Shear wave elastography helps differentiate biliary atresia from other neonatal/infantile liver diseases
Jessica R Leschied1, Jonathan R Dillman, Jacob Bilhartz
1Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, C.S. Mott Children's Hospital, 1540 East Hospital Drive, Ann Arbor, MI, 48109-4252, USA.
Insights
Ultrasound shear wave elastography (SWE) can effectively differentiate biliary atresia from other infant liver diseases by measuring liver hardness. Increased liver stiffness detected by SWE is a key indicator of biliary atresia in neonates.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Medical Imaging
Background:
- Biliary atresia is a severe neonatal liver disease requiring early diagnosis and surgical intervention.
- Accurate differentiation from other infantile liver conditions is crucial for timely treatment.
Purpose of the Study:
- To evaluate the efficacy of ultrasound shear wave elastography (SWE) in distinguishing biliary atresia from other neonatal/infantile liver diseases.
- To assess liver hardness as a diagnostic marker for biliary atresia.
Main Methods:
- Ultrasound shear wave elastography (SWE) was performed on 11 infants under 1 year with suspected liver disease prior to liver biopsy.
- Two SWE modes (VTQ and VTIQ) were used to measure liver stiffness.
- Results were compared between infants with biliary atresia (n=6) and those with other liver diseases (n=5).
Main Results:
- Significantly higher mean liver shear wave speed was observed in the biliary atresia group compared to the non-biliary atresia group using both VTQ (P < 0.0001) and VTIQ (P = 0.003) modes.
- Fibrosis scores (Ishak) were markedly higher in infants with biliary atresia (3-6) versus other conditions (0-1).
Conclusions:
- Liver shear wave speed is significantly elevated in neonates and infants diagnosed with biliary atresia.
- SWE demonstrates potential as a non-invasive tool for diagnosing biliary atresia based on liver stiffness.
Background:
Biliary atresia is a rapidly progressive liver disease necessitating prompt diagnosis and surgical intervention, so it must be promptly distinguished from other neonatal/infantile liver diseases.
Objective:
To determine whether US shear wave elastography (SWE) can differentiate biliary atresia from other neonatal/infantile liver diseases based on liver hardness.
Materials And Methods:
Eleven children younger than 1 year who had suspected liver disease underwent anatomically and temporally-related hepatic shear wave elastography and clinically indicated percutaneous core needle biopsy. Shear wave elastography was performed immediately prior to liver biopsy at the targeted biopsy site using an Acuson S3000 US system/9L4 transducer (Siemens Medical Solutions USA, Malvern, PA). Shear wave elastography was performed using Virtual Touch Quantification (VTQ) and Virtual Touch IQ (VTIQ) modes, and six shear wave speed measurements were acquired from each subject for each mode. Children were placed in two groups based on histology, biliary atresia (n = 6) vs. non-biliary atresia (other neonatal/infantile liver diseases) (n = 5), and mean shear wave speed measurements were compared using the unpaired student's t-test (two-tailed). A P-value <0.05 was considered significant.
Results:
Using the VTQ mode, mean liver shear wave speed was 2.08 ± 0.17 m/s for the biliary atresia group and 1.28 ± 0.13 m/s for the non-biliary atresia group (P < 0.0001). Using the VTIQ mode, mean liver shear wave speed was 3.14 ± 0.73 m/s for the biliary atresia group and 1.61 ± 0.23 m/s for the non-biliary atresia group (P = 0.003). Ishak liver fibrosis scores ranged from 3 to 6 for the biliary atresia group and from 0 to 1 for the non-biliary atresia group.
Conclusion:
Liver shear wave speed is abnormally increased in neonates and infants with biliary atresia.
