Transient elastography correlated to four different histological fibrosis scores in children with liver disease.

Currently, liver histology is the gold standard for the detection of liver fibrosis. In recent years, new methods such as transient elastography (TE) have been introduced into clinical practice, which allow a non-invasive assessment of liver fibrosis. The aim of the present study was to investigate...

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Publicado en:European Journal of Pediatrics Vol. 180; no. 7; pp. 2237 - 2245
Autores principales: Teufel-Schäfer, Ulrike, Flechtenmacher, Christa, Fichtner, Alexander, Hoffmann, Georg Friedrich, Schenk, Jens Peter, Engelmann, Guido
Formato: Journal Article
Publicado: Springer Nature Jul2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2021
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00431-021-04001-6
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        atl: Transient elastography correlated to four different histological fibrosis scores in children with liver disease.
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        au:
          Teufel-Schäfer, Ulrike
          Flechtenmacher, Christa
          Fichtner, Alexander
          Hoffmann, Georg Friedrich
          Schenk, Jens Peter
          Engelmann, Guido
        affil: Department of General Pediatrics, Adolescent Medicine and Neonatology, Faculty of Medicine, Medical Center, University of Freiburg, Mathildenstr. 1, 79106, Freiburg, Germany
      sug:
        subj:
          Ultrasonography
          Liver Diseases
          Liver Cirrhosis
          Biopsy
          ROC Curve
          Child
          Liver Cirrhosis Pathology
          Aspartate Aminotransferase
          Liver
          Adult
          Liver Pathology
          Scales
          Child: 6-12 years
          Adult: 19-44 years
      ab: Currently, liver histology is the gold standard for the detection of liver fibrosis. In recent years, new methods such as transient elastography (TE) have been introduced into clinical practice, which allow a non-invasive assessment of liver fibrosis. The aim of the present study was to investigate the predictive value of TE for higher grade fibrosis and whether there is any relevance which histologic score is used for matching. For this purpose, we compared TE with 4 different histologic scores in pediatric patients with hepatopathies. Furthermore, we also determined the aspartate aminotransferase-to-platelet ratio (APRI) score, another non-invasive method, to investigate whether it is equally informative. Therefore, liver fibrosis in 75 children was evaluated by liver biopsy, TE and laboratory values. Liver biopsies were evaluated using four common histological scoring systems (Desmet, Metavir, Ishak and Chevalier's semi-quantitative scoring system). The median age of the patients was 12.3 years. TE showed a good correlation to the degree of fibrosis severity independent of the histological scoring system used. The accuracy of the TE to distinguish between no/minimal fibrosis and severe fibrosis/cirrhosis was good (p = 0.001, AUC-ROCs > 0.81). The optimal cut-off value for the prediction of severe fibrosis was 10.6 kPa. In contrast, the APRI score in our collective showed no correlation to fibrosis.Conclusion: TE shows a good correlation to the histological findings in children with hepatopathy, independent of the used histological scoring system. What is Known: • The current gold standard for detecting liver fibrosis is liver biopsy. Novel non-invasive ultrasound-based methods are introduced to clinical diagnostics. • Most histological scores have been developed and evaluated in adult populations and for only one specific liver disease. What is New: • Transient elastography (TE) in children showed a good correlation to fibrosis severity irrespective of the utilized histological scoring system. • The aspartate aminotransferase-to-platelet ratio (APRI) showed no correlation with different stages of liver fibrosis in children.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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