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- Title
2D shear wave elastography combined with age and serum biomarkers prior to kasai surgery predicts native liver survival of biliary atresia infants.
- Authors
Wang, G.; Chen, H.; Xie, X.; Cao, Q.; Liao, B.; Jiang, H.; Shan, Q.; Zhong, Z.; Zhou, W.; Zhou, L.
- Abstract
<bold>Background: </bold>The prognosis of patients with biliary atresia (BA) after Kasai portoenterostomy (KPE) varies, and precisely predicting the outcomes of KPE before surgery is still challenging.<bold>Methods: </bold>A total of 158 patients who underwent KPE in our hospital were included in this study. The patients in the training cohort were recruited from January 2012 to October 2017 (n = 118), and then, those in the validation cohort were recruited from November 2017 to April 2019 (n = 40). Combined nomogram models were developed based on two-dimensional shear wave elastography (2D SWE) values and other biomarkers. The utility of the proposed models was evaluated by C-index.<bold>Results: </bold>2D SWE played a potentially important role in predicting native liver survival (NLS) of BA patients with a C-index of 0.69 (0.63 to 0.75) in the training cohort and 0.76 (0.67 to 0.85) in the validation cohort. The nomogram A based on 2D SWE values, age, gamma-glutamyl transferase (GGT) and aspartate aminotransferase-to-platelet ratio (APRI) had a better C-index in the training cohort [0.74 (0.68-0.80) vs. 0.66 (0.60-0.73), P = 0.017] and in the validation cohort [0.78 (0.70-0.86) vs. 0.60 (0.49-0.71), P = 0.002] than the nomogram B (without 2D SWE). Using risk score developed from nomogram A, we successfully predicted 88.0% (22/25) of patients in the training cohort and 75.0% (9/12) in the validation cohort to have survival time of less than 12 months after KPE.<bold>Conclusion: </bold>The combined nomogram model based on 2D SWE values, age, GGT and APRI prior to KPE can effectively predict NLS in BA infants.
- Subjects
BILIARY atresia; ACOUSTIC radiation force impulse imaging; SHEAR waves; ELASTOGRAPHY; INFANTS; LIVER
- Publication
Journal of Internal Medicine, 2020, Vol 288, Issue 5, p570
- ISSN
0954-6820
- Publication type
journal article
- DOI
10.1111/joim.13097