Application and Limitations of Transient Liver Elastography in Children

Abstract

TE is feasible even in extremely young children, but confounding influences on test results such as probe choice, sedation, or food intake need to be taken into account when interpreting results.

Ultrasound Elastography Is Useful for Evaluation of Liver Fibrosis in Children—A Systematic Review

“…Eight studies did not find any effect of age (19,23,24,31,37,(43)(44)(45). Success rates were lower in younger children (14,19,21,23,43,44).…”

“…Success rates were lower in younger children (14,19,21,23,43,44). Boys had higher liver stiffness values compared with girls in two studies (21,45), but in six studies gender had no effect on measurements (19,22,23,37,41,42).…”

“…Boys had higher liver stiffness values compared with girls in two studies (21,45), but in six studies gender had no effect on measurements (19,22,23,37,41,42). BMI did not influence liver stiffness in four studies (22,24,31,41), while a high BMI lead to unsuccessful measurement in other studies (23,34,37). Increasing necroinflammatory grade was correlated to increasing liver stiffness in two studies (24,25).…”

Current Knowledge in Ultrasound-Based Liver Elastography of Pediatric Patients

“…Inter-and intra-observer agreements were good. Normal liver stiffness was 4.5 (2.5-8.9) kPa and did not vary significantly with age or sex [50]. However, another study found that LSMs were significantly age-dependent with values of 4.40, 4.73, and 5.1 kPa in children 0-5, 6-11, and 12-18 years (p = 0.001) respectively (Table 1), while the interquartile range decreased with age (0.8, 0.7, and 0.6 kPa).…”

Magnetic resonance elastography (MRE) in assessing hepatic fibrosis: performance in a cohort of patients with histological data

“…However, ultrasound elastography also has the limitation of sampling error (it evaluates a small cylindrical portion of the right lobe of the liver) and is less accurate in patients with significant truncal obesity [14,15]. This can limit its utility in patients with non-alcoholic fatty liver disease, a major cause of hepatic dysfunction in current times when obesity afflicts a large proportion of the population [16,17].…”