Can Point Shear Wave Elastography Be Used as an Early Indicator of Involvement?

Abstract

ObjectivesThe aim of this study was to determine the effect of cystic fibrosis (CF) on pancreas and liver elasticity in young children using point shear wave elastography and to determine the relationship with clinical findings.MethodsTwenty‐two patients with genetically proven CF, who were admitted to our pediatric gastroenterology clinic, and 22 healthy control participants were enrolled in the study. The shear wave velocity (SWV) of the liver and pancreas were measured with point shear wave elastography.ResultsThe 22 patients with CF included 45.5% girls with a mean age ± SD of 35 ± 35.8 months (range, 5–123 months). The 22 healthy control participants included 41.2% girls with a mean age of 58.9 ± 44.4 months (range, 2–159 months). The mean SWV of the pancreas in the patients with CF (1.06 ± 0.26 m/s) was significantly higher than that of the healthy control participants (0.85 ± 0.23 m/s; P = .01). The mean SWV of the liver in the patients with CF (1.46 ± 0.24 m/s) was significantly higher than that of the healthy control participants (1.12 ± 0.21 m/s; P = .001). The SWV of the pancreas and liver did not show any significant differences depending on ursodeoxycholic acid use, malnutrition status, and the presence of the F508 deletion mutation.ConclusionsThis study showed an increased SWV of the pancreas in children with CF, contrary to the literature. We also found an increased liver SWV even in the absence of CF‐related liver disease. Ultrasound elastography may be a useful method of evaluating early changes in the pancreas and liver before the obvious clinical, laboratory, and B‐mode ultrasound signs of CF‐related involvement.

Assessment of hepatic involvement by two‐dimensional shear wave elastography in paediatric patients with cystic fibrosis

“…reported increased liver stiffness in paediatric patients with CF over time and patients with further increase in liver stiffness progressed to CFLD. In liver elastography studies by Sağlam et al 10 . in 19 CF patients and control subjects, significantly increased liver stiffness values were observed among patients with CF compared to healthy children.…”

“…Studies on adult patients have found that US and magnetic resonance imaging elastography methods can detect liver fibrosis with high accuracy rates 7,8 . However, since paediatric patients less frequently present with clinical manifestations of hepatic involvement, the role of elastography in this setting has been investigated in only a few studies 9,10 …”

“…7,8 However, since paediatric patients less frequently present with clinical manifestations of hepatic involvement, the role of elastography in this setting has been investigated in only a few studies. 9,10 Therefore, this study aimed to demonstrate parenchymal changes in the liver in paediatric patients with CF in comparison to healthy children and to analyse the diagnostic performance of 2D-SWE for the detection of hepatic involvement.…”

Evaluation of children and adolescent with cystic fibrosis by pancreatic elastography

“…While all three techniques can be applied for spleen examination, pSWE and 2D‐SWE are preferred for the evaluation of the pancreas, kidney, gastrointestinal system, and other organs 12 . Studies on pancreatic elastography involving pediatric and adult CF patients are limited in the literature 8,13 . It may be important to observe pancreatic elasticity early in young patients with CF and to detect pancreatic insufficiency by elastography.…”

“…12 Studies on pancreatic elastography involving pediatric and adult CF patients are limited in the literature. 8,13 It may be important to observe pancreatic elasticity early in young patients with CF and to detect pancreatic insufficiency by elastography.…”