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Transient elastography (TE) provides non-invasive liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) values in children. LSM increases with age in healthy pediatric patients, while CAP remains consistent across age groups.

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Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Medical Imaging

Background:

  • Liver transient elastography (TE) offers a non-invasive method for assessing liver health in children.
  • Establishing pediatric reference values for TE is crucial for accurate diagnosis and monitoring.
  • Current reference ranges for TE in pediatric populations are limited.

Purpose of the Study:

  • To determine reference values for liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) using M-probe TE in children aged 1 to 18 years.
  • To evaluate the feasibility and age-dependency of TE parameters in a pediatric cohort.
  • To establish normative data for non-invasive liver assessment in healthy children.

Main Methods:

  • Transient elastography (TE) with an M probe was performed on 139 pediatric patients (1-18 years).
  • Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were recorded.
  • Patients were stratified into three age groups: 1-5 years, 6-11 years, and 12-18 years. Exclusion criteria included overweight/obesity, known liver disease, elevated liver enzymes, or hepatic abnormalities.

Main Results:

  • Successful M-probe TE was achieved in 123 children (88.5%) without anesthesia.
  • Median LSM showed a significant age-dependent increase: 3.4 kPa (1-5 yrs), 3.8 kPa (6-11 yrs), and 4.1 kPa (12-18 yrs) (P=0.001).
  • Median CAP was consistent across all age groups, with a median value of 183 (112-242) for ages 1-18 years.

Conclusions:

  • M-probe transient elastography is a feasible and reliable method for assessing liver stiffness and fat deposition in children as young as 1 year.
  • Liver stiffness measurement (LSM) in healthy children increases with age.
  • Controlled attenuation parameter (CAP) measurements for hepatic fat deposition do not vary significantly with age in pediatric patients.