EVALUATION OF LIVER ELASTICITY USING pSWE AND 2D-SWE TECHNIQUES IN HEALTHY CHILDREN

Year 2023, Volume: 30 Issue: 1, 69 - 77, 14.03.2023

Hüseyin Aydın , Fatma İssi

https://doi.org/10.17343/sdutfd.1252498

Abstract

Objective
Shear wave elastography (SWE) is a new
ultrasonography technique that can non-invasively
evaluate liver stiffness. The efficacy of SWE in adults
has been demonstrated by numerous studies, but
there are few SWE studies of pediatric groups. Since
the liver stiffness values (LSV) vary according to the
device and the SWE method used, standard reference
values have not been established as yet. The aim of
this study was to establish the reference values of
normal liver stiffness in healthy children according to
the two SWE methods.
Materials and Method
Liver stiffness values were measured using the two
different SWE methods of point SWE (pSWE) and
2-dimensional SWE (2D-SWE) in 107 healthy children
aged 8-18 years with no liver disease. The pSWE
(EPQ) and 2D-SWE (EQI) measurements were taken
in one session on the same device (Philips Epiq Elite)
and after at least 4 hours of fasting. The effects on
liver elasticity values were investigated of gender,
age, body mass index (BMI), some biochemical
markers (such as fasting blood glucose, aspartate
aminotransferase (AST), alanine aminotransferase
(ALT), albumin, platelet, INR) and liver size.
Results
The mean LSV was 4.04±0.84kPa ((95% confidence
interval (CI):3.67-4.42)) on pSWE and 4.41±0.71kPa
(95% CI:4.09-4.72) on 2D-SWE. The upper limit LSVs
were found to be 4.42kPa and 4.72kPa, respectively.
The LSVs measured on 2D-SWE were found to be
higher than on pSWE ((median; min-max, 4.34kPa;
2.82-6kPa and 3.86kPa; 2.55–5.78, respectively,
(r=0.59, p<0.001)). A low-level significant positive
correlation was determined between LSV and age
(r=0.267; p=0.006). No significant association was
determined between LSV and hepatic size, gender,
BMI and biochemical markers.
Conclusion
In healthy children aged 8-18 years, the mean liver
stiffness reference values obtained on the Philips Epiq
Elite ultrasound device were 4.04±0.84kPa using the
pSWE method and 4.41±0.71kPa using the 2D-SWE
method.These reference values will help the SWE
method to be used more effectively in the evaluation
of liver parenchyma in chronic liver diseases.

Keywords

Children, liver stiffness, ultrasound, shear wave elastography, two-dimensional shear wave imaging

Supporting Institution

None

SAĞLIKLI ÇOCUKLARDA KARACİĞER ELASTİKİYETİNİN pSWE VE 2D-SWE TEKNİKLERİ İLE DEĞERLENDİRİLMESİ

Abstract

Amaç
Share wave elastografi (SWE), karaciğer sertliğini
non-invaziv olarak değerlendirebilen yeni bir ultrasonografi
tekniğidir. Yetişkinlerde SWE'nin etkinliği çok
sayıda çalışmayla gösterilmiştir, ancak pediatrik gruplarda
çok az SWE çalışması vardır. Karaciğer sertliği
değerleri (KSD), cihaza ve kullanılan SWE yöntemine
göre değişiklik gösterdiğinden, standart referans değerleri
henüz oluşturulmamıştır. Bu çalışmanın amacı,
iki farklı SWE yöntemine göre, sağlıklı çocuklarda
normal karaciğerin referans sertlik değerlerini belirlemekti.
Gereç ve Yöntem
Karaciğer sertliği değerleri, 8-18 yaş arası 107 sağlıklı
çocukta, iki farklı SWE yöntemi olan point SWE
(pSWE) ve 2-dimentional SWE (2D-SWE) ile ölçüldü.
pSWE (EPQ) ve 2D-SWE (EQI) ölçümleri aynı cihaz
(Philips Epiq Elite) ile, tek seansta ve en az 4 saat
aç kaldıktan sonra alındı. Cinsiyet, yaş, vücut kitle indeksi
(VKİ), bazı biyokimyasal belirteçler ((açlık kan
şekeri, aspartat aminotransferaz (AST), alanin aminotransferaz
(ALT), albümin, trombosit, INR gibi)) ve
karaciğer boyutunun, KSD’ye etkisi araştırıldı.
Bulgular
Ortalama KSD, pSWE ile 4,04±0,84kPa ((%95 güven
aralığı (CI):3,67-4,42)) ve 2D-SWE ile 4,41±0,71kPa
(%95 CI:4,09-4,72) bulundu. Üst sınır KSD'ler sırasıyla
4,42kPa ve 4,72kPa idi. 2D-SWE'de ölçülen
KSD'ler, pSWE'den daha yüksekti ((sırasıyla medyan;
min-maks, 4,34kPa; 2,82-6kPa ve 3,86kPa; 2,55–
5,78, (r=0,59, p<0,001)). KSD ile yaş arasında düşük
düzeyde anlamlı pozitif korelasyon saptandı (r=0,267;
p=0,006). Fakat karaciğer büyüklüğü, cinsiyet, VKİ ve
biyokimyasal belirteçler ile KDS arasında anlamlı ilişki
saptanmadı.
Sonuç
8-18 yaş arası sağlıklı çocuklarda ortalama karaciğer
sertliği referans değerleri, Philips Epiq Elite ultrason
cihazı ile yapılan ölçümlerde, pSWE yöntemi ile
4,04±0,84kPa ve 2D-SWE yöntemi ile 4,41±0,71kPa
olarak bulundu. Bu referans değerleri, kronik karaciğer
hastalıklarında karaciğer parankiminin değerlendirilmesinde
SWE yönteminin daha etkin kullanılmasına
yardımcı olacaktır.

Keywords

Çocuk, karaciğer sertliği, ultrason, shear wave elastografi, iki boyutlu-shear wave elastografi.

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