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Reference values for liver stiffness in children using shear-wave elastography
Célia Charlier1, Saskia Vande Perre1, Béatrice Dubern2
1Department of Radiology, Trousseau Hospital, APHP, Sorbonne Université, Paris, France.
Insights
This study establishes reference liver elasticity values for healthy children using ultrasound shear wave elastography (SWE). Values decrease with age and vary by ultrasound probe, providing essential clinical data.
Area of Science:
- Pediatric gastroenterology and hepatology
- Medical imaging and diagnostics
- Non-invasive liver disease assessment
Background:
- Ultrasound shear wave elastography (SWE) is a non-invasive method for assessing liver stiffness in chronic liver diseases.
- Establishing age-specific reference values for liver elasticity in healthy children is crucial for clinical practice.
Purpose of the Study:
- To determine reference values for liver elasticity in a pediatric population using 2D SWE, stratified by age.
- To provide age-based normative data for liver elasticity in children and adolescents.
Main Methods:
- Retrospective analysis of 266 healthy children (0-19 years) undergoing abdominal ultrasonography.
- Measurement of liver elasticity and shear wave speed using convex (6C1) and linear (SL15-4) transducers on a Canon Aplio 500 system.
- Stratification of participants into five age groups to analyze age-dependent variations.
Main Results:
- Overall median liver elasticity was 5.50 kPa (IQR 4.9-6.3).
- Liver elasticity and speed decreased significantly with increasing age (p < 10⁻³).
- Elasticity values differed between the convex (5.20 kPa) and linear (6.2 kPa) transducers (p < 10⁻⁴).
Conclusions:
- This study provides crucial age-stratified reference values for liver elasticity in healthy children using 2D SWE.
- The findings highlight the influence of the ultrasound probe on measured liver elasticity values.
- These reference ranges aid in the accurate interpretation of liver stiffness measurements in pediatric patients.
Background:
Ultrasound shear wave elastography (SWE) measures liver stiffness non-invasively in chronic liver diseases. Reference values in healthy children by age are needed in clinical practice.
Objectives:
Our study aimed to measure the reference values for liver elasticity by 2D SWE in a pediatric population stratified by age.
Materials And Methods:
This retrospective study included 266 children without liver disease referred for an abdominal or renal ultrasonography from February 2022 to April 2022. Shear wave elasticity and shear wave speed were measured with a convex (6C1) or linear (SL15-4) transducer with a Canon Aplio 500 Aplio system performed for another reason in healthy children aged 0 to 19 years distributed in five age groups.
Results:
Median liver elasticity value was 5.50 kPa (interquartile range [IQR] 4.9-6.3) overall. Global analyses revealed values decreasing with increasing age from newborn to adolescence (elasticity: 6.0 kPa [IQR 5.4-6.5] to 5.3 kPa [IQR 4.7-6.4]; speed: 1.41 m/s [IQR 1.34-1.47] to 1.33 m/s [IQR 1.27-1.46], p < 10-3). Elasticity values were lower with the convex than linear transducer (5.20 kPa [IQR 4.7-5.8] vs 6.2 kPa [IQR 5.6-6.6], p < 10-4). Elasticity values increase with increasing age if we study each probe individually (from 1 year old to older). Median elasticity values were not associated with sex after adjustment for age or with BMI.
Conclusion:
Our study provides reference values for liver elasticity in healthy children by age and for two probes using an Aplio system. Liver elasticity values differed according to the probe used.
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