Simple Magnetic Resonance Scores Associate With Outcomes of Patients With Primary Sclerosing Cholangitis
| Autor: | Nora Cazzagon, Gideon M. Hirschfield, Christophe Corpechot, Astrid Kemgang, Jeffrey Barkun, Annarosa Floreani, Sara Lemoinne, Alan N. Barkun, Raffaella Motta, Olivier Chazouillères, Lionel Arrivé, Sanaâ El Mouhadi, Anthony Dohan, Yves Chretien, Chantal Housset, Palak J. Trivedi, Benoit Gallix, Karima Ben Belkacem |
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| Přispěvatelé: | Centre de Référence des Maladies Rares - Maladies Inflammatoires des Voies Biliaires et Service d’Hépatologie [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Service de Radiologie [CHU Saint-Antoine], University of Birmingham [Birmingham], AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'hépatologie [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], University Health Network, Department of Surgery, Oncology and Gastroenterology [Padova], Azienda Ospedaliera di Padova, Division of Gastroenterology [Padova], Azienda Ospedaliera di Padova -Azienda Ospedaliera di Padova, McGill University Health Center [Montreal] (MUHC), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'Hépato-gastro-entérologie [CHU Saint-Antoine], Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CCSD, Accord Elsevier |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
Cirrhosis [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging medicine.medical_treatment Liver transplantation Gastroenterology Imaging 0302 clinical medicine Biliary Tract biliary tract cholestatic liver disease imaging prognosis radiology Univariate analysis Middle Aged Prognosis Magnetic Resonance Imaging 3. Good health Liver Cholestatic Liver Disease 030220 oncology & carcinogenesis Cohort Disease Progression 030211 gastroenterology & hepatology Female Radiology Cholangiography Dilatation Pathologic Adult medicine.medical_specialty Cholangitis Sclerosing Primary sclerosing cholangitis 03 medical and health sciences Internal medicine Hypertension Portal medicine Humans Decompensation Proportional Hazards Models Retrospective Studies Hepatology Proportional hazards model business.industry Retrospective cohort study [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology medicine.disease [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology Liver Transplantation Bile Ducts Intrahepatic [SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging Atrophy business |
| Zdroj: | Clinical Gastroenterology and Hepatology Clinical Gastroenterology and Hepatology, WB Saunders, 2019, 17 (13), pp.2785-2792.e3. ⟨10.1016/j.cgh.2019.03.013⟩ Clinical Gastroenterology and Hepatology, 2019, 17 (13), pp.2785-2792.e3. ⟨10.1016/j.cgh.2019.03.013⟩ |
| ISSN: | 1542-3565 |
| Popis: | Background & Aims Primary sclerosing cholangitis (PSC) has a variable, often progressive, course. Magnetic resonance cholangiography (MRC) is used in the diagnosis of PSC. Magnetic resonance risk scoring systems, called Anali without and with gadolinium, are used to predict disease progression, determined by radiologic factors. We aimed to assess the prognostic value of Anali scores in patients with PSC and validate our findings in a separate cohort. Methods We performed a retrospective study of patients with large-duct PSC (internal cohort, 119 patients in France; external cohort, 119 patients in Canada, Italy, and the United Kingdom). All the first-available MRC results were reviewed by 2 radiologists and the Anali scores were calculated as follows: Anali without gadolinium = (1× dilatation of intrahepatic bile ducts) + (2× dysmorphy) + (1× portal hypertension); Anali with gadolinium = (1× dysmorphy) + (1× parenchymal enhancement heterogeneity). The primary end point was survival without liver transplantation or cirrhosis decompensation. The prognostic value of Anali scores was assessed by Cox regression modeling. Results During a total of 549 patient-years for the internal cohort and 497 patient-years for the external cohort, we recorded 2 and 8 liver transplantations, 4 and 3 liver-related deaths, and 26 and 25 cirrhosis decompensations, respectively. In the univariate analysis, factors associated with survival without liver transplantation or cirrhosis decompensation in the internal cohort were as follows: serum levels of bilirubin, aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transferase, alkaline phosphatase, albumin, and Anali scores. Anali scores without and with gadolinium identified patients' survival without liver transplantation or cirrhosis decompensation with a c-statistic of 0.89 (95% CI, 0.84–0.95) and 0.75 (95% CI, 0.64–0.87), respectively. Independent prognostic factors identified by multivariate analysis were Anali scores and bilirubinemia. The prognostic value of Anali scores was confirmed in the external cohort. Conclusions In internal and external cohorts, we found that Anali scores, determined from MRC, were associated with outcomes of patients with PSC. These scores might be used as prognostic factors. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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