Validation of transient elastography cut-points for assessing the stage of liver fibrosis in children

Liver fibrosis is a dynamic process of deposition in the liver of connective tissue in various forms of chronic pathology of this organ. Currently, a liver biopsy remains the gold standard for diagnosing fibrosis, but this procedure is associated with the risk of bleeding, intrahepatic hematomas, and infectious complications. The works of various authors show that the measurement of liver density using transient elastography allows you to diagnose the stage of fibrosis in chronic liver diseases. The aim of this study was to obtain optimal transient elastography for differentiating the degree of liver fibrosis F1, F2, F3, F4 according to METAVIR in children. The study included 135 patients from the National Medical Research Center for Children’s Health, who underwent transient elastography measurements of liver density from 2012 to 2018 and liver biopsy ≤ 12 months before elastography. The results obtained were analyzed using ROC analysis. Cohorts — 39% of boys and 61% of girls, average age 10.2 ± 4.7 years. The results showed that liver densities of 5.8 kPa and 7.8 kPa correspond to liver fibrosis F1 and F2 according to METAVIR, respectively, and 9.4 kPa and 12.7 kPa for diagnosis the degree of fibrosis F3 and F4 in children, respectively. Transient elastography is an accurate, non-invasive method for diagnosing fibrosis in children with chronic liver disease. 

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