https://scholars.lib.ntu.edu.tw/handle/123456789/438989
標題: | Transient elastography is useful in diagnosing biliary atresia and predicting prognosis after hepatoportoenterostomy | 作者: | JIA-FENG WU Lee C.-S. WEN-HSI LIN YUNG-MING JENG HUEY-LING CHEN YEN-HSUAN NI HONG-YUAN HSU MEI-HWEI CHANG |
公開日期: | 2018 | 出版社: | John Wiley and Sons Inc. | 卷: | 68 | 期: | 2 | 起(迄)頁: | 616-624 | 來源出版物: | Hepatology | 摘要: | We investigated the utility of transient elastography (TE) for diagnosing biliary atresia (BA) in cholestatic infants and predicting the outcome of BA. Forty-eight cholestatic infants (9-87 days of age) with direct bilirubin level >1 mg/dL were enrolled. Liver stiffness measurement (LSM) by TE was performed during the cholestasis workup, and 15 subjects were diagnosed as BA. We assessed liver histology using liver biopsies from 36 subjects and graded fibrosis status using the METAVIR score. BA infants had significantly higher LSM values and METAVIR scores than non-BA cholestatic infants. A receiver operating characteristic (ROC) curve analysis showed that an LSM >7.7 kPa was predictive of BA among cholestatic infants (sensitivity = 80%; specificity = 97%; area under the curve [AUC] = 85.3%; P = 0.0001). Cholestatic infants with an LSM >7.7 kPa were more likely to be diagnosed with BA (odds ratio [OR] = 128; P < 0.001). Very early measurement of LSM after hepatoportoenterostomy (HPE) is associated with occurrence of thrombocytopenia, splenomegaly, and esophageal varices 6 months post-HPE. Five of the BA subjects were awaiting or had received liver transplantation (LT), and they had a significantly higher LSM measured 1 week post-HPE than that in the other BA subjects (26.0 vs. 10.8 kPa; P = 0.006). A Cox proportional analysis demonstrated that the need for LT was significantly higher in BA subjects with LSM >16 kPa measured 1 week post-HPE than other BA subjects (hazard ratio [HR] = 10.16; P = 0.04). Conclusion: LSM assessment during the workup of cholestatic infants may facilitate the diagnosis of BA. LSM post-HPE may predict complications and the need for early LT in infants with BA. (Hepatology 2018). ? 2018 by the American Association for the Study of Liver Diseases. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85047553920&doi=10.1002%2fhep.29856&partnerID=40&md5=785b10f2864c0fb6f54be5fbf262adf9 https://scholars.lib.ntu.edu.tw/handle/123456789/438989 |
ISSN: | 0270-9139 | DOI: | 10.1002/hep.29856 | SDG/關鍵字: | bile acid; bilirubin; bilirubin glucuronide; Article; bile acid blood level; bile duct atresia; bilirubin blood level; cholestasis; clinical article; clinical outcome; common bile duct cyst; cystic fibrosis; Cytomegalovirus; diagnostic test accuracy study; diagnostic value; esophagus varices; female; follow up; glycogen storage disease; hepatoportoenterostomy; human; human tissue; infant; intrahepatic cholestasis; liver biopsy; liver histology; liver stiffness; liver transplantation; male; newborn hepatitis; portoenterostomy; prediction; predictive value; priority journal; prognosis; sensitivity and specificity; splenomegaly; thrombocytopenia; transient elastography; urinary tract infection; area under the curve; bile duct atresia; cholestasis; diagnostic imaging; elastography; esophagus varices; liver; liver cirrhosis; newborn; pathology; portoenterostomy; postoperative complication; procedures; prognosis; prospective study; receiver operating characteristic; Area Under Curve; Biliary Atresia; Cholestasis; Elasticity Imaging Techniques; Esophageal and Gastric Varices; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Liver; Liver Cirrhosis; Liver Transplantation; Male; Portoenterostomy, Hepatic; Postoperative Complications; Prognosis; Prospective Studies; ROC Curve |
顯示於: | 醫學教育暨生醫倫理學科所 |
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