Related Experiment Video

Updated: Jan 18, 2026

Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis
05:56

Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis

Published on: August 29, 2025

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Effect of breath control on hepatic shear wave elasticity and dispersion in pediatric patients

Chanyoung Rhee1, Seunghyun Lee1, Young Hun Choi1

  • 1Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Ultrasonography (Seoul, Korea)
|September 11, 2025
PubMed

Insights

Breath-holding improves the reliability of pediatric liver stiffness measurements using two-dimensional shear wave elastography (2D-SWE) and shear wave dispersion (SWD). Free-breathing remains a feasible option for uncooperative children, showing comparable reproducibility.

Area of Science:

  • Pediatric Imaging
  • Medical Ultrasound
  • Elastography

Background:

  • Assessing liver stiffness in children is crucial for diagnosing and managing liver diseases.
  • Two-dimensional shear wave elastography (2D-SWE) and shear wave dispersion (SWD) are non-invasive ultrasound techniques for measuring liver stiffness.
  • The reliability of these techniques can be affected by patient cooperation and respiratory motion.

Purpose of the Study:

  • To evaluate the impact of breath control (breath-holding vs. free-breathing) on the reliability of 2D-SWE and SWD measurements in pediatric patients.
  • To compare the inter- and intra-rater agreement and correlation with magnetic resonance elastography (MRE) under different respiratory conditions.

Main Methods:

  • Retrospective and prospective study involving 190 children (aged 8-17 years).
  • Measurements of liver stiffness and dispersion using 2D-SWE and SWD were performed under both free-breathing and breath-hold conditions.
  • Prospective cohort also underwent MRE for comparison.

Main Results:

  • Liver stiffness and dispersion values were significantly higher during free-breathing compared to breath-hold (P<0.01).
  • Breath-holding significantly improved inter-rater agreement for both 2D-SWE (ICC, 0.94 vs. 0.83) and SWD (ICC, 0.85 vs. 0.70).
  • Intra-rater agreement remained stable, and correlations with MRE were stronger, though not significantly, under breath-hold.

Conclusions:

  • Breath-holding enhances the reliability of pediatric 2D-SWE and SWD by improving inter-rater agreement and correlation with MRE.
  • Free-breathing offers comparable reproducibility with minimal bias, making it clinically feasible for uncooperative pediatric patients.
Abstract

Keywords:
Breath holdingElasticity imaging techniquesMagnetic resonance elastographyPediatricsUltrasonography

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