Spleen shear wave elastography measurements do not correlate with histological grading of liver fibrosis in Fontan physiology: a preliminary investigation.

IF 2.1 3区医学 Q2 PEDIATRICS

Pediatric Radiology Pub Date : 2024-11-01 Epub Date: 2024-09-28 DOI:10.1007/s00247-024-06052-x

Shyam Sunder B Venkatakrishna, Adarsh Ghosh, Ivan A Gonzalez, Benjamin J Wilkins, Suraj D Serai, Elizabeth B Rand, Sudha A Anupindi, Michael R Acord

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引用次数: 0

Abstract

Background: Elevated spleen stiffness may be seen in patients with portal hypertension due to cirrhosis. In patients with Fontan physiology, elevated liver stiffness has been shown to correlate poorly with liver fibrosis. It is unknown whether spleen stiffness may instead serve as a surrogate marker of liver fibrosis in these patients.

Objective: To compare spleen stiffness determined by shear wave elastography (SWE) with histological findings of an ultrasound-guided liver biopsy in patients who had undergone Fontan palliation as a potential surrogate for Fontan-associated liver disease.

Materials and methods: This was an IRB-approved single-center, retrospective study. Patients with Fontan palliation who had undergone both a spleen SWE study and a percutaneous liver biopsy between 2016 and 2020 were included. Biopsy, performed during cardiac catheterization, within 3 months of the SWE was required for inclusion. Using Kruskal-Wallis tests, spleen stiffness was compared with three liver biopsy scoring methods: Ishak, METAVIR, and congestive hepatic fibrosis score (CHFS). When available, Pearson's correlation was also used to compare collagen deposition determined using Sirius Red stain (%SR) with SWE values. A P-value < 0.05 was considered statistically significant.

Results: Twenty-two patients (15 males) were included in the study, with a median age of 17 years (IQR is 14.8-20.5 years; age range: 7 years to 30.2 years). The median spleen stiffness was 2.94 m/s (IQR: 2.57-3.61 m/s; range: 1.48-4.27 m/s). The median Fontan pressure was 11 mm Hg (IQR: 10-13.3 mm Hg; range: 7-19 mm Hg) obtained within a median of 10 days (IQR: 1-41 days) of SWE. Splenic stiffness did not correlate with the extent of fibrosis determined by histology (all P > 0.05). There was also no statistically significant correlation between the %SR staining and SWE-determined spleen stiffness (Pearson's correlation of 0.165, P = 0.59, n = 13).

Conclusions: In this preliminary study, SWE spleen stiffness values did not correlate with biopsy-determined scoring of liver fibrosis in patients with Fontan physiology.

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脾脏剪切波弹性成像测量结果与丰坦生理学肝纤维化的组织学分级不相关：一项初步调查。

背景：肝硬化导致门静脉高压的患者可能会出现脾脏僵硬度升高。在丰坦生理学患者中，肝脏僵硬度升高与肝纤维化的相关性较差。这些患者的脾脏僵硬度是否可作为肝纤维化的替代标志物尚不清楚：目的：比较剪切波弹性成像（SWE）测定的脾脏硬度与超声引导下肝活检的组织学结果，将其作为接受丰坦姑息治疗的患者中丰坦相关肝病的潜在替代指标：这是一项经IRB批准的单中心回顾性研究。研究纳入了在2016年至2020年间接受过脾脏SWE研究和经皮肝脏活检的Fontan姑息治疗患者。纳入患者必须在接受脾脏SWE检查后的3个月内，在心导管检查过程中进行活检。通过 Kruskal-Wallis 检验，将脾脏僵硬度与三种肝活检评分方法进行了比较：Ishak、METAVIR 和充血性肝纤维化评分 (CHFS)。在有条件的情况下，还使用皮尔逊相关性来比较使用天狼星红染色法确定的胶原沉积（%SR）和 SWE 值。A P值结果：研究共纳入 22 名患者（15 名男性），中位年龄为 17 岁（IQR 为 14.8-20.5 岁；年龄范围：7 岁至 30.2 岁）。脾脏僵硬度中位数为 2.94 m/s（IQR：2.57-3.61 m/s；范围：1.48-4.27 m/s）。丰坦压力中位数为 11 毫米汞柱（IQR：10-13.3 毫米汞柱；范围：7-19 毫米汞柱），是在接受 SWE 后 10 天（IQR：1-41 天）内获得的。脾脏僵硬度与组织学确定的纤维化程度没有相关性（所有 P > 0.05）。SR染色%与SWE确定的脾脏僵硬度之间也没有统计学意义上的显著相关性（Pearson相关性为0.165，P = 0.59，n = 13）：在这项初步研究中，SWE 脾脏硬度值与活组织检查确定的丰坦生理学患者肝纤维化评分没有相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Radiology 医学-核医学

CiteScore

4.40

自引率

17.40%

发文量

300

审稿时长

3-6 weeks

期刊介绍： Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.