title: Limitations and opportunities of non-invasive liver stiffness measurement in children.
abstract: Changes in liver structure are an important issue in chronic hepatopathies. Until the end of the 20thcentury, these changes could only be determined by histological analyses of a liver specimen obtainedviabiopsy. The well-known limitations of this technique (i.e., pain, bleeding and the need for sedation) have precluded its routine use in follow-up of patients with liver diseases. However, the introduction of non-invasive technologies, such as ultrasound and magnetic resonance imaging, for measurement of liver stiffness as an indirect marker of fibroses has changed this situation. Today, several non-invasive tools are available to physicians to estimate the degree of liver fibrosis by analysing liver stiffness. This review describes the currently available tools for liver stiffness determination that are applicable to follow-up of liver fibrosis/cirrhosis with established clinical use in children, and discusses their features in comparison to the "historical" tools.
authors.affiliation: Guido Engelmann, Jasmin Quader, Department of Paediatrics, Lukas Hospital, D-41464 Neuss, Germany.
authors.forename: Guido
authors.initials: G
authors.lastname: Engelmann
authors.affiliation: Guido Engelmann, Jasmin Quader, Department of Paediatrics, Lukas Hospital, D-41464 Neuss, Germany.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Quader
authors.affiliation: Guido Engelmann, Jasmin Quader, Department of Paediatrics, Lukas Hospital, D-41464 Neuss, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Teufel
authors.affiliation: Guido Engelmann, Jasmin Quader, Department of Paediatrics, Lukas Hospital, D-41464 Neuss, Germany.
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Schenk
keywords: Children; Liver biopsy; Liver fibrosis; Transient elastography