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Assessment of native liver fibrosis using ultrasound elastography and serological fibrosis indices in children with biliary atresia after the Kasai procedure

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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)
김경모김대연남궁정만오석희윤희망조영아황지선
Issued Date
2021
Type
Article
Keyword
Biliary atresiaKasai procedureelasticity imaging techniquesliver fibrosisultrasonography
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
Appears in Collections:
Medicine > Medicine
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