Diagnosing native liver fibrosis and esophageal varices using liver and spleen stiffness measurements in biliary atresia: a pilot study

Hirofumi Tomita, Kiyoshi Ohkuma, Yohei Masugi, Naoki Hosoe, Ken Hoshino, Yasushi Fuchimoto, Akihiro Fujino, Takahiro Shimizu, Mototoshi Kato, Takumi Fujimura, Hideo Ishihama, Nobuhiro Takahashi, Yutaka Tanami, Hirotoshi Ebinuma, Hidetsugu Saito, Michiie Sakamoto, Miwako Nakano, Tatsuo Kuroda

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Biliary atresia commonly leads to liver fibrosis and cirrhotic complications, including esophageal varices. Objective: To evaluate liver and spleen stiffness measurements using acoustic radiation force impulse (ARFI) imaging for diagnosing grade of liver fibrosis and predicting the presence of esophageal varices in patients treated for biliary atresia. Materials and methods: ARFI imaging of the spleen and native liver was performed in 28 patients with biliary atresia. We studied the relation between ARFI imaging values and liver histology findings (n=22), upper gastrointestinal endoscopy findings (n=16) and several noninvasive test results. Diagnostic accuracy was assessed using receiver operating characteristic curve analyses. Results: Liver stiffness measurements exhibited a significant difference among the different grades of liver fibrosis (P=0.009), and showed higher values in patients with high-risk esophageal varices than in the other patients (P=0.04). The areas under the receiver operating characteristic curves of liver stiffness measurements for liver fibrosis grades ≥ F2, ≥F3 and = F4 were 0.83, 0.93 and 0.94, respectively. Patients with high-risk esophageal varices were preferentially diagnosed by the combined liver and spleen stiffness measurements (area under the curve, 0.92). Conclusion: Liver and spleen stiffness measurements using ARFI imaging are potential noninvasive markers for liver fibrosis and esophageal varices in patients treated for biliary atresia.

Original languageEnglish
Pages (from-to)1409-1417
Number of pages9
JournalPediatric Radiology
Volume46
Issue number10
DOIs
Publication statusPublished - 2016 Sep 1

Keywords

  • Acoustic radiation force impulse imaging
  • Biliary atresia
  • Esophageal varices
  • Liver
  • Liver fibrosis
  • Liver stiffness
  • Spleen stiffness

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Radiology Nuclear Medicine and imaging

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    Tomita, H., Ohkuma, K., Masugi, Y., Hosoe, N., Hoshino, K., Fuchimoto, Y., Fujino, A., Shimizu, T., Kato, M., Fujimura, T., Ishihama, H., Takahashi, N., Tanami, Y., Ebinuma, H., Saito, H., Sakamoto, M., Nakano, M., & Kuroda, T. (2016). Diagnosing native liver fibrosis and esophageal varices using liver and spleen stiffness measurements in biliary atresia: a pilot study. Pediatric Radiology, 46(10), 1409-1417. https://doi.org/10.1007/s00247-016-3637-4