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Transient Elastography and Sonography for Prediction of Liver Fibrosis in Infants With Biliary Atresia

 Na-Young Shin  ;  Myung-Joon Kim  ;  Mi-Jung Lee  ;  Seok Joo Han  ;  Hong Koh  ;  Ran Namgung  ;  Young Nyun Park 
 JOURNAL OF ULTRASOUND IN MEDICINE, Vol.33(5) : 853-864, 2014 
Journal Title
Issue Date
Algorithms* ; Biliary Atresia/complications* ; Biliary Atresia/diagnostic imaging* ; Elasticity Imaging Techniques/methods* ; Female ; Humans ; Image Interpretation, Computer-Assisted/methods* ; Infant ; Liver Cirrhosis/diagnostic imaging* ; Liver Cirrhosis/etiology* ; Male ; Prognosis ; Reproducibility of Results ; Risk Assessment ; Sensitivity and Specificity
biliary atresia ; elastography ; fibrosis ; histology ; pediatric ultrasound ; sonography
OBJECTIVES: The purpose of this study was to assess the diagnostic performance of transient elastography and sonography for noninvasive evaluation of liver fibrosis in infants with biliary atresia. METHODS: Forty-seven infants with biliary atresia who underwent both transient elastography and sonography before surgery were included in this study. Two types of transient elastographic probes were used: an M probe, which is used for the general adult population; and an S probe, which is specific to children. Transient elastographic measurements and sonographic findings such as triangular cord thickness and hepatic artery and portal vein diameters were compared with the METAVIR histopathologic fibrosis scoring system. RESULTS: Only transient elastography (ρ = 0.63; P < .001) was significantly correlated with METAVIR fibrosis stages. The areas under the receiver operating characteristic curves for transient elastography were 0.86 and 0.96 for diagnosis of severe fibrosis and cirrhosis, respectively. The cutoff value of transient elastography for diagnosis of severe fibrosis was greater than 9.6 kPa, with sensitivity of 89.5% and specificity of 75%. The cutoff value of transient elastography for diagnosis of cirrhosis was greater than 18.1 kPa, with sensitivity of 100% and specificity of 90.5%. The success rate for the S probe (100%) was significantly higher than that for the M probe (77%; P < .001). CONCLUSIONS: Transient elastography may be a useful noninvasive method for diagnosis of severe fibrosis and cirrhosis and may help predict outcomes before surgery or invasive liver biopsy in infants with biliary atresia. The success rate of transient elastography in infants was improved by using the S probe.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Koh, Hong(고홍) ORCID logo https://orcid.org/0000-0002-3660-7483
Kim, Myung Joon(김명준) ORCID logo https://orcid.org/0000-0002-4608-0275
Namgung, Ran(남궁란) ORCID logo https://orcid.org/0000-0001-7182-9535
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Shin, Na Young(신나영)
Lee, Mi-Jung(이미정) ORCID logo https://orcid.org/0000-0003-3244-9171
Han, Seok Joo(한석주) ORCID logo https://orcid.org/0000-0001-5224-1437
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