The utility of shear wave elastography and serum biomarkers for diagnosing biliary atresia and predicting clinical outcomes

Aims: To enable comparison and interconversion of elasticity measurements between two-dimensional (2D) shear wave elastography (SWE) and transient elastography (TE).Materials and methods: Elasticities of three phantoms were measured by 2D SWE (supersonic shear imaging) using four probes and TE using two probes. We performed regression analyses to evaluate correlation between the measurements and phantom elasticities, and make converting equations. In pediatric biliary atresia patients who had stiffness measurements by both 2D SWE and TE within 1-year interval, TE measurements were retrospectively converted into correlating 2D SWE values. We compared the calculated values with 2D SWE measurements by intraclass correlation coefficient.Results: Measurements in phantoms varied according to elastography method and probe selection. However, the measurement by both 2D SWE (R2, 0.974-0.985; p<0.001) and TE (R2, 0.996-0.999; p<0.001) showedsignificant linear correlation with phantom elasticity in all probe settings. From 67 biliary atresia patients (age, 2 months-20 years), agreements between the measured and calculated values were excellent in all 88 examinations within 1-year interval(ρ=0.828; p<0.001) and in 63 examinations within 2-month interval (ρ=0.863, p<0.001). Conclusions: The equations enabledinterconversion of elasticity values among different probes of 2D SWE and TE and provided reliable estimation of elasticityvalues for different probe settings in biliary atresia patients.

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Does Supersonic Shear Wave Elastography Help Differentiate Biliary Atresia from Other Causes of Cholestatic Hepatitis in Infants Less than 90 Days Old? Compared with Grey-Scale US

BioMed Research International ◽

10.1155/2019/9036362 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10

Author(s):

Xingxing Duan ◽

Ya Peng ◽

Wengang Liu ◽

Liu Yang ◽

Jie Zhang

Keyword(s):

Biliary Atresia ◽

Young’S Modulus ◽

Shear Wave ◽

Sensitivity And Specificity ◽

Diagnostic Performance ◽

Young's Modulus ◽

Shear Wave Elastography ◽

Cholestatic Hepatitis ◽

Serial Test ◽

Grey Scale

Purpose. To investigate the diagnostic performance of shear wave elastography (SWE) for measuring liver stiffness to identify and differentiate biliary atresia (BA) from cholestatic hepatitis in infants younger than 90 days. Methods. A total of 138 infants younger than 90 days with cholestatic hepatitis were examined by SWE. The infants were subclassified into BA and nonbiliary atresia (non-BA) groups. Receiver operating characteristic (ROC) analysis was used to determine the sensitivity and specificity of hepatic Young’s modulus measurements, the ultrasonic findings in the differential diagnosis of suspected BA, and the cut-off value to diagnose BA. Results. In all infants with cholestatic hepatitis, the cut-off value of hepatic Young’s modulus to differentiate the BA group from the non-BA group was 12.35 kPa and the area under the ROC curve (AUC) was 0.937, with a sensitivity of 84.3% and a specificity of 89.7%; nevertheless the AUC of the abnormal gallbladder (AbGB) was 0.940, with a sensitivity of 96.1% and a specificity of 92.0%. In the parallel test, triangular cord (TC) sign combined with AbGB had the best diagnostic performance and the AUC was 0.960, with a sensitivity of 100% and a specificity of 92.0%. In the serial test, SWE combined with AbGB achieved the best diagnostic performance; the AUC was 0.902, the sensitivity and specificity were 80.4% and 100%, respectively. Conclusions. SWE could not only help differentiate BA from cholestatic hepatic diseases but also increase the diagnostic specificity when combined with grey-scale ultrasound in the serial test.

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