Shear-wave ultrasound elastography of the liver in normal-weight and obese children

2017 ◽  
Vol 58 (12) ◽  
pp. 1511-1518 ◽  
Author(s):  
Smita Sane Bailey ◽  
Mostafa Youssfi ◽  
Mittun Patel ◽  
Houchun H Hu ◽  
Gabriel Q Shaibi ◽  
...  
Keyword(s):  
Shear Wave ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Liver Parenchyma ◽  
Normal Weight ◽  
Ultrasound Elastography ◽  
Qualitative Assessment ◽  
Imaging Biomarker ◽  
Imaging Biomarkers ◽  
Obese Children

Background The identification and subsequent management of liver diseases in children is challenging due to the lack of non-invasive imaging biomarkers. Ultrasound shear-wave elastography (US-SWE) is an emerging imaging technique which can quantitatively assess liver stiffness and may be useful as a tool in the management of liver disease in overweight and obese children. Purpose To evaluate US-SWE velocities of the liver in normal-weight and obese children, to correlate US-SWE findings with age and body-mass-index (BMI), and to compare US-SWE values with qualitative assessment (i.e. normal versus abnormal echogenicity) of the liver by conventional US. Material and Methods A cohort of 300 children (mean age, 9.9 ± 5.3 years; age range, 0.06–18.9 years) were studied, comprising 176 normal-weight and 124 obese participants. In each patient, both US-SWE and conventional US of the liver were obtained. Three pediatric radiologists individually and in consensus determined whether liver parenchyma was of normal or abnormal echogenicity. Results US-SWE velocities differed between normal-weight and obese children (1.08 ± 0.14 versus 1.44 ± 0.39 m/s; P < 0.001), but not by gender. Multivariate linear regression demonstrated US-SWE velocity to be primarily associated with age in normal-weight children ( P < 0.05) and with BMI in obese children ( P < 0.001). In the obese group, mean US-SWE velocity was statistically higher in participants with abnormal echogenic livers than in those with normal-appearing livers (1.53 ± 0.38 vs. 1.17 ± 0.27). The difference was not significant in the normal-weight group. Conclusion US-SWE provides a useful quantitative imaging biomarker for evaluating liver stiffness in children.

scholarly journals On the Impact of Nonalcoholic Fatty Liver Disease, Confirmed by Biopsy, on the Results of the Two-Dimensional Shear Elastography

2017 ◽  
pp. 88-95
Author(s):  
A. N. Katrich ◽  
A. V. Okhotina ◽  
O. N. Ponkina ◽  
N. S. Ryabin
Keyword(s):  
Shear Wave ◽  
Liver Tissue ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Liver Parenchyma ◽  
Outcome Analysis ◽  
Diagnostic Efficiency ◽  
Nonalcoholic Fatty Liver ◽  
Group 2 ◽  
The Impact

The aim:to study of the effect of NAFLD on the results of shear elastography (based on the results of liver biopsy).  Materials and methods.We have performed outcome analysis in 137 patients, treated from 2015 to 2016. All patients had chronic diffuse liver diseases and were hospitalized for morphological evaluation and diagnosis clarification. Group 1 (n = 117) with no fat changes in the liver parenchyma. Group 2 (n = 20) with steatosis of the liver.  In our work, we used: scanner Aixplorer (France). All patients underwent shear wave elastography (2DSWE) with the study of the quantitative index of stiffness of liver tissue, staging the results on the Metavir scale.Results.In the 1st group of patients (without steatosis), in the ROC analysis, cutoff values of elasticity were obtained, the diagnostic efficiency of the Metavir stage of fibrosis was the most optimal: for F2 > 6.8 kPa (sensitivity 85.7, specificity 52, 9, AUROC 0.684); For F3 > 8.5 kPa (sensitivity 91, specificity 57.1, AUROC 0.745); For F4 > 14 kPa (sensitivity 95.7, specificity 52.2, AUROC 0.791). It was found, that the presence of steatosis significantly increases the elasticity of the liver tissue. So, in the subgroup sF0 (with steatosis) was a significant increasing of young's module Ме = 11,2 kPa (95% CI 7,3–17,5) compared to Ме = 6,1 kPa (95% CI 5,4– 9,6) in the subgroup F0 (without steatosis) (P = 0,0168, AUROC = 0,741) and up to Ме=9,95 kPa (95% CI 6,8–13,0) in the subgroup sF0 + sF1 (with steatosis) compared with Ме=6,65 kPa (95%CI 5,6–9,5) of the subgroup F0 + F1 (without steatosis) (P = 0.0295, = 0.707). This increase was, respectively, 83,6% and 49.6%  Сonclusions.This study confirmed the effectiveness of the shear wave elastography method in assessing the relationship between stiffness parameters and the morphological fibrosis of the liver parenchyma and also contributed to the final confirmation of the effect of steatosis on  liver stiffness.

