Simple Magnetic Resonance Scores Associate With Outcomes of Patients With Primary Sclerosing Cholangitis.

Lemoinne, Sara and Cazzagon, Nora and El Mouhadi, Sanaâ and Trivedi, Palak J and Dohan, Anthony and Kemgang, Astrid and Ben Belkacem, Karima and Housset, Chantal and Chretien, Yves and Corpechot, Christophe and Hirschfield, Gideon and Floreani, Annarosa and Motta, Raffaella and Gallix, Benoit and Barkun, Alan and Barkun, Jeffrey and Chazouillères, Olivier and Arrivé, Lionel (2019) Simple Magnetic Resonance Scores Associate With Outcomes of Patients With Primary Sclerosing Cholangitis. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. ISSN 1542-7714. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

Full text not available from this repository.
Official URL: https://linkinghub.elsevier.com/retrieve/pii/S1542...

Abstract

BACKGROUND & AIMS

Primary sclerosing cholangitis (PSC) has a variable, often progressive course. Magnetic resonance cholangiography (MRC) is used in 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 and external cohort, 119 patients in Canada, Italy, and United Kingdom). All the first-available MRC results were reviewed by 2 radiologists and the Anali scores were calculated: Anali without gadolinium= (1x dilatation of intrahepatic bile ducts) + (2x dysmorphy) + (1x portal hypertension); Anali with gadolinium= (1x dysmorphy) + (1x parenchymal enhancement heterogeneity). The primary endpoint 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, 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: serum levels of bilirubin, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase, alkaline phosphatase, and 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, associate with outcomes of patients with PSCs. These scores might be used as prognostic factors.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WN Medical imaging. Radiology
Divisions: Clinical Support > Radiology
Related URLs:
Depositing User: Mr Philip O'Reilly
Date Deposited: 29 Mar 2019 10:16
Last Modified: 29 Mar 2019 10:16
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1969

Actions (login required)

View Item View Item