Objective:

To explore the diagnostic performance of ultrasound attenuation imaging (ATI) in assessing the severity of hepatic steatosis using pathohistology as the gold standard.

Methods:

Ninety-seven patients with hepatic steatosis were prospectivelycollected from September 2020 to June 2022

including 56 male and 41 female patients. The stability and differences of ATI measurements in patients with different steatosis grades were analyzed. Multiple linear regression was used to analyze the factors affecting the ATI measurements. The receiver operating characteristic (ROC) curves were used to assess the diagnostic performance of ATI measurements in diagnosis of hepatic steatosis.

Results:

The analysis found that the intra-class correlation coefficient (ICC) of patients with different pathological grades of hepatic steatosis exceeded 0.90. Significant differences were found in ATI measurement between different groups (

P

＜0.05)

but there was no significant difference between S2 and S3 in ATI measurements (

P

＞0.05). Pearson correlation analysis showed a significant positive correlation between ATI measurement and pathological steatosis (

r

=0.75

P

＜0.01)

and multiple regression analysis found that the degree of liver steatosis was an independent influencing factor of ATI measurement (

b

=0.13

t

=9.12

P

＜0.001). Taking pathological results as the gold standard

the area under the ROC curve (AUC) of ATI assessing the degree of hepatic steatosis of more than S1

S2 and S3 was 0.966 (95% CI 0.895-0.987)

0.931 (95% CI 0.876- 0.978)

0.708 (95% CI 0.655-0.818)

respectively.

Conclusion:

The degree of hepatic steatosis was an independent factor influencing the ATI measurement. The ATI technique showed good diagnostic performance in the evaluation of hepatic steatosis

especially for lower levels of hepatic steatosis.