Evaluation of Acoustic Radiation Force Impulse Imaging (ARFI) for the Determination of Liver Stiffness Using Transient Elastography as a Reference in Children.
OBJECTIVE
Transient elastography (Fibroscan(©); (FS)) and acoustic radiation force impulse imaging (ARFI) represent noninvasive, user-friendly and quick methods providing an objective and reproducible measure of liver stiffness. The aim of the study was to evaluate cut-off values and performance of ARFI measurements in children using transient elastography as a reference.


METHODS
A total of 198 children were enrolled in this study. All patients underwent liver stiffness measurements with FS (FS-LS) as well as ARFI (with shear wave velocity quantification; ARFI-SWV) and the performance of ARFI in comparison to FS was studied.


RESULTS
Significantly higher rates of successful measurements were found for ARFI compared to FS (198/198 (100%) vs. 160/198 (80.8%); p<0.001). ARFI-SWV correlated significantly with FS-LS (r=0.751, p=0.001). ARFI-SWV increased significantly with the stage of fibrosis (1.19+0.15 m/s for patients with FS-LS<7.6 kPa); 1.34+0.22 m/s for patients with 7.6<FS-LS<13.0 kPa); and 1.83+0.58 m/s for patients with FS-LS>13.0 kPa). ARFI-SWV cut-off values were identified for no significant fibrosis (1.31 m/s; sensitivity 61.8% and specificity 79.5%) and for liver cirrhosis (1.63 m/s; sensitivity 70.0% and specificity 97.4%). The median values of liver stiffness measured by FS were age-dependent in 90 children without liver diseases with 4.8, 5.6, and 5.7 kPa in children 0-5, 6-11, and 12-18 years, respectively.
Klinik für Gastroenterologie, Hepatologie und Infektiologie, Uniklinik Düsseldorf, Düsseldorf, Germany.
A
A
Sagir
Kinderklinik, Kath. Kinderkrankenhaus Wilhelmstift, Hamburg, Germany; Klinik für Allgemeine Pädiatrie, Neonatologie und KInderkardiologie, Uniklinik Düseldorf, Düsseldorf, Germany.
D
D
Ney
Klinik für Allgemeine Pädiatrie, Universität Hamburg/Eppendorf, Hamburg, Germany; Klinik für Allgemeine Pädiatrie, Neonatologie und KInderkardiologie, Uniklinik Düseldorf, Düsseldorf, Germany.
J
J
Oh
Klinik für Allgemeine Pädiatrie, Neonatologie und KInderkardiologie, Uniklinik Düseldorf, Düsseldorf, Germany.
S
S
Pandey
Klinik für Gastroenterologie, Hepatologie und Infektiologie, Uniklinik Düsseldorf, Düsseldorf, Germany.
G
G
Kircheis
Klinik für Allgemeine Pädiatrie, Neonatologie und KInderkardiologie, Uniklinik Düseldorf, Düsseldorf, Germany.
E
E
Mayatepek
Klinik für Gastroenterologie, Hepatologie und Infektiologie, Uniklinik Düsseldorf, Düsseldorf, Germany.
D
D
Häussinger
abdomen; diagnostic radiology; safety
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