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Shear-wave elastography-based assessment of liver, spleen, and thyroid stiffness in children with Familial
Ayse Gokce1, Betul Turen2, Melike Nadide Sav3
1Department of Radiology, Bursa Yuksek Ihtisas Research and Training Hospital, Bursa, Turkey.
Insights
Shear-wave elastography (SWE) did not detect subclinical organ changes in children with Familial Mediterranean Fever (FMF) during remission. This suggests SWE has limited sensitivity for identifying early inflammation-related parenchymal changes in FMF.
Area of Science:
- Pediatric rheumatology
- Medical imaging
- Inflammatory diseases
Background:
- Familial Mediterranean Fever (FMF) is a genetic autoinflammatory disorder.
- Chronic inflammation in FMF can lead to AA amyloidosis.
- Detecting subclinical organ involvement is crucial for managing FMF complications.
Purpose of the Study:
- To evaluate the utility of shear-wave elastography (SWE) in detecting subclinical parenchymal changes in children with FMF.
- To compare liver, spleen, and thyroid stiffness in FMF patients during remission versus healthy controls.
- To assess the relationship between organ stiffness and inflammatory markers in FMF.
Main Methods:
- Prospective case-control study involving 43 children with FMF in remission and 50 healthy controls.
- Standardized SWE protocol applied to measure liver, spleen, and thyroid stiffness.
- Clinical data and inflammatory markers (ESR, CRP, AST, ALT) were recorded and analyzed.
Main Results:
- Children with FMF showed higher AST, ALT, ESR, and CRP levels compared to controls.
- No significant differences in liver, spleen, or thyroid stiffness were observed between the FMF and control groups.
- A weak, non-significant association was found between thyroid stiffness and ESR.
Conclusions:
- SWE measurements did not reveal differences in organ stiffness between FMF patients in remission and healthy children.
- SWE appears to have limited sensitivity in detecting subclinical organ involvement related to chronic inflammation in FMF.
- Further research is needed to explore SWE's role in different FMF disease states and over time.
Objectives:
To determine whether shear-wave elastography (SWE) can detect subclinical parenchymal changes related to chronic inflammation and AA amyloid risk by measuring liver, spleen, and thyroid stiffness in children with Familial Mediterranean Fever (FMF) in remission compared with healthy controls.
Methods:
In this prospective case-control study, 43 children with FMF and 50 age- and sex-matched healthy controls underwent SWE of the liver, spleen, and thyroid using a standardized protocol. All FMF patients were evaluated during clinical remission. Clinical characteristics and laboratory parameters, including inflammatory markers, were recorded. Measurements were performed by two blinded radiologists. For the liver and spleen, five technically valid ROIs were obtained from each organ; for the thyroid gland, five ROIs were obtained from each lobe. The arithmetic mean of technically valid ROI measurements was used as the final stiffness value for each organ.
Results:
AST, ALT, ESR, and CRP levels were higher in the FMF group (all p < .001). However, liver, spleen, and thyroid stiffness values did not differ between groups (all p > .05). Thyroid stiffness showed a weak, non-significant association with ESR (Spearman's rho = 0.376, p = .013).
Conclusions:
SWE-derived stiffness values were similar between children with FMF in remission and controls, suggesting limited sensitivity for detecting subclinical organ involvement.
Advances In Knowledge:
This study demonstrates that SWE-derived organ stiffness remains unchanged in children with FMF in remission despite biochemical evidence of low-grade inflammation, highlighting the need for further studies across different disease states and longitudinal settings.
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