Yoon Hee Mang, Kim So Yeon, Kim Kyung Mo, Oh Seak Hee, Ko Gi-Young, Park Yangsoon, Lee Jin Seong, Jung Ah Young, Cho Young Ah
*Department of Radiology and Research Institute of Radiology †Department of Pediatrics ‡Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):892-897. doi: 10.1097/MPG.0000000000001517.
The aim of the study was to correlate liver stiffness (LS) and hepatic venous-pressure gradient (HVPG) and to evaluate the diagnostic performance of shear-wave elastography (SWE) for predicting clinically significant portal hypertension in children with suspected liver diseases, in consideration of the reliability criteria.
We identified 33 SWEs from 32 children who underwent HVPG measurement within 2 weeks between June 2012 and October 2015. The correlation between LS and HVPG was assessed. The diagnostic performance for predicting clinically significant portal hypertension (HVPG ≥ 10 mmHg) was assessed using the receiver-operating characteristic curve. Reliable measurement was evaluated based on the coefficient of variation (CV).
LS was significantly correlated with HVPG (r = 0.742, P < 0.001). The area under the receiver-operating characteristic curve for predicting clinically significant portal hypertension was 0.914, and the best cutoff value of 18.4 kPa showed sensitivity of 87.5% and specificity of 84.0%. LS measurements having CV ≤ 0.2 were significantly correlated with HVPG (r = 0.774, P < .001), whereas those having CV > 0.2 did not show a significant correlation with HVPG (r = 0.598, P = 0.089).
SWE had excellent diagnostic performance for predicting clinically significant portal hypertension in children with suspected liver diseases. LS measurements having CV ≤ 0.2 may possibly be used as a reliability criterion in SWE measurement.
本研究旨在关联肝脏硬度（LS）和肝静脉压力梯度（HVPG），并考虑可靠性标准，评估剪切波弹性成像（SWE）对疑似肝脏疾病儿童临床显著门静脉高压的诊断性能。
我们从2012年6月至2015年10月期间在2周内接受HVPG测量的32名儿童中识别出33次SWE检查。评估LS与HVPG之间的相关性。使用受试者工作特征曲线评估预测临床显著门静脉高压（HVPG≥10 mmHg）的诊断性能。基于变异系数（CV）评估可靠测量。
LS与HVPG显著相关（r = 0.742，P < 0.001）。预测临床显著门静脉高压的受试者工作特征曲线下面积为0.914，最佳截断值18.4 kPa的敏感性为87.5%，特异性为84.0%。CV≤0.2的LS测量与HVPG显著相关（r = 0.77４，P < 0.001），而CV>0.2的测量与HVPG无显著相关性（r = 0.598，P = 0.089）。
SWE对疑似肝脏疾病儿童临床显著门静脉高压具有出色的诊断性能。CV≤0.2的LS测量可能用作SWE测量的可靠性标准。
