Comparative evaluation of liver, spleen, and kidney stiffness in HIV-monoinfected pediatric patients via shear wave elastography

Abstract

Background/aim: This study aimed to evaluate the stiffness of the liver, spleen, and kidneys in HIV-monoinfected children via shear wave elastography (SWE). Materials and methods: Twenty-one HIV-monoinfected children and 37 healthy subjects were included in this study. Livers, spleens, and kidneys of the participants were examined via ultrasound and SWE. Patients were divided into two groups according to the presence of pathologic ultrasonographic findings. Routine laboratory tests were also recorded. Stiffness of these organs was compared between patients and control groups. Results: Liver transaminases, blood urea, and creatinine levels were normal in all subjects. Ultrasonographic examination revealed hepatosplenomegaly (n = 1, 4.7%), grade 1 hepatosteatosis (n = 1, 4.7%), and hepatosteatosis and minimal heterogeneity of the liver (n = 1, 4.7%). Ultrasonographic features were normal in 18 patients. Stiffness of the liver, spleen, and kidneys of all HIV-monoinfected children with normal laboratory parameters was significantly higher than in healthy subjects. Eighteen patients with normal ultrasonographic findings also had higher stiffness values when compared to control subjects. Conclusion: Stiffness of the liver, spleen, and kidneys in HIV-monoinfected children was increased. SWE can be used in the detection of early parenchymal changes even in patients with normal laboratory parameters and ultrasonographic findings.

Acoustic radiation force impulse imaging: normal values of spleen stiffness in healthy children

“…Some studies concerning splenic stiffness in children with chronic liver disease provide normal values in small control groups, but these were obtained from US machines from various manufacturers, thus compromising any reliable comparison of the values [ 6 , 18 ]. Splenic stiffness measurements from these manufacturers were either expressed in kilopascal (kPa), e.g., with a median of 17.85±1.3 kPa on 10 children ages 4 to 14 years [ 5 ], or expressed both in kPa and m/s, e.g., with a median of 16.8 kPa (1.6–22.8 kPa) and 2.4 m/s (2.0–2.7 m/s) in 37 patients (0.5–18.5 years) [ 19 ].…”

How to perform shear wave elastography. Part II

“…In adults, the convex transducer is used for performing the elastography studies. There is only one study on SS assessed in a pediatric population and the convex transducer was used [35]. Despite the lack of data, the transducer, either the linear or the curvilinear one, might be chosen depending on the body habitus and age of the patient, as we do for the assessment of the LS in children.…”