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Hepatic Subcapsular Flow as a Significant Diagnostic Marker for Biliary Atresia: A Meta-Analysis
Chao Sun1, Bin Wu1, Jiang Pan1
1Department of General Surgery, Soochow University Affiliated Children's Hospital, Suzhou, China.
Insights
Hepatic subcapsular flow (HSF) is a highly accurate noninvasive ultrasound marker for diagnosing biliary atresia (BA). This meta-analysis confirms its effectiveness, though larger studies are needed.
Area of Science:
- Medical Imaging
- Pediatric Gastroenterology
- Diagnostic Accuracy
Background:
- Hepatic subcapsular flow (HSF) shows promise as a noninvasive ultrasonographic marker for early biliary atresia (BA) diagnosis.
- Existing studies on HSF's diagnostic accuracy for BA are inconsistent, necessitating a comprehensive evaluation.
Purpose of the Study:
- To systematically evaluate the diagnostic value of HSF in predicting biliary atresia (BA) through a meta-analysis.
Main Methods:
- A systematic literature search was conducted across four databases.
- Meta-analysis was performed using STATA 12.0, including nine studies with 368 patients and 469 controls.
Main Results:
- The pooled sensitivity was 0.95 and specificity was 0.92.
- Key diagnostic indicators included a positive likelihood ratio (PLR) of 11.6, negative likelihood ratio (NLR) of 0.06, and an area under the curve (AUC) of 0.98.
- Metaregression and subgroup analyses identified sources of heterogeneity and detailed subgroup diagnostic values.
Conclusions:
- HSF assay demonstrates high accuracy in distinguishing biliary atresia (BA) patients from non-BA individuals.
- Further research with robust designs and larger sample sizes is recommended to validate these findings.
Aim:
Increasing evidence indicates that hepatic subcapsular flow (HSF) can serve as a noninvasive ultrasonographic marker for the early diagnosis of biliary atresia (BA). However, results regarding its diagnostic accuracy are inconsistent and inconclusive. We conducted this meta-analysis with an aim to systematically evaluate the diagnostic value of HSF in predicting BA.
Methods:
A comprehensive literature search of four databases was conducted to identify the eligible studies. All analyses were performed using STATA 12.0.
Results:
Nine studies from eight articles containing 368 patients and 469 controls were included in our meta-analysis. Briefly, the values for pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were 0.95 (95% CI 0.88-0.98), 0.92 (95% CI 0.85-0.96), 11.6 (95% CI 6.3-21.5), 0.06 (95% CI 0.02-0.14), 201 (95% CI 59-689), and 0.98 (95% CI 0.96-0.99), respectively. Additionally, metaregression along with subgroup analysis based on various covariates revealed the potential sources of heterogeneity and the detailed diagnostic value in each subgroup.
Conclusion:
Our meta-analysis showed that HSF assay could provide high accuracy in predicting BA patients and non-BA individuals. However, further studies with better design and larger sample size are required to support the results of the present study.
