title: Quantitative Shear-Wave Elastography of the Liver in Preterm Neonates with Intra-Uterine Growth Restriction.
abstract: The feasibility and reproducibility of liver stiffness measurements using Supersonic Shear-wave Imaging (SSI) in preterm neonate have not been reported. Our aim was to determine if liver stiffness differs between intra-uterine growth restriction (IUGR) and appropriate for gestational age (AGA) preterm infants with/without cholestasis. We measured liver stiffness (in kPa) in 45 AGA and 18 IUGR preterm infants, and assessed reproducibility in 26 preterms using Intraclass Correlation Coefficients (ICC) and Bland-Altman tests. Liver stiffness values were compared between AGA and IUGR with and without cholestasis and correlated with birth weight. Measurements showed high reproducibility (ICC = 0.94-0.98 for intra-operator, 0.86 for inter-operator) with good agreement (95% limits: -1.24 to 1.24 kPa). During the first postnatal week, liver stiffness was higher in IUGR (7.50 ±1.53 kPa) than in AGA infants (5.11 ±0.80 kPa, p<0.001). After day 8, liver stiffness remained unchanged in AGA but increased progressively in IUGR infants (15.57 ±6.49 kPa after day 21). Liver stiffness was higher in IUGR neonates with cholestasis (19.35 ± 9.80 kPa) than without cholestasis (7.72 ± 1.27 kPa, p<0.001). In conclusion, quantitative liver SSI in preterms is feasible and reproducible. IUGR preterms who will develop cholestasis present high liver stiffness even at birth, before biological cholestasis occurs.
authors.affiliation: Department of Pediatric Radiology, Robert Debré Children University Hospital and Denis Diderot Paris University, APHP, 75019 Paris, France.|PremUP foundation, 75014 Paris, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Alison
authors.affiliation: PremUP foundation, 75014 Paris, France.|Neonatal Intensive Care Unit and INSERM U1141, Robert Debré Children University Hospital and Denis Diderot Paris University, APHP, 75019 Paris, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Biran
authors.affiliation: Department of Pediatric Radiology, Robert Debré Children University Hospital and Denis Diderot Paris University, APHP, 75019 Paris, France.|PremUP foundation, 75014 Paris, France.
authors.forename: Anca
authors.initials: A
authors.lastname: Tanase
authors.affiliation: Neonatal Intensive Care Unit and INSERM U1141, Robert Debré Children University Hospital and Denis Diderot Paris University, APHP, 75019 Paris, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Bendavid
authors.affiliation: Department of Pediatric Radiology, Robert Debré Children University Hospital and Denis Diderot Paris University, APHP, 75019 Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Blouet
authors.affiliation: PremUP foundation, 75014 Paris, France.|Institut Langevin, CNRS UMR 7587, INSERM U979, ESPCI ParisTech, 75005 Paris, France.
authors.forename: Charlie
authors.initials: C
authors.lastname: Demené
authors.affiliation: Department of Pediatric Radiology, Robert Debré Children University Hospital and Denis Diderot Paris University, APHP, 75019 Paris, France.|PremUP foundation, 75014 Paris, France.
authors.forename: Guy
authors.initials: G
authors.lastname: Sebag
authors.affiliation: PremUP foundation, 75014 Paris, France.|Institut Langevin, CNRS UMR 7587, INSERM U979, ESPCI ParisTech, 75005 Paris, France.
authors.forename: Mickael
authors.initials: M
authors.lastname: Tanter
authors.affiliation: PremUP foundation, 75014 Paris, France.|Neonatal Intensive Care Unit and INSERM U1141, Robert Debré Children University Hospital and Denis Diderot Paris University, APHP, 75019 Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Baud
mesh_terms: D001724:Birth Weight; D002779:Cholestasis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology; D054459:Elasticity Imaging Techniques / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008099:Liver / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D015203:Reproducibility of Results; D016019:Survival Analysis