European journal of radiology · 2026
Head-to-head comparison of dual-elastography and 2D shear wave elastography for assessing steatosis, fibrosis, and inflammation in MASLD.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Cheng Guangwen, Li Xueqi, Liang Jing, Akiyama Iwaki, Qiao Xiaohui, Xue Liyun, Ding Hong
Аннотация
BACKGROUND: Quantitative ultrasound techniques enable noninvasive assessment of hepatic steatosis, fibrosis, and inflammation in metabolic dysfunction-associated steatotic liver disease (MASLD). This study performed a head-to-head comparison of dual-elastography and 2D shear wave elastography (2D-SWE) for comprehensive histologic evaluation.
METHODS: A total of 186 biopsy proven MASLD patients were enrolled. Dual-elastography provided attenuation imaging (ATI), fibrosis (F-index), and inflammatory activity (A-index), while 2D-SWE offered attenuation coefficient (ATT), shear wave elasticity (SWE), and shear wave dispersion (SWD). Histologic grades of steatosis (S0-S3), fibrosis (F0-F3), and inflammation (A0-A3) served as the reference standard. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis.
RESULTS: ATI outperformed ATT for detecting ≥S1 steatosis (AUROC 0.90 vs. 0.81, P = 0.036), while their performance for ≥S2 and ≥S3 was comparable. For significant fibrosis (≥F2), the F-index showed higher accuracy than SWE (AUROC 0.87 vs. 0.80, P = 0.046) with greater sensitivity (73.7%) and balanced specificity (85.3%). SWD demonstrated moderate diagnostic ability for inflammatory activity (AUROC 0.75 for ≥A2; 0.84 for ≥A3), and the A-index achieved AUROC 0.73 for detecting lobular inflammation grade ≥2.
CONCLUSIONS: ATI and ATT are reliable for assessing steatosis, the F-index provides superior accuracy for significant fibrosis, and SWD and A-index reflect overall and lobular inflammation, respectively. These multiparametric ultrasound techniques enable comprehensive, noninvasive evaluation of key histologic features in MASLD.
METHODS: A total of 186 biopsy proven MASLD patients were enrolled. Dual-elastography provided attenuation imaging (ATI), fibrosis (F-index), and inflammatory activity (A-index), while 2D-SWE offered attenuation coefficient (ATT), shear wave elasticity (SWE), and shear wave dispersion (SWD). Histologic grades of steatosis (S0-S3), fibrosis (F0-F3), and inflammation (A0-A3) served as the reference standard. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis.
RESULTS: ATI outperformed ATT for detecting ≥S1 steatosis (AUROC 0.90 vs. 0.81, P = 0.036), while their performance for ≥S2 and ≥S3 was comparable. For significant fibrosis (≥F2), the F-index showed higher accuracy than SWE (AUROC 0.87 vs. 0.80, P = 0.046) with greater sensitivity (73.7%) and balanced specificity (85.3%). SWD demonstrated moderate diagnostic ability for inflammatory activity (AUROC 0.75 for ≥A2; 0.84 for ≥A3), and the A-index achieved AUROC 0.73 for detecting lobular inflammation grade ≥2.
CONCLUSIONS: ATI and ATT are reliable for assessing steatosis, the F-index provides superior accuracy for significant fibrosis, and SWD and A-index reflect overall and lobular inflammation, respectively. These multiparametric ultrasound techniques enable comprehensive, noninvasive evaluation of key histologic features in MASLD.