title: Maternal liver elasticity determined by acoustic radiation force impulse elastosonography in intrahepatic cholestasis of pregnancy.
abstract: OBJECTIVE
  Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disorder characterized by maternal pruritus and impaired liver function. The objective of the study was to evaluate maternal liver elasticity by acoustic radiation force impulse (ARFI) elastosonography in ICP and to compare it with that in healthy pregnant women.
  
  
  METHODS
  This descriptive, case-control study consisted of 33 women with healthy pregnancies and 22 women with ICP in the third trimester of gestation. Maternal liver elasticity measurements were performed by ARFI elastosonography. The maternal characteristics and perinatal outcomes of the participants were also collected.
  
  
  RESULTS
  All maternal liver ARFI elastosonography scores were elevated in women with ICP compared to healthy controls (p = 0.015, p = 0.011, and p = 0.004, respectively). There was a significant positive correlation between maternal liver enzymes and ARFI elastosonography scores (r = 0.404, p = 0.002 and r = 0.389, p = 0.003, respectively). The optimal cut-off point of maternal liver ARFI-mean elastography score to identify the risk of ICP was >1.23 m/s, and the sensitivity and specificity were 68.2 and 69.7%, respectively [area under curve (AUC) 0.731, 95% confidence interval (CI) 0.594-0.869).
  
  
  CONCLUSIONS
  The current study found that maternal liver stiffness measured by ARFI elastosonography was increased in pregnancies complicated with ICP.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Dursun Odabas Tip Merkezi, Kampus, 65080, Van, Turkey. drorkuncetin34@hotmail.com.
authors.forename: Orkun
authors.initials: O
authors.lastname: Cetin
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Dursun Odabas Tip Merkezi, Kampus, 65080, Van, Turkey.
authors.forename: Erbil
authors.initials: E
authors.lastname: Karaman
authors.affiliation: Department of Radiology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey.
authors.forename: Harun
authors.initials: H
authors.lastname: Arslan
authors.affiliation: Department of Radiology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Akbudak
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Dursun Odabas Tip Merkezi, Kampus, 65080, Van, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Yildizhan
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Dursun Odabas Tip Merkezi, Kampus, 65080, Van, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Kolusari
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002780:Cholestasis, Intrahepatic / Q000097:blood / Q000000981:diagnostic imaging* / Q000201:enzymology; D004548:Elasticity; D054459:Elasticity Imaging Techniques; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000201:enzymology; D011248:Pregnancy Complications / Q000097:blood / Q000000981:diagnostic imaging* / Q000201:enzymology; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Acoustic radiation force impulse; Elasticity; Elastosonography; Intrahepatic cholestasis of pregnancy; Maternal liver