Diagnostic Performance of Transient Elastography in Biliary Atresia Among Infants With Cholestasis
Biliary atresia (BA) is a challenging liver disease in infancy. Early diagnosis of BA is important for timely hepatoportoenterostomy. We evaluated the age‐specific diagnostic performance of transient elastography (TE) with a liver stiffness measurement (LSM) greater than 7.7 kPa in BA among infants...
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Online Access: | https://doi.org/10.1002/hep4.1672 |
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doaj-36414b44326b4e47acda7a9dead9417f2021-05-15T09:50:11ZengWileyHepatology Communications2471-254X2021-05-015588289010.1002/hep4.1672Diagnostic Performance of Transient Elastography in Biliary Atresia Among Infants With CholestasisYin‐Ann Boo0Mei‐Hwei Chang1Yung‐Ming Jeng2Shinn‐Forng Peng3Wen‐Ming Hsu4Wen‐Hsi Lin5Huey‐Ling Chen6Yen‐Hsuan Ni7Hong‐Yuan Hsu8Jia‐Feng Wu9Department of Pediatrics National Taiwan University Hospital Taipei TaiwanDepartment of Pediatrics National Taiwan University Hospital Taipei TaiwanDepartment of Pathology National Taiwan University Hospital Taipei TaiwanDepartment of Radiology National Taiwan University Hospital Taipei TaiwanDepartment of Surgery National Taiwan University Hospital Taipei TaiwanDepartment of Surgery National Taiwan University Hospital Taipei TaiwanDepartment of Pediatrics National Taiwan University Hospital Taipei TaiwanDepartment of Pediatrics National Taiwan University Hospital Taipei TaiwanDepartment of Pediatrics National Taiwan University Hospital Taipei TaiwanDepartment of Pediatrics National Taiwan University Hospital Taipei TaiwanBiliary atresia (BA) is a challenging liver disease in infancy. Early diagnosis of BA is important for timely hepatoportoenterostomy. We evaluated the age‐specific diagnostic performance of transient elastography (TE) with a liver stiffness measurement (LSM) greater than 7.7 kPa in BA among infants with cholestasis. A total of 61 infants with cholestasis (5‐121 days of age) were enrolled in this prospective follow‐up study; 15 infants were BA. Four age groups were defined (≤30, 31‐60, 61‐90, and 91‐180 days). Picrosirius red staining was performed to quantify the percentage of collagen fibers in liver specimens. The utility of an LSM greater than 7.7 kPa for diagnosis of BA among infants with cholestasis was compared among age groups. In all four groups, TE showed high diagnostic power for BA using the criterion of an LSM greater than 7.7 kPa. Positive predictive values were 100%, 100%, and 100% in the groups aged 30 days or younger, 31 to 60 days, and 61 to 90 days, respectively. Respective negative predictive values were 90.9%, 94.7%, and 100%, and respective diagnostic accuracies were 92.9%, 95.2%, and 100%. The positive predictive value, negative predictive value, and diagnostic accuracy were 100%, 100%, and 100%, respectively, for LSM greater than 8.8 kPa in the group aged 91 to 180 days. The LSM was positively correlated with the percentage of collagen fibers stained by picrosirius red (P = 0.03). Conclusion: In this prospective follow‐up study, TE had good diagnostic accuracy for differentiation of BA from non‐BA cholestasis in infants with cholestasis who were 90 days of age or younger. The LSM was significantly positive correlated with the liver fibrosis status stained by picrosirius red in infants with cholestasis.https://doi.org/10.1002/hep4.1672 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yin‐Ann Boo Mei‐Hwei Chang Yung‐Ming Jeng Shinn‐Forng Peng Wen‐Ming Hsu Wen‐Hsi Lin Huey‐Ling Chen Yen‐Hsuan Ni Hong‐Yuan Hsu Jia‐Feng Wu |
spellingShingle |
Yin‐Ann Boo Mei‐Hwei Chang Yung‐Ming Jeng Shinn‐Forng Peng Wen‐Ming Hsu Wen‐Hsi Lin Huey‐Ling Chen Yen‐Hsuan Ni Hong‐Yuan Hsu Jia‐Feng Wu Diagnostic Performance of Transient Elastography in Biliary Atresia Among Infants With Cholestasis Hepatology Communications |
author_facet |
Yin‐Ann Boo Mei‐Hwei Chang Yung‐Ming Jeng Shinn‐Forng Peng Wen‐Ming Hsu Wen‐Hsi Lin Huey‐Ling Chen Yen‐Hsuan Ni Hong‐Yuan Hsu Jia‐Feng Wu |
author_sort |
Yin‐Ann Boo |
title |
Diagnostic Performance of Transient Elastography in Biliary Atresia Among Infants With Cholestasis |
title_short |
Diagnostic Performance of Transient Elastography in Biliary Atresia Among Infants With Cholestasis |
title_full |
Diagnostic Performance of Transient Elastography in Biliary Atresia Among Infants With Cholestasis |
title_fullStr |
Diagnostic Performance of Transient Elastography in Biliary Atresia Among Infants With Cholestasis |
title_full_unstemmed |
Diagnostic Performance of Transient Elastography in Biliary Atresia Among Infants With Cholestasis |
title_sort |
diagnostic performance of transient elastography in biliary atresia among infants with cholestasis |
publisher |
Wiley |
series |
Hepatology Communications |
issn |
2471-254X |
publishDate |
2021-05-01 |
description |
Biliary atresia (BA) is a challenging liver disease in infancy. Early diagnosis of BA is important for timely hepatoportoenterostomy. We evaluated the age‐specific diagnostic performance of transient elastography (TE) with a liver stiffness measurement (LSM) greater than 7.7 kPa in BA among infants with cholestasis. A total of 61 infants with cholestasis (5‐121 days of age) were enrolled in this prospective follow‐up study; 15 infants were BA. Four age groups were defined (≤30, 31‐60, 61‐90, and 91‐180 days). Picrosirius red staining was performed to quantify the percentage of collagen fibers in liver specimens. The utility of an LSM greater than 7.7 kPa for diagnosis of BA among infants with cholestasis was compared among age groups. In all four groups, TE showed high diagnostic power for BA using the criterion of an LSM greater than 7.7 kPa. Positive predictive values were 100%, 100%, and 100% in the groups aged 30 days or younger, 31 to 60 days, and 61 to 90 days, respectively. Respective negative predictive values were 90.9%, 94.7%, and 100%, and respective diagnostic accuracies were 92.9%, 95.2%, and 100%. The positive predictive value, negative predictive value, and diagnostic accuracy were 100%, 100%, and 100%, respectively, for LSM greater than 8.8 kPa in the group aged 91 to 180 days. The LSM was positively correlated with the percentage of collagen fibers stained by picrosirius red (P = 0.03). Conclusion: In this prospective follow‐up study, TE had good diagnostic accuracy for differentiation of BA from non‐BA cholestasis in infants with cholestasis who were 90 days of age or younger. The LSM was significantly positive correlated with the liver fibrosis status stained by picrosirius red in infants with cholestasis. |
url |
https://doi.org/10.1002/hep4.1672 |
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