title: A pilot study of the characterization of hepatic tissue strain in children with cystic-fibrosis-associated liver disease (CFLD) by acoustic radiation force impulse imaging.
abstract: BACKGROUND
  Progressive fibrotic alterations of liver tissue represent a major complication in children with cystic fibrosis. Correct assessment of cystic-fibrosis-associated liver disease (CFLD) in clinical routine is a challenging issue. Sonographic elastography based on acoustic radiation force impulse imaging (ARFI) is a new noninvasive approach for quantitatively assessing in vivo elasticity of biological tissues in many organs.
  
  
  OBJECTIVE
  To characterize ARFI elastography as a diagnostic tool to assess alteration of liver tissue elasticity related to cystic fibrosis in children.
  
  
  METHODS
  ARFI elastography and B-mode US imaging were performed in 36 children with cystic fibrosis. The children's clinical history and laboratory parameters were documented. According to the findings on conventional US, children were assigned to distinct groups indicating severity of hepatic tissue alterations. The relationship between US findings and respective elastography values was assessed. Additionally, differences between ARFI elastography values of each US group were statistically tested.
  
  
  RESULTS
  Children with sonomorphologic characteristics of fibrotic tissue remodeling presented significantly increased values for tissue elasticity. Children with normal B-mode US or discrete signs of hepatic tissue alterations showed a tendency toward increased tissue stiffness indicating early tissue remodeling.
  
  
  CONCLUSIONS
  Assessment of children with CFLD by means of ARFI elastography yields adequate results when compared to conventional US. For detection of early stages of liver disease with mild fibrotic reactions of hepatic tissue, ARFI elastography might offer diagnostic advantages over conventional US. Thus, liver stiffness measured by means of elastography might represent a valuable biological parameter for evaluation and follow-up of CFLD.
authors.affiliation: Department of Pediatric Radiology, University Hospital Giessen, Feulgenstrasse 10-12, 35392, Giessen, Germany. christopher.behrens@radiol.med.uni-giessen.de
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Behrens
authors.forename: Juliane H
authors.initials: JH
authors.lastname: Langholz
authors.forename: Jessika
authors.initials: J
authors.lastname: Eiler
authors.forename: Raphael
authors.initials: R
authors.lastname: Jenewein
authors.forename: Lutz
authors.initials: L
authors.lastname: Naehrlich
authors.forename: Konstantin
authors.initials: K
authors.lastname: Fuchs
authors.forename: Sebastian
authors.initials: S
authors.lastname: Harth
authors.forename: Gabriele A
authors.initials: GA
authors.lastname: Krombach
authors.forename: Gerhard F P
authors.initials: GF
authors.lastname: Alzen
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity