Clinical Research
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 28, 2006; 12(44): 7155-7160
Published online Nov 28, 2006. doi: 10.3748/wjg.v12.i44.7155
Noninvasive evaluation of hepatic fibrosis in children with infant hepatitis syndrome
Zhi-Xian Li, Yun He, Ji Wu, Dan-Mei Liang, Bu-Lin Zhang, Hong Yang, Ling-Ling Wang, Yun Ma, Kang-Lai Wei
Zhi-Xian Li, Yun He, Ji Wu, Bu-Lin Zhang, Hong Yang, Department of Ultrasound, First Affiliated Hospital, Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Dan-Mei Liang, Ling-Ling Wang, Department of Pediatrics, First Affiliated Hospital, Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Yun Ma, Kang-Lai Wei, Department of Pathology, First Affiliated Hospital, Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Supported by the Bureau of Education, Guangxi Zhuang Autonomous Region, China, No. A9909
Correspondence to: Dr. Zhi-Xian Li, Department of Ultrasound, First Affiliated Hospital, Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China. gxydlzx@163.com
Telephone: +86-771-5532688 Fax: +86-771-5532688
Received: November 29, 2005
Revised: January 8, 2006
Accepted: January 11, 2006
Published online: November 28, 2006
Abstract

AIM: To elucidate the impact of hemodynamic para-meters on ultrasonography and serum fibrosis markers for the assessment of liver fibrosis in the children with infant hepatitis syndrome (IHS).

METHODS: Forty-one children with IHS and 46 healthy infants were examined by ultrasonography, and several hemodynamic indices such as peak systolic velocity (PSV) and resistant index (RI) of proper hepatic artery (PHA) were measured. Serum fibrosis markers including hyaluronic acid (HA), pre-collagen type-III (PC-III), collagen type IV (C-IV), and laminin (LN) were assayed by radioimmunoassays. In children with IHS, liver tissues were obtained either by ultrasound-guided liver biopsy (n = 35) or in the course of operation (n = 6). The stages of hepatic fibrosis were scored as mild (S1 and S2), moderate (S3), or severe (S4) according to liver histological diagnosis. Multiple groups comparative and Spearman correlative analyses were carried out.

RESULTS: Histopathologically, 39 children (95.1%) were found to have hepatic fibrosis, 12 of them stage S1 or S2, 12 stage S3, and 15 stage S4. PSV, RI of the PHA, and serum HA showed a consecutive increase from mild to severe hepatic fibrosis and a close positive correlation with hepatic fibrosis in IHS group (r = 0.717, 0.745 and 0.712, respectively, P = 0.001). The Doppler waveform of HV was also positively correlated with the degree of hepatic fibrosis in IHS group (n = 0.783, P < 0.001).

CONCLUSION: Combination of ultrasonic studies on the hepatic hemodynamics with the evaluation of serum HA may provide an indicator for hepatic fibrosis in patients with IHS. This may be a useful noninvasive method for the diagnosis and evaluation of the prognosis of IHS.

Keywords: Infant hepatitis syndrome; Hepatic fibrosis; Doppler ultrasonography; Hemodynamics; Hyaluronic acid