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Imaging prediction with ultrasound and MRI of long-term medical outcome in native liver survivor patients with biliary atresia after kasai portoenterostomy: a pilot study

  • Hepatobiliary
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Abstract

Purpose

To comparatively assess the role of abdominal ultrasound (US) and magnetic resonance imaging (MRI) in predicting long-term medical outcome in native liver survivor patients with biliary atresia (BA) after Kasai portoenterostomy (KP).

Methods

Twenty-four retrospectively enrolled patients were divided in two groups according to clinical and laboratory data at initial evaluation after KP (median follow-up = 9.7 years; range = 5–25 years) as with ideal (Group 1; n = 15) or non-ideal (Group 2; n = 9) medical outcome. All patients were re-evaluated for a period of additional 4 years using clinical and laboratory indices. US and MRI studies were qualitatively analyzed assessing imaging signs suggestive of chronic liver disease (CLD).

Results

At re-evaluation, 6 patients (40%) of Group 1 changed their medical outcome in non-ideal (Group 1A); the other 9 patients (60%) remained stable (Group 1B); the mean time to change the medical outcome in non-ideal status at re-evaluation was 43.5 ± 2.3 months. The area under the ROC curve was 0.84 and 0.87 for US and MRI scores to predict long-term medical outcome with the best cut-off value score > 4 for both modalities (p = 0.89). In Group 2, 6 (67%) patients showed a clinical progression (Group 2A) with a mean time of 39.8 ± 3.8 months; in the other 3 (33%) patients, no clinical progression was observed (Group 2B).

Conclusion

In BA patients with ideal medical outcome after KP, US and MRI may both predict long-term outcome. US, non-invasive and widely available technique, should be preferred.

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Authors and Affiliations

  1. Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Via S. Pansini, 5, 80131, Naples, Italy

    Martina Caruso, Gianfranco Vallone, Valeria Romeo, Arturo Brunetti & Simone Maurea

  2. Department of Translational Medical Sciences, University of Naples “Federico II”, Via S. Pansini, 5, 80131, Naples, Italy

    Fabiola Di Dato, Mario Petretta & Raffaele Iorio

  3. Institute of Bio-Structures and Bio-Imaging of the National Research Council (CNR), Via Tommaso De Amicis, 80145, Napless, Italy

    Carmine Mollica, Raffaele Liuzzi & Pier Paolo Mainenti

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  1. Martina Caruso
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  2. Fabiola Di Dato
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Caruso, M., Di Dato, F., Mollica, C. et al. Imaging prediction with ultrasound and MRI of long-term medical outcome in native liver survivor patients with biliary atresia after kasai portoenterostomy: a pilot study. Abdom Radiol 46, 2595–2603 (2021). https://doi.org/10.1007/s00261-021-02958-4

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