scholarly journals Staging liver fibrosis after severe yellow fever with ultrasound elastography in Brazil: A six-month follow-up study

2021 ◽  
Vol 15 (7) ◽  
pp. e0009594
Author(s):  
Yuri Costa Sarno Neves ◽  
Victor Augusto Camarinha de Castro-Lima ◽  
Davi Jorge Fontoura Solla ◽  
Vivian Simone de Medeiros Ogata ◽  
Fernando Linhares Pereira ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Yellow Fever ◽  
Previous History ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Liver Parenchyma ◽  
Ultrasound Elastography ◽  
Hemorrhagic Disease ◽  
Saps 3

Background Yellow fever (YF) is a hemorrhagic disease caused by an arbovirus endemic in South America, with recent outbreaks in the last years. Severe cases exhibit fulminant hepatitis, but there are no studies regarding its late-term effects on liver parenchyma. Thus, the aim of this study was to determine the frequency and grade of liver fibrosis in patients who recovered from severe YF and to point out potential predictors of this outcome. Methodology/Principal findings We followed-up 18 patients who survived severe YF during a recent outbreak (January-April 2018) in Brazil using ultrasound (US) with shear-wave elastography (SWE) at 6 months after symptoms onset. No patient had previous history of liver disease. Median liver stiffness (LS) was 5.3 (4.6–6.4) kPa. 2 (11.1%) patients were classified as Metavir F2, 1 (8.3%) as F3 and 1 (8.3%) as F4; these two last patients had features of cardiogenic liver congestion on Doppler analysis. Age and cardiac failure were associated with increased LS (p = 0.036 and p = 0.024, respectively). SAPS-3 at ICU admission showed a tendency of association with significant fibrosis (≥ F2; p = 0.053). 7 patients used sofosbuvir in a research protocol, of which none showed liver fibrosis (p = 0.119). Conclusions/Significance We found a low frequency of liver fibrosis in severe YF survivors. US with SWE may have a role in the follow up of patients of age and / or with comorbidities after hospital discharge in severe YF, a rare but reemergent disease.

scholarly journals Motion effects on the measurement of stiffness on ultrasound shear wave elastography: a moving liver fibrosis phantom study

2018 ◽  
Vol 1 (1) ◽  
pp. 14 ◽  
Author(s):  
Hyun Joo Shin ◽  
Myung-Joon Kim ◽  
Choon-Sik Yoon ◽  
Kwanseop Lee ◽  
Kwan Sik Lee ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Shear Wave ◽  
Acoustic Radiation ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Normal Liver ◽  
Ultrasound Elastography ◽  
Acoustic Radiation Force Impulse ◽  
Lower Velocity ◽  
Velocity Motion

Aims: To evaluate the differences between shear wave velocities (SWVs) measured with ultrasound elastography during the continuous motion using liver fibrosis phantoms.Materials and methods: Elasticities were measured with convex and linear transducers of supersonic shear wave imaging (SSI) and acoustic radiation force impulse imaging (ARFI) using liver elasticity phantoms (3.0 and 16.9 kPa) at depths of 2, 3, 4, and 5 cm. Motion velocities were 30 and 60 rpm with the phantoms in an upright position on the Orbital shaker. To simulate different directional motion, the phantoms were laid on their side on the shaker. The values between moving and static status were compared, and the number of measurement failure was counted. Results: In SSI, the convex transducer was less affected by motion at 30 rpm with the 3 kPa phantom. In the higher velocity motion and in the higher stiffness phantom, most values from SSI were different comparing with static status, and there was a tendency for elasticity values to increase during movement. In ARFI, there were frequent measurement failures without stable results during the motion.Conclusions: Motion affected the measurement of elasticity differently in SSI and ARFI, according to the velocity, direction of the motion, and phantom stiffness. The convex transducer of SSI was less affected by motion in lower velocity motion and when using normal liver stiffness phantom.

scholarly journals NON INVASIVE ASSESSMENT OF LIVER FIBROSIS USING ULTRASOUND POINT SHEAR WAVE ELASTOGRAPHY

2021 ◽  
pp. 1-3
Author(s):  
Sunil Patel ◽  
Chinmay Kulkarni ◽  
Srikanth Moorthy
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Shear Wave ◽  
Hepatic Fibrosis ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Ultrasound Elastography ◽  
Non Invasive ◽  
Elevated Liver Enzymes ◽  
Clinically Significant

Aim To prospectively determine the sensitivity, specificity and accuracy of point shear wave elastography as a non-invasive method in the diagnosis of clinically significant hepatic fibrosis with various etiologies of liver using liver biopsy as gold standard.To determine the stiffness cut-off values for point shear wave elastography (pSWE) diagnosis of clinically significant hepatic fibrosis. Methods Fifty patients with elevated liver enzymes were examined by point shear wave Elastography and they subsequently underwent percutaneous liver biopsy. Ultrasound Elastography findings were correlated with the histopathology fibrosis staging (METAVIR / Brunt Scoring) Results Liver stiffness value of >7.6 kPa was cut-off for clinically significant fibrosis and had a sensitivity of 92%, a specificity of 78.3% and an accuracy of 86%. Conclusions ElastPQ is a non-invasive and sensitive technique for determining the clinically significant liver fibrosis in patients with various etiologies.

