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Diagnosis of liver cirrhosis with two-dimensional shear wave elastography in biliary atresia before Kasai portoenterostomy

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Abstract

Purpose

To evaluate the application value of two-dimensional shear wave elastography (2D-SWE) for non-invasive diagnosis of liver cirrhosis (LC) in patients with biliary atresia (BA) before Kasai portoenterostomy (KP), and the cutoff value of liver stiffness measurement (LSM) for diagnosing LC.

Methods

The clinical data of 51 patients with BA who were diagnosed via surgery and pathological results from May 2017 to December 2018 in the department of general surgery, Beijing Children's Hospital, Capital Medical University, were retrospectively analyzed. The liver tissue specimens obtained during KP were evaluated according to the METAVIR criteria. The LSM was obtained using the 2D-SWE technique before KP.

Results

There was a grade positive correlation between LSM and METAVIR staging, and the Spearman correlation coefficient was 0.432 (P = 0.002). The AUC for 2D-SWE diagnosing LC (METAVIR score S = 4) in patients with BA before KP was 0.843 (95% confidence interval 0.736 ~ 0.950). The best cutoff value was 16.05 kPa, and the corresponding sensitivity was 75.0%, specificity was 83.7%, positive predictive value (PPV) was 46.1%, negative predictive value (NPV) was 94.7%, and the accuracy was 82.4%.

Conclusion

2D-SWE can be used to noninvasively diagnose LC in patients with BA before KP, and the cutoff value is 16.05 kPa.

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Abbreviations

2D-SWE:

Two-dimensional shear wave elastography

BA:

Biliary atresia

LC:

Liver cirrhosis

KP:

Kasai portoenterostomy

LSM:

Liver stiffness measurement

PPV:

Positive predictive value

NPV:

Negative predictive value

ROI:

Region of interest

ROC:

Operating characteristic curve

AUROC:

Area under the receiver operating characteristic

LT:

Liver transplantation

UE:

Ultrasound elastography

TE:

Transient elastography

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Acknowledgements

The authors thank the entire staff of the Department of General Surgery, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health.

Funding

This study was supported by Beijing Municipal Commission of Education (Beijing Hospitals Authority Youth Programme, code: QML20191205). Grant recipient: Zengmeng Wang. He had helped with the analysis of the data and revise the work.

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Authors and Affiliations

  1. Department of General Surgery, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No. 56 Nanlishi Road, Xicheng District, Beijing, 100045, People’s Republic of China

    Cailin Ding, Zengmeng Wang, Chunhui Peng, Wenbo Pang, Sarah Siyin Tan & Yajun Chen

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  1. Cailin Ding
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  2. Zengmeng Wang
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Contributions

CLD and YJC conceived and designed the study, helped with the data collection. CLD analyzed the data and drafted the initial manuscript. ZMW and SST helped to revise the work, ZMW helped with the analysis of the data, CHP and WBP helped with the data collection. All authors have read and approved the manuscript and ensure that this is the case.

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Correspondence to Yajun Chen.

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Ding, C., Wang, Z., Peng, C. et al. Diagnosis of liver cirrhosis with two-dimensional shear wave elastography in biliary atresia before Kasai portoenterostomy. Pediatr Surg Int 38, 209–215 (2022). https://doi.org/10.1007/s00383-021-05044-4

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