Shear wave elastography and shear wave dispersion correlated to biopsy at the scheduled follow‐up of pediatric liver grafts

Abstract

BackgroundIt is unknown how shear wave dispersion (SWD) is displayed in pediatric liver transplant recipients and not fully elucidated how ultrasound shear wave elastography (2D‐SWE) display within this cohort, which is important to determine to improve noninvasive surveillance of these patients. The study aimed to compare SWE and SWD values with histopathology in pediatric liver recipients.MethodsForty‐eight pediatric liver recipients were examined with SWE in conjunction with an elective liver biopsy (clinically without complication). Additionally, SWD values were measured in 21 children. SWE and SWD values were compared to histologically determined fibrosis graded as none‐to‐mild (F0–1) and moderate‐to‐severe (F2–4), and inflammation graded as low (grade 0–1) and high (grade 2–4).ResultsTwo children were excluded due to SWE IQR/median > 30% kPa. The mean age across 46 included patients was 10.9 years (range 1.4–18). The number of patients and median (range) SWE value (kPa) for each stage of fibrosis were: F0–1 [n = 23; 5.8 (3.2–16.1)], F2 [n = 22; 6.0 (4.5–25.9)], F3 [n = 1; 33.3], and F4 [n = 0]. Significantly higher SWE values and greater variability were registered in F2–4 vs. F0–1 (p = .05). Grade of fibrosis correlated weakly to SWE values (r = .3; p = .05), but not to SWD values (r = .2; p = .27). In patients with low‐grade inflammation, median SWD was 13.7 m/s KHz (10.7–17.6). Only one patient had high‐grade inflammation.ConclusionsUncomplicated transplanted liver grafts in a small pediatric cohort revealed slightly increased SWE and SWD values compared to previously reported values in healthy children. This likely reflect both the fibrotic and inflammatory elements in the grafts; however, other confounders impacting the liver's viscoelastic properties are also probable factors.

European Society of Pediatric Radiology survey of perioperative imaging in pediatric liver transplantation: (3) postoperative imaging

“…Liver and spleen stiffness can be substantially increased after liver transplantation as in cases with hepatic outflow obstruction, rejection, and infection [ 47 – 51 ]. But so far, there is little systematic data available in children regarding the postoperative baseline liver stiffness values and cutoffs for pathologic changes using the various elastography methods [ 52 ]. A multiparametric approach applying the full bandwidth of US techniques for extended hepatic evaluation is not yet consensus among the European sites in the post-transplant monitoring scenario [ 53 ].…”