[Acoustic radiation force impulse imaging elastography is efficacious in detecting hepatic fibrosis in children]
S D Picó Aliaga1, D Muro Velilla1, G García-Martí2
1Servicio de Radiología, Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, España.
Insights
Acoustic radiation force impulse imaging (ARFI) effectively detects significant hepatic fibrosis in children. Higher ARFI values correlate with increased fibrosis, aiding in diagnosis.
Area of Science:
- Pediatric gastroenterology
- Medical imaging
- Hepatology
Background:
- Hepatic fibrosis in children can lead to serious liver disease.
- Accurate non-invasive diagnostic methods are needed for pediatric liver conditions.
Purpose of the Study:
- To assess the diagnostic accuracy of acoustic radiation force impulse imaging (ARFI) for significant hepatic fibrosis in pediatric patients.
- To investigate the relationship between ARFI measurements and the degree of liver fibrosis in children.
Main Methods:
- A study involving 96 children, including 31 with liver biopsies and 16 healthy controls.
- All participants underwent abdominal ultrasonography with Doppler and ARFI elastography.
- ARFI values (shear wave velocity) were averaged from both liver lobes and analyzed using statistical tests (ANOVA, t-tests, chi-square).
Main Results:
- ARFI values were significantly higher in children with fibrosis (≥ F2) compared to controls and those with less fibrosis (F0-F1) (P<.001).
- A strong association was found between ARFI values and necroinflammatory activity (P<.01).
- Steatosis did not show a significant relationship with ARFI values (P>.84).
Conclusions:
- Shear wave velocity measured by ARFI is significantly associated with the degree of hepatic fibrosis in children.
- ARFI shows promise as a non-invasive tool for diagnosing significant liver fibrosis in pediatric populations.
Objective:
To evaluate the diagnostic performance of acoustic radiation force impulse imaging (ARFI) in detecting significant hepatic fibrosis in children.
Material And Methods:
Our hospital's ethics committee approved the study and all patients or their representatives provided informed written consent. We included 96 children (50 boys, 46 girls; mean age, 8 y). We also studied 16 volunteers without liver disease as controls and 80 patients with diseases that can lead to fibrosis and cirrhosis of the liver. The final sample included 31 patients with biopsies and the 16 controls. All patients underwent abdominal ultrasonography including Doppler imaging and elastography with ARFI. The ARFI value, expressed as velocity (m/s) of shear wave propagation through the tissue, was calculated by averaging 16 measurements in both liver lobes. We used one-way analysis of variance to compare means between groups; we set statistical significance at P<.05. We used Student's t-tests and chi-square tests for categorical data.
Results:
The ARFI value in children with fibrosis ≥ F2 was higher (1.80±0.45m/s) than in controls and higher than in patients with F0-F1 (1.38±0.22m/s). The difference was significant (P<.001) for detecting F ≥ 2. Steatosis was not related with the ARFI value (Student's t-test, P>.84). Necroinflammatory activity was strongly associated with the ARFI value (Student's t-test, P<.01). Fibrosis and necroinflammatory activity were strongly associated with each other (chi-square test, P<.0001).
Conclusion:
The speed of shear wave propagation is significantly associated with the degree of hepatic fibrosis in children.
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