超音波による脂肪性肝疾患診断の標準化と課題
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- 資料種別
- 記事
- 著者・編者
- 熊田 卓豊田 秀徳腰山 裕一安田 諭日浅 陽一
- 並列タイトル等
- Standardization and Challenges in Ultrasound-Based Diagnosis of Steatotic Liver Disease
- タイトル（掲載誌）
- 肝臓
- 巻号年月日等（掲載誌）
- 67(2):2026.3
- 掲載巻
- 67
- 掲載号
- 2
- 掲載ページ
- 87-100
- 掲載年月日（W3CDTF）
- 2026-03
- ISSN（掲載誌）
- 0451-4203
- ISSN-L（掲載誌）
- 0451-4203
- 出版事項（掲載誌）
- 東京 : 日本肝臓学会
- 出版地（国名コード）
- JP
- 本文の言語コード
- jpn
- 件名標目
- NDLC
- 対象利用者
- 一般
- 所蔵機関
- 国立国会図書館
- 請求記号
- Z19-130
- 連携機関・データベース
- 国立国会図書館 : 国立国会図書館雑誌記事索引
- 書誌ID（NDLBibID）
- 034609681
- 整理区分コード
- 632
- 要約等
- <p>Metabolic dysfunction-associated steatotic liver disease (MASLD) affects an estimated 25%-30% of the global population, and its prevalence continues to increase. Accurate liver fat quantification is essential for monitoring treatment response, assessing prognosis, and evaluating risks for cardiovascular disease and diabetes mellitus. Magnetic resonance imaging-based proton density fat fraction (MRI-PDFF) has become the new reference standard, replacing invasive liver biopsy. Although conventional B-mode ultrasound remains widely accessible, it is limited by operator dependence and low sensitivity for mild steatosis. Recent developments in ultrasound attenuation technologies now allow objective fat quantification. In Japan, four methods-controlled attenuation parameter, ultrasound-guided attenuation parameter, improved attenuation, and attenuation imaging-have been validated in multicenter studies. Among these approaches, B-mode-guided techniques demonstrate stronger correlations with MRI-PDFF, improved diagnostic accuracy, and reduced influence from body habitus compared with one-dimensional measurements. Combining multiple acoustic parameters beyond attenuation coefficient may further enhance performance. Standardization will require unified acquisition protocols and clarification of confounding factors.</p><p>代謝機能障害関連脂肪性肝疾患（MASLD）は世界人口の25-30%に影響を与え，増加傾向にある．肝脂肪定量は治療効果判定，予後予測，心血管疾患や糖尿病などの肝外合併症リスク評価に重要である．MRI-based proton density fat fraction（MRI-PDFF）が新たな参照基準として確立されつつあるが，従来の超音波Bモードは簡便ながら術者依存性が高く軽度脂肪肝の検出感度に限界がある．近年，超音波減衰法による客観的定量評価が可能となり，本邦ではCAP，UGAP，iATT，ATIの4手法が多施設共同研究で検証されている．特にBモードガイド下減衰測定法はMRI-PDFFとの相関が高く，診断能に優れ，体型の影響を受けにくい．さらに多変量モデルにより診断精度の向上が期待される．超音波による脂肪性肝疾患診断の標準化には，測定条件の統一と交絡因子の理解が不可欠である．</p>
- DOI
- 10.2957/kanzo.67.87
- オンライン閲覧公開範囲
- インターネット公開
- 連携機関・データベース
- 科学技術振興機構 : J-STAGE
- 要約等
- <p>代謝機能障害関連脂肪性肝疾患（MASLD）は世界人口の25-30%に影響を与え，増加傾向にある．肝脂肪定量は治療効果判定，予後予測，心血管疾患や糖尿病などの肝外合併症リスク評価に重要である．MRI-based proton density fat fraction（MRI-PDFF）が新たな参照基準として確立されつつあるが，従来の超音波Bモードは簡便ながら術者依存性が高く軽度脂肪肝の検出感度に限界がある．近年，超音波減衰法による客観的定量評価が可能となり，本邦ではCAP，UGAP，iATT，ATIの4手法が多施設共同研究で検証されている．特にBモードガイド下減衰測定法はMRI-PDFFとの相関が高く，診断能に優れ，体型の影響を受けにくい．さらに多変量モデルにより診断精度の向上が期待される．超音波による脂肪性肝疾患診断の標準化には，測定条件の統一と交絡因子の理解が不可欠である．</p>
- DOI
- 10.2957/kanzo.67.87
- 関連情報（URI）
- 参照
- Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030Clinical utility of 30% relative decline in MRI-PDFF in predicting fibrosis regression in non-alcoholic fatty liver diseaseAssessment of Hepatic Steatosis by Expert PathologistsOptimization of measurements with an ultrasound attenuation coefficient algorithm for quantifying liver fatDiagnostic performance of attenuation imaging versus controlled attenuation parameter for hepatic steatosis with MRI-based proton density fat fraction as the reference standard: a prospective multicenter studyControlled attenuation parameter does not predict hepatic decompensation in patients with advanced chronic liver diseaseComparison Between Attenuation Measurement and the Controlled Attenuation Parameter for the Assessment of Hepatic Steatosis Based on <scp>MRI</scp> ImagesThe Role of Multiparametric US of the Liver for the Evaluation of Nonalcoholic SteatohepatitisAttenuation imaging based on ultrasound technology for assessment of hepatic steatosis: A comparison with magnetic resonance imaging‐determined proton density fat fractionThe Severity of Ultrasonographic Findings in Nonalcoholic Fatty Liver Disease Reflects the Metabolic Syndrome and Visceral Fat AccumulationUtility of Ultrasound-Guided Attenuation Parameter for Grading