Background: Biliary atresia (BA) is a rare obliterative cholangiopathy and Kasai portoenterostomy (KP) represents its first-line treatment; clinical and laboratory parameters together with abdominal ultrasound (US) are usually performed during the follow-up. Shear-wave elastography (SWE) is able to evaluate liver parenchyma stiffness; magnetic resonance imaging (MRI) has also been proposed to study these patients. Purpose: To correlate US, SWE, and MRI imaging findings with medical outcome in patients with BA who are native liver survivors after KP. Material and methods: We retrospectively enrolled 24 patients. They were divided in two groups based on "ideal" (n = 15) or "non-ideal" (n = 9) medical outcome. US, SWE, and MRI exams were analyzed qualitatively and quantitatively for imaging signs suggestive of chronic liver disease (CLD). Results: Significant differences were found in terms of liver surface (P = 0.007) and morphology (P = 0.013), portal vein diameter (P = 0.012) and spleen size (P = 0.002) by US, liver signal intensity (P = 0.013), portal vein diameter (P = 0.010), presence of portosystemic collaterals (P = 0.042), and spleen size (P = 0.001) by MRI. The evaluation of portal vein diameter (moderate, κ = 0.44), of portosystemic collaterals (good, κ = 0.78), and spleen size (very good, κ = 0.92) showed the best agreement between US and MRI. A significant (P = 0.01) difference in liver parenchyma stiffness by SWE was also found between the two groups (cut-off = 9.6 kPa, sensitivity = 55.6%, specificity = 100%, area under the ROC curve = 0.82). Conclusion: US, SWE, and MRI findings correlate with the medical outcome in native liver survivor patients with BA treated with KP.

Ultrasound, shear-wave elastography, and magnetic resonance imaging in native liver survivor patients with biliary atresia after Kasai portoenterostomy: correlation with medical outcome after treatment / Caruso, Martina; Cuocolo, Renato; Di Dato, Fabiola; Mollica, Carmine; Vallone, Gianfranco; Romeo, Valeria; Petretta, Mario; Liuzzi, Raffaele; Mainenti, Pier Paolo; Iorio, Raffaele; Brunetti, Arturo; Maurea, Simone. - In: ACTA RADIOLOGICA. - ISSN 0284-1851. - (2020), p. 284185120902379. [10.1177/0284185120902379]

Ultrasound, shear-wave elastography, and magnetic resonance imaging in native liver survivor patients with biliary atresia after Kasai portoenterostomy: correlation with medical outcome after treatment

Caruso, Martina;Cuocolo, Renato
;
Di Dato, Fabiola;Vallone, Gianfranco;Romeo, Valeria;Petretta, Mario;Liuzzi, Raffaele;Mainenti, Pier Paolo;Iorio, Raffaele;Brunetti, Arturo;Maurea, Simone
2020

Abstract

Background: Biliary atresia (BA) is a rare obliterative cholangiopathy and Kasai portoenterostomy (KP) represents its first-line treatment; clinical and laboratory parameters together with abdominal ultrasound (US) are usually performed during the follow-up. Shear-wave elastography (SWE) is able to evaluate liver parenchyma stiffness; magnetic resonance imaging (MRI) has also been proposed to study these patients. Purpose: To correlate US, SWE, and MRI imaging findings with medical outcome in patients with BA who are native liver survivors after KP. Material and methods: We retrospectively enrolled 24 patients. They were divided in two groups based on "ideal" (n = 15) or "non-ideal" (n = 9) medical outcome. US, SWE, and MRI exams were analyzed qualitatively and quantitatively for imaging signs suggestive of chronic liver disease (CLD). Results: Significant differences were found in terms of liver surface (P = 0.007) and morphology (P = 0.013), portal vein diameter (P = 0.012) and spleen size (P = 0.002) by US, liver signal intensity (P = 0.013), portal vein diameter (P = 0.010), presence of portosystemic collaterals (P = 0.042), and spleen size (P = 0.001) by MRI. The evaluation of portal vein diameter (moderate, κ = 0.44), of portosystemic collaterals (good, κ = 0.78), and spleen size (very good, κ = 0.92) showed the best agreement between US and MRI. A significant (P = 0.01) difference in liver parenchyma stiffness by SWE was also found between the two groups (cut-off = 9.6 kPa, sensitivity = 55.6%, specificity = 100%, area under the ROC curve = 0.82). Conclusion: US, SWE, and MRI findings correlate with the medical outcome in native liver survivor patients with BA treated with KP.
2020
Ultrasound, shear-wave elastography, and magnetic resonance imaging in native liver survivor patients with biliary atresia after Kasai portoenterostomy: correlation with medical outcome after treatment / Caruso, Martina; Cuocolo, Renato; Di Dato, Fabiola; Mollica, Carmine; Vallone, Gianfranco; Romeo, Valeria; Petretta, Mario; Liuzzi, Raffaele; Mainenti, Pier Paolo; Iorio, Raffaele; Brunetti, Arturo; Maurea, Simone. - In: ACTA RADIOLOGICA. - ISSN 0284-1851. - (2020), p. 284185120902379. [10.1177/0284185120902379]
File in questo prodotto:
File Dimensione Formato  
Caruso et al.pdf

non disponibili

Tipologia: Versione Editoriale (PDF)
Licenza: Accesso privato/ristretto
Dimensione 789.7 kB
Formato Adobe PDF
789.7 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/789400
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 14
  • ???jsp.display-item.citation.isi??? 15
social impact