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Weight-specific normal liver stiffness values in children
Paul Knebelmann1, Antoine Martin-Champetier2, Anderson Loundou3
1Department of Pediatric and Prenatal Radiology, Hôpital Timone Enfants, APHM, 264 Rue Saint Pierre, 13005, Marseille, France. paul.knebelmann@gmail.com.
Insights
Pediatric liver stiffness, measured by two-dimensional shear wave elastography, significantly increases with a child's weight. These findings establish crucial weight-specific reference values for diagnosing liver conditions in children.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Diagnostic Ultrasound
Background:
- Two-dimensional (2-D) shear wave elastography is a noninvasive method for assessing liver stiffness.
- Limited data exists on liver stiffness in pediatric populations and its correlation with body weight.
Purpose of the Study:
- To establish weight-specific reference liver stiffness values in children without liver disease.
- To investigate the association between body weight and liver elasticity in pediatric patients.
Main Methods:
- Retrospective single-center study of 171 children undergoing clinically indicated ultrasound.
- 2-D shear wave elastography performed using Canon Medical Systems Aplio i800 and a450 devices.
- Children categorized into ten weight groups to analyze weight-related trends in liver stiffness.
Main Results:
- Liver stiffness values demonstrated a significant global trend of increase with rising body weight.
- No significant differences were observed between right and left liver lobe stiffness measurements.
- The mean normal liver stiffness value across all pediatric participants was 5.3 ± 1.1 kPa.
Conclusions:
- Pediatric liver stiffness, assessed via 2-D shear wave elastography, is positively correlated with body weight.
- These established weight-specific reference values can aid in differentiating normal from pathological liver stiffness in children.
Background:
Two-dimensional (2-D) shear wave elastography is a commonly used sonographic elastography method for the noninvasive measurement of liver stiffness. There is little liver stiffness data available in the pediatric population and its association with the child's weight is scarce.
Objective:
The principal aim of our study was to determine weight-specific reference liver stiffness values in a pediatric population free of liver disease.
Materials And Methods:
In this retrospective single-center study, 2-D shear wave elastography values were recorded in children with no history of liver disease and with a clinically indicated ultrasound examination, between April 2021 and July 2022. Examinations were performed using an Aplio i800 and two Aplio a450 (Canon Medical Systems), with a convex probe (i8CX1 or 8C1 transducers). This population was divided into ten weight groups. We evaluated the relation between weight and liver elasticity values and compared right and left lobe measurements.
Results:
During the period of the study, 235 children were included. We then excluded 64 patients (weight not available = 13, interquartile range to median ratio (IQR/M) greater than 30% = 51). On the final sample (171 patients, median age 6.5 years [0-18], median weight 22.6 kg [2.5-80]), stiffness values showed a global significant trend to increase with weight. In each group, there was no significant difference between right and left liver stiffness values. The mean normal liver stiffness value including all children was 5.3 ± 1.1 kPa.
Conclusion:
Liver stiffness in our pediatric sample with no history of liver disease increases with weight. These data may help to distinguish normal from pathological elastography values.
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