Kim Seung, Kang Yunkoo, Lee Mi Jung, Kim Myung Joon, Han Seok Joo, Koh Hong
*Department of Pediatrics †Department of Radiology and Research Institute of Radiological Science ‡Department of Pediatric Surgery, Yonsei University College of Medicine, Severance Pediatric Liver Disease Research Group, Severance Children's Hospital, Seoul, South Korea.
J Pediatr Gastroenterol Nutr. 2014 Nov;59(5):624-8. doi: 10.1097/MPG.0000000000000489.
With the introduction of smaller probes (S1, S2), the use of transient elastography has been expanded to children. Accordingly, we aimed to address points of consideration in probe choice and interpretation of measured liver stiffness by applying and comparing FibroScan S and M probes in biliary atresia.
Using S1, S2, and M probes, 3 liver stiffness measurements, success rates, and interquartile ranges were obtained from 100 patients. Patients were assigned to 2 groups according to thoracic perimeter (≤ 45 cm vs > 45 cm). In both groups, obtained values were compared and the relation between liver stiffness measurement and aspartate aminotransferase-to-platelet ratio index was analyzed.
In the small-thorax group, the success rate was highest with the S1 probe and the intraclass correlation coefficient (ICC) was highest for S1 versus S2 (0.98), compared with that for S1 versus M (0.69) and S2 versus M (0.77). In the large-thorax group, ICC was the highest for S2 versus M (0.88), compared with that for S1 versus S2 (0.69) and S1 versus M (0.51). In the small-thorax group, correlations between aspartate aminotransferase-to-platelet ratio index and liver stiffness measurement were stronger for S1 (0.65) and S2 (0.64) than for M (0.49). In the large-thorax group, all probes showed good correlation, S1 (0.68), S2 (0.62), and M (0.62).
We recommend that the S1 probe is more appropriate for use in small children, especially those with a thorax perimeter of < 45 cm. If no S probe is available, the M probe may be acceptable in children whose thorax perimeter is > 45 cm.
随着更小探头（S1、S2）的引入，瞬时弹性成像技术已扩展应用于儿童。因此，我们旨在通过在胆道闭锁患儿中应用和比较FibroScan S和M探头，探讨探头选择及所测肝脏硬度值解读方面的注意事项。
使用S1、S2和M探头，对100例患者进行3次肝脏硬度测量、成功率及四分位数间距测定。根据胸围（≤45 cm与>45 cm）将患者分为两组。比较两组所获数值，并分析肝脏硬度测量值与天冬氨酸转氨酶与血小板比值指数之间的关系。
在小胸围组中，S1探头的成功率最高，S1与S2的组内相关系数（ICC）最高（0.98），而S1与M的ICC为0.69，S2与M的ICC为0.77。在大胸围组中，S2与M的ICC最高（0.88），S1与S2的ICC为0.69，S1与M的ICC为0.51。在小胸围组中，S1（0.65）和S2（0.64）的天冬氨酸转氨酶与血小板比值指数与肝脏硬度测量值之间的相关性强于M（0.49）。在大胸围组中，所有探头均显示出良好的相关性，S1为0.68，S2为0.62，M为0.62。
我们建议S1探头更适合用于幼儿，尤其是胸围<45 cm的患儿。如果没有S探头，对于胸围>45 cm的儿童，M探头也可接受。
