Hirofumi Tomita1,2, Kiyoshi Ohkuma3, Yohei Masugi4, Naoki Hosoe5, Ken Hoshino6, Yasushi Fuchimoto7, Akihiro Fujino6, Takahiro Shimizu6, Mototoshi Kato6, Takumi Fujimura6, Hideo Ishihama6, Nobuhiro Takahashi6, Yutaka Tanami3, Hirotoshi Ebinuma8, Hidetsugu Saito8, Michiie Sakamoto4, Miwako Nakano9, Tatsuo Kuroda6. 1. Department of Pediatric Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku,, Tokyo, 160-8582, Japan. htomita@a3.keio.jp. 2. Department of Pediatric Surgery, Saitama City Hospital, 2460 Mimuro, Midori-ku,, Saitama-shi, 336-8522, Japan. htomita@a3.keio.jp. 3. Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku,, Tokyo, 160-8582, Japan. 4. Department of Pathology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku,, Tokyo, 160-8582, Japan. 5. Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku,, Tokyo, 160-8582, Japan. 6. Department of Pediatric Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku,, Tokyo, 160-8582, Japan. 7. Division of Surgery, Department of Surgical Subspecialties, National Center for Child Health and Development, 2-10-1 Okura Setagaya-ku, Tokyo, 157-8535, Japan. 8. Department of Internal Medicine, Saitama City Hospital, 35 Shinanomachi, Shinjuku-ku,, Tokyo, 160-8582, Japan. 9. Department of Pediatric Surgery, Saitama City Hospital, 2460 Mimuro, Midori-ku,, Saitama-shi, 336-8522, Japan.
Abstract
BACKGROUND: Biliary atresia commonly leads to liver fibrosis and cirrhotic complications, including esophageal varices. OBJECTIVE: To evaluate liver and spleen stiffness measurements using acoustic radiation force impulse (ARFI) imaging for diagnosing grade of liver fibrosis and predicting the presence of esophageal varices in patients treated for biliary atresia. MATERIALS AND METHODS: ARFI imaging of the spleen and native liver was performed in 28 patients with biliary atresia. We studied the relation between ARFI imaging values and liver histology findings (n=22), upper gastrointestinal endoscopy findings (n=16) and several noninvasive test results. Diagnostic accuracy was assessed using receiver operating characteristic curve analyses. RESULTS: Liver stiffness measurements exhibited a significant difference among the different grades of liver fibrosis (P=0.009), and showed higher values in patients with high-risk esophageal varices than in the other patients (P=0.04). The areas under the receiver operating characteristic curves of liver stiffness measurements for liver fibrosis grades ≥ F2, ≥F3 and = F4 were 0.83, 0.93 and 0.94, respectively. Patients with high-risk esophageal varices were preferentially diagnosed by the combined liver and spleen stiffness measurements (area under the curve, 0.92). CONCLUSION: Liver and spleen stiffness measurements using ARFI imaging are potential noninvasive markers for liver fibrosis and esophageal varices in patients treated for biliary atresia.
BACKGROUND:Biliary atresia commonly leads to liver fibrosis and cirrhotic complications, including esophageal varices. OBJECTIVE: To evaluate liver and spleen stiffness measurements using acoustic radiation force impulse (ARFI) imaging for diagnosing grade of liver fibrosis and predicting the presence of esophageal varices in patients treated for biliary atresia. MATERIALS AND METHODS: ARFI imaging of the spleen and native liver was performed in 28 patients with biliary atresia. We studied the relation between ARFI imaging values and liver histology findings (n=22), upper gastrointestinal endoscopy findings (n=16) and several noninvasive test results. Diagnostic accuracy was assessed using receiver operating characteristic curve analyses. RESULTS:Liver stiffness measurements exhibited a significant difference among the different grades of liver fibrosis (P=0.009), and showed higher values in patients with high-risk esophageal varices than in the other patients (P=0.04). The areas under the receiver operating characteristic curves of liver stiffness measurements for liver fibrosis grades ≥ F2, ≥F3 and = F4 were 0.83, 0.93 and 0.94, respectively. Patients with high-risk esophageal varices were preferentially diagnosed by the combined liver and spleen stiffness measurements (area under the curve, 0.92). CONCLUSION: Liver and spleen stiffness measurements using ARFI imaging are potential noninvasive markers for liver fibrosis and esophageal varices in patients treated for biliary atresia.
Authors: Mireen Friedrich-Rust; Katrin Wunder; Susanne Kriener; Fariba Sotoudeh; Swantje Richter; Joerg Bojunga; Eva Herrmann; Thierry Poynard; Christoph F Dietrich; Johannes Vermehren; Stefan Zeuzem; Christoph Sarrazin Journal: Radiology Date: 2009-08 Impact factor: 11.105
Authors: Ellen S Wagner; Hussien Ahmed H Abdelgawad; Meghan Landry; Belal Asfour; Mark B Slidell; Ruba Azzam Journal: World J Gastroenterol Date: 2022-08-28 Impact factor: 5.374