Diagnosis of Liver Cirrhosis with Two-dimensional Shear Wave Elastography in Biliary Atresia Before Kasai Portoenterostomy

Overview

Journal Pediatr Surg Int

Specialties General Surgery
Pediatrics

Date 2021 Dec 1

PMID 34850287

Citations 6

Authors

CaiLin Ding

Zengmeng Wang

Chunhui Peng

Wenbo Pang

Sarah Siyin Tan

Yajun Chen

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the application value of two-dimensional shear wave elastography (2D-SWE) for non-invasive diagnosis of liver cirrhosis (LC) in patients with biliary atresia (BA) before Kasai portoenterostomy (KP), and the cutoff value of liver stiffness measurement (LSM) for diagnosing LC.

Methods: The clinical data of 51 patients with BA who were diagnosed via surgery and pathological results from May 2017 to December 2018 in the department of general surgery, Beijing Children's Hospital, Capital Medical University, were retrospectively analyzed. The liver tissue specimens obtained during KP were evaluated according to the METAVIR criteria. The LSM was obtained using the 2D-SWE technique before KP.

Results: There was a grade positive correlation between LSM and METAVIR staging, and the Spearman correlation coefficient was 0.432 (P = 0.002). The AUC for 2D-SWE diagnosing LC (METAVIR score S = 4) in patients with BA before KP was 0.843 (95% confidence interval 0.736 ~ 0.950). The best cutoff value was 16.05 kPa, and the corresponding sensitivity was 75.0%, specificity was 83.7%, positive predictive value (PPV) was 46.1%, negative predictive value (NPV) was 94.7%, and the accuracy was 82.4%.

Conclusion: 2D-SWE can be used to noninvasively diagnose LC in patients with BA before KP, and the cutoff value is 16.05 kPa.

Citing Articles

Assessment of the utility of two-dimensional shear wave elastography and superb microvascular imaging in postoperative patients with biliary atresia.

Oita S, Toma M, Hirono K, Masuko T, Shimizu T, Shimizu S Pediatr Surg Int. 2024; 40(1):219.

PMID: 39115726 DOI: 10.1007/s00383-024-05804-y.

Shear wave elastography as a non-invasive tool for staging liver fibrosis in children: A study in Algerian pediatric patients.

Bicha S, Boumaraf H, Lakehal A Indian J Gastroenterol. 2023; 43(3):601-608.

PMID: 37962819 DOI: 10.1007/s12664-023-01464-3.

Performance of two-dimensional shear wave elastography for detecting advanced liver fibrosis and cirrhosis in patients with biliary atresia: a systematic review and meta-analysis.

Dong B, Duan Y, Wang H, Chen Y, Lyu G Pediatr Radiol. 2023; 53(13):2642-2650.

PMID: 37917168 DOI: 10.1007/s00247-023-05796-2.

Predictive value of liver and spleen stiffness measurement based on two-dimensional shear wave elastography for the portal vein pressure in patients with compensatory viral cirrhosis.

Wang P, Hu X, Xie F PeerJ. 2023; 11:e15956.

PMID: 37727690 PMC: 10506585. DOI: 10.7717/peerj.15956.

Pre- and Immediate Post-Kasai Portoenterostomy Shear Wave Elastography for Predicting Hepatic Fibrosis and Native Liver Outcomes in Patients With Biliary Atresia.

Yoon H, Ihn K, Kim J, Lim H, Park S, Han S Korean J Radiol. 2023; 24(5):465-475.

PMID: 37056157 PMC: 10157319. DOI: 10.3348/kjr.2022.0586.

References

Hartley J, Davenport M, Kelly D . Biliary atresia. Lancet. 2009; 374(9702):1704-13. DOI: 10.1016/S0140-6736(09)60946-6. View

Weerasooriya V, White F, Shepherd R . Hepatic fibrosis and survival in biliary atresia. J Pediatr. 2004; 144(1):123-5. DOI: 10.1016/j.jpeds.2003.09.042. View

Wang G, Chen H, Xie X, Cao Q, Liao B, Jiang H . 2D shear wave elastography combined with age and serum biomarkers prior to kasai surgery predicts native liver survival of biliary atresia infants. J Intern Med. 2020; 288(5):570-580. DOI: 10.1111/joim.13097. View

Shiha G, Ibrahim A, Helmy A, Sarin S, Omata M, Kumar A . Asian-Pacific Association for the Study of the Liver (APASL) consensus guidelines on invasive and non-invasive assessment of hepatic fibrosis: a 2016 update. Hepatol Int. 2016; 11(1):1-30. DOI: 10.1007/s12072-016-9760-3. View

Dardanelli E, Orozco M, Lostra J, Laprida C, Lulkin S, Bosaleh A . Bidimensional shear-wave elastography for assessing liver fibrosis in children: a proposal of reference values that correlate with the histopathological Knodell-Ishak score. Pediatr Radiol. 2020; 50(6):817-826. DOI: 10.1007/s00247-020-04632-1. View

