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Published in: Pediatric Radiology 3/2015

01-03-2015 | Original Article

Shear wave elastography helps differentiate biliary atresia from other neonatal/infantile liver diseases

Authors: Jessica R. Leschied, Jonathan R. Dillman, Jacob Bilhartz, Amer Heider, Ethan A. Smith, M. James Lopez

Published in: Pediatric Radiology | Issue 3/2015

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Abstract

Background

Biliary atresia is a rapidly progressive liver disease necessitating prompt diagnosis and surgical intervention, so it must be promptly distinguished from other neonatal/infantile liver diseases.

Objective

To determine whether US shear wave elastography (SWE) can differentiate biliary atresia from other neonatal/infantile liver diseases based on liver hardness.

Materials and methods

Eleven children younger than 1 year who had suspected liver disease underwent anatomically and temporally-related hepatic shear wave elastography and clinically indicated percutaneous core needle biopsy. Shear wave elastography was performed immediately prior to liver biopsy at the targeted biopsy site using an Acuson S3000 US system/9L4 transducer (Siemens Medical Solutions USA, Malvern, PA). Shear wave elastography was performed using Virtual Touch Quantification (VTQ) and Virtual Touch IQ (VTIQ) modes, and six shear wave speed measurements were acquired from each subject for each mode. Children were placed in two groups based on histology, biliary atresia (n = 6) vs. non-biliary atresia (other neonatal/infantile liver diseases) (n = 5), and mean shear wave speed measurements were compared using the unpaired student’s t-test (two-tailed). A P-value <0.05 was considered significant.

Results

Using the VTQ mode, mean liver shear wave speed was 2.08 ± 0.17 m/s for the biliary atresia group and 1.28 ± 0.13 m/s for the non-biliary atresia group (P < 0.0001). Using the VTIQ mode, mean liver shear wave speed was 3.14 ± 0.73 m/s for the biliary atresia group and 1.61 ± 0.23 m/s for the non-biliary atresia group (P = 0.003). Ishak liver fibrosis scores ranged from 3 to 6 for the biliary atresia group and from 0 to 1 for the non-biliary atresia group.

Conclusion

Liver shear wave speed is abnormally increased in neonates and infants with biliary atresia.
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Metadata
Title
Shear wave elastography helps differentiate biliary atresia from other neonatal/infantile liver diseases
Authors
Jessica R. Leschied
Jonathan R. Dillman
Jacob Bilhartz
Amer Heider
Ethan A. Smith
M. James Lopez
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 3/2015
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-014-3149-z

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