Demirtaş Duygu, Ünal Emre, İdilman İlkay S, Akçören Zuhal, Göktaş Mehmet Akif, Boyraz Meryem Seda, Karahan Sevilay, Orhan Diclehan, Haliloğlu Mithat, Karçaaltıncaba Muşturay, Özen Hasan
Division of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Insights Imaging. 2023 Feb 28;14(1):39. doi: 10.1186/s13244-023-01390-0.
Magnetic resonance elastography (MRE) has been used to stage liver fibrosis in adults. We aimed to assess the agreement between the Ishak scoring system and magnetic resonance elastography-measured liver stiffness (MRE-LS) in children. This study included all the children who underwent abdominal MRE and liver biopsies between February 2018 and January 2021. The correlation between MRE-LS and Ishak fibrosis stage, MRE parameters, and clinical and biochemical markers affecting this relationship was investigated.
A total of 52 patients (31 male; a median age of 11.8 years) were included in the study. The MRE-LS values were significantly different between Ishak fibrosis stages (p = 0.036). With a cut-off value of 2.97 kilopascals, MRE-LS had sensitivity, specificity, PPV, NPV and accuracy values of 90.9%, 82.9%, 58.8%, 97.1%, and 84.6%, respectively, for differentiating mild/moderate fibrosis (F0, 1, 2, 3) from severe fibrosis (F ≥ 4). Although MRE-LS was moderately correlated with Ishak fibrosis score and histological activity index and weakly correlated with aspartate aminotransferase, hepatic steatosis, and R2*, only Ishak fibrosis score was a significant predictor of MRE-LS. MRE-measured spleen stiffness was weakly correlated with the Ishak fibrosis score.
MRE has high sensitivity and specificity for evaluating liver fibrosis in children. MRE may be used to evaluate liver fibrosis in pediatric patients.
磁共振弹性成像（MRE）已用于评估成人肝纤维化分期。我们旨在评估儿童中Ishak评分系统与磁共振弹性成像测量的肝脏硬度（MRE-LS）之间的一致性。本研究纳入了2018年2月至2021年1月期间接受腹部MRE检查和肝活检的所有儿童。研究了MRE-LS与Ishak纤维化分期、MRE参数以及影响这种关系的临床和生化标志物之间的相关性。
本研究共纳入52例患者（31例男性；中位年龄11.8岁）。Ishak纤维化分期之间的MRE-LS值存在显著差异（p = 0.036）。以2.97千帕为临界值，MRE-LS区分轻度/中度纤维化（F0、1、2、3）和重度纤维化（F≥4）的灵敏度、特异度、阳性预测值、阴性预测值和准确度分别为90.9%、82.9%、58.8%、97.1%和84.6%。虽然MRE-LS与Ishak纤维化评分和组织学活动指数中度相关，与天冬氨酸转氨酶、肝脂肪变性和R2*弱相关，但只有Ishak纤维化评分是MRE-LS的显著预测因子。MRE测量的脾脏硬度与Ishak纤维化评分弱相关。
MRE在评估儿童肝纤维化方面具有高灵敏度和特异度。MRE可用于评估儿科患者的肝纤维化。
