Magnetic resonance elastography in evaluation of liver fibrosis in children with chronic liver disease

• Published in: Insights into imaging Vol. 14; no. 1; p. 39
• Main Authors: Demirtaş, Duygu, Ünal, Emre, İdilman, İlkay S., Akçören, Zuhal, Göktaş, Mehmet Akif, Boyraz, Meryem Seda, Karahan, Sevilay, Orhan, Diclehan, Haliloğlu, Mithat, Karçaaltıncaba, Muşturay, Özen, Hasan
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 28-02-2023; Springer Nature B.V; SpringerOpen
• Subjects: Children; Diagnostic Radiology; Evaluation; Fibrosis; Imaging; Internal Medicine; Interventional Radiology; Ishak scoring system; Liver; Liver stiffness; Magnetic resonance; Magnetic resonance elastography; Medicine; Medicine & Public Health; Neuroradiology; Original; Original Article; Parameters; Radiology; Sensitivity analysis; Spleen stiffness; Stiffness; Ultrasound; Magnetic resonance elastography; Liver stiffness; Ishak scoring system; Spleen stiffness
• ISSN: 1869-4101; 1869-4101
• DOI: 10.1186/s13244-023-01390-0

Background
Magnetic resonance elastography (MRE) has been used to stage liver fibrosis in adults. We aimed to assess the agreement between the Ishak scoring system and magnetic resonance elastography-measured liver stiffness (MRE-LS) in children. This study included all the children who underwent abdominal MRE and liver biopsies between February 2018 and January 2021. The correlation between MRE-LS and Ishak fibrosis stage, MRE parameters, and clinical and biochemical markers affecting this relationship was investigated.
Results
A total of 52 patients (31 male; a median age of 11.8 years) were included in the study. The MRE-LS values were significantly different between Ishak fibrosis stages (
p
 = 0.036). With a cut-off value of 2.97 kilopascals, MRE-LS had sensitivity, specificity, PPV, NPV and accuracy values of 90.9%, 82.9%, 58.8%, 97.1%, and 84.6%, respectively, for differentiating mild/moderate fibrosis (F0, 1, 2, 3) from severe fibrosis (F ≥ 4). Although MRE-LS was moderately correlated with Ishak fibrosis score and histological activity index and weakly correlated with aspartate aminotransferase, hepatic steatosis, and R2*, only Ishak fibrosis score was a significant predictor of MRE-LS. MRE-measured spleen stiffness was weakly correlated with the Ishak fibrosis score.
Conclusions
MRE has high sensitivity and specificity for evaluating liver fibrosis in children. MRE may be used to evaluate liver fibrosis in pediatric patients.
Key points
MRE has high sensitivity and specificity in evaluating liver fibrosis in children.
MRE-LS is significantly correlated with histological Ishak fibrosis stage.
Comparing to other parameters, only MRE-LS is a predictor of fibrosis stage.
In the future, MRE may replace biopsy to evaluate liver fibrosis.