Ultrasound-derived fat fraction for the noninvasive quantification of hepatic steatosis: a prospective multicenter study

作者：Liyun Xue, Yuli Zhu, Guangwen Cheng, Hao Han, Nianan He, Lin Chen, Zhe Ma, Haiya Ge, Dong Jiang, Ting He, Rui Shen, Wei Jiang, Liping Sun, Jianxing Zhang, Xiaofeng Cai, Huixiong Xu, Hong Ding · 发表于：Insights into Imaging · 年份：2025 · DOI：10.1186/s13244-025-02092-5 · 被引用次数：7 · 研究领域：Liver Disease Diagnosis and Treatment、Hepatocellular Carcinoma Treatment and Prognosis、Cardiovascular Disease and Adiposity

Abstract Objectives To prospectively evaluate the diagnostic accuracy of ultrasound-derived fat fraction (UDFF) in quantifying hepatic steatosis, to establish and validate a dual-threshold UDFF classification system, and to investigate its efficacy for risk stratification in body mass index (BMI)-defined subgroups. Materials and methods This prospective multicenter study involved 790 suspected metabolic dysfunction-associated steatotic liver disease (MASLD) participants from April 2023 to November 2024 (derivation: n = 553; validation: n = 237). Liver biopsy histopathology ( n = 342), MRI proton density fat fraction (MRI-PDFF) ( n = 396), or proton magnetic resonance spectroscopy ( 1 H-MRS) ( n = 52) was used as the reference standard. UDFF was compared to noninvasive test Hepatic Steatosis Index (HSI) and Fatty Liver Index (FLI) using area under the curve (AUC). The diagnostic thresholds were optimized to maintain at least 90% sensitivity and specificity in stratifying hepatic steatosis severity. A two-step strategy of UDFF followed by HSI was used to rule in and rule out steatosis at BMI ≥ 23 kg/m 2 subgroup. Results UDFF demonstrated significant correlations with three reference standards (Spearman’s ρ = 0.798–0.847). Comparing with HSI and FLI, UDFF showed higher AUC (0.933, 0.948, and 0.914, respectively) for assessing ≥ S1, ≥ S2 and S3. A clinically practical dual-threshold system effectively classified hepatic steatosis severity. A sequential UDFF/HSI strategy achieved...