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Normal Liver Stiffness Measured with MR Elastography in Children
Andrew T Trout1, Sudha A Anupindi1, Michael S Gee1
1From the Department of Radiology (A.T.T., J.R.D.), Division of Gastroenterology, Hepatology and Nutrition (S.A.X.), and Division of Biostatistics and Epidemiology (B.Z.), Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229; Departments of Radiology (A.T.T., J.R.D.) and Pediatrics (A.T.T., S.A.X., B.Z.), University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pa (S.A.A., S.D.S., J.S.C.T.); Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (S.A.A., S.D.S.); Department of Radiology (M.S.G.) and Center for Ultrasound Research & Translation, Department of Radiology (M.B., A.O.), Massachusetts General Hospital, Boston, Mass; Department of Radiology, Harvard Medical School, Boston, Mass (M.S.G.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (G.K.).
Normal liver stiffness in children measured by MR elastography is 2.1 kPa, similar to adults. This study establishes normative data, showing liver stiffness is independent of patient or MRI factors, with a 95th percentile of 2.8 kPa.
Area of Science:
- Radiology and Imaging
- Pediatric Gastroenterology
- Medical Physics
Background:
- Liver stiffness thresholds for pediatric MR elastography (MRE) lack standardization and may differ from adult values.
- Establishing normative liver stiffness data in children is crucial for accurate diagnostic threshold determination.
Purpose of the Study:
- To determine normal liver stiffness values and their associated ranges in children using MR elastography.
- To assess liver stiffness across different MRI vendors and field strengths (1.5 T and 3.0 T) in a pediatric cohort.
Main Methods:
- Prospective, multicenter cohort study (NCT03235414) involving healthy volunteers aged 7-17.9 years.
- Standardized MRI scans including MRE, proton density fat fraction (PDFF), and R2* measurements were performed.
- Data were centrally analyzed, with statistical methods including Pearson correlation and t-tests/ANOVA to assess associations.
Main Results:
- Seventy-one children with complete data had a mean liver stiffness of 2.1 kPa (95% CI: 2.0-2.2 kPa).
- The 95th percentile for normal liver stiffness was 2.8 kPa.
- No significant associations were found between liver stiffness and patient demographics (age, sex, BMI) or MRI scanner factors (vendor, field strength).
Conclusions:
- Mean liver stiffness in children, measured by MRE, is comparable to adult values (2.1 kPa).
- Normal liver stiffness in children is independent of age, sex, BMI, MRI vendor, or field strength.
- The established 95th percentile of 2.8 kPa provides a valuable reference for pediatric liver stiffness assessment.
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