• Acta radiologica · Oct 2020

    Ultrasound, shear-wave elastography, and magnetic resonance imaging in native liver survivor patients with biliary atresia after Kasai portoenterostomy: correlation with medical outcome after treatment.

    • Martina Caruso, Renato Cuocolo, Fabiola Di Dato, Carmine Mollica, Gianfranco Vallone, Valeria Romeo, Mario Petretta, Raffaele Liuzzi, Pier Paolo Mainenti, Raffaele Iorio, Arturo Brunetti, and Simone Maurea.
    • Department of Advanced Biomedical Sciences, University of Naples "Federico II," Naples, Italy.
    • Acta Radiol. 2020 Oct 1; 61 (10): 1300-1308.

    BackgroundBiliary atresia (BA) is a rare obliterative cholangiopathy and Kasai portoenterostomy (KP) represents its first-line treatment; clinical and laboratory parameters together with abdominal ultrasound (US) are usually performed during the follow-up. Shear-wave elastography (SWE) is able to evaluate liver parenchyma stiffness; magnetic resonance imaging (MRI) has also been proposed to study these patients.PurposeTo correlate US, SWE, and MRI imaging findings with medical outcome in patients with BA who are native liver survivors after KP.Material And MethodsWe retrospectively enrolled 24 patients. They were divided in two groups based on "ideal" (n = 15) or "non-ideal" (n = 9) medical outcome. US, SWE, and MRI exams were analyzed qualitatively and quantitatively for imaging signs suggestive of chronic liver disease (CLD).ResultsSignificant differences were found in terms of liver surface (P = 0.007) and morphology (P = 0.013), portal vein diameter (P = 0.012) and spleen size (P = 0.002) by US, liver signal intensity (P = 0.013), portal vein diameter (P = 0.010), presence of portosystemic collaterals (P = 0.042), and spleen size (P = 0.001) by MRI. The evaluation of portal vein diameter (moderate, κ = 0.44), of portosystemic collaterals (good, κ = 0.78), and spleen size (very good, κ = 0.92) showed the best agreement between US and MRI. A significant (P = 0.01) difference in liver parenchyma stiffness by SWE was also found between the two groups (cut-off = 9.6 kPa, sensitivity = 55.6%, specificity = 100%, area under the ROC curve = 0.82).ConclusionUS, SWE, and MRI findings correlate with the medical outcome in native liver survivor patients with BA treated with KP.

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