Tokuhara Daisuke, Cho Yuki, Shintaku Haruo
Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka, Japan.
PLoS One. 2016 Nov 18;11(11):e0166683. doi: 10.1371/journal.pone.0166683. eCollection 2016.
Pediatric use of liver transient elastography (TE) is attractive for its non-invasiveness, but reference values have not been established. We aimed to determine reference values for TE in children.
In pediatric patients (1 to 18 years), TE (FibroScan®) with an M probe was used for both liver stiffness measurement (LSM) and measurement of hepatic fat deposition by using a controlled attenuation parameter (CAP). The patients were divided into three relevant age groups: preschoolers (1 to 5 years), elementary school children (6 to 11 years), and adolescents (12 to 18 years). Overweight or obese patients or those with known liver disease, elevated serum liver enzymes, or hepatic echogenic abnormality were excluded from the study.
Among 139 children, 123 (88.5%; 62 male; median age, 11.7 years; age range, 1.3 to 17.2 years) were successfully subjected to M-probe TE without anesthesia. Median LSM increased with age: it was 3.4 kPa (2.3 to 4.6 kPa, 5th to 95th percentiles) at ages 1 to 5 years; 3.8 (2.5 to 6.1) kPa at ages 6 to 11; and 4.1 (3.3 to 7.9) kPa at ages 12 to 18 (P = 0.001). Median CAP was not age dependent: it was 183 (112 to 242) for ages 1 to 18 years.
M-probe TE is suitable in a wide age range of children from age 1 year up. In children without evidence of liver disease, LSM has an age-dependent increase, whereas CAP does not differ between ages 1 and 18.
肝脏瞬时弹性成像（TE）用于儿科具有无创性优势，但尚未确立参考值。我们旨在确定儿童TE的参考值。
对儿科患者（1至18岁）使用配备M探头的TE（FibroScan®）进行肝脏硬度测量（LSM），并通过受控衰减参数（CAP）测量肝脏脂肪沉积。患者分为三个相关年龄组：学龄前儿童（1至5岁）、小学生（6至11岁）和青少年（12至18岁）。超重或肥胖患者、已知患有肝病、血清肝酶升高或肝脏回声异常的患者被排除在研究之外。
139名儿童中，123名（88.5%；62名男性；中位年龄11.7岁；年龄范围1.3至17.2岁）在未麻醉情况下成功接受了M探头TE检查。LSM中位数随年龄增长而增加：1至5岁时为3.4 kPa（第5至95百分位数为2.3至4.6 kPa）；6至11岁时为3.8（2.5至6.1）kPa；12至18岁时为4.1（3.3至7.9）kPa（P = 0.001）。CAP中位数与年龄无关：1至18岁时为183（112至242）。
M探头TE适用于1岁及以上的广泛年龄段儿童。在无肝病证据的儿童中，LSM随年龄增长而增加，而CAP在1至18岁之间无差异。
