title: Shear wave elastography helps differentiate biliary atresia from other neonatal/infantile liver diseases.
abstract: BACKGROUND
  Biliary atresia is a rapidly progressive liver disease necessitating prompt diagnosis and surgical intervention, so it must be promptly distinguished from other neonatal/infantile liver diseases.
  
  
  OBJECTIVE
  To determine whether US shear wave elastography (SWE) can differentiate biliary atresia from other neonatal/infantile liver diseases based on liver hardness.
  
  
  METHODS
  Eleven children younger than 1 year who had suspected liver disease underwent anatomically and temporally-related hepatic shear wave elastography and clinically indicated percutaneous core needle biopsy. Shear wave elastography was performed immediately prior to liver biopsy at the targeted biopsy site using an Acuson S3000 US system/9L4 transducer (Siemens Medical Solutions USA, Malvern, PA). Shear wave elastography was performed using Virtual Touch Quantification (VTQ) and Virtual Touch IQ (VTIQ) modes, and six shear wave speed measurements were acquired from each subject for each mode. Children were placed in two groups based on histology, biliary atresia (n = 6) vs. non-biliary atresia (other neonatal/infantile liver diseases) (n = 5), and mean shear wave speed measurements were compared using the unpaired student's t-test (two-tailed). A P-value <0.05 was considered significant.
  
  
  RESULTS
  Using the VTQ mode, mean liver shear wave speed was 2.08 ± 0.17 m/s for the biliary atresia group and 1.28 ± 0.13 m/s for the non-biliary atresia group (P < 0.0001). Using the VTIQ mode, mean liver shear wave speed was 3.14 ± 0.73 m/s for the biliary atresia group and 1.61 ± 0.23 m/s for the non-biliary atresia group (P = 0.003). Ishak liver fibrosis scores ranged from 3 to 6 for the biliary atresia group and from 0 to 1 for the non-biliary atresia group.
  
  
  CONCLUSIONS
  Liver shear wave speed is abnormally increased in neonates and infants with biliary atresia.
authors.affiliation: Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, C.S. Mott Children's Hospital, 1540 East Hospital Drive, Ann Arbor, MI, 48109-4252, USA.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Leschied
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Dillman
authors.forename: Jacob
authors.initials: J
authors.lastname: Bilhartz
authors.forename: Amer
authors.initials: A
authors.lastname: Heider
authors.forename: Ethan A
authors.initials: EA
authors.lastname: Smith
authors.forename: M James
authors.initials: MJ
authors.lastname: Lopez
mesh_terms: D001656:Biliary Atresia / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000000981:diagnostic imaging; D008107:Liver Diseases / Q000000981:diagnostic imaging*; D008297:Male