Shear wave elastography correlates with liver fibrosis scores in pediatric patients with liver disease.
Background: While liver biopsy remains the gold standard, given the procedure risks and sampling errors, there is a need for reliable noninvasive biomarkers of hepatic fibrosis.Objective: Determine the accuracy of two-dimensional shear wave elastography (2-D SWE) in predicting the histological sever...
| Publicado en: | Pediatric Radiology Vol. 49; no. 13; pp. 1742 - 1754 |
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| Autores principales: | , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Dec2019
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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=139745165&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 139745165 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03010449 O03 jtl: Pediatric Radiology issn: 03010449 maglogo: N pubinfo: dt: Dec2019 vid: 49 iid: 13 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 139745165 139745165 NLM31418057 10.1007/s00247-019-04493-3 NLM31418057 139745165 ppf: 1742 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Shear wave elastography correlates with liver fibrosis scores in pediatric patients with liver disease. aug: au: Farmakis, Shannon G. Buchanan, Paula M. Guzman, Miguel A. Hardy, Anna K. Jain, Ajay K. Teckman, Jeffrey H. affil: Department of Radiology, SSM Health Cardinal Glennon Children's Hospital and St. Louis University School of Medicine, 3635 Vista Avenue at Grand Boulevard, 63110, St. Louis, MO, USA sug: subj: Liver Cirrhosis Pathology Liver Diseases Ultrasonography Methods Liver Cirrhosis Liver Diseases Pathology Confidence Intervals Case Control Studies Child Reference Values Biopsy, Needle Predictive Value of Tests Retrospective Design Female ROC Curve Severity of Illness Indices Child, Preschool Adolescence Nonparametric Statistics Risk Assessment Immunohistochemistry Prognosis Scales Child: 6-12 years Child, Preschool: 2-5 years Adolescent: 13-18 years Female ab: Background: While liver biopsy remains the gold standard, given the procedure risks and sampling errors, there is a need for reliable noninvasive biomarkers of hepatic fibrosis.Objective: Determine the accuracy of two-dimensional shear wave elastography (2-D SWE) in predicting the histological severity of liver fibrosis in pediatric patients with known or suspected liver disease.Materials and Methods: Subjects 0-18 years old with known or suspected liver disease and liver biopsy within 30 days (n=70) were included. Comparisons by 2-D SWE were made to a control group (n=79). Two-dimensional SWE was performed using the GE LOGIQ E9 system. Liver biopsy specimens were scored according to METAVIR and Ishak scoring systems using Spearman's Rho correlation. Receiver operator characteristic (ROC) analysis, Kruskal-Wallis and Mann-Whitney U tests were conducted.Results: Control group median 2-D SWE measurements were lower than in subjects with any degree of liver fibrosis (P<0.001). Those with METAVIR F0 and Ishak 0 scores had significantly lower median 2-D SWE measurements (1.35 m/s; 1.36 m/s) than those with more advanced liver disease (F1-F3: 1.49-1.62 m/s; 1-4: 1.45-1.63 m/s) (P<0.05 for all), whereas the 2-D SWE in the higher scores were similar. Results did not differ between METAVIR and Ishak scores for any degree of fibrosis. Fibrosis scores moderately correlated with median 2-D SWE measurements (rs=0.43). The area under the curve for F1 compared to combined control/F0 was 0.89 (95% confidence interval [CI] 0.83-0.95; P<0.001) with sensitivity of 94.6% and specificity of 78.6%. Results for Ishak score 1 were similar. The ideal cutoff value for identifying fibrosis was determined to be 1.29 m/s.Conclusion: The liver 2-D SWE measurements correlated with the histological liver fibrosis scores, regardless of the histopathological scoring system, although 2-D SWE was better at identifying patients with early fibrosis, not at distinguishing among the individual fibrosis levels. Two-dimensional SWE using the GE LOGIQ US system is useful for identifying pediatric patients at risk for liver fibrosis. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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