Predicting gastroesophageal varices through spleen magnetic resonance elastography in pediatric liver fibrosis

Table 1 Patient characteristics in the Kasai group and control group

		Kasai group (n = 22)	Control group (n = 9)	P value1
Clinical and laboratory findings	Age (yr)	10.0 (4.0-18.0)	14.0 (9.0-18.0)	0.012
	BMI (kg/m2)	17.1 (14.8-29.9)	20.6 (14.7-24.2)	0.593
	APRI	0.61 (0.18-5.00)	0.33 (0.18-0.51)	0.033
	Varices	n = 6	n = 0
Liver MRI findings	Spleen size (cm)	11.8 (7.1-19.0)	9.5 (7.9-10.1)	0.009
	Spleen size ratio	1.03 (0.63-1.73)	0.83 (0.68-0.92)	0.004
	Liver fat fraction (%)	3.0 (1.0-18.0)	3.1 (2.5-5.8)	0.313
	Liver T2* value (msec)	23.5 (15.0-64.1)	25.6 (12.0-30.0)	0.824
	Liver MRE value (kPa)	3.4 (2.5-6.0)	2.2 (1.6-2.5)	< 0.001
	Spleen MRE value (kPa)	9.0 (5.0-17.8)	5.5 (4.7-6.4)	< 0.001

¹From the Mann-Whitney U test. The values are the median (range). BMI: Body mass index; APRI: Aspartate aminotransferase to platelet ratio index; MRE: Magnetic resonance elastography; MRI: Magnetic resonance imaging.

Table 2 Characteristics of biliary atresia patients with and without portal hypertension

		With PHT (n = 11)	Without PHT (n = 11)	P value1
Clinical and laboratory findings	Age (yr)	10.0 (7.0-18.0)	10.0 (4.0-15.0)	0.797
	BMI (kg/m2)	16.6 (15.1-25.6)	17.4 (14.8-29.9)	0.797
	APRI	1.17 (0.47-5.00)	0.30 (0.18-1.82)	< 0.001
Liver MRI findings	Spleen size (cm)	14.6 (10.9-19.0)	9.6 (7.1-12.1)	< 0.001
	Spleen size ratio	1.30 (0.97-1.73)	0.91 (0.63-1.06)	< 0.001
	Liver fat fraction (%)	3.0 (1.6-7.0)	2.0 (1.0-18.0)	0.300
	Liver T2* value (msec)	22.5 (15.0-38.8)	24.1 (17.5-64.1)	0.654
	Liver MRE value (kPa)	3.7 (2.9-6.0)	3.1 (2.5-5.7)	0.056
	Spleen MRE value (kPa)	11.1 (7.1-17.8)	7.6 (5.0-9.6)	< 0.001

¹From the Mann-Whitney U test. The values are the median (range). BMI: Body mass index; APRI: Aspartate aminotransferase to platelet ratio index; MRE: Magnetic resonance elastography; MRI: Magnetic resonance imaging; PHT: Portal hypertension.

Table 3 Characteristics of biliary atresia patients with and without gastroesophageal varices

		With varices (n = 6)	Without varices (n = 16)	P value1
Clinical and laboratory findings	Age (yr)	9.0 (7.0-11.0)	10.0 (4.0-18.0)	0.203
	BMI (kg/m2)	17.1 (15.3-25.6)	17.1 (14.8-29.9)	0.914
	APRI	1.21 (0.83-5.00)	0.40 (0.18-3.39)	0.013
Liver MRI findings	Spleen size (cm)	14.1 (10.9-17.2)	11.1 (7.1-19.0)	0.070
	Spleen size ratio	1.33 (0.97-1.52)	0.95 (0.63-1.73)	0.027
	Liver fat fraction (%)	3.0 (2.2-7.0)	2.8 (1.0-18.0)	0.294
	Liver T2* value (msec)	24.7 (15.0-38.8)	23.5 (17.2-64.1)	0.791
	Liver MRE value (kPa)	3.7 (2.9-4.6)	3.3 (2.5-6.0)	0.541
	Spleen MRE value (kPa)	12.0 (7.1-17.8)	8.4 (5.0-11.4)	0.013

¹From the Mann-Whitney U test. The values are the median (range). BMI: Body mass index; APRI: Aspartate aminotransferase to platelet ratio index; MRE: Magnetic resonance elastography; MRI: Magnetic resonance imaging.

Table 4 Diagnostic performance in assessing the presence of gastroesophageal varices

Parameter	AUC	95%CI	Cut-off value	Sensitivity (%)	Specificity (%)
APRI	0.844	0.627-0.961	> 0.65	100.0	75.0
Spleen size ratio	0.813	0.591-0.945	> 1.08	83.3	75.0
Spleen MRE (kPa)	0.844	0.627-0.961	> 9.9	83.3	81.3

APRI: Aspartate aminotransferase to platelet ratio index; MRE: Magnetic resonance elastography; AUC: Area under the curve.