Background

We investigated the utilities of the liver-to-psoas apparent diffusion coefficient ratios (LTPAR) yielded by diffusion-weighted magnetic resonance imaging (DWMRI) and the age-adjusted serum matrix metalloproteinase-7 (MMP-7) for the diagnosis of biliary atresia (BA) in cholestatic infants.

Methods

In total, 170 cholestatic infants were recruited, of whom 50 (29.41%) were diagnosed with BA after cholestatic workups. The LTPAR and MMP7 levels were assessed.

Results

The LTPAR was significantly lower in BA infants, and the age-adjusted MMP7 ratio was significantly higher, compared to other cholestatic infants (both p < 0.001). Receiver operating characteristic curve analysis yielded a cutoff > 0.1 ng/mL.day for the age-adjusted MMP-7 ratio, and an LTPAR < 1.01 for the optimal prediction of BA (both p < 0.001). Univariate logistic regression analysis revealed that both an age-adjusted MMP-7 ratio > 0.1 ng/mL.day and an LTPAR < 1.01 were significant predictors of BA among cholestatic infants (odds ratio = 30.98 and 13.28; p < 0.001 and < 0.001, respectively). The significance of the age-adjusted MMP-7 ratio and the LTPAR persisted on multivariate logistic regression analysis after adjusting for sex and the serum gamma-glutamyl transferase level (p < 0.001 and < 0.001, respectively). The negative predictive values (NPVs) for BA were 91.49% and 94.17%, respectively, for the LTPAR and age-adjusted MMP-7 ratio.

Conclusion

The age-adjusted MMP-7 ratio and the LTPAR are both significant non-invasive predictors of BA. The consideration of both serum and imaging parameters may enhance BA diagnostic performance in cholestatic infants.

中文翻译：

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磁共振成像和年龄调整的基质金属蛋白酶7有助于胆道闭锁的诊断

背景

我们研究了弥散加权磁共振成像 (DWMRI) 产生的肝脏与腰肌表观弥散系数比 (LTPAR) 和年龄调整的血清基质金属蛋白酶 7 (MMP-7) 在诊断胆道闭锁中的效用(BA) 胆汁淤积婴儿。

方法

总共招募了 170 名胆汁淤积婴儿，其中 50 名（29.41%）经胆汁淤积检查后被诊断为 BA。评估了 LTPAR 和 MMP7 水平。

结果

与其他胆汁淤积婴儿相比，BA 婴儿的 LTPAR 显着较低，且年龄调整后的 MMP7 比率显着较高（均p  < 0.001）。接受者操作特征曲线分析得出年龄调整的 MMP-7 比率的截止值 > 0.1 ng/mL.day，BA 最佳预测的 LTPAR < 1.01（均 p < 0.001 ）  。单变量逻辑回归分析显示，年龄调整后的 MMP-7 比率 > 0.1 ng/mL.day 和 LTPAR < 1.01 是胆汁淤积婴儿中 BA 的显着预测因子（比值比 = 30.98 和 13.28；p < 0.001 和 < 0.001  ，分别）。在调整性别和血清 γ-谷氨酰转移酶水平后，年龄调整后的 MMP-7 比率和 LTPAR 的显着性在多变量逻辑回归分析中仍然存在（分别为 p < 0.001 和 < 0.001 ）  。LTPAR 和年龄调整的 MMP-7 比率的 BA 阴性预测值 (NPV) 分别为 91.49% 和 94.17%。

结论

年龄调整后的 MMP-7 比率和 LTPAR 都是 BA 的重要非侵入性预测因子。考虑血清和成像参数可能会提高胆汁淤积婴儿的 BA 诊断性能。