Ultrasound Elastography Applications in Pediatrics

Abstract

Ultrasound is one of the most important imaging modalities in pediatric imaging because of its accessibility, portability, lack of ionizing radiation, and ability to generally perform examinations without need for sedation. Ultrasound elastography can measure the stiffness of various tissues. This review article aims to discuss how ultrasound elastography has performed in evaluating multiple pathologies in the pediatric population. The best studied pediatric applications are in liver diseases such as fibrosis, biliary atresia, and hepatic vascular congestion. Measuring muscle stiffness in cerebral palsy is the most promising pediatric musculoskeletal application, but many other applications are in the early stages of research. Other applications in pediatric small organ imaging have been explored and still need more study before gaining clinical relevance.

Value of strain-wave sonoelastography as an imaging modality in assessment of benign acute myositis in children

“…Strain elastography is also referred to as compression elastography and depends on the principle that harder tissues are less compressible and demonstrate lower strain, while softer tissues are more compressible and demonstrate higher strain. In strain-based elastography, force is applied by the application of probe pressure or through endogenous mechanical force (e.g., carotid pulsation) In shear-wave based elastography, a tissue shear-wave is induced by the imaging system [4][5][6].…”

“…Advanced ultrasound techniques can enhance the diagnostic sensitivity of conventional gray-scale imaging [4]. At this point sonoelastography, which is one of the latest advances in ultrasonography and offers a good functional and quantitative evaluation by measuring the stiffness /elasticity of the muscles, is promising as an accessible, low-cost, radiation-free technique [5].…”

Imaging in Hepatic Veno-Occlusive Disease/Sinusoidal Obstruction Syndrome

“…The use of ultrasound elastography has evolved rapidly in recent years as a noninvasive method for assessing the mechanical properties of tissue [24][25][26]. Ultrasound elastography techniques include different methods to measure qualitative and quantitative changes in soft tissue elasticity [25].…”

“…Ultrasound elastography techniques include different methods to measure qualitative and quantitative changes in soft tissue elasticity [25]. Qualitative imaging is performed using mechanical forces or intrinsic internal forces, whereas quantitative imaging is generally performed through the application of force produced by an ultrasound probe [26]. The 3 ultrasound elastography methods in use today are TE; point shear wave elastography (pSWE), also known as acoustic radiation force impulse quantification; and 2-dimensional shear wave elastography (SWE) (Figure 3) [27,28].…”

“…The 3 ultrasound elastography methods in use today are TE; point shear wave elastography (pSWE), also known as acoustic radiation force impulse quantification; and 2-dimensional shear wave elastography (SWE) (Figure 3) [27,28]. SWE uses qualitative and quantitative techniques (Figure 4) [26]. Among these techniques, liver stiffness measurement assessed by TE (FibroScan; Echosens, Paris, France) is the most validated approach with wide application in liver diseases [21].…”