Disease severity prognostication in primary sclerosing cholangitis: a validation of the Anali scores and comparison with the potential functional stricture

作者：Sarah Poetter‐Lang, Ahmed Ba‐Ssalamah, Alina Messner, Nina Bastati, Raphael Ambros, Antonia Kristic, Jakob Kittinger, Svitlana Pochepnia, Sami A Ba-Ssalamah, Jacqueline C. Hodge, Emina Halilbasic, Sudhakar K. Venkatesh, Nikolaos Kartalis, Kristina I. Ringe, Lionel Arrivé, Michael Trauner · 发表于：European Radiology · 年份：2024 · DOI：10.1007/s00330-024-10787-4 · 被引用次数：14 · 研究领域：Liver Diseases and Immunity、Gallbladder and Bile Duct Disorders、Pediatric Hepatobiliary Diseases and Treatments

Abstract Objectives Our aim was twofold. First, to validate Anali scores with and without gadolinium (ANALI Gd and ANALI NoGd ) in primary sclerosing cholangitis (PSC) patients. Second, to compare the ANALIs prognostic ability with the recently-proposed potential functional stricture (PFS). Materials and methods This retrospective study included 123 patients with a mean age of 41.5 years, who underwent gadoxetic acid-enahnced MRI (GA-MRI). Five readers independently evaluated all images for calculation of ANALI Gd and ANALI NoGd scores based upon following criteria: intrahepatic bile duct change severity, hepatic dysmorphia, liver parenchymal heterogeneity, and portal hypertension. In addition, hepatobiliary contrast excretion into first-order bile ducts was evaluated on 20-minute hepatobiliary-phase (HBP) images to assess PFS. Inter- and intrareader agreement were calculated (Fleiss´and Cohen kappas). Kaplan-Meier curves were generated for survival analysis. ANALI NoGd , ANALI Gd , and PFS were correlated with clinical scores, labs and outcomes (Cox regression analysis). Results Inter-reader agreement was almost perfect (ϰ = 0.81) for PFS, but only moderate-(ϰ = 0.55) for binary ANALI NoGd . For binary ANALI Gd , the agreement was slightly better on HBP (ϰ = 0.64) than on arterial-phase (AP) (ϰ = 0.53). Univariate Cox regression showed that outcomes for decompensated cirrhosis, orthotopic liver transplantation or death significantly correlated with PFS (HR (hazard ratio) = 3...