Shear‐wave elastography of the liver in a healthy pediatric population

Yang, Hanning; Sun, Yu; Tang, Yueyue; Lu, Yongping; Hu, Bing; Ying, Tao

doi:10.1002/jcu.22794

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…The latter studies demonstrated age-related differences in SWE, which we could confirm only by bivariate correlation, but have to negate considering multiple covariates. The absolute SWE values in our cohort (mean 4.37 ± 0.60 kPa) are comparable to already published data in children (16, [44][45][46][47] but lower than the mean values in other studies (48)(49)(50), possibly due to the usage of different ultrasound devices. Fasting duration did not significantly influence SWE in our study, as suggested by Simkin et al (51).…”

Section: Shear Wave Elastographysupporting

confidence: 88%

Validation of attenuation imaging coefficient, shear wave elastography, and dispersion as emerging tools for non-invasive evaluation of liver tissue in children

et al. 2023

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IntroductionThe number of children with acute and chronic liver disease is rising. Moreover, liver involvement may be limited to subtle changes in organ texture especially in early childhood and some syndromic conditions, such as ciliopathies. Attenuation imaging coefficient (ATI), shear wave elastography (SWE), and dispersion (SWD) are emerging ultrasound technologies providing data about attenuation, elasticity, and viscosity of liver tissue. This additional and qualitative information has been correlated with certain liver pathologies. However, limited data are available for healthy controls and have mainly been raised in adults.MethodsThis prospective monocentric study was conducted at a university hospital with a specialization in pediatric liver disease and transplantation. Between February and July 2021, 129 children aged 0-17.92 years were recruited. Study participants attended outpatient clinics due to minor illnesses excluding liver or cardiac diseases, acute (febrile) infections or other conditions affecting liver tissue and function. ATI, SWE, and SWD measurements were performed on an Aplio i800 (Canon Medical Systems) with an i8CX1 curved transducer by two different investigators with long-standing experience in pediatric ultrasound according to a standardized protocol.ResultsConsidering multiple potential covariates, we derived percentile charts for all 3 devices relying on the Lambda-Mu-Sigma (LMS) approach. 112 children were considered for further analysis, excluding those with abnormal liver function and under-/overweight (BMI SDS<-1.96/> 1.96, respectively). Age range was 0-17.92 years (mean 6.89±0.50SD), 58% were male. The mean duration of the ultrasound examination (basic ultrasound plus SWE, SWD, and ATI) was 6.67±0.22 minutes and it was well tolerated in 83% (n=92) of cases. While ATI was related to age, SWD was found to depend on BMI SDS, and SWE on abdominal wall thickness and sex. ATI correlated with neither SWE nor SWD, but SWE was correlated with SWD.ConclusionsOur study provides norm values and reference charts for ATI, SWE, and SWD considering important covariates including age, sex and, BMI. This may help to implement these promising tools into imaging diagnostics of liver disease and to improve the diagnostic relevance of liver ultrasound. In addition, these noninvasive techniques proved to be time-effective and highly reliable, which make them ideal for application in children.

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Section: Shear Wave Elastographysupporting

confidence: 88%

Validation of attenuation imaging coefficient, shear wave elastography, and dispersion as emerging tools for non-invasive evaluation of liver tissue in children

et al. 2023

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“…Impairment of wholekidney elasticity probably requires the profound histological changes of diabetic nephropathy. Previous studies reported reduced global kidney SWV and eGFR values in both patients with and those without severe proteinuria 6,12,19 . However, such findings probably require kidney damage that is more severe than glomerulosclerosis, such as irreversible tubulointerstitial fibrosis and vascular changes.…”

Section: Discussionmentioning

confidence: 89%

“…Although the SWVs were correlated positively with the extent of liver fibrosis 19 , they were correlated negatively with the CKD stage and eGFR 6,12 . The mechanism underlying the inverse relationship between kidney stiffness and the eGFR in CKD patients remains unclear.…”

Section: Discussionmentioning

confidence: 94%

Does Early Diabetic Kidney Damage Alter Renal Elasticity? An Ultrasound-Based, Two-Dimensional Shear Wave Elastography Study

