Use of shear wave elastography for the diagnosis and follow-up of biliary atresia: A meta-analysis

作     者：Ellen S Wagner Hussien Ahmed H Abdelgawad Meghan Landry Belal Asfour Mark B Slidell Ruba Azzam 

作者机构：Pediatric GastroenterologyHepatologyand NutritionThe University of Chicago MedicineComer Children’s HospitalChicagoIL 60637United States Department of MedicineZagazig UniversityZagazig 44511EgyptEgypt Department of PediatricsThe University of Chicago MedicineComer Children’s HospitalChicagoIL 60637United States Graduate School of Professional Education-Biomedical InformaticsUniversity of ChicagoChicagoIL 60637United States Department of SurgeryThe University of Chicago MedicineComer Children’s HospitalChicagoIL 60637United States 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2022年第28卷第32期

页      面：4725-4739页

核心收录：

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：Biliary atresia Cholestasis Hepatic portoenterostomy Fibrosis Esophageal and gastric varices Elasticity imaging techniques 

摘      要：BACKGROUND Timely differentiation of biliary atresia(BA)from other infantile cholestatic diseases can impact patient ***,non-invasive staging of fibrosis after Kasai hepatoportoenterostomy has not been widely *** wave elastography is an ultrasound modality that detects changes in tissue *** authors propose that the utility of elastography in BA can be elucidated through meta-analysis of existing *** To assess the utility of elastography in:(1)BA diagnosis,and(2)post-Kasai fibrosis *** A literature search identified articles that evaluated elastography for BA diagnosis and for post-Kasai *** studies met criteria for meta-analysis:Eleven for diagnosis and nine for follow-up *** diagnostic odds ratio(DOR),sensitivity,and specificity of elastography were calculated through a random-effects model using Meta-DiSc *** Mean liver stiffness in BA infants at diagnosis was significantly higher than in non-BA,with overall DOR 24.61,sensitivity 83%,and specificity 79%.Post-Kasai,mean liver stiffness was significantly higher in BA patients with varices than in patients without,with DOR 16.36,sensitivity 85%,and specificity 76%.Elastography differentiated stage F4 fibrosis from F0-F3 with DOR of 70.03,sensitivity 96%,and specificity 89%.Elastography also differentiated F3-F4 fibrosis from F0-F2 with DOR of 24.68,sensitivity 85%,and specificity 81%.CONCLUSION Elastography has potential as a non-invasive modality for BA diagnosis and surveillance *** paper’s limitations include inter-study method heterogeneity and small sample ***,standardized,multi-center studies are recommended.