title: Acoustic radiation force impulse (ARFI) elastography for the noninvasive diagnosis of liver fibrosis in children.
abstract: BACKGROUND
  Acoustic radiation force impulse (ARFI) imaging) is correlated with histopathological findings using METAVIR and semiquantitative scoring system (SSS) criteria for liver fibrosis.
  
  
  OBJECTIVE
  To compare acoustic radiation force impulse imaging with biopsy results in the evaluation of liver fibrosis in children.
  
  
  METHODS
  Children with chronic liver disease and healthy children underwent acoustic radiation force impulse imaging liver measurements. ARFI gives a shear-wave velocity corresponding to tissue elasticity. In 39 children with liver disease, the values obtained were correlated with biopsy results. Receiver-operating characteristic (ROC) curves were used to determine the reliability of ARFI in estimating liver fibrosis in children.
  
  
  RESULTS
  ARFI mean value was 1.12 in the healthy group and 1.99 in children with chronic liver disease. ROC curves show that an ARFI cutoff of 1.34 m/s is predictive of both METAVIR and SSS scores with a sensitivity of SSS > 2:0.85; METAVIR > F0:0.82. A cutoff of 2 m/s yielded a sensitivity of 100% to detect SSS > 4 or METAVIR > F2.
  
  
  CONCLUSIONS
  Acoustic radiation force impulse imaging is a reliable, noninvasive and rapid method to estimate moderate to severe liver fibrosis in children. It might prove useful to clinicians for fibrosis monitoring in children with liver disease and postpone the time of liver biopsy.
authors.affiliation: Department of Pediatric Radiology, University Hospitals Geneva, Geneva, Switzerland. sylviane.hanquinet-ginter@hcuge.ch
authors.forename: Sylviane
authors.initials: S
authors.lastname: Hanquinet
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Rougemont
authors.forename: Delphine
authors.initials: D
authors.lastname: Courvoisier
authors.forename: Laura
authors.initials: L
authors.lastname: Rubbia-Brandt
authors.forename: Valérie
authors.initials: V
authors.lastname: McLin
authors.forename: Michela
authors.initials: M
authors.lastname: Tempia
authors.forename: Mehrak
authors.initials: M
authors.lastname: Anooshiravani
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007223:Infant; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity