Application value of an acoustic radiation force impulse diagnostic model in pediatric biliary atresia-related hepatic fibrosis

FAN Yanhui; LIU Lei; NIE Lili; ZHANG Huixin; GENG Jianlei; HE Xinjian

doi:10.19300/j.2024.L20831

Abstract：Objective To analyze the diagnostic value of noninvasive diagnostic model based on quantitative parameters of acoustic radiation force impulse(ARFI)for hepatic fibrosis in children with biliary atresia.Methods A total of 100 children with biliary atresia who underwent ARFI examination,hepatohilar-jejunostomy(Kasai procedure)and liver biopsy were retrospectively collected,including 42 males and 58 females,with an average age of(68.79±8.79)days.According to the biopsy results,the patients were divided into hepatic fibrosis group(71 cases)and non-hepatic fibrosis group(29 cases).Liver fibrosis was classified into five grades according to the Metavir grading standard:F0(29 cases),F1(31 cases),F2(24 cases),F3(11 cases)and F4(5 cases).The clinical data and ARFI quantitative parameters of the two groups were compared by t-test or χ2 test.The shear wave velocity(SWV)values among different stages of hepatic fibrosis were compared using one-way ANOVA.Multivariate Logistic regression was used to analyze independent risk factors for liver fibrosis in children with biliary atresia.Subsequently,a noninvasive diagnostic model based on ARFI quantitative parameters was constructed.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficiency of the model,and the area under the curve(AUC)was calculated.Results Serum levels of neutrophil(NEUT),total bilirubin(TBIL),laminin(LN),hyaluronic acid(HA),procollagen typeⅢ(PCⅢ),Ⅳtypecollagen(Ⅳ-Col),and SWV in hepatic fibrosis group were higher than those in non-hepatic fibrosis group(all P<0.05).The difference of SWV among F0-F4 grades was statistically significant,and SWV increased gradually with the increase of F0-F4 grades(P<0.05).Multivariate Logistic regression analysis showed that high concentrations of SWV,serum TBIL,LN,HA,PCⅢ,andⅣ-Col were risk factors for liver fibrosis in children with biliary atresia(all P<0.05).The optimal critical value of SWV-based noninvasive diagnostic model for diagnosing liver fibrosis in children with biliary atresia was determined to be 1.75 m/s.It exhibited sensitivity,specificity,accuracy,positive predictive value,and AUC of 93.15%,70.09%,90.25%,88.80%,and 0.922,respectively.Conclusion The non-invasive diagnostic model established based on ARFI quantitative parameters can accurately diagnose liver fibrosis in children with biliary atresia and has high application value.