The Diagnostic Value Of Shear Wave Elastography To Biliary Atresia

Objective:To investigate the diagnostic value of shear wave elastography(SWE)to biliary atresia(BA).Methods:Infants within 90 days who were suspected with cholestatic hepatopathy were underwen conventional ultrasonography and SWE used to measure the liver stiffness measurement(LSM).Blood biochemical tests such as GGT(gamma glutamyl transpeptadase),ALP(alkaline phosphatase),ALT(alanine aminotransferase),AST(aspartate aminotransferase),TBIL(total bilirubn),TBA(total bile acid)were collected within 3days from SWE examination.All the patients were classified into BA group and non biliary atresia(Non-BA)group according to surgical results.The unpaired t-test was applied when normality and homogeneity of variance assumptions are satisfied,otherwise the equivalent non-parametric test would be used.The count data was valued by chi-square test or Fisher's exact test.The ROC(receiver operating characteristic curve)was used to evaluate the efficacy to diagnose BA.Results:Totally,100 infants with infantile cholestatic hepatopathy(ICH)were collected and finally 57 were included accordingto exclusion criteria.Of the 57 infants,24 cases were diagnosed as BA group and 33 cases were assigned to the non-BA group.In blood biochemical test,GGT had the best diagnostic performance.The ROC analysis showed a cut-off value of 282.165IU/L,the area under the ROC curve(AUROC)was 0.754,with a accuracy of 75.4%.The GB had the best diagnostic performance in conventional ultrasonography examination.The AUROC was 0.843,with a accuracy of 82.5%.The LSM of BA group and Non-BA group were(16.2±4.0)KPa,(10.7±2.9)KPa,with a significant difference(P < 0.001).The ROC analysis showed a cut-off value of11.9KPa for differentiation between the BA group and Non-BA group.The AUROC was 0.822,with a accuracy of 80.7%.In the series tests,LSM combining with GB had the best diagnostic performance,the AUROC was0.907 with a accuracy of 91.2%;adding SWE examination to GGT tests had a better diagnostic performance than GGT test only,the AUROC was elevated from 0.754 to 0.814.Conclusion:SWE has a good diagnostic performance in identifying BA,and can be used as a feasible and valuable reference index,but its diagnostic value does not exceed that of conventional ultrasound.