Department of Radiology, Cathay General Hospital, Taipei, Taiwan.
Department of Medical Imaging, National Taiwan University Hospital and Medical School, No. 7, Chung Shan South Road, Taipei, 100, Taiwan.
Pediatr Radiol. 2021 Feb;51(2):257-264. doi: 10.1007/s00247-020-04823-w. Epub 2020 Sep 22.
Biliary atresia is a progressive obliterative cholangiopathy affecting both extrahepatic and intrahepatic biliary trees, resulting in fibrous obliteration of the biliary tract and subsequent development of cirrhosis.
The aim of this study was to find noninvasive indices to predict the status of hepatic fibrosis in children with biliary atresia.
We retrospectively measured the volume of the hepatic lobes and spleen from MR images, obtained biochemical data and analyzed the relationship between the imaging and biochemical indices, and the pathological status of hepatic fibrosis in 35 children with biliary atresia.
A combined index was obtained by logistic regression: logit (likelihood of cirrhosis) = 0.00043 x age at MR examination + 1.67 x aspartate aminotransferase and platelet ratio index (APRI) + 0.0029 x body-surface-area-adjusted left liver lobe volume (BSA adLLV) - 6.57 (log-likelihood chi-square P<0.05, pseudo-R=0.59). The area under the receiver operator characteristic curve of age at MR examination, APRI, BSA adLLV and the combined index for prediction of cirrhosis were 0.91, 0.86, 0.83 and 0.94, respectively. The optimal cut-off value (sensitivity and specificity) of age at MR examination, APRI, BSA adLLV and combined index were 132 (86% and 92%), 1.3 (91% and 85%), 855.5 (96% and 62%) and 0.689 (91% and 92%). The accuracy of age at MR examination, APRI, BSA adLLV and combined index were 89%, 89%, 83% and 91%, respectively.
A combined noninvasive index of age, aspartate aminotransferase and platelet ratio index, and the body-surface-area-adjusted left liver lobe volume measured from MR images is a potential marker of liver cirrhosis in children with biliary atresia.
先天性胆道闭锁是一种影响肝内外胆管的进行性闭塞性胆管病，导致胆管纤维性闭塞，并随后发展为肝硬化。
本研究旨在寻找非侵入性指标来预测胆道闭锁患儿的肝纤维化状态。
我们回顾性地从磁共振成像（MRI）中测量肝叶和脾脏的体积，获得生化数据，并分析成像和生化指标与 35 例胆道闭锁患儿肝纤维化病理状态之间的关系。
通过逻辑回归得到一个联合指标：logit（肝硬化可能性）= 0.00043 x MRI 检查时的年龄+1.67 x 天门冬氨酸氨基转移酶和血小板比值指数（APRI）+0.0029 x 体表面积校正左肝叶体积（BSA adLLV）-6.57（对数似然卡方 P<0.05，伪 R=0.59）。MRI 检查时的年龄、APRI、BSA adLLV 和联合指标预测肝硬化的受试者工作特征曲线下面积分别为 0.91、0.86、0.83 和 0.94。MRI 检查时的年龄、APRI、BSA adLLV 和联合指标的最佳截断值（敏感性和特异性）分别为 132（86%和 92%）、1.3（91%和 85%）、855.5（96%和 62%）和 0.689（91%和 92%）。MRI 检查时的年龄、APRI、BSA adLLV 和联合指标的准确性分别为 89%、89%、83%和 91%。
由年龄、天门冬氨酸氨基转移酶和血小板比值指数以及从 MRI 图像中测量的体表面积校正左肝叶体积组成的联合非侵入性指数是胆道闭锁患儿肝硬化的潜在标志物。
