Objective To investigate the clinical utility of two non-invasive quantitative ultrasound techniques ultrasonic attenuation coefficient (ATT) and shear wave elastography (SWE)for evaluating liver reserve function in patients with Wilson′s disease (WD).

Methods A total of 166 WD patients were enrolled as the study subjects.Data extracted from electronic medical records were retrospectively analyzed, including demographic data, ultrasound findings, liver function tests, copper metabolism parameters, and four serum markers of hepatic fibrosis.The albumin-bilirubin (ALBI) score was calculated for each patient.Subjects were divided into two groups based on ALBI grade: ALBI grade < 2 and ALBI grade ≥2.Binary logistic regression analysis was performed to identify independent factors associated with ALBI grade ≥2 (indicating impaired liver reserve function) in WD patients.Additionally, the relationships between ATT, SWE, and liver reserve function in WD were analyzed.

Results Univariate analysis of liver reserve function in WD patients showed that age, type Ⅳ collagen, hyaluronic acid, laminin, portal vein flow velocity, and SWE were associated with ALBI grade ≥2 (P < 0.05 to P < 0.01), while no statistically significant difference was observed in ATT (P>0.05).Multivariate analysis revealed that portal vein flow velocity (OR=0.828, 95%CI: 0.742-0.924) and SWE (OR=12.245, 95%CI: 3.528-41.806) were independent factors for ALBI grade ≥2.ROC curve analysis showed that the area under the curve of SWE for diagnosing ALBI grade ≥2 in WD patients was 0.85 (95%CI: 0.780-0.900, P < 0.01), with an optimal cutoff value of 1.84 m/s, a sensitivity of 0.81, and a specificity of 0.77.

Conclusions ATT shows limited value in evaluating liver reserve function in WD patients.SWE correlates closely with ALBI score and may serve as a reliable non-invasive indicator for assessing liver reserve function in this population.