Role of Transient Elastography (Fibroscan) In Diagnosis and Staging of Liver Fibrosis in Chronic Liver Diseases Among Paediatrics

Abstract

Chronic liver diseases in children have various aetiologies, including congenital, metabolic, toxic and infectious. Most liver diseases diagnosed in childhood progress to fibrosis and ultimately cirrhosis warranting liver transplantation. Children with chronic liver disease need regular monitoring of the progression of their liver disease. Liver biopsy has traditionally been considered the reference method for evaluation of tissue damage such as hepatic fibrosis in patients with chronic liver disease. However, it is associated with obvious patient discomfort and risk of complications ranging from pain to more serious events with hospitalization rate of 1.4–3.2% and mortality varying from 0.0088 to 0.3%. Besides, LB provides only a quite small part of the organ, and thus there is a risk that the small part might not be representative for the live fibrosis in the whole liver. Therefore, research has been focused on the evaluation of noninvasive methods for the assessment of liver fibrosis. The different approaches include routine hematologic and biochemical tests, surrogate fibrosis markers in the blood and recently transient elastography. There is considerable clinical need to identify surrogate markers of liver fibrosis. Such tests might be used to estimate the extent of fibrosis in place of a biopsy or, alternatively, might be used in conjunction with a single liver biopsy to follow up progression or regression of fibrosis. Ideally, these markers would be based on accurate and reproducible tests that could be automated and performed repeatedly with little disruption to patients.