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Title: [Clinical value of acoustic radiation force impulse technique to predict esophageal and gastric varices in patients with biliary atresia].
Author: Zhang GY, Tang Y, Niu NN, Wu HT.
Journal: Zhonghua Yi Xue Za Zhi; 2017 Feb 21; 97(7):525-528. PubMed ID: 28260293.
Abstract:
Objective: To investigate the clinical value of acoustic radiation force impulse (ARFI)technique in predicting esophageal and gastric varices in patients with biliary atresia after Kasai portoenterostomy. Methods: A total of 42 patients with biliary atresia after Kasai portoenterostomy were collected from September 2015 to May 2016 in Tianjin First Central Hospital.ARFI technique was used to measure the stiffness of liver and spleen, and 28 healthy children as control.According to the result of CT examination , patients with biliary atresia were divided into two groups , twenty-three patients with esophageal and gastric varices(A group) and nineteen patients without esophageal and gastric varices (B group), Comparing the difference of liver and spleen stiffness between the two groups.The ROC curve analysis was carried out to test the diagnostic power of effective parameter. Results: The ARFI value of liver (2.98±0.80) m/s and spleen (3.00±0.33) m/s of patients with biliary atresia was significantly higher than that of control group((1.10±0.16) m/s, (2.12±0.32) m/s), the differences had statistical significance (both P<0.01). Between group A and group B, the spleen ARFI value of group A(3.16±0.26) m/s was higher than group B(2.83±0.32) m/s, the difference had statistical significance (P<0.01), whereas there was no statistical difference of liver ARFI value between two group((2.93±0.65), (3.02±0.96) m/s)(P>0.05). The cut-off ARFI value of spleen to diagnose esophageal and gastric varices in biliary atresia was 3.02 m/s, and the biggest area under the ROC curve, sensitivity, and specificity were 0.81, 78.6% and 84.5%, respectively. Conclusion: ARFI can be used as a noninvasive method to predict the presence of esophageal and gastric varices in patients with biliary atresia after Kasai portoenterostomy. 目的：探讨应用声脉冲辐射力弹性成像技术(ARFI)预测胆道闭锁葛西术后患儿食管胃底静脉曲张的临床价值。 方法：收集2015年9月至2016年5月天津市第一中心医院就诊的胆道闭锁葛西术后患儿42例，应用ARFI技术对其肝脏及脾脏进行弹性测量，与28名健康查体儿童作对照。依据CT检查结果，将胆道闭锁患儿有、无食管胃底静脉曲张分为两组，有食管胃底静脉曲张组(A组)23例及无食管胃底静脉曲张组(B组)19例，比较组间肝脏及脾脏ARFI值的差异，应用受试者工作特征(ROC)曲线下面积(AUC)评价有效参数的诊断价值。 结果：胆道闭锁组肝脏ARFI值[(2.98±0.80) m/s]、脾脏ARFI值[(3.00±0.33) m/s]明显高于健康对照组肝脏ARFI值[(1.10±0.16) m/s]、脾脏ARFI值[(2.12±0.32) m/s]，差异均有统计学意义(均P<0.01)。A组与B组相比，A组脾脏ARFI值[(3.16±0.26) m/s]高于B组脾脏ARFI值[(2.83±0.32) m/s]，差异有统计学意义(P<0.01)，而两组间肝脏ARFI值[(2.93±0.65)、(3.02±0.96) m/s)]，差异无统计学意义(P>0.05)；脾脏ARFI值诊断胆道闭锁患儿食管胃底静脉曲张的截断值为3.02 m/s，曲线下面积0.81，敏感度78.6%，特异度84.5%。 结论： ARFI技术测量脾脏硬度可作为一种无创性手段预测胆道闭锁葛西术后患儿食管胃底静脉曲张。.

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