Transient elastography and diffusion-weighted magnetic resonance imaging for assessment of liver fibrosis in children with chronic hepatitis C

Table 1 Clinical, laboratory, and histopathological characteristics

Parameter	Value
Hepatomegaly	24 (26.9)
Splenomegaly	19 (23.5)
Ascites	0.0
Aspartate transaminase (U/L)	49.72 ± 42.67
Alanine transaminase (U/L)	58.36 ± 56.40
Prothrombin time (second)	13.01 ± 1.16
Hemoglobin (g/dL)	12.42 ± 1.50
White blood cells (× 103/mm3)	7.04 ± 2.46
Platelets (× 103/mm3)	267.96 ± 102.50
PCR (U/mL	827319.64 ± 2415665.23
Fibrosis stage
F1	17 (26.5)
F2	36 (56.3)
F3	11 (17.2)
Activity grade
Absent: A0	1 (16.0)
Minimal: A1-A3	14 (21.9)
Mild: A4-A8	44 (68.8)
Moderate: A9-A12	5 (7.8)
Severe: A12-A18	0 (0)

Data are n (%) or mean ± standard deviation. PCR: Polymerase chain reaction.

Table 2 Liver stiffness, and liver and spleen apparent diffusion coefficient in different fibrosis stages

Noninvasive parameter	F1, n = 17	F2, n = 36	F3, n = 11	aP value
LSM (kPa)	4.04 ± 1.41	4.98 ± 1.63	7.20 ± 5.21	0.034
	bP = 0.096	cP = 0.035
Liver ADC (mm2/s)	1.12 ± 0.24	1.15 ± 0.23	0.95 ± 0.22	0.039
	bP = 0.0787	cP = 0.017
Spleen ADC (mm2/s)	1.12 ± 0.23	1.01 ± 0.15	0.99 ± 0.26	0.271
Normalized liver ADC	1.01 ± 0.22	1.16 ± 0.23	0.99 ± 0.25	0.036
	bP = 0.033	cP = 0.016
APRI score	0.44 ± 0.42	0.48 ± 0.29	0.38 ± 0.37	0.332
FIB-4 score	0.34 ± 0.30	0.34 ± 0.15	0.22 ± 0.16	0.083

^aP: Significance among the three groups by Kruskal-Wallis test.

^bP: F1 vs F2.

^cP: F2 vs F3.

ADC: Apparent diffusion coefficient; APRI: Aspartate aminotransferase-to-platelet ratio; FIB-4: Fibrosis-4 index; LSM: Liver stiffness measurement.

Table 3 Correlation of fibrosis and activity with different studied parameters

Parameters	Fibrosis		Activity
	R value	P value	R value	P value
Age in yr	0.068	0.594	0.159	0.208
Aspartate transaminase (U/L)	-0.044	0.751	0.192	0.160
Alanine transaminase (U/L)	0.092	0.501	0.242	0.073
Prothrombin time (second)	-0.066	0.637	-0.184	0.188
Hemoglobin (g/dL)	0.041	0.764	-0.050	0.718
White blood cells as × 103/mm3	0.680	0.620	0.015	0.913
Platelets as × 103/mm3	0.047	0.731	-0.032	0.815
LSM (kPa)	0.338	0.008	0.385	0.002
Liver ADC (mm2/s)	-0.299	0.086	-0.281	0.840
Spleen ADC (mm2/s)	-0.212	0.145	-0.019	0.897
Normalized liver ADC	-0.064	0.653	-0.148	0.300
APRI score	-0.003	0.984	-0.088	0.549
FIB-4 score	-0.128	0.376	0.148	0.305

ADC: Apparent diffusion coefficient; APRI: Aspartate aminotransferase-to-platelet ratio; FIB-4: Fibrosis-4 index; LSM: Liver stiffness measurement.