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. 2011 Apr 18:11:41.
doi: 10.1186/1471-230X-11-41.

Transient elastography for predicting esophageal/gastric varices in children with biliary atresia

Voranush Chongsrisawat  1 , Paisarn Vejapipat, Nipaporn Siripon, Yong Poovorawan
Affiliations

Transient elastography for predicting esophageal/gastric varices in children with biliary atresia

Voranush Chongsrisawat et al. BMC Gastroenterol. .

Abstract

Background: Transient elastography (TE) is an innovative, noninvasive technique to assess liver fibrosis by measuring liver stiffness in patients with chronic liver diseases. The purpose of this study has been to explore the accuracy of TE and clinical parameters in predicting the presence of esophageal/gastric varices in children with biliary atresia (BA) following portoenterostomy.

Methods: Patients with BA status post portoenterostomy and normal children were recruited. Splenomegaly and presence of EV/GV were determined by physical examination and endoscopy, respectively. Aspartate transaminase to platelet ratio index (APRI) was used as a serum fibrosis marker. TE was performed by using FibroScan. Data was expressed as mean ± SD.

Results: Seventy-three BA patients (male:female = 32:41; age 9.11 ± 5.64 years) and 50 normal controls (male:female = 19:31; age 11.00 ± 3.31 years) were enrolled. The liver stiffness score of BA patients was significantly higher than that of normal controls (27.37 ± 22.48 and 4.69 ± 1.03 kPa; p < 0.001). Patients with EV/GV had significantly higher liver stiffness score and APRI than those without EV/GV. As for EV/GV diagnosis, the areas under the receiver operating characteristic curve were 0.89 (95% CI 0.80 to 0.98) for TE and 0.87 (95% CI 0.78 to 0.96) for APRI, respectively. The sensitivity (and specificity) of TE (using a cut-off value of 12.7 kPa) and APRI (using a cut-off value of 1.92) in predicting EV/GV were 84% (77%) and 84% (83%), respectively, whereas the sensitivity (and specificity) of splenomegaly in predicting EV/GV were 92% (85%).

Conclusions: Transient elastography is a useful tool for predicting the presence of EV/GV. In addition, basic physical examination, routine biochemical and hematological tests, are still worthwhile and correlate well with the presence of EV/GV in patients with BA post portoenterostomy.

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Figures

Figure 1
Figure 1
ROC curve of FibroScan and aspartate transaminase to platelet ratio index (APRI) for diagnosis of esophageal and/or gastric varices.
See this image and copyright information in PMC

References

    1. Haber BA, Russo P. Biliary atresia. Gastroenterol Clin North Am. 2003;32(3):891–911. doi: 10.1016/S0889-8553(03)00049-9. - DOI - PubMed
    1. Otte JB, de Ville de Goyet J, Reding R, Hausleithner V, Sokal E, Chardot C, Debande B. Sequential treatment of biliary atresia with Kasai portoenterostomy and liver transplantation. Hepatology. 1994;20(1 Pt 2):41S–48S. - PubMed
    1. Weigand K, Weigand K. Percutaneous liver biopsy: retrospective study over 15 years comparing 287 inpatients with 428 outpatients. J Gastroenterol Hepatol. 2009;24(5):792–799. doi: 10.1111/j.1440-1746.2008.05718.x. - DOI - PubMed
    1. Amaral JG, Schwartz J, Chait P, Temple M, John P, Smith C, Taylor G, Connolly B. Sonographically guided percutaneous liver biopsy in infants: a retrospective review. Am J Roentgenol. 2006;187(6):W644–649. doi: 10.2214/AJR.05.1536. - DOI - PubMed
    1. van der Poorten D, Kwok A, Lam T, Ridley L, Jones DB, Ngu MC, Lee AU. Twenty-year audit of percutaneous liver biopsy in a major Australian teaching hospital. Intern Med J. 2006;36(11):692–699. doi: 10.1111/j.1445-5994.2006.01216.x. - DOI - PubMed

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