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Impact of probe-induced abdominal compression on two-dimensional shear wave elastography measurement of split liver
Michael Groth1, Lutz Fischer2, Uta Herden2
1Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Section of Pediatric Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Insights
Probe-induced compression significantly increases 2D-shear wave elastography (SWE) values in pediatric split liver transplants (SLT). Careful control of probe pressure is crucial for accurate, operator-independent SWE measurements in free-hand examinations.
Area of Science:
- Pediatric imaging
- Hepatology
- Medical ultrasonography
Background:
- Split liver transplantation (SLT) is a complex procedure in pediatric recipients.
- 2D-shear wave elastography (SWE) is a non-invasive method to assess liver stiffness.
- Standardized SWE measurements are essential for accurate liver transplant evaluation.
Purpose of the Study:
- To evaluate the impact of probe-induced abdominal compression on SWE measurements in pediatric SLT.
- To determine the effect of slight pressure on liver stiffness quantification.
- To assess the influence of compression on SLT diameter measurements.
Main Methods:
- Retrospective analysis of SWE data from 11 pediatric SLT patients.
- Elastograms acquired with convex and linear transducers under no and slight probe compression.
- Measurement of SLT diameter and liver stiffness (kPa) under varying compression levels.
Main Results:
- Slight probe compression significantly reduced SLT diameter (12-15% reduction, p<0.0001).
- Liver stiffness values were significantly higher with slight compression compared to no compression (p<0.0001 for both transducers).
- Significant increases in median liver stiffness were observed with slight probe pressure.
Conclusions:
- Probe-induced abdominal compression can artificially elevate SWE values in pediatric SLT.
- Consistent and controlled probe pressure is critical for reliable free-hand SWE examinations.
- Monitoring transplant diameter may offer an indirect measure of applied pressure.
Purpose:
To evaluate the effect of probe-induced abdominal compression of split liver transplants (SLT) in children on 2D-shear wave elastography (SWE) values.
Materials And Methods:
Data from 11 children (4.7 ± 4.8 years) who had undergone SLT and SWE were evaluated retrospectively. Elastograms were obtained with probes placed in an epigastric, midline position on the abdominal wall, with no and slight compression, using convex and linear transducers. For each identically positioned probe and condition, 12 serial elastograms were obtained and the SLT diameter was measured. Liver stiffness and degree of SLT compression were compared.
Results:
Slight probe pressure resulted in SLT compression, with a shorter distance between the cutis and the posterior margin of the liver transplant than in the measurement with no pressure (curved array, 5.0 ± 1.1 vs. 5.9 ± 1.3 cm, mean compression 15 %± 8 %; linear array, 4.7 ± 0.9 vs. 5.3 ± 1.0 cm, mean compression 12 %± 8 %; both p < 0.0001). The median liver stiffness was significantly greater with slight pressure than with no pressure (curved transducer, 13.38 ± 3.0 vs. 7.02 ± 1.7 kPa, p < 0.0001; linear transducer, 18.53 ± 7.1 vs. 9.03 ± 1.5 kPa, p = 0.0003).
Conclusion:
Slight abdominal compression can significantly increase SWE values in children with left-lateral SLT. To obtain meaningful results and reduce operator dependency in free-hand examinations, probe pressure must be controlled carefully.
Key Points:
· Probe-induced compression can increase elastography values in split liver transplants in children. · In free-hand examination, probe pressure must be controlled carefully. · Pressure loading can be determined indirectly by the anteroposterior transplant diameter.
Citation Format:
· Groth M, Fischer L, Herden U et al. Impact of probe-induced abdominal compression on two-dimensional shear wave elastography measurement of split liver transplants in children. Fortschr Röntgenstr 2023; 195: 905 - 912.
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