Gündüz¹,

Buz²,

Kabaalioğlu³

2021

MMJ

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Objective: Kidney damage caused by type 2 diabetes mellitus (T2DM) can reduce renal elasticity. Limited number of data exist indicating whether early kidney damage causes stiffening of renal tissue. This comparative study aims to assess kidney elasticity in T2DM patients with or without moderate albuminuria, using ultrasound-based two-dimensional shear wave velocity (2D-SWV) measurements. Methods: Fifty-seven cases (40 T2D patients with stage 1 or 2 chronic kidney disease and 17 age- and sex-matched healthy controls) were included in this single-center prospective study. The T2DM patients were divided into those with moderate albuminuria (n=22) and those without albuminuria (n=18). Bilateral renal parenchymal 2D-SWV values were measured (separately) in the upper, middle, and lower kidney regions. Group data were compared using the t-test or Mann-Whitney-U test (whichever appropriate). Inter-observer agreement was assessed by deriving the intra-class correlation coefficient. Results: There was no difference between the T2DM and control groups in terms of the median age [55.5 (50-62) vs. 55 (48.5-59.5) years, p=0.48] and sex ratio [18 (45%) males vs. 10 (58.8%) females, p=0.34]. The average regional 2D-SWV values were all similar between the groups (all p>0.05). The average 2D-SWV values were similar between the subgroups with and without albuminuria. The inter-observer agreement was good (intra-class correlation coefficient=0.66, 95% CI 0.19-0.88, p=0.006). Conclusion: Kidney elasticity does not seem to be compromised in patients with diabetes and preserved estimated glomerular filtration rate with or without moderate albuminuria

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“…Several ultrasound-based techniques have been investigated in recent years for liver stiffness assessment (6,7). Point shear wave elastography (8)(9)(10)(11), transient elastography (10)(11)(12)(13), acoustic radiation force impulse (10,11,14,15), 2D shear wave elastography (10,11,16), and supersonic shear wave elastography (17) have been validated in the pediatric population to determine normal stiffness values, or to detect and stage liver fibrosis. The advantages of these methods are the low price, rapid assessment of liver stiffness, and the noninvasive character that allows for regular follow-up.…”

Section: Introductionmentioning

confidence: 99%

A tailored passive driver for liver MRE in pediatric patients

et al. 2022

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ObjectivesMagnetic resonance elastography (MRE) is increasingly used in the pediatric population for diagnosis and staging of liver fibrosis. However, the MR-compatible driver and sequences are usually those used for adult patients. Our feasibility study aimed to adapt the standardized adult MRE passive driver and vibrational parameters to a pediatric population.MethodsWe designed an elliptic passive driver shaped on a torus equipped with an elastic membrane and adapted to children's morphologies. As a first step, eight children (aged 8–18 years) were enrolled in a prospective pilot study aiming to determine the threshold vibrational amplitude for MRE using a custom passive driver, based on phase aliasing assessment and the occurrence of signal void artifacts on magnitude MR images. In the second step, the practicality and the consistency of the custom driver were assessed in a further 11 pediatric patients (aged 7–18 years). In the third step, we compared our custom driver vs. the commercial driver on six adult volunteers, in terms of the reliable region of interest area within the acquired MRE slices, the shear wave maps’ quality, and measured stiffness values obtained.ResultsBased on pediatric patient data, the threshold vibrational amplitude expressed as percentage of maximum output was found to be 0.4 and 1.1 times the body weight (kg) at 40 and 60 Hz frequencies, respectively. In comparison to the commercial passive driver, the custom driver improved threefold the contact with the body surface, also enabling a more comfortable examination as self-assessed by the volunteers.ConclusionsOur custom driver was more comfortable for the volunteers and was able to generate more homogenous shear waves, yielding larger usable hepatic area, and more reliable stiffness values.

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Shear‐wave elastography of the liver in a healthy pediatric population

Cited by 6 publications

References 24 publications

Validation of attenuation imaging coefficient, shear wave elastography, and dispersion as emerging tools for non-invasive evaluation of liver tissue in children

Validation of attenuation imaging coefficient, shear wave elastography, and dispersion as emerging tools for non-invasive evaluation of liver tissue in children

Does Early Diabetic Kidney Damage Alter Renal Elasticity? An Ultrasound-Based, Two-Dimensional Shear Wave Elastography Study

A tailored passive driver for liver MRE in pediatric patients

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