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Periportal thickening on magnetic resonance imaging for hepatic fibrosis in infantile cholestasis
BACKGROUND: Untreated neonatal cholestasis can progress to liver cirrhosis and end stage liver disease in infancy due to prolonged hepatocyte and biliary tree injury and may require liver transplantation. Therefore, non-invasive evaluation of hepatic fibrosis is important in infants with cholestasis...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7284183/ https://www.ncbi.nlm.nih.gov/pubmed/32550757 http://dx.doi.org/10.3748/wjg.v26.i21.2821 |
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author | Lee, Myung Hwan Shin, Hyun Joo Yoon, Haesung Han, Seok Joo Koh, Hong Lee, Mi-Jung |
author_facet | Lee, Myung Hwan Shin, Hyun Joo Yoon, Haesung Han, Seok Joo Koh, Hong Lee, Mi-Jung |
author_sort | Lee, Myung Hwan |
collection | PubMed |
description | BACKGROUND: Untreated neonatal cholestasis can progress to liver cirrhosis and end stage liver disease in infancy due to prolonged hepatocyte and biliary tree injury and may require liver transplantation. Therefore, non-invasive evaluation of hepatic fibrosis is important in infants with cholestasis. AIM: To investigate the usefulness of periportal thickening (PT) measured on liver magnetic resonance imaging (MRI) for the assessment of hepatic fibrosis in infants with cholestasis including biliary atresia (BA). METHODS: This retrospective study included infants less than 6 mo who underwent liver MRI and biopsy for the evaluation of infantile cholestasis. PT and spleen size were measured on MRI. Serologic assessment was based on aspartate transaminase to platelet ratio index (APRI). The grade of histopathologic fibrosis was assessed by the METAVIR grading system. Correlation and diagnostic performance of PT, normalized spleen size ratio (SR, using the upper normal size limit), and APRI for diagnosing hepatic fibrosis were obtained by receiver-operating characteristic (ROC) curve analysis. RESULTS: A total of 155 patients were included, 110 of which were diagnosed with BA. Mean age at the time of MRI was 57.6 ± 34.4 d. There were positive correlations between fibrosis grade and PT and SR, even after adjusting age (all, P < 0.001). For the diagnosis of significant fibrosis (METAVIR grade F2-F4), the area under the ROC curve was 0.899 (95%CI: 0.840–0.941) for PT (cutoff, 4.2 mm), which was higher than 0.741 (95%CI: 0.664–0.808) for SR and 0.712 (95%CI: 0.634–0.782) for APRI (both, P < 0.001). For the diagnosis of cirrhosis (F4), the area under the ROC curve was the highest with SR as 0.790 (95%CI: 0.718–0.852). CONCLUSION: Liver MRI findings of PT and SR are useful to assess clinically significant hepatic fibrosis (F2 and higher) in infants with cholestasis including BA. |
format | Online Article Text |
id | pubmed-7284183 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-72841832020-06-17 Periportal thickening on magnetic resonance imaging for hepatic fibrosis in infantile cholestasis Lee, Myung Hwan Shin, Hyun Joo Yoon, Haesung Han, Seok Joo Koh, Hong Lee, Mi-Jung World J Gastroenterol Retrospective Cohort Study BACKGROUND: Untreated neonatal cholestasis can progress to liver cirrhosis and end stage liver disease in infancy due to prolonged hepatocyte and biliary tree injury and may require liver transplantation. Therefore, non-invasive evaluation of hepatic fibrosis is important in infants with cholestasis. AIM: To investigate the usefulness of periportal thickening (PT) measured on liver magnetic resonance imaging (MRI) for the assessment of hepatic fibrosis in infants with cholestasis including biliary atresia (BA). METHODS: This retrospective study included infants less than 6 mo who underwent liver MRI and biopsy for the evaluation of infantile cholestasis. PT and spleen size were measured on MRI. Serologic assessment was based on aspartate transaminase to platelet ratio index (APRI). The grade of histopathologic fibrosis was assessed by the METAVIR grading system. Correlation and diagnostic performance of PT, normalized spleen size ratio (SR, using the upper normal size limit), and APRI for diagnosing hepatic fibrosis were obtained by receiver-operating characteristic (ROC) curve analysis. RESULTS: A total of 155 patients were included, 110 of which were diagnosed with BA. Mean age at the time of MRI was 57.6 ± 34.4 d. There were positive correlations between fibrosis grade and PT and SR, even after adjusting age (all, P < 0.001). For the diagnosis of significant fibrosis (METAVIR grade F2-F4), the area under the ROC curve was 0.899 (95%CI: 0.840–0.941) for PT (cutoff, 4.2 mm), which was higher than 0.741 (95%CI: 0.664–0.808) for SR and 0.712 (95%CI: 0.634–0.782) for APRI (both, P < 0.001). For the diagnosis of cirrhosis (F4), the area under the ROC curve was the highest with SR as 0.790 (95%CI: 0.718–0.852). CONCLUSION: Liver MRI findings of PT and SR are useful to assess clinically significant hepatic fibrosis (F2 and higher) in infants with cholestasis including BA. Baishideng Publishing Group Inc 2020-06-07 2020-06-07 /pmc/articles/PMC7284183/ /pubmed/32550757 http://dx.doi.org/10.3748/wjg.v26.i21.2821 Text en ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Retrospective Cohort Study Lee, Myung Hwan Shin, Hyun Joo Yoon, Haesung Han, Seok Joo Koh, Hong Lee, Mi-Jung Periportal thickening on magnetic resonance imaging for hepatic fibrosis in infantile cholestasis |
title | Periportal thickening on magnetic resonance imaging for hepatic fibrosis in infantile cholestasis |
title_full | Periportal thickening on magnetic resonance imaging for hepatic fibrosis in infantile cholestasis |
title_fullStr | Periportal thickening on magnetic resonance imaging for hepatic fibrosis in infantile cholestasis |
title_full_unstemmed | Periportal thickening on magnetic resonance imaging for hepatic fibrosis in infantile cholestasis |
title_short | Periportal thickening on magnetic resonance imaging for hepatic fibrosis in infantile cholestasis |
title_sort | periportal thickening on magnetic resonance imaging for hepatic fibrosis in infantile cholestasis |
topic | Retrospective Cohort Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7284183/ https://www.ncbi.nlm.nih.gov/pubmed/32550757 http://dx.doi.org/10.3748/wjg.v26.i21.2821 |
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