Magnetic resonance elastography may be a viable alternative to detecting liver fibrosis in children.
Magnetic resonance elastography (MRE) detects fibrosis in children with chronic liver disease, according to a study published online in the Journal of Pediatrics.
Pediatric chronic liver disease, such as non-alcoholic fatty liver disease (NAFLD), is being seen more often in the United States. This is partly due to the rising levels of childhood obesity, experts say. Currently, physicians use liver biopsies, which are invasive and not risk-free, to detect liver disease. The biopsies also cause anxiety among many patients. Alternative ultrasound-based methods are not as effective in detecting fibrosis, particularly among children who are obese.
Researchers from Cincinnati Children’s Hospital Center in Ohio sought to determine if there would be a better way to detect fibrosis by using MRE. In 2011 and 2012, they evaluated 35 children and teens, ages between 4 and 20 years old (median age 13), for liver disease. The patients underwent both MRE and liver biopsy.
Results showed that the 22 patients had NAFLD with borderline non-alcoholic steatohepatitis (NASH). Of the remaining eight patients, one each had:
· progressive familial intrahepatic cholestasis type 2
· glycogenic hepatopathy related to type 1 diabetes
· autoimmune sclerosing cholangitis
· Wilson disease
· a1-antitrypsin deficiency
· portal venous cavernous transformation and thrombosis
· transfusion hemosiderosis
One patient with obesity and hepatomegaly had a normal biopsy.
“On histologic staging, 27 subjects had minimal or no fibrosis, 11 with stage 1 and 16 with stage 0. Eight subjects had significant fibrosis, four with stage 2, three with stage 3, and one with stage 4,” the authors wrote.
“Having the ability to easily and non-invasively assess the degree of fibrosis in a child’s liver could help us identify the issue early and begin the right course of treatment in a timely and effective manner,” study co-author Daniel Podberesky, MD, said in a release. Podberesky is chief of thoracoabdominal imaging at Cincinatti Children’s.