Hepato-Renal Index measurements showed high reliability for pediatric MAFLD diagnosis, with excellent agreement across imaging planes (ICC=0.84), devices (ICC=0.95), and operators (ICC=0.80-0.92).
The Hepato-Renal Index demonstrates high stability and reproducibility across ultrasound platforms and operators, supporting its use in the early diagnosis of pediatric metabolic dysfunction-associated fatty liver disease.
Absolute Event Rate: 0% vs 0%
ABSTRACT Objective To quantitatively evaluate the agreement of the HRI measurements. Materials and Methods In 2024, 307 children underwent ultrasonography by an experienced sonographer (> 5 years). ICC assessed reproducibility between longitudinal (HRI L ) / transverse (HRI T ) planes, devices, and intra‐operator measurements. Inter‐operator reproducibility was determined by a junior sonographer in 40 children; systematic bias was quantified by Bland–Altman analysis. Results HRI measurements demonstrated high reliability: among 307 subjects, HRI L (1.39 ± 0.55) and HRI T (1.36 ± 0.67) showed no significant difference ( t = 1.29, p = 0.20; ICC = 0.84, 95% CI 0.80–0.87); in 70 subjects using different ultrasound systems, HRI (1.68 ± 0.64, 1.69 ± 0.64, 1.71 ± 0.74) exhibited no inter‐device variation ( H = 0.31, p = 0.86; ICC = 0.95, 95% CI 0.93–0.97). Intra‐operator reproducibility was consistent for Operator 1 (baseline: 1.54 ± 0.65 vs. 2‐week: 1.54 ± 0.56; t = −0.01, p = 0.99; ICC = 0.92, 95% CI 0.84–0.96) and Operator 2 (1.27 ± 0.50 vs. 1.30 ± 0.50; t = −0.62, p = 0.53; ICC = 0.86, 95% CI 0.75–0.92). Inter‐operator analyses agreed between Operator 2 baseline (1.27 ± 0.50) and Operator 1 baseline (1.31 ± 0.61; t = 0.72, p = 0.48; ICC = 0.80, 95% CI 0.65–0.89), and Operator 2 2‐week (1.30 ± 0.50) and Operator 1 baseline ( t = 0.30, p = 0.77; ICC = 0.86, 95% CI 0.75–0.92). Measurement frequency assessments revealed consistency for Operator 1 baseline (first‐three: 1.55 ± 0.58 vs. five: 1.54 ± 0.65; t = −0.18, p = 0.86; ICC = 0.91, 95% CI 0.83–0.95), Operator 2 baseline (1.19 ± 0.54 vs. 1.27 ± 0.50; t = 1.74, p = 0.09; ICC = 0.84, 95% CI 0.71–0.91), and Operator 2 2‐week (1.31 ± 0.60 vs. 1.30 ± 0.50; t = −0.27, p = 0.79; ICC = 0.87, 95% CI 0.77–0.93). Conclusion HRI demonstrates high stability and reproducibility across platforms, supporting MAFLD early diagnosis.
Yuan et al. (Thu,) reported a other. Hepato-Renal Index measurements showed high reliability for pediatric MAFLD diagnosis, with excellent agreement across imaging planes (ICC=0.84), devices (ICC=0.95), and operators (ICC=0.80-0.92).