Transient elastography correlated with diffusion-weighted magnetic resonance imaging and cholestatic complications

Abstract

The study aim to investigate the correlation between diffusion-weighted magnetic resonance imaging (DW-MRI) and transient elastography (TE) liver fibrosis findings in children with cholestatic liver diseases, and the utility of TE findings to predict cholestatic complications in children. This cross-sectional study enrolled 36 cholestatic children (21 boys and 15 girls). All study subjects underwent TE and DW-MRI studies to assess liver stiffness. All study subjects were followed prospectively, and their cholestatic complications were analyzed. The optimum cut-off TE value for the prediction of cholestatic complications was determined by receiver operating characteristic (ROC) analysis. A significant negative correlation between liver stiffness measurements (LSMs) and right-liver-to-psoas apparent diffusion coefficient ratios (LTPARs) was found in the study cohort (correlation coefficient=-0.52, p=0.001). An LSM cut-off > 8.6kPa was optimal for predicting complications of cholestasis in 6 months of this cohort (p<0.001). Survival analysis revealed that an LSM of >8.6kPa was significantly predictive of cholestatic complications in 6 months (hazard ratio=4.89; 95% CI=1.41-16.97; p=0.01). TE and DW-MRI findings showed a similar ability to predict liver fibrosis in cholestatic children. The LSMs measured by TE are predictive of the occurrence of cholestatic complications in 6 months in children with cholestatic liver diseases.