Ultrafast shear-wave elastography for pediatric deep vein thrombosis: a prospective feasibility study

Area of Science:

• Pediatric radiology
• Vascular imaging
• Biomaterials science

Background:

• Deep vein thrombosis (DVT) in children is a significant clinical concern.
• Accurate assessment of thrombus characteristics is crucial for effective management.
• Current methods for evaluating thrombus stiffness are limited, especially in pediatric populations.

Purpose of the Study:

• To assess the feasibility of ultrafast shear-wave elastography (SWE) for quantifying thrombus stiffness in pediatric deep vein thrombosis (DVT).
• To explore the changes in thrombus stiffness over time using SWE.
• To establish SWE as a potential non-invasive biomarker for thrombus maturation in children.

Main Methods:

• A prospective, single-center study enrolled pediatric patients (<18 years) with confirmed DVT.
• Bedside ultrafast SWE ultrasound was performed using a research platform and a linear transducer.
• Mean shear-wave velocity (SWV) was calculated using MATLAB, with measurements planned at multiple time points post-diagnosis.

Main Results:

• Ultrafast SWE was feasible in 19 out of 35 pediatric DVT patients, with higher success rates in older children and occlusive DVTs.
• A statistically significant increase in mean SWV (thrombus stiffness) of 0.012 m/s per day was observed over time (P<0.001).
• Older age at DVT diagnosis and female sex were independently associated with increased SWV.

Conclusions:

• Ultrafast SWE is a feasible technique for quantifying thrombus stiffness in pediatric DVT, particularly in older children and those with occlusive thrombi.
• Longitudinal analysis revealed that thrombus stiffness increases over time, suggesting a maturation process.
• Ultrafast SWE shows promise as a non-invasive quantitative biomarker for monitoring thrombus maturation in pediatric DVT.