Value Of Virtual Touch Tissue Imaging Quantification In The Differential Diagnosis Of Biliary Atresia And Infantile Hepatitis Syndrome

Objective:To explore the differential diagnosis value of virtual touch tissue imaging quantification(VTIQ)on biliary atresia(BA)and infant hepatitis syndrome(IHS)in babies within 150 days using ROC curve and on this basis to further explore the differential diagnosis value of VTIQ on babies with jaundice,with 60 days old as a stratification factor.Methods:39 infants who were proposed to be diagnosed with BA or IHS were selected from Bozhou People's Hospital between January 2016 and June 2019,and were divided into the BA group and IHS group based on clinical follow-up and surgical pathological diagnosis.25 peer healthy infants were matched as the control group.VTIQ was carried out on each group of infants respectively.Liver shear wave velocity(SWV)was achieved.The area under the curve(AUC)was used to evaluate the diagnostic performance of SWV on BA and IHS through the receiver-operating characteristic curve(ROC)analysis,and the largest Youden index was used to define the optimal diagnostic critical value,and calculate the sensitivity and specificity.The sensitivity,specificity and area under the curve of SWV value measured by VTIQ technique in BA group and IHS group were further calculated with days of age as stratified factors.The two groups of infants were compared for differences in gender and days of age.VTIQ was carried out by 2 physicians respectively(They had 2 and 8 years of experiences,respectively,with a full set of training by the company of the technology and successfully completed more than 50 cases of measurements),both of whom were unknown about the inspections and results of each other during the research.Interclass Correlation Coefficient(ICC)was used to evaluate the consistency of liver elasticity measured by different physicians and the success rate of elasticity imaging was recorded.Results1.Among 39 cases that were clinically diagnosed as BA or IHS,1 patient was unable to cooperate and gave up the examination,and 38 cases were successfully measured.Among them,20 cases were diagnosed as BA by surgery or pathology,and18 cases were confirmed as IHS by laboratory examination and follow-up.There were no statistically significant differences between the two groups in gender and days of age(P > 0.05).After performing liver VTIQ on infants in each group,the mean SWV value was(2.64±0.29)m/s in the BA group,(1.98±0.18)m/s in the IHS group,and(1.15±0.16)m/s in the control group.Pairwise comparison between the three groups showed statistically significant differences(P < 0.05).2.The success rate of VTIQ technique was 98.4%(63/64)in measuring SWV value of liver;ICC of repeatable comparison between different operators was 0.981.3.ROC curve indicated that the optimal critical value of diagnosis was 2.09m/s,the AUC was 0.954,and the sensitivity and specificity of diagnosis were 92.9% and80.4% in differential diagnosis of BA and HIS using difference in liver stiffness.The age of day of children with jaundice was further used as the stratified factor.For infants with days of age < 60 days,the diagnostic sensitivity,specificity and AUC were88.7%,82.3% and 0.941,respectively.For infants with days of age ? 60 days,the diagnostic sensitivity,specificity and AUC were 94.4%,75.1% and 0.937,respectively.Conclusions VTIQ technology acquires the quantitative indicators of liver stiffness in infants,with a higher success rate due to the visual standards of quality control.In addition,the quality control standards are easy to master,so doctors of different length of experiences after a simple study can obtain the good operation consistency;the operator's subjective factors can be effectively avoided.VTIQ technology has better differential diagnosis efficacy for BA and IHS,especially for children < 60 days group.VTIQ technology has higher sensitivity and specificity,so it is more suitable for early differential diagnosis of BA,and it is necessary to further study and promote.