Diagnostic value of ultrasound attenuated imaging in metabolic-dysfunction-associated fatty liver disease in children

Abstract

Objective：To evaluate the diagnostic value of ultrasound attenuated imaging in children with metabolic-dysfunction-associated fatty liver disease (MAFLD). Methods：A total of 110 overweight and obese children with MAFLD who visited the Fourth Affiliated Hospital of Nanjing Medical University from January 2023 to June 2024 were selected as the study subjects, along with 40 randomly selected healthy children as the control group. All children underwent two-dimensional ultrasound and attenuation imaging examinations. Height, weight, body mass index (BMI), and attenuation coefficient (AC) were recorded. Based on the result of two-dimensional ultrasound, the fatty liver in the MAFLD group was classified into mild, moderate, and severe subgroups. Differences in BMI and AC between the control group and the MAFLD group were compared, and the diagnostic value of ultrasound attenuation imaging for childhood MAFLD was analyzed. Results： The BMI of the MAFLD group was higher than that of the control group ［(25.81±3.48)kg/m2 vs (18.63±1.76)kg/m2, t=16.38,P＜0.01］. The BMI values for mild, moderate, and severe MAFLD were (23.63±1.24), (26.56±1.80), and (30.69±4.14)kg/m2, respectively, with significant differences among the groups (F=54.11, P＜0.01). The AC of the MAFLD group was higher than that of the control group ［(0.68±0.05)dB/(cm·MHz) vs (0.48±0.05)dB/(cm·MHz), t=15.53,P＜0.01］. The AC values for mild, moderate, and severe MAFLD were (0.62±0.07), (0.75±0.05), and (0.89±0.05)dB/(cm·MHz), respectively, with significant differences among the groups (F=164.06, P＜0.01). AC showed a positive correlation with ultrasound grading result (r=0.921, P＜0.05), and was also positively correlated with BMI (r=0.829, P＜0.05). Ultrasound grading result were positively correlated with BMI (r=0.801, P＜0.05). The area under the curve (AUC) for diagnosing mild, moderate, and severe MAFLD using AC was 0.941, 0.933, and 0.975, respectively. Conclusion： Ultrasound attenuation imaging can quantitatively and non-invasively assess the degree of hepatic fat infiltration in children with MAFLD. Compared with two-dimensional ultrasound, AC shows a stronger correlation with BMI, and can serve as an early, precise, and non-invasive evaluation indicator for MAFLD.

Keywords

• metabolic-dysfunction-associated fatty liver disease
• attenuated imaging
• attenuation coefficients
• overweight/obese children
• body mass index