Ultrasound Shear Wave Elastography, Shear Wave Dispersion and Attenuation Imaging of Pediatric Liver Disease with Histological Correlation
Abstract
:1. Introduction
2. Materials and Methods
2.1. Liver Measurements
2.2. Histopathology Scoring
2.3. Grading of Fibrosis
2.4. Grading of Inflammation
2.5. Grading of Steatosis
2.6. Reliability Valuation
2.7. Statistics
3. Results
3.1. Patient Characteristics and Liver Measures
3.2. Liver Biomarkers and Histopathology
3.2.1. SWE
3.2.2. SWD
3.2.3. ATI
3.3. Image-Based Liver Biomarkers and Serological Markers
3.4. Patients with Increased Serological Liver Markers without an Established Liver Disease
3.5. Controls
3.6. Comparison between Patients and Controls
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Number of Patients | |
---|---|
Liver transplants, yearly check-ups and acute indications | 8 |
Unspecified—increased serological liver markers | 8 |
Autoimmune hepatitis | 7 |
Alfa-1-antitrypsin deficiency | 4 |
Cholestatic disease | 2 |
Primary and autoimmune sclerosing cholangitis | 1 |
Non-alcoholic steatohepatitis (NASH) | 1 |
Steatosis | 1 |
Under Anesthesia | Awake | p-Value | |
---|---|---|---|
SWE (kPa) | 5.4 (2.9; 39.3) n = 41 | 5.4 (3; 20.1) n = 25 | 0.17 |
SWD (m/s kHz) | 13 (8.4; 24.2) n = 41 | 13.6 (9.4; 16.9) n = 25 | 0.15 |
ATI (dB/cm/MHz) | 0.56 (0.45; 0.94) n = 27 | 0.54 (0.38; 0.85) n = 19 | 0.14 |
Fibrosis Grade | n (%) | SWE (kPa) Median (Min; Max) |
0 | 10 (31.3) | 4.9 (2.9; 8.1) |
1 | 12 (37.5) | 5.9 (5.3; 9.4) |
2 | 7 (21.9) | 13.5 (4.7; 39.3) |
3 | 3 (9.4) | 23.6 (13.9; 33.3) |
Inflammation grade | SWD (m/s/kHz) | |
0 | 14 (43.8) | 13.1 (8.4; 17.2) |
1 | 13 (40.6) | 13.6 (11.3; 17.2) |
2 | 4 (12.5) | 16.1 (10.7; 24.2) |
3 | 1 (3.1) | 15.8 (15.3; 16.3) |
Steatosis score | ATI (dB/cm/MHz) | |
0 | 22 (95.6) | 0.56 (0.4; 0.94) |
1 | 1 (4.4) | 0.82 |
Patient (n = 32) | Control (n = 15) | p-Value | |
---|---|---|---|
Male | 22 (68.8%) | 8 (53.3%) | 0.48 |
Female | 10 (31.3%) | 7 (46.7%) | |
Age (years) | 12.1 (0.1; 17.9) | 11.8 (0.1; 17.9) | 0.75 |
Height (cm) | 148.5 (57; 191.3) | 149 (86; 177) | 0.78 |
Weight (kg) | 37.5 (4.5; 96) | 44 (11; 71) | 0.91 |
BMI (kg/m2) | 17.7 (13.5; 28.9) | 17.7 (13; 26.7) | 0.78 |
INR (prothrombin time) | 1.05 (0.9; 1.6) | 1 (0.9; 1.2) | 0.12 |
AST (µkat/L) | 15 (3; 15) | N/A | |
ALT (µkat/L) | 0.8 (0.22; 16) | 0.14 (0.1; 0.4) | <0.005 |
White cell count (×109/L) | 5.4 (2.2; 12.2) | 8.4 (5.1; 25.5) | <0.035 |
Thrombocytes (×109/L) | 239 (44; 444) | 333 (149; 707) | <0.02 |
Gamma-GT (µkat/L) | 0.53 (0.15; 10) | 0.83 (0.16; 1.5) | 0.9 |
Bilirubin (µkat/L) | 8.6 (3.3; 357) | 6.2 (5; 7.2) | <0.17 |
SWE (kPa) | 6.2 (2.9; 39.3) | 4.6 (3.3; 7.5) | <0.002 |
SWD (m/s/kHz) | 14.4 (8.4; 24.2) | 11.7 (9.4; 13.7) | <0.005 |
ATI (dB/cm/MHz) | 0.56 (0.4; 0.94) n = 23 | 0.54 (0.45; 0.85) n = 11 | 0.87 |
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Cetinic, I.; de Lange, C.; Simrén, Y.; Ekvall, N.; Östling, M.; Stén, L.; Boström, H.; Lagerstrand, K.; Hebelka, H. Ultrasound Shear Wave Elastography, Shear Wave Dispersion and Attenuation Imaging of Pediatric Liver Disease with Histological Correlation. Children 2022, 9, 692. https://doi.org/10.3390/children9050692
Cetinic I, de Lange C, Simrén Y, Ekvall N, Östling M, Stén L, Boström H, Lagerstrand K, Hebelka H. Ultrasound Shear Wave Elastography, Shear Wave Dispersion and Attenuation Imaging of Pediatric Liver Disease with Histological Correlation. Children. 2022; 9(5):692. https://doi.org/10.3390/children9050692
Chicago/Turabian StyleCetinic, Ivan, Charlotte de Lange, Yvonne Simrén, Nils Ekvall, Maja Östling, Liselotte Stén, Håkan Boström, Kerstin Lagerstrand, and Hanna Hebelka. 2022. "Ultrasound Shear Wave Elastography, Shear Wave Dispersion and Attenuation Imaging of Pediatric Liver Disease with Histological Correlation" Children 9, no. 5: 692. https://doi.org/10.3390/children9050692