Xiao G, Zhu S, Xiao X, Yan L, Yang J, Wu G . Comparison of laboratory tests, ultrasound, or magnetic resonance elastography to detect fibrosis in patients with nonalcoholic fatty liver disease: A meta-analysis. Hepatology. 2017; 66(5):1486-1501. DOI: 10.1002/hep.29302. View

Cassinotto C, Lapuyade B, Mouries A, Hiriart J, Vergniol J, Gaye D . Non-invasive assessment of liver fibrosis with impulse elastography: comparison of Supersonic Shear Imaging with ARFI and FibroScan®. J Hepatol. 2014; 61(3):550-7. DOI: 10.1016/j.jhep.2014.04.044. View

Yao T, Pan J, Qian J, Cheng H, Wang Y, Wang G . Shear wave elastography may be sensitive and more precise than transient elastography in predicting significant fibrosis. World J Clin Cases. 2020; 8(17):3730-3742. PMC: 7479564. DOI: 10.12998/wjcc.v8.i17.3730. View

Herrmann E, de Ledinghen V, Cassinotto C, Chu W, Leung V, Ferraioli G . Assessment of biopsy-proven liver fibrosis by two-dimensional shear wave elastography: An individual patient data-based meta-analysis. Hepatology. 2017; 67(1):260-272. PMC: 5765493. DOI: 10.1002/hep.29179. View

10.

Ye J, Wang W, Feng S, Huang Y, Liao X, Kuang M . Precise fibrosis staging with shear wave elastography in chronic hepatitis B depends on liver inflammation and steatosis. Hepatol Int. 2020; 14(2):190-201. DOI: 10.1007/s12072-020-10017-1. View

11.

Kim J, Suh C, Yoon H, Lee J, Cho Y, Jung A . The diagnostic performance of shear-wave elastography for liver fibrosis in children and adolescents: A systematic review and diagnostic meta-analysis. Eur Radiol. 2017; 28(3):1175-1186. DOI: 10.1007/s00330-017-5078-3. View

12.

Franchi-Abella S, Corno L, Gonzales E, Antoni G, Fabre M, Ducot B . Feasibility and Diagnostic Accuracy of Supersonic Shear-Wave Elastography for the Assessment of Liver Stiffness and Liver Fibrosis in Children: A Pilot Study of 96 Patients. Radiology. 2015; 278(2):554-62. DOI: 10.1148/radiol.2015142815. View

13.

Liu S, Wan C, Li H, Chen W, Pan C . Diffusion Tensor Imaging of the Lateral Pterygoid Muscle in Patients with Temporomandibular Joint Disorders and Healthy Volunteers. Korean J Radiol. 2021; 23(2):218-225. PMC: 8814700. DOI: 10.3348/kjr.2021.0132. View

14.

Chen S, Liao B, Zhong Z, Zheng Y, Liu B, Shan Q . Supersonic shearwave elastography in the assessment of liver fibrosis for postoperative patients with biliary atresia. Sci Rep. 2016; 6:31057. PMC: 4980634. DOI: 10.1038/srep31057. View

15.

Hwang J, Yoon H, Kim K, Oh S, Namgoong J, Kim D . Assessment of native liver fibrosis using ultrasound elastography and serological fibrosis indices in children with biliary atresia after the Kasai procedure. Acta Radiol. 2020; 62(8):1088-1096. DOI: 10.1177/0284185120948489. View

16.

Boursier J, de Ledinghen V, Poynard T, Guechot J, Carrat F, Leroy V . An extension of STARD statements for reporting diagnostic accuracy studies on liver fibrosis tests: the Liver-FibroSTARD standards. J Hepatol. 2014; 62(4):807-15. DOI: 10.1016/j.jhep.2014.10.042. View

17.

Wang X, Qian L, Jia L, Bellah R, Wang N, Xin Y . Utility of Shear Wave Elastography for Differentiating Biliary Atresia From Infantile Hepatitis Syndrome. J Ultrasound Med. 2016; 35(7):1475-9. DOI: 10.7863/ultra.15.08031. View

18.

Yuan W, Yu Q, Wang Z, Huang J, Wang J, Long L . Efficacy of Diffusion-Weighted Imaging in Neoadjuvant Chemotherapy for Osteosarcoma: A Systematic Review and Meta-Analysis. Acad Radiol. 2021; 29(2):326-334. DOI: 10.1016/j.acra.2020.11.013. View

19.

El-Araby H, Saber M, Radwan N, Taie D, Adawy N, Sira A . Temporal histopathological changes in biliary atresia: A perspective for rapid fibrosis progression. Ann Hepatol. 2020; 21:100263. DOI: 10.1016/j.aohep.2020.09.007. View

20.

Hukkinen M, Lohi J, Heikkila P, Kivisaari R, Jahnukainen T, Jalanko H . Noninvasive Evaluation of Liver Fibrosis and Portal Hypertension After Successful Portoenterostomy for Biliary Atresia. Hepatol Commun. 2019; 3(3):382-391. PMC: 6396371. DOI: 10.1002/hep4.1306. View