超音波定量參數評估非酒精性脂肪肝與糖尿病之相關性探討

Quantitative ultrasound evaluation of nonalcoholic fatty liver and diabetes mellitus.

邱育宗(Yu-Tsung Chiu)

指導教授 ： 廖尹吟

中山醫學大學/醫學科技學院/醫學影像暨放射科學系/碩士(2023年)

https://doi.org/10.6834/csmu202200291

摘要

目的：
許多研究已證實糖尿病與非酒精性脂肪肝病之間是具有雙向關係，當病人患有糖尿病時，在後續數年內發生非酒精性脂肪肝病的風險會比正常人還要高出許多，抑或是病人在患有嚴重脂肪肝病的同時，也更容易伴隨糖尿病的發生，並且當病人同時患有糖尿病與非酒精性脂肪肝病時，對於脂肪肝的惡化風險也會提高。因此若能及早檢測糖尿病病人發展成脂肪肝的風險以及提供相對應的預防與治療是重要的。
材料與方法：
本研究利用能夠代表介質微觀結構物理特性的三種超音波定量參數，分別為紋理特徵參數、訊號雜訊比、夏農熵參數，藉由超音波定量參數對68名受試者的肝臟右葉實質進行分析，並依照受試者的脂肪肝以及糖尿病的狀況進行實驗分析群組的分類，以評估糖尿病在脂肪肝的各種狀況下對於組織微觀結構所引起的變化是否會反映在超音波定量參數的變化趨勢上。
結果：
研究結果顯示，對於輕度、中重度脂肪肝的病人而言，糖尿病的存在與否對於參數數值上並無顯著的統計差異，但是仍可發現在患有糖尿病的病人，其整體參數數值是具有增加的趨勢，而此趨勢在中重度脂肪肝的分析群組中更為顯著。除此之外，對於沒有脂肪肝卻有糖尿病（nonFLD-DM）的肝臟而言，其參數數值與輕度脂肪肝沒有糖尿病（Mild FLD-nonDM）的肝臟是無顯著差異。
結論：
根據本研究的結果初步表明了，在受到糖尿病影響的肝臟，超音波定量參數數值的分布趨勢是會較沒有糖尿病的肝臟還要高，尤其是在中重度脂肪肝群組中，並且對於尚未發展成輕度脂肪肝的糖尿病病人，可以早期發現肝臟超音波定量參數數值的異常，這意味著本研究所選用的超音波定量參數是具有檢測脂肪肝與糖尿病之相關性的發展潛力。

關鍵字

超音波定量參數 ； 非酒精性脂肪肝病 ； 糖尿病

並列摘要

Objective：
Numerous studies have demonstrated a bilateral relationship between diabetes and non-alcoholic fatty liver disease. When a patient has diabetes, the risk of developing non-alcoholic fatty liver disease in the following years is much higher than normal. Patients with severe fatty liver disease are also more likely to develop diabetes. Moreover, when patients suffer from diabetes and NAFLD simultaneously, the risk of deterioration of fatty liver will also increase. Therefore, it is important to detect the risk of developing fatty liver for diabetic patients early and provide corresponding prevention and treatment.
Material and method：
In this study, three ultrasonic quantitative parameters that can represent the physical characteristics of the microstructure of the medium are used, namely texture feature parameters, signal-to-noise ratio, and Shannon entropy parameters. Analysis of right lobe parenchyma of 68 subjects by using ultrasound quantitative parameters. Also, according to the fatty liver and diabetes status of the subjects, the experimental analysis group classification is carried out to evaluate whether the changes caused by diabetes in the various conditions of fatty liver on the microstructure of the tissue will be reflected in the changing trend of the ultrasound quantitative parameters.
Results：
The results of the study revealed that for patients with mild and moderate to severe fatty liver, the presence or absence of diabetes had no significant statistical difference in parameter values. Whereas it can still be found that in patients with diabetes, the overall parameter values tend to increase, and this trend is more outstanding in the analysis group of moderate to severe fatty liver. In addition, for the livers without fatty liver but with diabetes (nonFLD-DM), the parameter values were not significantly different from those of livers with mild fatty liver without diabetes (Mild FLD-nonDM).
Conclusion：
According to the results of this study, it is preliminarily shown that in the liver affected by diabetes, the distribution trend of the value of ultrasound quantitative parameters is higher than that in the liver without diabetes, especially in the moderate to severe fatty liver group. Also, for diabetic patients who have not yet developed mild fatty liver, the abnormal values of liver ultrasound quantitative parameters can be detected early. This means that the ultrasound quantitative parameters selected in this study have the potential to detect the correlation between fatty liver and diabetes.

並列關鍵字

Quantitative ultrasound parameter ； Non-alcoholic fatty liver disease ； Diabetes mellitus

參考文獻

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