Association Between Transient Elastography and Controlled Attenuated Parameter and Liver Ultrasound in Children With Cystic Fibrosis

被引：8

作者：

Ye, Wen ^{[1
]}

Leung, Daniel H. ^{[2
]}

Molleston, Jean P. ^{[3
]}

Ling, Simon C. ^{[4
]}

Murray, Karen F. ^{[5
,6
]}

Nicholas, Jennifer L. ^{[7
]}

Huang, Suiyuan ^{[1
]}

Karmazyn, Boaz W. ^{[8
]}

Harned, Roger K. ^{[9
,10
]}

Masand, Prakash ^{[11
]}

Alazraki, Adina L. ^{[12
,13
]}

Navarro, Oscar M. ^{[14
,15
]}

Otto, Randolph K. ^{[6
,16
]}

Palermo, Joseph J. ^{[17
,18
]}

Towbin, Alexander J. ^{[19
,20
]}

Alonso, Estella M. ^{[21
]}

Karnsakul, Wikrom W. ^{[22
]}

Jane Schwarzenberg, Sarah ^{[23
]}

Seidel, Glenn F. ^{[24
]}

Siegel, Marilyn ^{[7
]}

Magee, John C. ^{[25
]}

Narkewicz, Michael R. ^{[26
,27
]}

Jay Freeman, A. ^{[28
]}

机构：

[1] Univ Michigan, Sch Publ Hlth, Dept Biostat, Ann Arbor, MI 48109 USA

[2] Texas Childrens Hosp, Baylor Coll Med, Div Gastroenterol Hepatol & Nutr, Dept Pediat, Houston, TX 77030 USA

[3] Indiana Univ Sch Med, Pediat Gastroenterol Hepatol & Nutr, Riley Hosp Children IU Hlth, Indianapolis, IN 46202 USA

[4] Univ Toronto, Dept Pediat, Hosp Sick Children, Toronto, ON, Canada

[5] Univ Washington, Div Gastroenterol & Hepatol, Seattle, WA 98195 USA

[6] Seattle Childrens Hosp, Seattle, WA USA

[7] Washington Univ, Sch Med, Mallinckrodt Inst Radiol, St Louis, MO USA

[8] Indiana Univ Sch Med, Riley Hosp Children IU Hlth, Pediat Radiol, Indianapolis, IN 46202 USA

[9] Childrens Hosp Colorado, Div Pediat Radiol, Aurora, CO USA

[10] Univ Colorado, Sch Med, Aurora, CO USA

[11] Texas Childrens Hosp, Div Radiol, Houston, TX 77030 USA

[12] Emory Univ, Sch Med, Dept Radiol, Atlanta, GA 30322 USA

[13] Childrens Healthcare Atlanta, Atlanta, GA USA

[14] Univ Toronto, Dept Med Imaging, Toronto, ON, Canada

[15] Hosp Sick Children, Dept Diagnost Imaging, Toronto, ON, Canada

[16] Univ Washington, Dept Radiol, Seattle, WA 98195 USA

[17] Cincinnati Childrens Hosp Med Ctr, Div Pediat Gastroenterol Hepatol & Nutr, Cincinnati, OH 45229 USA

[18] Univ Cincinnati, Coll Med, Dept Pediat, Cincinnati, OH USA

[19] Cincinnati Childrens Hosp Med Ctr, Dept Radiol, Cincinnati, OH 45229 USA

[20] Univ Cincinnati, Coll Med, Dept Radiol, Cincinnati, OH USA

[21] Ann & Robert H Lurie Childrens Hosp, Div Pediat Gastroenterol Hepatol & Nutr, Chicago, IL USA

[22] Johns Hopkins Sch Med, Div Pediat Gastroenterol Hepatol & Nutr, Baltimore, MD USA

[23] Univ Minnesota, Pediat Gastroenterol, Mason Childrens Hosp, Minneapolis, MN USA

[24] Lucile Packard Childrens Hosp, Pediat Radiol, Palo Alto, CA USA

[25] Univ Michigan, Sch Med, Dept Surg, Ann Arbor, MI USA

[26] Childrens Hosp Colorado, Digest Hlth Inst, Aurora, CO USA

[27] Univ Colorado, Sch Med, Sect Pediat Gastroenterol Hepatol & Nutr, Dept Pediat, Aurora, CO USA

[28] Emory Univ, Sch Med, Childrens Healthcare Atlanta, Div Pediat Gastroenterol Hepatol & Nutr, Atlanta, GA USA

来源：

HEPATOLOGY COMMUNICATIONS | 2021年 / 5卷 / 08期

基金：

美国国家卫生研究院;

关键词：

FATTY LIVER; FOLLOW-UP; DISEASE; PREDICTION; PATTERNS; BIOPSY;

D O I：

10.1002/hep4.1719

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Methods to identify children with cystic fibrosis (CF) at risk for development of advanced liver disease are lacking. We aim to determine the association between liver stiffness measurement (LSM) by vibration-controlled transient elastography (VCTE) with research ultrasound (US) patterns and conventional hepatic markers as a potential means to follow liver disease progression in children with CF. ELASTIC (Longitudinal Assessment of Transient Elastography in CF) is a nested cohort of 141 patients, ages 7-21, enrolled in the Prediction by US of Risk of Hepatic Cirrhosis in CF (PUSH) Study. We studied the association between LSM with research-grade US patterns (normal [NL], heterogeneous [HTG], homogeneous [HMG], or nodular [NOD]) and conventional hepatic markers. In a subgroup (n = 79), the association between controlled attenuation parameter (CAP) and US pattern was explored. Among 133 subjects undergoing VCTE, NOD participants (n = 26) had a significantly higher median (interquartile range) LSM of 9.1 kPa (6.3, 15.8) versus NL (n = 72, 5.1 kPa [4.2, 7.0]; P < 0.0001), HMG (n = 17, 5.9 kPa [5.2, 7.8]; P = 0.0013), and HTG (n = 18, 6.1 kPa [4.7, 7.0]; P = 0.0008) participants. HMG participants (n = 14) had a significantly higher mean CAP (SD) (270.5 dB/m [61.1]) compared with NL (n = 40, 218.8 dB/m [46.5]; P = 0.0027), HTG (n = 10, 218.1 dB/m [60.7]; P = 0.044), and NOD (n = 15, 222.7 dB/m [56.4]; P = 0.041) participants. LSM had a negative correlation with platelet count (r(s) = -0.28, P = 0.0071) and positive correlation with aspartate aminotransferase-to-platelet ratio index (r(s) = 0.38, P = 0.0002), Fibrosis-4 index (r(s) = 0.36, P = 0.0007), gamma-glutamyltransferase (GGT; r(s) = 0.35, P = 0.0017), GGT-to-platelet ratio (r(s) = 0.35, P = 0.003), and US spleen size z-score (r(s) = 0.27, P = 0.0073). Conclusion: VCTE is associated with US patterns and conventional markers in patients with liver disease with CF.

引用

页码：1362 / 1372

页数：11

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