Evaluation Of Liver Elasticity In Children With Acoustic Radiation Force Impulse Imaging:Initial Research

PART Ⅰ ACOUSTIC RADIATION FORCE IMPULSE IMAGING IN MEASUREMENT OF LIVER ELASTICITY IN NORMAL CHILDRENObjective:To measure the liver elasticity in normal children with virtual touch tissue quantification (VTQ) and compared the shear wave velocity (SWV) among children of different age.Methods:458 children were divided into neonatal group (0-28 days, n=71), baby group (≥28 days and<1 year, n=53), children’s group (≥1 and< 3 years, n=61), preschool group (≥3 and< 6 years, n=86), school-age group (≥6 and<10 years, n=112), adolescence group (≥10 and <18 years, n=75) and underwent acoustic radiation force impulse imaging (ARFI). SWV values were compared between different groups. SWV value was measured under eupnea and apnea in 40 adolescence children to examine the influence of breathing. SWV value of different sample depth was measured and compared in 35 school-age children and 60 adolescence children, respectively.Results:The mean SWV value of all the children was (1.11±0.08) m/s. There were no significant differences of SWV among different age group (P>0.05), Neither breathing nor sample depth had no significant influence on SWV values (P>0.05).Conclusion:ARFI can be used to evaluate the liver elastography of normal children and there were no significant difference of SWV among children of different age. Taking (1.11±0.08) m/s as SWV values of normal children can provide a reference for researches of hepatic fibrosis children.PART II EVALUATION OF LIVER ELASTICTY IN CHILDREN WITH ACOUSTIC RADIATION FORCE IMPULSE IMAGING INObjective:To explore the value of ARFI in children with liver fibrosis.Methods:70 children with chronic liver disease comparing ARFI and the aspartate aminotransferase (AST):platelet ratio index (APRI)with histopathological analysis.50 Children with no history of liver disease served as a control group. The gold standard of liver biopsy was referred; ROC curve analysis was used to assess all SWV values and APRI. The corresponding cut-off values,sensitivities,and specificities were calculated and compared. In addition, the correlation analysis of pathological results with SWV and APRI were also tested, to evaluate the clinical value of elastography and liver fibrosis serological examination in children with liver fibrosis.Results:The SWV correlated positively with the stage of liver flbrosis(r=0.71,P<0.05):increasing stiffness with increasing fibrosis. The values of SWV in F1-F4 were 1.57±0.30 m/s,1.89±0.32 m/s,2.14±0.36 m/s,2.59±0.22 m/s, respectively. The APRI values had no correlation with liver fibrosis stages(r=-0.02,P>0.05).Diagnostic performance of ARFI for identifying fibrosis stage were:cut-off values of SWV of 1.73 m/s for F1 or higher,1.67 m/s for F2 or higher,1.84 m/s for F3 or higher, the Sensitivity were 54.30%,89.50%,84.60%,the Specificity were 100%,74.50%,83.3%,and the areas under the ROC curves were 0.82,0.89,0.91, respectively.Conclusion:ARFI plays an important role to evaluate the liver fibrosis of children, it could identify stage of liver fibrosis, especially in moderate and severe stage, and it provides a reference for prognosis and cure for children with liver disease.