Histopathology Versus Imaging: A Comparative Study of Liver Biopsy, Ultrasonography, and Triphasic Computed Tomography in Paediatric Patients With Chronic Liver Disease
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Assessment of liver fibrosis and cirrhotic changes in children with chronic liver disease (CLD) can be challenging, particularly when invasive assessment is limited by clinical factors. This study compared ultrasonography and triphasic computed tomography (CT) findings with histopathology in paediatric patients with CLD. AIM: The aim of the study is to compare ultrasonography and triphasic CT findings with liver biopsy findings in paediatric patients with CLD and to assess their concordance with histopathology using predefined study-specific categories of good, partial, and poor agreement. MATERIALS AND METHODS: A prospective analytical observational study was conducted at the Department of Paediatrics and Paediatric Gastroenterology, Pakistan Kidney and Liver Institute and Research Center, Lahore, from April 10, 2026 to July 10, 2026. A total of 100 children aged 0-15 years with CLD or decompensated CLD were included. Clinical, biochemical, ultrasonographic, triphasic CT, and liver biopsy findings were recorded. Histopathology was used as the reference standard. Agreement analysis was performed in patients with adequate biopsy samples using predefined study-specific criteria. Paired binary comparisons were assessed using the McNemar test, while the Bowker test was used for comparison across the three agreement categories. A p-value of less than 0.05 was considered statistically significant. RESULTS: Liver biopsy was performed in 93 patients, with adequate biopsy samples obtained in 90 patients. Among patients with adequate biopsy samples, 81/90 (90%) had F3 or F4 fibrosis. Good agreement with histopathology was observed more frequently with triphasic CT than with ultrasonography (59/90 versus 17/90, p < 0.001). Good or partial agreement was also higher with triphasic CT than with ultrasonography (83/90 versus 61/90, p < 0.001). CONCLUSION: Triphasic CT demonstrated greater concordance with histopathology than ultrasonography in this predominantly advanced CLD cohort. These findings mainly reflect the assessment of advanced fibrosis and cirrhotic changes and should not be extrapolated to early-stage disease. Triphasic CT may provide complementary structural information, while liver biopsy remains necessary when definitive histological diagnosis or fibrosis staging is required.
Source: Cureus
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7213964923