Gastroenterologìa · Published 2025-01-01 · Journal article · DOI 10.22141/2308-2097.60.2.2026.722
Background. Metabolic dysfunction-associated steatotic liver disease is one of the most common chronic liver diseases in pediatric population, especially among children with overweight and obesity. Early detection of hepatic steatosis (HS) is of important clinical relevance; however, the use of invasive methods in pediatrics is limited. Magnetic resonance imaging-proton density fat fraction (MRI-PDFF) is regarded as a non-invasive reference standard for the quantitative assessment of HS, although its availability in routine clinical practice remains extremely limited. In this context, quantitative ultrasound techniques (QUT) for the assessment of HS appear promising; however, their diagnostic threshold values in children require further clarification. The purpose was to compare the results of QUT-based steatometry obtained on different ultrasound systems with MRI-PDFF findings and to determine the optimal diagnostic thresholds for HS in children. Materials and methods. This study had a prospective, single-center, comparative diagnostic design. The analysis included 32 children aged 10–18 years: 10 without HS (S0) and 22 with mild steatosis (S1) according to MRI-PDFF. QUT-based steatometry parameters obtained on different ultrasound systems were evaluated, including attenuation coefficient measurement (ACM), ultrasound-guided attenuation parameter (UGAP), tissue attenuation imaging (TAI), tissue scatter distribution imaging (TSI), and Deep Ultrasound Fat Fraction (DeepUSFF). Correlation analysis and receiver operating characteristic (ROC) analysis were performed, including determination of the area under the ROC curve (AUC) and optimal cut-off values using MRI-PDFF as the reference standard. Results. All investigated ultrasound parameters demonstrated a statistically significant positive association with MRI-PDFF. The strongest correlation with overall MRI-PDFF was observed for DeepUSFF (ρ = 0.792; p < 0.001), followed by ACM (ρ = 0.696; p < 0.001), UGAP (ρ = 0.555; p < 0.001), TSI (ρ = 0.532; p < 0.001), and TAI (ρ = 0.380; p = 0.012). According to ROC analysis, the optimal threshold values for detecting HS were as follows: ACM ≥ 2.30 (AUC 0.88), TAI ≥ 0.69 (AUC 0.79), TSI ≥ 97.92 (AUC 0.92), UGAP ≥ 0.65 (AUC 0.89), and DeepUSFF ≥ 5.20 (AUC 0.98). DeepUSFF demonstrated the highest diagnostic performance. Conclusions. QUT for assessing steatosis show a statistically significant association with MRI-PDFF and may be useful for the non-invasive early detection of HS in children. Different ultrasound platforms are characterized by different diagnostic thresholds, highlighting the need for standardization of approaches and further external validation in larger pediatric cohorts.
Abstract from DOAJ. Public domain (CC0 1.0).
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