Steatosis With Reference to MRI-PDFF in a Large CohortIncreasing liver fat is associated with progression of cardiovascular risk factorsThe association of the steatosis severity in fatty liver disease with coronary plaque pattern in general populationiATT liver fat quantification for steatosis grading by referring to MRI proton density fat fraction: a multicenter studySevere hepatic steatosis promotes increased liver stiffness in the early stages of metabolic dysfunction–associated steatotic liver diseaseWFUMB Guidelines/Guidance on Liver Multiparametric Ultrasound. Part 2: Guidance on Liver Fat QuantificationClinical utility of liver fat quantification for determining cardiovascular disease risk among patients with type 2 diabetesLiver Fibrosis, Fat, and Iron Evaluation with MRI and Fibrosis and Fat Evaluation with US: A Practical Guide for RadiologistsThe B-Mode Image-Guided Ultrasound Attenuation Parameter Accurately Detects Hepatic Steatosis in Chronic Liver DiseaseTwo-dimensional shear wave elastography and ultrasound-guided attenuation parameter for progressive non-alcoholic steatohepatitisHepatic Steatosis: Quantification by Proton Density Fat Fraction with MR Imaging versus Liver BiopsyQuantitative magnetic resonance imaging of hepatic steatosis: Validation in ex vivo human liversAssociation of nonalcoholic fatty liver disease (NAFLD) with hepatocellular carcinoma (HCC) in the United States from 2004 to 2009Non-invasive methods for imaging hepatic steatosis and their clinical importance in NAFLDAASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver diseaseDiagnostic accuracy of hepatic proton density fat fraction measured by magnetic resonance imaging for the evaluation of liver steatosis with histology as reference standard: a meta-analysisReply: A multi-society Delphi consensus statement on new fatty liver disease nomenclatureUS Attenuation for Liver Fat Quantification: An AIUM-RSNA QIBA Pulse-Echo Quantitative Ultrasound InitiativeCharacterising the microstructure of random media using ultrasoundValidation of a B‐mode ultrasonography scoring system for assessing liver steatosis: A comparison with MRI‐Derived proton density fat fractionMagnetic Resonance Imaging More Accurately Classifies Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease Than Transient ElastographyNoninvasive Markers of Portal Hypertension Detect Decompensation in Overweight or Obese Patients With Compensated Advanced Chronic Liver DiseaseMultivariable Quantitative US Parameters for Assessing Hepatic SteatosisHepatic Steatosis Is Prevalent in Stillborns Delivered to Women With Diabetes MellitusNonalcoholic fatty liver disease is a risk factor for large-for-gestational-age birthweightA comparative study of hepatic steatosis using two different qualitative ultrasound techniques measured based on magnetic resonance imaging‐derived proton density fat fractionUsefulness of Attenuation Imaging with an Ultrasound Scanner for the Evaluation of Hepatic SteatosisStatistics of Speckle in Ultrasound B-ScansResolution of Fatty Liver and Risk of Incident DiabetesSampling Variability of Liver Biopsy in Nonalcoholic Fatty Liver DiseaseAccuracy of MR Imaging–estimated Proton Density Fat Fraction for Classification of Dichotomized Histologic Steatosis Grades in Nonalcoholic Fatty Liver DiseaseMagnetic Resonance Imaging Proton Density Fat Fraction Associates With Progression of Fibrosis in Patients With Nonalcoholic Fatty Liver DiseaseUtility of Attenuation Coefficient Measurement Using an Ultrasound-Guided Attenuation Parameter for Evaluation of Hepatic Steatosis: Comparison With MRI-Determined Proton Density Fat FractionRobust sound speed estimation for ultrasound-based hepatic steatosis assessmentLiver Fibrosis, but No Other Histologic Features, Is Associated With Long-term Outcomes of Patients With Nonalcoholic Fatty Liver DiseaseGlobal epidemiology of nonalcoholic fatty liver disease—Meta‐analytic assessment of prevalence, incidence, and outcomes非アルコール性脂肪性肝疾患の肝脂肪化評価におけるUGAPの有用性：CAP，ATIとの比較検討
- 連携機関・データベース
- 国立情報学研究所 : CiNii Research
- 提供元機関・データベース
- Japan Link Center雑誌記事索引データベースCrossref
- 書誌ID（NDLBibID）
- 034609681