Department of Pediatric Radiology, Dr Sami Ulus Research and Training Hospital, 06580 Altindag, Ankara, Turkey.
Department of Pediatric Radiology, 55080 Omu, Samsun, Turkey.
Diagn Interv Imaging. 2018 Mar;99(3):151-156. doi: 10.1016/j.diii.2017.10.009. Epub 2017 Nov 14.
The purpose of this study was to determine the usefulness of point shear wave elastography (p-SWE) of the liver and spleen for the detection of portal hypertension in pediatric patients.
The study consisted of 38 healthy children and 56 pediatric patients with biopsy-proven liver disease who underwent splenic and liver p-SWE. The diagnostic performance of p-SWE in detecting clinically significant portal hypertension was assessed using receiver operating characteristic (ROC) curves.
Reliable measurements of splenic and liver stiffness with p-SWE were obtained in 76/94 (81%) and 80/94 patients (85%), respectively. The splenic stiffness was highest in the portal hypertension group (P<0.01). At ROC curve analysis, the area under the curve in the detection of portal hypertension was lower for splenic p-SWE than for liver p-SWE (0.906 vs. 0.746; P=0.0239). The cut-off value of splenic p-SWE for portal hypertension was 3.14m/s, with a specificity of 98.59% and a sensitivity of 68.18%. The cut-off value of liver p-SWE for portal hypertension was 2.09m/s, with a specificity of 80.28% and a sensitivity of 77.27%.
In pediatric patients, p-SWE is a reliable method for detecting portal hypertension. However, splenic p-SWE is less accurate than liver p-SWE for the diagnosis of portal hypertension.
本研究旨在确定肝脏和脾脏点剪切波弹性成像（p-SWE）在儿科患者门静脉高压检测中的作用。
本研究纳入 38 名健康儿童和 56 名经肝活检证实患有肝病的儿科患者，这些患者均接受了脾脏和肝脏 p-SWE 检查。使用受试者工作特征（ROC）曲线评估 p-SWE 检测临床显著门静脉高压的诊断性能。
p-SWE 成功获得了 76/94（81%）名和 80/94 名患者（85%）的脾脏和肝脏硬度可靠测量值。门静脉高压组的脾脏硬度最高（P<0.01）。在 ROC 曲线分析中，脾脏 p-SWE 检测门静脉高压的曲线下面积低于肝脏 p-SWE（0.906 对 0.746；P=0.0239）。脾脏 p-SWE 检测门静脉高压的截断值为 3.14m/s，特异性为 98.59%，敏感性为 68.18%。肝脏 p-SWE 检测门静脉高压的截断值为 2.09m/s，特异性为 80.28%，敏感性为 77.27%。
在儿科患者中，p-SWE 是一种可靠的检测门静脉高压的方法。然而，与肝脏 p-SWE 相比，脾脏 p-SWE 对门静脉高压的诊断准确性较低。
