Sensitivity and specificity of magnetic resonance elastography in liver diseases in the pediatric age group

IF 2.6 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology Pub Date : 2026-03-01 Epub Date: 2026-01-19 DOI:10.1016/j.clinre.2026.102768

Paulina Chodnicka, Elżbieta Jurkiewicz, Kamil Janowski, Maria Janowska, Agnieszka Pytlewska, Małgorzata Gołuch, Małgorzata Markiewicz-Kijewska, Maciej Pronicki, Wiesława Grajkowska, Piotr Socha

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引用次数: 0

Abstract

Objectives

Liver fibrosis staging in pediatric patients traditionally relies on invasive methods, such as liver biopsy, which pose risks and limitations. Magnetic Resonance Elastography (MRE) has emerged as a promising noninvasive alternative. This study aimed to validate the use of MRE in pediatric liver diseases and assess its diagnostic accuracy.

Methods

A total of 110 participants (61 with autoimmune hepatitis (AIH), 33 post-liver transplantation (LTx), and 16 healthy controls) underwent MRE examinations. Liver biopsies were performed based on ESPGHAN indications in patients with AIH and according to institutional post-transplant protocols in LTx patients. Biochemical data were collected including ALT (alanine aminotransferase), AST (aspartate transaminase), INR (international normalized ratio), bilirubin, and platelet counts. The APRI (aspartate aminotransferase to platelet ratio index) and FIB 4 (Fibrosis Index Based on 4 Factors) were calculated.

Results

In AIH patients MRE showed a sensitivity of 76.2% and specificity of 84.6% for moderete to severe fibrosis, incomplete cirrhosis and cirrhosis (Ishak 4–6, AUC 0.828, cutoff 3.28 kPa) and a sensitivity of 80% and specificity of 88.9% for incomplete cirrhosis and cirrhosis (Ishak 5–6, AUC 0.896, cutoff 3.68 kPa). In LTx patients, MRE demonstrated a sensitivity of 80% and specificity of 91.3% for moderete to severe fibrosis and cirrhosis (Ishak 4–6, AUC 0.865, cutoff 3.1 kPa). Inter-observer agreement for MRE was excellent (ICC(3,1) of 0.988)

Conclusions

MRE is a valuable noninvasive tool offering an accurate assessment of fibrosis. Further research is warranted to expand MRE's utility across diverse pediatric liver conditions. This validation of the MRE highlights its potential to enhance clinical decision-making and patient care in pediatric hepatology.

查看原文本刊更多论文

磁共振弹性成像在儿童年龄组肝脏疾病中的敏感性和特异性。

目的：儿童肝纤维化分期传统上依赖于侵入性方法，如肝活检，这存在风险和局限性。磁共振弹性成像（MRE）已成为一种很有前途的非侵入性替代技术。本研究旨在验证MRE在儿童肝脏疾病中的应用，并评估其诊断准确性。方法：共有110名参与者（自身免疫性肝炎（AIH） 61名，肝移植后（LTx） 33名，健康对照16名）进行了MRE检查。根据AIH患者的ESPGHAN适应症和LTx患者的机构移植后方案进行肝活检。收集生化数据，包括谷丙转氨酶（ALT）、谷草转氨酶（AST）、国际标准化比值（INR）、胆红素、血小板计数。计算APRI（天冬氨酸转氨酶与血小板比值指数）和FIB 4（基于4因素的纤维化指数）。结果：在AIH患者中，MRE对中重度纤维化、不完全肝硬化和肝硬化（Ishak 4-6, AUC 0.828，截止值3.28 kPa）的敏感性为76.2%，特异性为84.6%；对不完全肝硬化和肝硬化（Ishak 5-6, AUC 0.896，截止值3.68 kPa）的敏感性为80%，特异性为88.9%。在LTx患者中，MRE对中重度纤维化和肝硬化的敏感性为80%，特异性为91.3% （Ishak 4-6, AUC 0.865，截止值3.1 kPa）。MRE的观察者间一致性非常好（ICC(3,1) = 0.988）。结论：MRE是一种有价值的无创工具，可以准确评估纤维化。进一步的研究是必要的，以扩大MRE的效用在不同的儿童肝脏疾病。MRE的验证强调了其在儿科肝病学中加强临床决策和患者护理的潜力。

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

Clinics and research in hepatology and gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.30

自引率

3.70%

发文量

198

审稿时长

42 days

期刊介绍： Clinics and Research in Hepatology and Gastroenterology publishes high-quality original research papers in the field of hepatology and gastroenterology. The editors put the accent on rapid communication of new research and clinical developments and so called "hot topic" issues. Following a clear Editorial line, besides original articles and case reports, each issue features editorials, commentaries and reviews. The journal encourages research and discussion between all those involved in the specialty on an international level. All articles are peer reviewed by international experts, the articles in press are online and indexed in the international databases (Current Contents, Pubmed, Scopus, Science Direct). Clinics and Research in Hepatology and Gastroenterology is a subscription journal (with optional open access), which allows you to publish your research without any cost to you (unless you proactively chose the open access option). Your article will be available to all researchers around the globe whose institution has a subscription to the journal.