Transient elastography and sonography for prediction of liver fibrosis in infants with biliary atresia.
OBJECTIVE
The purpose of this study was to assess the diagnostic performance of transient elastography and sonography for noninvasive evaluation of liver fibrosis in infants with biliary atresia.


METHODS
Forty-seven infants with biliary atresia who underwent both transient elastography and sonography before surgery were included in this study. Two types of transient elastographic probes were used: an M probe, which is used for the general adult population; and an S probe, which is specific to children. Transient elastographic measurements and sonographic findings such as triangular cord thickness and hepatic artery and portal vein diameters were compared with the METAVIR histopathologic fibrosis scoring system.


RESULTS
Only transient elastography (ρ = 0.63; P < .001) was significantly correlated with METAVIR fibrosis stages. The areas under the receiver operating characteristic curves for transient elastography were 0.86 and 0.96 for diagnosis of severe fibrosis and cirrhosis, respectively. The cutoff value of transient elastography for diagnosis of severe fibrosis was greater than 9.6 kPa, with sensitivity of 89.5% and specificity of 75%. The cutoff value of transient elastography for diagnosis of cirrhosis was greater than 18.1 kPa, with sensitivity of 100% and specificity of 90.5%. The success rate for the S probe (100%) was significantly higher than that for the M probe (77%; P < .001).


CONCLUSIONS
Transient elastography may be a useful noninvasive method for diagnosis of severe fibrosis and cirrhosis and may help predict outcomes before surgery or invasive liver biopsy in infants with biliary atresia. The success rate of transient elastography in infants was improved by using the S probe.
Department of Radiology, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-ku, Seoul 120-752, Korea. mjkim@yuhs.ac.
Na-Young
NY
Shin
Myung-Joon
MJ
Kim
Mi-Jung
MJ
Lee
Seok Joo
SJ
Han
Hong
H
Koh
Ran
R
Namgung
Young Nyun
YN
Park
D000465:Algorithms; D001656:Biliary Atresia / Q000150:complications* / Q000000981:diagnostic imaging*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007223:Infant; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity
biliary atresia; elastography; fibrosis; histology; pediatric ultrasound; sonography