Assessment of native liver fibrosis using ultrasound elastography and serological fibrosis indices in children with biliary atresia after the Kasai procedure
- Abstract
- Background: Validated non-invasive examinations are necessary to monitor liver fibrosis in children with biliary atresia
(BA) after the Kasai procedure.
Purpose: To evaluate the diagnostic accuracy of two-dimensional shear wave elastography (2D-SWE), transient
elastography (TE), and the serologic biomarkers of aspartate transaminase-to-platelet ratio index (APRI) and
Fibrosis-4 (FIB-4) score for evaluating native liver fibrosis in children with BA.
Material and Methods: We retrospectively reviewed same-day 2D-SWE and TE liver stiffness (LS) measurements of
63 patients with BA who underwent the Kasai procedure. The APRI and FIB-4 score were computed. Hepatic fibrosis
was categorized into three clinical categories based on the ultrasound (US) hepatic morphology and clinical manifestations of liver cirrhosis: I, pre-cirrhotic liver state (n ¼ 15); II, US and/or clinical signs of liver cirrhosis with compensated
liver function (n ¼ 27); and III, liver cirrhosis with decompensated liver function (n ¼ 21). We compared area under the
receiver operating characteristic curve (AUC) data among 2D-SWE, TE, APRI, and FIB-4 score. Combined evaluation of
serologic fibrosis indices and US elastography was conducted and AUCs of combinations were analyzed.
Results: 2D-SWE, TE, APRI, and FIB-4 score showed good to excellent diagnostic accuracy for differentiating clinical
categories (AUCs 0.779?0.955). AUC values were significantly increased after adding TE to FIB-4 score for detecting
liver cirrhosis (P ¼ 0.02).
Conclusion: 2D-SWE, TE, APRI, and FIB-4 score are accurate non-invasive markers for monitoring native liver fibrosis
in patients with BA. Combined use of serologic markers and US elastography could yield more accurate diagnoses of
liver fibrosis than serologic markers alone.
- Author(s)
- 김경모; 김대연; 남궁정만; 오석희; 윤희망; 조영아; 황지선
- Issued Date
- 2021
- Type
- Article
- Keyword
- Biliary atresia; Kasai procedure; elasticity imaging techniques; liver fibrosis; ultrasonography
- DOI
- 10.1177/0284185120948489
- URI
- https://oak.ulsan.ac.kr/handle/2021.oak/7399
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2435530540&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Assessment%20of%20native%20liver%20fibrosis%20using%20ultrasound%20elastography%20and%20serological%20fibrosis%20indices%20in%20children%20with%20biliary%20atresia%20after%20the%20Kasai%20procedure&offset=0&pcAvailability=true
- Publisher
- ACTA RADIOLOGICA
- Location
- 영국
- Language
- 영어
- ISSN
- 0284-1851
- Citation Volume
- 62
- Citation Number
- 8
- Citation Start Page
- 1088
- Citation End Page
- 1096
-
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- Medicine > Medicine
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