ObjectiveTo evaluate the application value of imaging techniques in the noninvasive diagnosis of metabolic dysfunction-associated fatty liver disease (MAFLD), with a view to providing a reference basis for early screening and precise diagnosis and treatment. MethodsThe literature on research progress of ultrasound, CT, MRI, and other imaging techniques in the diagnosis of MAFLD in recent years was reviewed. And the advantages, limitations, and clinical application prospects of different methods were analyzed. ResultsThe core of MAFLD diagnosis lies in the early noninvasive assessment of hepatic steatosis and fibrosis. Current imaging techniques such as ultrasound, CT, and MRI are used in the diagnosis of MAFLD. Ultrasound is convenient and cost-effective, but its accuracy is operator-dependent; CT can quantify liver fat content, but carries radiation risks; MRI-derived proton density fat fraction is currently the reference standard for noninvasive diagnosis, offering high accuracy, yet it is more costly and has limited accessibility. Emerging technologies like artificial intelligence-assisted image analysis can improve diagnostic performance, but their clinical utility still requires further validation. ConclusionsCurrent imaging techniques such as ultrasound, CT, and MRI play significant roles in the noninvasive diagnosis of MAFLD, with each method having its own advantages. Clinical selection should consider accuracy, accessibility, and economic factors. Future research should focus on optimizing existing technologies, exploring multimodal imaging integration, and developing artificial intelligence assisted diagnostics to enhance early detection rate and guide personalized treatment.
Objective To explore the impact of metabolic dysfunction-associated fatty liver disease (MAFLD) on the achievement of textbook outcome (TO) of patients with hepatocellular carcinoma (HCC) after hepatectomy, and to identify the risk factors affecting the achievement of TO of HCC patients after hepatectomy. MethodsThe data of patients with Barcelona Clinic Liver Cancer stage 0/A HCC who received primary hepatectomy at our center from 2014 to 2022 were retrospectively reviewed. Patients were divided into the MAFLD group and the non-MAFLD group based on whether coexisting MAFLD. Propensity score matching (PSM) was used to balance the baseline characteristics of the two groups. The achievement of TO and its seven items before and after PSM was compared between the two groups. Logistic regression was applied to analyze the independent risk factors affecting the achievement of TO based the total population. ResultsA total of 2 301 patients were included in this study. After PSM, 299 patients in each group were included in the analysis. After PSM, the TO achievement rate in the MAFLD group was 63.5% (190/299), which was significantly poor than that in the non-MAFLD group [71.6% (214/299)], χ2=4.395, P=0.036. Among the seven items of TO, the proportion of prolonged hospital stay in the MAFLD group was 29.4% (88/299), while that in the non-MAFLD group was 21.1% (63/299), the difference was statistically significant (χ2=5.537, P=0.019). The rates of ≥ Clavien-Dindo grade 3 complications within 30 days, perioperative blood transfusion, mortality within 90 days after surgery, readmission within 30 days after discharge, conversion from laparoscopic to open hepatectomy, and R0 resection rate were similar between the two groups (P>0.05). Multivariate logistic regression analysis confirmed that tumor diameter>5 cm [OR=1.539, 95%CI (1.264, 1.874), P<0.001], albumin-bilirubin grade 2 [OR=1.941, 95%CI (1.588, 2.372), P<0.001], FIB-4>3.25 [OR=1.545, 95%CI (1.273, 1.875), P<0.001], Barcelona Clinic Liver Cancer stage A [OR=1.696, 95%CI (1.132, 2.542), P=0.010], major hepatectomy [OR=1.431, 95%CI (1.178, 1.738), P<0.001], and MAFLD [OR=1.549, 95%CI (1.188, 2.019), P=0.001] were independent risk factors affecting the achievement of TO, but laparoscopic hepatectomy [OR=0.629, 95%CI (0.503, 0.786), P<0.001] was a protective factor for achieving TO. ConclusionHCC patients coexisting MAFLD have a higher incidence of prolonged hospital stay after hepatectomy and are less likely to achieve TO.