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Pediatric Radiology

Published in:

01-05-2013 | Original Article

Acoustic radiation force impulse imaging—normal values of liver stiffness in healthy children

Authors: Sylviane Hanquinet, Delphine Courvoisier, Aikaterini Kanavaki, Amira Dhouib, Mehrak Anooshiravani

Published in: Pediatric Radiology | Issue 5/2013

Abstract

Background

Acoustic radiation force impulse imaging (ARFI) is a recent ultrasound technique to assess tissue stiffness.

Objective

Our aim was to describe the feasibility and to define normal ARFI values in liver in children.

Materials and methods

ARFI values were measured in 103 children (ages 2 weeks to 17 years) divided into four age groups, at a minimum depth of 3 cm. In 20 children, measurements were done at 3-, 4- and 5-cm depth in the liver to assess the suitability of measurement location. The impact of age groups and of depth groups was examined using multilevel models. The precision of the measurements was determined using intraclass correlation coefficient (ICC).

Results

There was no statistical difference between measurements taken at different ages, with a mean propagation velocity of 1.12 m/s (range: 0.73 to 1.45 m/s). There was no significant difference according to the depth of the regions of interest (up to 5 cm). The ICC was 0.77 (95% CI 0.69–0.83).

Conclusion

ARFI is feasible in children at any age with an acceptable reliability. The depth of measurements in the liver seems to have no influence on test results. We set the standard ARFI elastography values for healthy liver in children.

Bedossa P, Carrat F (2009) Liver biopsy: the best, not the gold standard. J Heptatol 50:1–3CrossRef

Lin ZH, Xin YN, Dong QJ et al (2011) Performance of the aspartate aminotransferase-to-platelet ratio index for the staging of hepatitis C-related fibrosis: an updated meta-analysis. Hepatology 53:726–736PubMedCrossRef

Nobili V, Alisi A, Vania A et al (2009) The pediatric NAFLD fibrosis index: a predictor of liver fibrosis in children with non-alcoholic fatty liver disease. BMC Med 7:21PubMedCrossRef

Hermeziu B, Messous D, Fabre M et al (2010) Evaluation of FibroTest-ActiTest in children with chronic hepatitis C virus infection. Gastroenterol Clin Biol 34:16–22PubMedCrossRef

Nobili V, Parkes J, Bottazzo G et al (2009) Performance of ELF serum markers in predicting fibrosis stage in pediatric non-alcoholic fatty liver disease. Gastroenterology 136:160–167PubMedCrossRef

Breton E, Bridoux-Henno L, Guyader D et al (2009) Intérêt de l’élastométrie impulsionnelle dans l’évaluation non invasive du stade de fibrose hépatique chez l’enfant. Arch Pediatr 16:1005–1010PubMedCrossRef

de Ledinghen V, Le Bail B, Rebouissoux L et al (2007) Liver stiffness measurement in children using FibroScan: feasibility study and comparison with Fibrotest, aspartate transaminase to platelets ratio index, and liver biopsy. J Pediatr Gastroenterol Nutr 45:443–450PubMedCrossRef

Menten R, Leonard A, Clapuyt P et al (2010) Transient elastography in patients with cystic fibrosis. Pediatr Radiol 40:1231–1235PubMedCrossRef

Engelmann G, Gebhardt C, Wenning D et al (2012) Feasibility study and control values of transient elastography in healthy children. Eur J Pediatr 171:353–360PubMedCrossRef

10.

Castera L, Foucher J, Bernard PH et al (2010) Pitfalls of liver stiffness measurement: a 5-year prospective study of 13,369 examinations. Hepatology 51:828–835PubMed

11.

Millonig G, Reimann FM, Friedrich S et al (2008) Extrahepatic cholestasis increases liver stiffness (FibroScan) irrespective of fibrosis. Hepatology 48:1718–1723PubMedCrossRef

12.

Sandrin L, Fourquet B, Hasquenoph JM et al (2003) Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound Med Biol 29:1705–1713PubMedCrossRef

13.

