Chronic viral hepatitis C in pediatric age group; assessment of viral activity and hepatic fibrosis by 1H magnetic resonance spectroscopy and diffusion weighted imaging in asymptomatic patient

BackgroundChronic hepatitis C is the most common cause of chronic liver disease and cirrhosis. Egypt is the highest affected country with a prevalence of 22%. In children, seroprevalence of HCV is 0.2% in children less than 11 years of age and 0.4% in children equal and more than 11 years of age.Aim of the workThe purpose of this study was to assess the value of 1H MRS and DW-MRI as noninvasive tool in evaluation of activity and fibrosis of hepatic parenchyma in asymptomatic children with chronic hepatitis C.Subjects and methodsAcross-section study was conducted over a period of two years, included thirty children of asymptomatic chronic hepatitis C virus infection (mean age ± SD 14.1 ± 2.8 years) and twenty healthy children as controls were included. Abdominal ultrasonography, percutaneous liver biopsy, MRS and DW-MRI were done to all cases.ResultsThe results showed that HCV infection was more common in our males (83.3%). The results of METAVIR grades showed 29 cases (99.9%) had activity while 17 cases (56.4%) had fibrosis. The results of MRS and DW-MRI showed significant differences between cases and controls and positive correlations between of the results of 1H MRS with the results of liver biopsy (METAVIR grades and METAVIR stages).ConclusionEarly diagnosis of asymptomatic chronic hepatitis C is essential to prevent or delay end stage chronic parenchymal liver disease. 1H MRS may be a potential noninvasive helpful diagnostic tool in the assessment of staging and fibrosis of asymptomatic chronic hepatitis C. The increase in metabolites were correlated with histopathological changes. DW-MRI can be considered as an effective predictor in the assessment of activity in chronic hepatitis C.