Elastography to assess the stage of liver fibrosis in children: Concepts, opportunities, and challenges

Serai, Suraj D.; Trout, Andrew T.; Sirlin, Claude B.

doi:10.1002/cld.607

Cited by 31 publications

(16 citation statements)

References 16 publications

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“…Furthermore, future studies should widen the scope of methods used to detect liver fibrosis in patients. Alternate methods, that may enhance the value of T1 mapping and measurement of ECV when used in multi-parametric combinations, include T2 mapping, diffusion weighted imaging, MR perfusion, MR elastography and serologic markers of fibrosis [18, 21, 22].…”

Section: Discussionmentioning

confidence: 99%

Using T1 mapping in cardiovascular magnetic resonance to assess congestive hepatopathy

et al. 2018

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The goal of this study was to assess the ability of quantitative T1 cardiovascular magnetic resonance (CMR) imaging to calculate liver extracellular volume (ECV) in patients with varying degrees of congestive hepatopathy (CH). T1 measurements and ECV calculations were performed retrospectively in three cohorts of patients: normal cardiac function, tetralogy of fallot (TOF) repair and Fontan palliation. All CMR studies included modified look-locker inversion recovery (MOLLI) T1 mapping scans performed pre- and post-injection of a gadolinium-based contrast agent (GBCA). Pixel intensity data were manually collected from images of the liver and cardiac blood pool to determine contrast-induced changes in T1 for liver and blood. These data were then used to compute liver ECV. 172 subjects were included in the study. Of these, 140 subjects were normal cardiac function patients, 16 were TOF repair patients and 16 patients were with Fontan palliation. A statistically significant difference in both the liver native T1 and ECV measurements was found between patients with normal cardiac function vs. Fontan palliation patients (p < 0.01). Our data indicate that measuring T1 maps both pre- and post-GBCA injection within CMR scan session can be used to follow progression of liver fibrosis. This technique has the potential to improve diagnosis and treatment of patients with chronic liver disease and liver fibrosis.

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Section: Discussionmentioning

confidence: 99%

Using T1 mapping in cardiovascular magnetic resonance to assess congestive hepatopathy

et al. 2018

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“…The primary reason for organomegaly in GD is thought to be the increased expression and release of inflammatory mediators by Gaucher cells. This chronic inflammatory state in addition to splenectomy and iron overload may be the reason why Gaucher disease is associated with the long-term liver-related complication of fibrosis and eventually cirrhosis in some individuals [13]. In our case, patient had enlarged liver which can lead to liver fibrosis.…”

Section: Discussionmentioning

confidence: 62%

“…Thus the severity of the disease and hepatomegaly necessitate us to perform elastography. In our center, MRE is not yet available, but there has been Ultrasound (US) elastography which can also be used to monitor the degree of liver fibrosis [13]. Macrophage directed Enzyme replacement therapy (ERT) has been the most accepted form of treatment for GD.…”

Section: Discussionmentioning

confidence: 99%

Gaucher’s Disease in a 2 Years Old Child: A Case Report

Mahayani¹,

Sidiartha²,

Pratiwi³

2020

AJP

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“…An intercostal or subcostal approach was used according to the best visual window. SWE uses acoustic radiation force to induce microscopic tissue movements, in order to evaluate tissue stiffness, expressed as Young’s modulus (kPa) (13,20,21). The position of the regions of interest (ROI) is selected by the operator on a real-time gray-scale mode imaging, allowing to choose a homogeneous vessel free area, placed at least 1 cm below the liver capsule (14).…”

Section: Methodsmentioning

confidence: 99%

“…Although conventional ultrasound (US) is the most commonly employed technique (8,11), it is operator-dependent (12). Shear-wave elastography (SWE), a quantitative non-invasive US technique, assesses liver parenchyma stiffness and has been proposed for chronic liver disease (CLD) evaluation, identifying high-risk patients for liver transplantation (13–15). Magnetic resonance imaging (MRI) has been used to assess CLD in BA after KP (16–18) both for initial detection of liver abnormalities or for prognostic evaluation.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound, shear-wave elastography, and magnetic resonance imaging in native liver survivor patients with biliary atresia after Kasai portoenterostomy: correlation with medical outcome after treatment

et al. 2020

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Background Biliary atresia (BA) is a rare obliterative cholangiopathy and Kasai portoenterostomy (KP) represents its first-line treatment; clinical and laboratory parameters together with abdominal ultrasound (US) are usually performed during the follow-up. Shear-wave elastography (SWE) is able to evaluate liver parenchyma stiffness; magnetic resonance imaging (MRI) has also been proposed to study these patients. Purpose To correlate US, SWE, and MRI imaging findings with medical outcome in patients with BA who are native liver survivors after KP. Material and Methods We retrospectively enrolled 24 patients. They were divided in two groups based on “ideal” (n = 15) or “non-ideal” (n = 9) medical outcome. US, SWE, and MRI exams were analyzed qualitatively and quantitatively for imaging signs suggestive of chronic liver disease (CLD). Results Significant differences were found in terms of liver surface ( P = 0.007) and morphology ( P = 0.013), portal vein diameter ( P = 0.012) and spleen size ( P = 0.002) by US, liver signal intensity ( P = 0.013), portal vein diameter ( P = 0.010), presence of portosystemic collaterals ( P = 0.042), and spleen size ( P = 0.001) by MRI. The evaluation of portal vein diameter (moderate, κ = 0.44), of portosystemic collaterals (good, κ = 0.78), and spleen size (very good, κ = 0.92) showed the best agreement between US and MRI. A significant ( P = 0.01) difference in liver parenchyma stiffness by SWE was also found between the two groups (cut-off = 9.6 kPa, sensitivity = 55.6%, specificity = 100%, area under the ROC curve = 0.82). Conclusion US, SWE, and MRI findings correlate with the medical outcome in native liver survivor patients with BA treated with KP.

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Elastography to assess the stage of liver fibrosis in children: Concepts, opportunities, and challenges

Abstract: http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/9-1-reading-serai.html a video presentation of this article http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/9-1-interview-trout.html the interview with the author

Cited by 31 publications

References 16 publications

Using T1 mapping in cardiovascular magnetic resonance to assess congestive hepatopathy

Using T1 mapping in cardiovascular magnetic resonance to assess congestive hepatopathy

Gaucher’s Disease in a 2 Years Old Child: A Case Report

Ultrasound, shear-wave elastography, and magnetic resonance imaging in native liver survivor patients with biliary atresia after Kasai portoenterostomy: correlation with medical outcome after treatment

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