Diagnostic performance and reproducibility of shear wave elastography techniques for liver stiffness assessment in children with biliary atresia.

IF 2.3 3区医学 Q2 PEDIATRICS

Pediatric Radiology Pub Date : 2025-08-01 Epub Date: 2025-07-16 DOI:10.1007/s00247-025-06333-z

Manli Fu, Chao Geng, Liqiong Shi, Jiaoyan Tan, Han Jing, Xueqiang Yan, Li Yuan

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引用次数: 0

Abstract

Background: Biliary atresia casuses progressive liver fibrosis in infants. After Kasai portoenterostomy (KPE), non-invasive liver monitoring is essential. Shear wave elastography (SWE) offers a promising alternative to biopsy.

Objectives: To evaluate the diagnostic performance, reproducibility, and inter-technique consistency of three shear wave elastography (SWE) modalities-point-SWE (p-SWE), two-dimensional SWE (2D-SWE), and supersonic shear imaging (supersonic-SWE)-in children with biliary atresia post-KPE.

Materials and methods: This prospective study (March 2024-November 2024) recruited 76 children: 47 biliary atresia patients (mean age, 5.7 ± 3.3 years; 24 girls) post-KPE and 29 healthy controls (mean age, 6.9 ± 3.2 years; 12 girls). Liver stiffness values were obtained using three SWE techniques. Statistical methods included the Mann-Whitney U test, Friedman test, intraclass correlation coefficients (ICCs), Spearman correlation, and generalized liner model analysis.

Results: Biliary atresia group showed significantly higher liver stiffness values than controls across all techniques (supersonic-SWE: 8.20 vs. 5.20 kPa, p-SWE: 6.60 vs. 3.50 kPa, 2D-SWE: 4.90 vs. 2.90 kPa; all P< 0.001). Supersonic-SWE yielded higher liver stiffness values than p-SWE and 2D-SWE (P< 0.05). Strong correlations were observed. Reproducibility was good to excellent (ICCs: 0.74 to 0.90), with supersonic-SWE demonstrating the highest ICC. Anteroposterior diameter of the left lobe was an independent predictor significantly associated with liver stiffness values (P< 0.001). Supersonic-SWE required longer measurement time than other techniques (P< 0.001).

Conclusion: SWE is a reliable tool for liver stiffness assessment in biliary atresia patients, however, inter-technique and inter-vendor discrepancies highlight the need for standardized protocol and techniques should not be used interchangeably.

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横波弹性成像技术对胆道闭锁儿童肝脏硬度评估的诊断性能和可重复性。

背景：胆道闭锁导致婴儿进行性肝纤维化。Kasai门肠造口术（KPE）后，无创肝脏监测是必不可少的。横波弹性成像（SWE）是一种很有前途的活检替代方法。目的：评价三种剪切波弹性成像（SWE）模式——点剪切波弹性成像（p-SWE）、二维剪切波弹性成像（2D-SWE）和超声剪切成像（超音速-SWE）对kpe后胆道闭锁儿童的诊断性能、再现性和技术间一致性。材料与方法：本前瞻性研究（2024年3月- 2024年11月）招募76名儿童：47例胆道闭锁患者(平均年龄5.7±3.3岁；24名女孩)kpe后和29名健康对照(平均年龄，6.9±3.2岁；12个女孩)。使用三种SWE技术获得肝脏刚度值。统计方法包括Mann-Whitney U检验、Friedman检验、类内相关系数（ICCs）、Spearman相关和广义线性模型分析。结果：在所有技术中，胆道闭锁组的肝脏硬度值均显著高于对照组(超音速swe: 8.20 vs. 5.20 kPa, p-SWE: 6.60 vs. 3.50 kPa, 2D-SWE: 4.90 vs. 2.90 kPa；结论：SWE是评估胆道闭锁患者肝脏硬度的可靠工具，然而，技术间和供应商间的差异突出了标准化方案的必要性，技术不应互换使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Radiology 医学-核医学

CiteScore

4.40

自引率

17.40%

发文量

300

审稿时长

3-6 weeks

期刊介绍： Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.