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Spleen stiffness in a healthy pediatric population undergoing liver magnetic resonance elastography
Suraj D Serai1,2, Alexandra Glenn3, Andrew T Trout3,4
1Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA. serais@chop.edu.
Insights
In healthy children, spleen stiffness measured by MR elastography is typically below 6.1 kPa. This spleen stiffness measurement is consistent across different MRI vendors and field strengths, providing a reliable reference for portal hypertension assessment.
Area of Science:
- Radiology
- Medical Imaging
- Hepatology
Background:
- Splenic stiffness is a key imaging biomarker for portal hypertension.
- Establishing normative spleen stiffness values is crucial for accurate diagnostic thresholds.
Purpose of the Study:
- To determine spleen stiffness measurements in healthy children using liver magnetic resonance (MR) elastography.
- To evaluate spleen stiffness across various MRI vendors and field strengths in a pediatric cohort.
Main Methods:
- Post-hoc analysis of a prospective multicenter cross-sectional study involving healthy volunteers aged 7-17.9 years.
- MR elastography performed on three vendor platforms at 1.5 T and 3 T field strengths.
- Spleen stiffness, length, and volume measured by two independent reviewers; statistical analyses included correlation and t-tests/Mann-Whitney tests.
Main Results:
- Of 101 volunteers, 72 had measurable splenic stiffness (mean 4.7 ± 0.9 kPa; 95th percentile 6.1 kPa).
- High inter-reviewer agreement (ICC = 0.89). Male volunteers exhibited slightly higher stiffness than females (P=0.014).
- Spleen stiffness correlated with body mass index (r=0.33, P=0.024) but not other size measures; no significant differences observed across MRI vendors or field strengths.
Conclusions:
- MR elastography-derived spleen stiffness in healthy children is below 6.1 kPa.
- Spleen stiffness measurements are reliable and do not vary significantly with MRI vendor or field strength in this population.
Background:
Splenic stiffness is a potential imaging marker of portal hypertension. Normative spleen stiffness values are needed to define diagnostic thresholds.
Objective:
To report stiffness measurements of the spleen in healthy children undergoing liver magnetic resonance (MR) elastography across MRI vendors and field strengths.
Materials And Methods:
This was a post-hoc analysis of data collected under a prospective multicenter cross-sectional study. Volunteers aged 7-17.9 years without a known history of liver or spleen disease were recruited for a research MRI between February 2018 and October 2019. Gradient recalled echo (GRE) or spin-echo-echo-planar imaging (SE-EPI) MR elastography was performed on a total of three vendor platforms and at two field strengths (1.5 T (T) and 3 T) with standard right upper quadrant passive driver placement (frequency of 60 Hz). Two independent reviewers measured spleen stiffness, length, and volume. Descriptive statistics, independent sample t-tests or Mann-Whitney test, and Pearson's or Spearman's correlation were used.
Results:
From 101 study volunteers, 72 (34 female) had measurable splenic stiffness. Median age was 12 years (interquartile range [IQR], 9.9-14.9 years). Mean (± SD) spleen stiffness was 4.7 ± 0.9 kPa (IQR, 3.8-5.4 kPa) with 6.1 kPa reflecting the 95th percentile. Strong correlation was observed between reviewers (ICC = 0.89 [95%CI, 0.71-0.93; P < 0.001]). Male volunteers had slightly higher splenic stiffness compared to females: 4.9 ± 0.9 vs. 4.3 ± 0.8 kPa (P = 0.014). There was significant correlation between spleen stiffness and body mass index (r = 0.33 [95%CI, 0.06-0.56; P = 0.024]) but no other measure of patient size (r = 0.15-0.29). No significant difference in spleen stiffness was observed across vendors (P = 0.089) or field strengths (P = 0.236).
Conclusion:
MR elastography-based spleen stiffness, measured as part of a liver MR elastography acquisition, is < 6.1 kPa in a healthy pediatric population and does not vary with MRI vendor or field strength.
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