Transient elastography for predicting esophageal/gastric varices in children with biliary atresia
<p>Abstract</p> <p>Background</p> <p>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 c...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2011-04-01
|
| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | http://www.biomedcentral.com/1471-230X/11/41 |
| _version_ | 1811320579318349824 |
|---|---|
| author | Siripon Nipaporn Vejapipat Paisarn Chongsrisawat Voranush Poovorawan Yong |
| author_facet | Siripon Nipaporn Vejapipat Paisarn Chongsrisawat Voranush Poovorawan Yong |
| author_sort | Siripon Nipaporn |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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; <it>p </it>< 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%).</p> <p>Conclusions</p> <p>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.</p> |
| first_indexed | 2024-04-13T13:01:57Z |
| format | Article |
| id | doaj.art-641bf5e0038e4e57ae6cb6409f756d19 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-04-13T13:01:57Z |
| publishDate | 2011-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-641bf5e0038e4e57ae6cb6409f756d192022-12-22T02:45:54ZengBMCBMC Gastroenterology1471-230X2011-04-011114110.1186/1471-230X-11-41Transient elastography for predicting esophageal/gastric varices in children with biliary atresiaSiripon NipapornVejapipat PaisarnChongsrisawat VoranushPoovorawan Yong<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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; <it>p </it>< 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%).</p> <p>Conclusions</p> <p>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.</p>http://www.biomedcentral.com/1471-230X/11/41Transient elastographyesophageal varicesgastric varicesbiliary atresia |
| spellingShingle | Siripon Nipaporn Vejapipat Paisarn Chongsrisawat Voranush Poovorawan Yong Transient elastography for predicting esophageal/gastric varices in children with biliary atresia BMC Gastroenterology Transient elastography esophageal varices gastric varices biliary atresia |
| title | Transient elastography for predicting esophageal/gastric varices in children with biliary atresia |
| title_full | Transient elastography for predicting esophageal/gastric varices in children with biliary atresia |
| title_fullStr | Transient elastography for predicting esophageal/gastric varices in children with biliary atresia |
| title_full_unstemmed | Transient elastography for predicting esophageal/gastric varices in children with biliary atresia |
| title_short | Transient elastography for predicting esophageal/gastric varices in children with biliary atresia |
| title_sort | transient elastography for predicting esophageal gastric varices in children with biliary atresia |
| topic | Transient elastography esophageal varices gastric varices biliary atresia |
| url | http://www.biomedcentral.com/1471-230X/11/41 |
| work_keys_str_mv | AT siriponnipaporn transientelastographyforpredictingesophagealgastricvaricesinchildrenwithbiliaryatresia AT vejapipatpaisarn transientelastographyforpredictingesophagealgastricvaricesinchildrenwithbiliaryatresia AT chongsrisawatvoranush transientelastographyforpredictingesophagealgastricvaricesinchildrenwithbiliaryatresia AT poovorawanyong transientelastographyforpredictingesophagealgastricvaricesinchildrenwithbiliaryatresia |