Noruegas MJ, Matos H, Goncalves I et al (2011) Acoustic radiation force impulse-imaging in the assessment of liver fibrosis in children. Pediatr Radiol 42:201–204PubMedCrossRef

14.

Rifai K, Cornberg J, Mederacke I et al (2011) Clinical feasibility of liver elastography by acoustic radiation force impulse imaging (ARFI). Dig Liver Dis 43:491–497PubMedCrossRef

15.

Toshima T, Shirabe K, Takeishi K et al (2011) New method for assessing liver fibrosis based on acoustic radiation force impulse: a special reference to the difference between right and left liver. J Gastroenterol 46:705–711PubMedCrossRef

16.

D’Onofrio M, Gallotti A, Mucelli RP (2010) Tissue quantification with acoustic radiation force impulse imaging: Measurement repeatability and normal values in the healthy liver. AJR Am J Roentgenol 195:132–136PubMedCrossRef

17.

Horster S, Mandel P, Zachoval R et al (2010) Comparing acoustic radiation force impulse imaging to transient elastography to assess liver stiffness in healthy volunteers with and without valsalva manoeuvre. Clin Hemorheol Microcirc 46:159–168PubMed

18.

Popescu A, Sporea I, Sirli R et al (2011) The mean values of liver stiffness assessed by acoustic radiation force impulse elastography in normal subjects. Med Ultrasound 13:33–37

19.

Son CY, Kim SU, Han WK et al (2011) Normal liver elasticity values using acoustic radiation force impulse (ARFI) imaging: a prospective study in healthy living liver and kidney donors. J Gastroenterol Hepatol 27:130–136CrossRef

20.

Gallotti A, D’Onofrio M, Pozzi Mucelli R (2010) Acoustic radiation force impulse (ARFI) technique in ultrasound with Virtual Touch tissue quantification of the upper abdomen. Radiol Med 115:889–897PubMedCrossRef

21.

Ebinuma H, Saito H, Komuta M et al (2011) Evaluation of liver fibrosis by transient elastography using acoustic radiation force impulse: comparison with Fibroscan. J Gastroenterol 46:1238–1248PubMedCrossRef

22.

Friedrich-Rust M, Wunder K, Kriener S et al (2009) Liver fibrosis in viral hepatitis: noninvasive assessment with acoustic radiation force impulse imaging versus transient elastography. Radiology 252:595–604PubMedCrossRef

23.

Goertz RS, Zopf Y, Jugl V et al (2010) Measurement of liver elasticity with acoustic radiation force impulse (ARFI) technology: an alternative noninvasive method for staging liver fibrosis in viral hepatitis. Ultraschall Med 31:151–155PubMedCrossRef

24.

Kim JE, Lee JY, Kim YJ et al (2010) Acoustic radiation force impulse elastography for chronic liver disease: comparison with ultrasound-based scores of experienced radiologists, Child-Pugh scores and liver function tests. Ultrasound Med Biol 36:1637–1643PubMedCrossRef

25.

Motosugi U, Ichikawa T, Niitsuma Y et al (2011) Acoustic radiation force impulse elastography of the liver: can fat deposition in the liver affect the measurement of liver stiffness? Jpn J Radiol 29:639–643PubMedCrossRef

26.

Karlas T, Pfrepper C, Wiegand J et al (2011) Acoustic radiation force impulse imaging (ARFI) for non-invasive detection of liver fibrosis: examination standards and evaluation of interlobe differences in healthy subjects and chronic liver disease. Scand J Gastroenterol 46:1458–1467PubMedCrossRef

Title: Acoustic radiation force impulse imaging—normal values of liver stiffness in healthy children
Authors: Sylviane Hanquinet
Delphine Courvoisier
Aikaterini Kanavaki
Amira Dhouib
Mehrak Anooshiravani
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: Pediatric Radiology / Issue 5/2013
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-012-2553-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Acoustic radiation force impulse imaging—normal values of liver stiffness in healthy children

Abstract

Background

Objective

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Objective

Materials and methods

Results

Conclusion

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