Normal values of liver elasticity measured by real-time tissue elastography (RTE) in healthy infants and children
Buket Selmi1, Guido Engelmann2, Ulrike Teufel2
1Division of Pediatric Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 430, 69120, Heidelberg, Germany. buketselmi@gmail.com.
Insights
This study established normal liver elasticity values in children using real-time tissue elastography (RTE). These reference data aid in assessing pediatric liver health and potential fibrosis.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Hepatology
Background:
- Liver elasticity assessment is crucial for diagnosing pediatric liver diseases.
- Real-time tissue elastography (RTE) offers a non-invasive method to evaluate liver stiffness.
Purpose of the Study:
- To establish normal liver elasticity values in healthy infants and children using RTE.
- To provide reference data for pediatric liver parenchyma elasticity assessment.
Main Methods:
- Real-time tissue elastography (RTE) was performed on 91 healthy children and adolescents.
- Liver elasticity was quantified using mean stiffness values (MEAN) and percentage of stiffer areas (%AREA).
- Reproducibility was assessed using the intraclass correlation coefficient (ICC).
Main Results:
- The median liver elasticity was 106 arbitrary units (a.u.).
- No significant influence of gender or age groups (0-10 vs. 11-20 years) on elasticity parameters was observed.
- Moderate agreement was found for MEAN (ICC=0.582) and %AREA (ICC=0.659), indicating good reproducibility.
Conclusions:
- Real-time elastography (RTE) is a valuable supportive tool for assessing liver elasticity in children.
- This study provides essential reference values for RTE in pediatric liver evaluations, particularly for suspected fibrosis.
Purpose:
To define normal values of liver elasticity measured by real-time tissue elastography (RTE) in healthy infants and children.
Methods:
RTE was performed on 91 children and adolescents by two experienced observers (female, n = 43; male, n = 48) and in two age groups (0-10 years, n = 45; 11-20 years, n = 46). Hepatopathies were excluded clinically by extensive laboratory testing and by ultrasound. RTE provides a histogram from a region of interest (ROI) in the liver representing the degree of stiffness of the liver. The distribution of the colors in the histogram corresponds to organ elasticity. By calculating the mean of stiffness values, a numerical value is expressed in arbitrary units (a.u.) representing the mean elasticity of the liver (MEAN). Additionally, the percentage values of relatively stiffer areas (color coded in blue) in the ROI can be calculated (%AREA). A Mann-Whitney U test was performed for these two parameters according to gender. The reproducibility of these values was determined with an intraclass correlation coefficient (ICC) test on another group of 18 healthy volunteers.
Results:
The median elasticity was 106 a.u. Gender did not have an influence on the parameters (MEAN: p = 0.052; %AREA: p = 0.051). Age-specific analyses did not yield any significant difference between the two age groups for either of the two analyzed parameters (MEAN: p = 0.059; %AREA: p = 0.058). The ICC test demonstrated a moderate agreement for MEAN (ICC = 0.582) and %AREA (ICC = 0.659).
Conclusion:
Real-time elastography is a new sonography-based method and may be used as a supportive analysis to assess liver parenchyma elasticity in children, especially when fibrosis is suspected. We measured RTE normal values in children as reference data.
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