Periportal thickening on magnetic resonance imaging for hepatic fibrosis in infantile cholestasis  

作　　者：Myung Hwan Lee Hyun Joo Shin Haesung Yoon Seok Joo Han Hong Koh Mi-Jung Lee 

机构地区：[1]Department of Radiology,Severance Hospital,Severance Pediatric Liver Disease Research Group,Research Institute of Radiological Science,Yonsei University College of Medicine,Seoul 03722,South Korea [2]Department of Surgery,Severance Hospital,Severance Pediatric Liver Disease Research Group,Yonsei University College of Medicine,Seoul 03722,South Korea [3]Division of Gastroenterology,Hepatology and Nutrition,Department of Pediatrics,Severance Children’s Hospital,Severance Pediatric Liver Disease Research Group,Yonsei University College of Medicine,Seoul 03722,South Korea

出　　处：《World Journal of Gastroenterology》2020年第21期2821-2830,共10页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Untreated neonatal cholestasis can progress to liver cirrhosis and end stage liver disease in infancy due to prolonged hepatocyte and biliary tree injury and may require liver transplantation.Therefore,non-invasive evaluation of hepatic fibrosis is important in infants with cholestasis.AIM To investigate the usefulness of periportal thickening(PT)measured on liver magnetic resonance imaging(MRI)for the assessment of hepatic fibrosis in infants with cholestasis including biliary atresia(BA).METHODS This retrospective study included infants less than 6 mo who underwent liver MRI and biopsy for the evaluation of infantile cholestasis.PT and spleen size were measured on MRI.Serologic assessment was based on aspartate transaminase to platelet ratio index(APRI).The grade of histopathologic fibrosis was assessed by the METAVIR grading system.Correlation and diagnostic performance of PT,normalized spleen size ratio(SR,using the upper normal size limit),and APRI for diagnosing hepatic fibrosis were obtained by receiveroperating characteristic(ROC)curve analysis.RESULTS A total of 155 patients were included,110 of which were diagnosed with BA.Mean age at the time of MRI was 57.6±34.4 d.There were positive correlations between fibrosis grade and PT and SR,even after adjusting age(all,P<0.001).For the diagnosis of significant fibrosis(METAVIR grade F2-F4),the area under the ROC curve was 0.899(95%CI:0.840–0.941)for PT(cutoff,4.2 mm),which was higher than 0.741(95%CI:0.664–0.808)for SR and 0.712(95%CI:0.634–0.782)for APRI(both,P<0.001).For the diagnosis of cirrhosis(F4),the area under the ROC curve was the highest with SR as 0.790(95%CI:0.718–0.852).CONCLUSION Liver MRI findings of PT and SR are useful to assess clinically significant hepatic fibrosis(F2 and higher)in infants with cholestasis including BA.

关 键 词：INFANTS CHOLESTASIS Biliary atresia Liver FIBROSIS Magnetic resonance imaging 

分 类 号：R445.2[医药卫生—影像医学与核医学] R725.7[医药卫生—诊断学]