Abstract
Introduction The native liver survival in biliary atresia (BA) depends on various factors, and
one of the crucial factors is the rate of progression of liver fibrosis after portoenterostomy,
but there is no reliable investigation to assess it. This study evaluated shear wave
elastography (SWE) to detect liver fibrosis in BA patients and assess its utility
during follow-up.
Materials and Methods This was an observational study; SWE was done preoperatively and postoperatively
at 3 and 6 months. The SWE values were analyzed to determine their correlations with
preoperative liver histology as well as with postoperative SWE variation between different
postoperative outcomes.
Results Twenty-one patients were included in the study; the preoperative SWE values were
strongly correlated with liver biopsy grading (p < 0.001). At the 3 months postoperatively, SWE was done for 18 children: 12 in group
A (patent bilioenteric drainage on hepatobiliary iminodiacetic acid scan) and 6 (nonpatent)
in group B; mean SWE value was 12.8 and 17.3 kPa, respectively (p < 0.001). Ten children from group A underwent SWE 6 months postoperatively, and the
mean value was 13.23 kPa.
Conclusion The SWE values correlate with liver histology grading, suggesting a reliable alternative
to biopsy. Additionally, the baseline SWE values and their trend during follow-up
can provide information on the disease's progression.
Keywords biliary atresia - shear wave elastography - liver biopsy - Kasai portoenterostomy
- liver fibrosis
