Liver cirrhosis in children – the role of imaging in the diagnostic pathway

Herrmann, Jochen; Petit, Philippe; Grabhorn, Enke; Lenz, Alexander; Jürgens, Julian; Franchi-Albella, Stéphanie

doi:10.1007/s00247-022-05480-x

Cited by 3 publications

(1 citation statement)

References 116 publications

(138 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Quantitative longitudinal measurements of liver stiffness are seen as especially useful for monitoring disease activity in a variety of disorders including liver transplantation. However, as the change of liver stiffness over time (delta) can also be a result of measurement variability, a standardized setup for the follow-up of individual patients is important [21].…”

Section: Discussionmentioning

confidence: 99%

Impact of probe-induced abdominal compression on two-dimensional shear wave elastography measurement of split liver transplants in children

Groth

Fischer

Herden

et al. 2023

Rofo

Self Cite

View full text Add to dashboard Cite

Purpose To evaluate the effect of probe-induced abdominal compression of split liver transplants (SLT) in children on 2D-shear wave elastography (SWE) values. Materials and Methods Data from 11 children (4.7 ± 4.8 years) who had undergone SLT and SWE were evaluated retrospectively. Elastograms were obtained with probes placed in an epigastric, midline position on the abdominal wall, with no and slight compression, using convex and linear transducers. For each identically positioned probe and condition, 12 serial elastograms were obtained and the SLT diameter was measured. Liver stiffness and degree of SLT compression were compared. Results Slight probe pressure resulted in SLT compression, with a shorter distance between the cutis and the posterior margin of the liver transplant than in the measurement with no pressure (curved array, 5.0 ± 1.1 vs. 5.9 ± 1.3 cm, mean compression 15 %± 8 %; linear array, 4.7 ± 0.9 vs. 5.3 ± 1.0 cm, mean compression 12 %± 8 %; both p < 0.0001). The median liver stiffness was significantly greater with slight pressure than with no pressure (curved transducer, 13.38 ± 3.0 vs. 7.02 ± 1.7 kPa, p < 0.0001; linear transducer, 18.53 ± 7.1 vs. 9.03 ± 1.5 kPa, p = 0.0003). Conclusion Slight abdominal compression can significantly increase SWE values in children with left-lateral SLT. To obtain meaningful results and reduce operator dependency in free-hand examinations, probe pressure must be controlled carefully. Key points: Citation Format

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of probe-induced abdominal compression on two-dimensional shear wave elastography measurement of split liver transplants in children

Groth

Fischer

Herden

et al. 2023

Rofo

Self Cite

View full text Add to dashboard Cite

show abstract

Shear wave elastography as a diagnostic tool in biliary atresia and liver fibrosis

Elzayat,

Hussien,

Adel

et al. 2024

Egypt J Radiol Nucl Med

View full text Add to dashboard Cite

Background The study aims to investigate Shear Wave Elastography's accuracy in assessing pediatric cholestasis and differentiating biliary atresia from other causes. The early diagnosis of cholestasis in newborns, when caused by true liver disease and not physiological or transient jaundice is usually eluded. To maximize the diagnostic reliability of ultrasound as an initial imaging modality to diagnose biliary atresia, ultrasound elastography has been introduced as a quantitative non-invasive sonographic technique to measure liver stiffness which is presumed to be different in biliary atresia from other cholestasis as well as follow-up liver stiffness post-Kasai operation. Results Ten patients (34.48%) were diagnosed with cholestasis with normal/low GGT. Five patients (17.24%) were diagnosed with hepatitis, and 2 patients had syndromes (10.34%). Other causes were found in 11 patients (37.93%). Major bile duct obstruction with fibrosis/cirrhosis was the majority of findings found in biliary atresia patients (100%), most of them with mild fibrosis (40%), followed by moderate (36.67%), then marked fibrosis (13.33%) and secondary cirrhosis (10%). ROC curve analysis shows that the best cut-off value for SWE = 1.97 with a sensitivity of 75.0% and specificity of 83.5%, with positive and negative predictive values were 82.8% and 74.1%, respectively. Mean shear wave elastography was significantly higher among the biliary atresia group (median 2.86) than in non-biliary atresia (median 1.81) and control groups (median 1.64) (P < 0.001) The best cut-off value of shear wear elastography for predicting outcome in pediatric patients post-Kasai procedure was 3.55, with a sensitivity of 66.7%, specificity of 64.7%, positive and negative predictive values were 25% and 91.7% respectively, with accuracy 65%. Conclusion The results of this study suggest that shear-wave elastography is a useful diagnostic tool for differentiating biliary atresia from other causes of cholestasis in pediatric patients, with a high sensitivity and specificity. Further studies are needed to validate the findings and determine the optimal cut-off value for shear wear elastography in clinical practice.

show abstract

Pediatric Perspectives on Liver Cirrhosis: Unravelling Clinical Patterns and Therapeutic Challenges

Forna,

Bozomitu,

Lupu

et al. 2024

JCM

View full text Add to dashboard Cite

Background: Liver cirrhosis presents significant challenges in the pediatric population due to a complex interplay of etiological factors, clinical manifestations, and limited therapeutic options. The leading contributors to cirrhosis among pediatric patients are chronic cholestasis, metabolic disorders present from birth, and long-term hepatitis. Materials and method: Our narrative review aimed to synthesize literature data on the etiology, clinical picture, diagnostic techniques, optimal management of complications, and timely transplantation. Results: The epidemiology of liver cirrhosis in pediatric patients is evolving. The introduction of a universal vaccination and effective long-term viral suppression in viral hepatitis have significantly decreased complications rates. Liver transplantation programs worldwide have also improved the management of cirrhosis complications. Conclusions: Early diagnosis, comprehensive management strategies, and advancements in treatment modalities are critical for improving outcomes. Understanding these differences is crucial in providing age-appropriate care and support for those affected by cirrhosis.

show abstract

Liver cirrhosis in children – the role of imaging in the diagnostic pathway

Cited by 3 publications

References 116 publications

Impact of probe-induced abdominal compression on two-dimensional shear wave elastography measurement of split liver transplants in children

Impact of probe-induced abdominal compression on two-dimensional shear wave elastography measurement of split liver transplants in children

Shear wave elastography as a diagnostic tool in biliary atresia and liver fibrosis

Pediatric Perspectives on Liver Cirrhosis: Unravelling Clinical Patterns and Therapeutic Challenges

Contact Info

Product

Resources

About