Application of transient elastography in assessing hepatic fibrosis in pediatric chronic liver disease / 中华实用儿科临床杂志

ABSTRACT

Objective:To assess the transient elastography (TE) in assessing hepatic fibrosis in pediatric chronic liver disease.Methods:Children with chronic liver disease who were both examined with TE and percutaneous transhepatic puncture for grading Scheuer scores in the Children′s Hospital of Fudan University from January 2017 to September 2017 were recruited.Ordinal Logistic regression analysis was used to analyze the interfering factors for hepatic fibrosis.Receiver operating characteristic (ROC) curves were plotted to acquire the optimal cut-off value and to calculate the area under the curve (AUC). Results:Thirty-eight children were enrolled finally, including 28 boys and 10 girls with the mean age of 7.4 years old (1.1-16.0 years). The success rate of detecting hepatic fibrosis was 85%.Ordinal Logistic regression analysis discovered that only the value of liver stiffness measured by TE was correlated with the grade of hepatic fibrosis ( β=0.055, P<0.001). TE was effective to differentiate hepatic fibrosis[<S2 vs.≥S2 (6.6±4.0) kPa vs.(21.2±18.6) kPa, P=0.001], significant hepatic fibrosis[<S3 vs.≥S3 (7.4±4.0) kPa vs.(34.8±19.0) kPa, P=0.000 1, and cirrhosis[<S4 vs.S4 (10.6±12.3) kPa vs.(35.8±15.1) kPa, P=0.002]. At the cut-off values of liver stiffness measurement with 6.89 kPa and 14.39 kPa, AUC of it to predict the grade of hepatic fibrosis ≥S2 and ≥S3 were 0.81 ( P=0.001) and 0.94( P<0.001), respectively. Conclusions:TE is a useful and reliable noninvasive tool to assess hepatic fibrosis in pediatric chronic liver disease.