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Updated: Jun 19, 2025
Novel In Vivo Micro-Computed Tomography Imaging Techniques for Assessing the Progression of Non-Alcoholic Fatty Liver Disease
Published on: March 24, 2023
Quantitative Liver Imaging in Children
Haesung Yoon1, Jisoo Kim, Hyun Ji Lim
1From the Department of Radiology, Gangnam Severance Hospital, Seoul, South Korea (H.Y.); Department of Radiology and Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, South Korea (H.Y., J.K., H.J.L., M.-J.L.); and Department of Pediatric Radiology, Severance Children's Hospital, Seoul, South Korea (J.K., H.J.L., M.-J.L.).
Insights
Quantitative imaging is crucial for pediatric liver disease treatment assessment. This review details updated ultrasound and MRI techniques tailored for children, addressing challenges like motion and sedation.
Area of Science:
- Pediatric Radiology
- Medical Imaging
- Hepatology
Background:
- Pediatric liver disease diagnosis and monitoring require quantitative imaging, but children present unique challenges compared to adults.
- Children's movement during scans necessitates sedation, and longer follow-up periods impact imaging protocols.
- Tailoring noninvasive imaging tests is essential for accurate pediatric liver disease assessment.
Purpose of the Study:
- To provide an overview of updated quantitative imaging techniques for assessing pediatric liver disease.
- To highlight the specific considerations and challenges in imaging children with liver conditions.
- To review quantitative imaging methods for various pediatric liver diseases.
Main Methods:
- Review of current ultrasound techniques, including echo analysis and novel attenuation imaging for fatty liver.
- Discussion of ultrasound elastography and probe selection across the pediatric age spectrum.
- Exploration of Magnetic Resonance Imaging (MRI) quantitative analysis, including fat analysis and MR elastography, acknowledging sedation needs.
Main Results:
- Ultrasound remains a primary tool, with advancements in fatty liver evaluation.
- MRI offers quantitative analysis but requires sedation in younger children.
- Specific quantitative imaging approaches are discussed for conditions like fatty liver, Wilson disease, biliary atresia, hepatic fibrosis, Fontan-associated liver disease, autoimmune hepatitis, sinusoidal obstruction syndrome, and liver transplantation.
Conclusions:
- Updated quantitative imaging techniques, particularly ultrasound and MRI, are vital for pediatric liver disease management.
- Addressing pediatric-specific challenges like motion and growth is critical for effective imaging.
- Tailored imaging protocols ensure accurate assessment and monitoring of liver conditions in children.
Abstract:
In children and adults, quantitative imaging examinations determine the effectiveness of treatment for liver disease. However, pediatric liver disease differs in presentation from liver disease in adults. Children also needed to be followed for a longer period from onset and have less control of their bodies, showing more movement than adults during imaging examinations, which leads to a greater need for sedation. Thus, it is essential to appropriately tailor and accurately perform noninvasive imaging tests in these younger patients. This article is an overview of updated imaging techniques used to assess liver disease quantitatively in children. The common initial imaging study for diffuse liver disease in pediatric patients is ultrasound. In addition to preexisting echo analysis, newly developed attenuation imaging techniques have been introduced to evaluate fatty liver. Ultrasound elastography is also now actively used to evaluate liver conditions, and the broad age spectrum of the pediatric population requires caution to be taken even in the selection of probes. Magnetic resonance imaging (MRI) is another important imaging tool used to evaluate liver disease despite requiring sedation or anesthesia in young children because it allows quantitative analysis with sequences such as fat analysis and MR elastography. In addition to ultrasound and MRI, we review quantitative imaging methods specifically for fatty liver, Wilson disease, biliary atresia, hepatic fibrosis, Fontan-associated liver disease, autoimmune hepatitis, sinusoidal obstruction syndrome, and the transplanted liver. Lastly, concerns such as growth and motion that need to be addressed specifically for children are summarized.