Liver Elastography in Healthy Children Using Three Different Systems – How Many Measurements Are Necessary?

2020 ◽  
Author(s):  
Anders Batman Mjelle ◽  
Anesa Mulabecirovic ◽  
Roald Flesland Havre ◽  
Edda Jonina Olafsdottir ◽  
Odd Helge Gilja ◽  
...  
Keyword(s):  
Shear Wave ◽  
Transient Elastography ◽  
Intraclass Correlation ◽  
Age Groups ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Healthy Children ◽  
Significant Difference ◽  
Pediatric Liver Disease ◽  
Liver Elastography

Abstract Purpose Liver elastography is increasingly being applied in screening for and follow-up of pediatric liver disease, and has been shown to correlate well with fibrosis staging through liver biopsy. Because time is of the essence when examining children, we wanted to evaluate if a reliable result can be achieved with fewer acquisitions. Materials and Methods 243 healthy children aged 4–17 years were examined after three hours of fasting. Participants were divided into four age groups: 4–7 years; 8–11 years; 12–14 years and 15–17 years. Both two-dimensional shear wave elastography (2D-SWE; GE Logiq E9) and point shear wave elastography (pSWE; Samsung RS80A with Prestige) were performed in all participants, while transient elastography (TE, Fibroscan) was performed in a subset of 87 children aged 8–17 years. Median liver stiffness measurement (LSM) values of 3, 4, 5, 6, 7, and 8 acquisitions were compared with the median value of 10 acquisitions (reference standard). Comparison was performed for all participants together as well as within every specific age group. We investigated both the intraclass correlation coefficient (ICC) with absolute agreement and all outliers more than 10 %, 20 % or ≥ 0.5 or 1.0 kPa from the median of 10 acquisitions. Results For all three systems there was no significant difference between three and ten acquisitions, with ICCs ≥ 0.97. All systems needed 4 acquisitions to achieve no LSM deviating ≥ 1.0 kPa of a median of ten. To achieve no LSM deviating ≥ 20 % of a median of ten acquisitions, pSWE and TE needed 4 acquisitions, while 2D-SWE required 6 acquisitions. Conclusion Our results contradict recommendations of 10 acquisitions for pSWE and TE and only 3 for 2D-SWE.

Noninvasive Assessment of Liver Diseases using 2D Shear Wave Elastography

2016 ◽  
Vol 25 (4) ◽  
pp. 525-532 ◽  
Author(s):  
Monica Lupșor-Platon ◽  
Radu Badea ◽  
Mirela Gersak ◽  
Anca Maniu ◽  
Ioana Rusu ◽  
...  
Keyword(s):  
Shear Wave ◽  
Predictive Value ◽  
Liver Diseases ◽  
Venous Pressure ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Acoustic Radiation Force Impulse ◽  
Two Dimensional ◽  
Non Invasive ◽  
Examination Technique

There has been great interest in the development of non-invasive techniques for the diagnosis of liver fibrosis in chronic liver diseases, including ultrasound elastographic methods. Some of these methods have already been adequately studied for the non-invasive assessment of diffuse liver diseases. Others, however, such as two-dimensional Shear Wave Elastography (SWE), of more recent appearance, have yet to be validated and some aspects are for the moment incompletely elucidated. This review discusses some of the aspects related to two-dimensional SWE: the examination technique, the examination performance indicators, intra and interobserver agreement and clinical applications. Recommendations for a high-quality examination technique are formulated. Key words:  –  –  – Two-dimensional Shear Wave Elastography. Abbreviations: 2D- SWE: Two-dimensional Shear Wave Elastography; 3D- SWE: Three-dimensional Shear Wave Elastography; AUROC: area under the receiver operating characteristic curves; ARFI Acoustic Radiation Force Impulse Elastography; EFSUMB: European Federation of Societies for Ultrasound in Medicine and Biology; HVPG: hepatic venous pressure gradient; LS: liver stiffness; LR: likelihood ratio; NPV: negative predictive value; PPV: positive predictive value; ROI: region of interest; RT-E: Real Time-Elastography; Se: sensitivity; Sp: specificity; TE: Transient Elastography; US: ultrasound; VM: valid measurement; E: Young’s modulus

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