Transient elastography is a useful noninvasive tool for the evaluation of fibrosis in paediatric chronic liver disease.
Background: Outcome of liver disease in children is mainly determined by severity and progression of liver fibrosis. Liver biopsy is the accepted standard for evaluating fibrosis but is limited by the need for sedation in children, sampling error, and risks including bleeding. The aim of the present...
| Publicado en: | Journal of Pediatric Gastroenterology & Nutrition Vol. 56; no. 1; pp. 72 - 77 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
2013 Jan
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107985361&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 107985361 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02772116 N1F jtl: Journal of Pediatric Gastroenterology & Nutrition issn: 02772116 maglogo: N pubinfo: dt: 2013 Jan vid: 56 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 107985361 107985361 NLM22922372 2012017956 10.1097/MPG.0b013e31826f2760 NLM22922372 107985361 ppf: 72 ppct: 5 formats: tig: atl: Transient elastography is a useful noninvasive tool for the evaluation of fibrosis in paediatric chronic liver disease. aug: au: Fitzpatrick, Emer Quaglia, Alberto Vimalesvaran, Sunitha Basso, Maria Sole Dhawan, Anil affil: Paediatric Liver, GI and Nutrition Centre, King's College London School of Medicine at King's College Hospital, London, UK. sug: subj: Ultrasonography Methods Liver Pathology Liver Cirrhosis Ultrasonography Liver Diseases Pathology Adolescence Pharmacokinetics Autoimmune Diseases Pathology Autoimmune Diseases Ultrasonography Biopsy Adverse Effects Child Chronic Disease Fatty Liver Pathology Fatty Liver Ultrasonography Female Hepatitis Pathology Hepatitis Ultrasonography Hepatolenticular Degeneration Pathology Hepatolenticular Degeneration Ultrasonography Human Liver Ultrasonography Liver Cirrhosis Etiology Liver Diseases Ultrasonography Liver Transplantation Male ROC Curve Adolescent: 13-18 years Child: 6-12 years Female Male ab: Background: Outcome of liver disease in children is mainly determined by severity and progression of liver fibrosis. Liver biopsy is the accepted standard for evaluating fibrosis but is limited by the need for sedation in children, sampling error, and risks including bleeding. The aim of the present study was to compare tools for noninvasive assessment of liver fibrosis in a paediatric cohort. Methods: Children undergoing liver biopsy for chronic liver disease were recruited and underwent transient elastography (TE). Liver biopsies were scored by a hepatohistopathologist from F0 (no fibrosis) to F4 (cirrhosis). TE was compared with biopsy score. Results: During the study period, 104 children (62 boys) were enrolled (median age 13.6 years). Diagnosis was autoimmune liver disease in 27; nonalcoholic fatty liver disease in 37; posttransplant in 16; hepatitis B/C in 8; Wilson disease in 5; and the remainder, miscellaneous. TE was successful in all but 7 patients and was a good discriminator of significant fibrosis (≥ F2) (P < 0.001), severe fibrosis (≥ F3) (P < 0.001), and cirrhosis (F4) (P = 0.003). The area under the receiver operating characteristic curve for the prediction of ≥ F2, ≥ F3, and F4 using TE was 0.78, 0.79, and 0.96, respectively. TE performed best in children with autoimmune liver disease and in those posttransplant. Conclusions: The present study demonstrates that TE is a reliable tool in distinguishing different stages of liver fibrosis in paediatric patients. Thus, TE may serve as a useful adjunct to liver biopsy for diagnostic purposes providing a reliable method of noninvasively monitoring liver disease progression in children. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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