT NAFLD group.The CT NAFLD group was significantly different from CAP and/or CT NAFLD group,and it had statistical significance.5.Among the people with different LSM values,FibroScan and liver/spleen density were significantly different between these two diagnosis methods of NAFLD,which were statistically significant.Conclusion1.Age,LSM,TG,CHOL,LDL-C,TBIL,DBIL and other factors may affect the diagnosis of NAFLD with FibroScan CAP values;age,TG and other factors may affect the use of CT liver/spleen density ratio to diagnose NAFLD.2.Compared with the LSM?9.8 group,in the LSM<7.9 group,the coincidence rate between FibroScan and ultrasound was higher than the CT and the ultrasound.The LSM value did not affect the coincidence rate between CT and ultrasound.3.As LSM<9.8kPa,there was no significant difference between the coincidence rates when used both the FibroScan CAP value and the combined use of the two diagnostic methods.As LSM?9.8kPa,there was no significant difference between the diagnostic results when used FibroScan CAP value and the liver/spleen density alone.When two diagnostic methods were used together.The coincidence rate was higher than a single diagnosis method.4.Regardless of the liver stiffness,there are differences in the assessment of the severity of NAFLD disease diagnosed by FibroScan and CT.Therefore,the definition of the limits of the two diagnostic methods may require more clinical research to be precise. |
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