title: Shear-wave ultrasound elastography of the liver in normal-weight and obese children.
abstract: Background The identification and subsequent management of liver diseases in children is challenging due to the lack of non-invasive imaging biomarkers. Ultrasound shear-wave elastography (US-SWE) is an emerging imaging technique which can quantitatively assess liver stiffness and may be useful as a tool in the management of liver disease in overweight and obese children. Purpose To evaluate US-SWE velocities of the liver in normal-weight and obese children, to correlate US-SWE findings with age and body-mass-index (BMI), and to compare US-SWE values with qualitative assessment (i.e. normal versus abnormal echogenicity) of the liver by conventional US. Material and Methods A cohort of 300 children (mean age, 9.9 ± 5.3 years; age range, 0.06-18.9 years) were studied, comprising 176 normal-weight and 124 obese participants. In each patient, both US-SWE and conventional US of the liver were obtained. Three pediatric radiologists individually and in consensus determined whether liver parenchyma was of normal or abnormal echogenicity. Results US-SWE velocities differed between normal-weight and obese children (1.08 ± 0.14 versus 1.44 ± 0.39 m/s; P < 0.001), but not by gender. Multivariate linear regression demonstrated US-SWE velocity to be primarily associated with age in normal-weight children ( P < 0.05) and with BMI in obese children ( P < 0.001). In the obese group, mean US-SWE velocity was statistically higher in participants with abnormal echogenic livers than in those with normal-appearing livers (1.53 ± 0.38 vs. 1.17 ± 0.27). The difference was not significant in the normal-weight group. Conclusion US-SWE provides a useful quantitative imaging biomarker for evaluating liver stiffness in children.
authors.affiliation: 1 Department of Medical Imaging and Radiology, Phoenix Children's Hospital, Phoenix, AZ, USA.
authors.forename: Smita Sane
authors.initials: SS
authors.lastname: Bailey
authors.affiliation: 1 Department of Medical Imaging and Radiology, Phoenix Children's Hospital, Phoenix, AZ, USA.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Youssfi
authors.affiliation: 1 Department of Medical Imaging and Radiology, Phoenix Children's Hospital, Phoenix, AZ, USA.
authors.forename: Mittun
authors.initials: M
authors.lastname: Patel
authors.affiliation: 1 Department of Medical Imaging and Radiology, Phoenix Children's Hospital, Phoenix, AZ, USA.
authors.forename: Houchun H
authors.initials: HH
authors.lastname: Hu
authors.affiliation: 2 Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.
authors.forename: Gabriel Q
authors.initials: GQ
authors.lastname: Shaibi
authors.affiliation: 1 Department of Medical Imaging and Radiology, Phoenix Children's Hospital, Phoenix, AZ, USA.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Towbin
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008099:Liver / Q000000981:diagnostic imaging; D008107:Liver Diseases / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D063766:Pediatric Obesity / Q000150:complications* / Q000000981:diagnostic imaging*; D011446:Prospective Studies
keywords: Ultrasound elastography; children; liver stiffness; obese; shear-wave elastography; ultrasound velocity