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Acoustic Radiation Force Impulse Imaging for Assessing Liver Fibrosis Preoperatively in Infants With Biliary Atresia:
Fen Gao1, Ya-Qing Chen1, Jing Fang1
1Department of Ultrasound, Xinhua Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Insights
Acoustic radiation force impulse (ARFI) imaging effectively assesses liver fibrosis in infants with biliary atresia (BA), correlating well with biopsy results. This non-invasive method aids in prognosis and clinical management.
Area of Science:
- Hepatology
- Medical Imaging
- Pediatric Gastroenterology
Background:
- Biliary atresia (BA) is a serious condition in infants requiring accurate liver fibrosis assessment.
- Preoperative non-invasive methods for evaluating liver fibrosis in BA are crucial for management.
Purpose of the Study:
- To evaluate the diagnostic performance of acoustic radiation force impulse (ARFI) imaging for assessing liver fibrosis in infants with BA.
- To determine the correlation between ARFI-measured shear wave speeds (SWSs) and liver biopsy findings.
Main Methods:
- Fifty infants with BA and 50 healthy infants underwent ARFI imaging using Siemens Acuson S2000.
- Liver biopsy was performed on BA infants within 3 days of ARFI, staged using the Batts-Ludwig system.
- Correlation analysis and receiver operating characteristic (ROC) curves were used to analyze SWSs and fibrosis stages.
Main Results:
- Infants with BA showed significantly higher mean SWS (1.89 m/s) compared to controls (1.12 m/s).
- A strong positive correlation was observed between SWS and liver fibrosis stage (r=0.719, P<.001).
- Specific SWS cut-off values accurately predicted significant fibrosis, severe fibrosis, and cirrhosis.
Conclusions:
- ARFI imaging demonstrates a significant correlation with liver fibrosis severity in infants with BA, as confirmed by biopsy.
- ARFI serves as a promising non-invasive tool for liver fibrosis assessment and prognosis prediction in BA.
- This technique can potentially improve clinical management strategies for infants diagnosed with BA.
Objectives:
The purpose of this study was to investigate the diagnostic performance of acoustic radiation force impulse (ARFI) in assessing liver fibrosis preoperatively in infants with biliary atresia (BA).
Methods:
A total of 50 consecutive infants with BA and 50 healthy infants who underwent ARFI examination were recruited. Siemens Acuson S2000 in Virtual Touch Quantification mode (Siemens Medical Solutions, Mountain View, CA) was used to measure shear wave speeds (SWSs). All infants with BA underwent a liver biopsy within 3 days after ARFI imaging. The liver fibrosis stages of specimens were defined according to the Batts-Ludwig scoring system. The correlation analysis was performed between SWSs and pathological findings. Cut-off values were determined using receiver operating characteristic (ROC) curves.
Results:
The mean SWS in the BA group was significantly higher than controls (mean ± standard deviation): 1.89 ± 0.45 versus 1.12 ± 0.06 m/s; P < .001). A significant correlation was found between the SWSs and fibrosis stages (r = 0.719, P < .001). The cut-off value for predicting significant fibrosis (F ≥ 2), severe fibrosis (F ≥ 3), and cirrhosis (F = 4) was 1.53, 1.80 and 2.16 m/s, respectively, and the area under the ROC curve was 0.823, 0.884 and 0.917, respectively.
Conclusions:
Acoustic radiation force impulse imaging showed significant correlation with the severity of liver fibrosis by comparing it with liver fibrosis biopsy pathology. It may be an effective method for liver fibrosis assessment, prognosis prediction, and clinical management in infants with BA.
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