Cetinic Ivan, de Lange Charlotte, Simrén Yvonne, Ekvall Nils, Östling Maja, Stén Liselotte, Boström Håkan, Lagerstrand Kerstin, Hebelka Hanna
Department of Radiology & Pediatric Radiology, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden.
Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 41345 Gothenburg, Sweden.
Children (Basel). 2022 May 9;9(5):692. doi: 10.3390/children9050692.
Aim: To evaluate the feasibility of multiple ultrasound markers for the non-invasive characterization of fibrosis, inflammation and steatosis in the liver in pediatric patients. Materials and methods: The quantitative ultrasound measures shear wave elastography (SWE), shear wave dispersion (SWD) and attenuation imaging (ATI) were compared and correlated with percutaneous liver biopsies and corresponding measures in a control cohort. Results: The median age of the 32 patients was 12.1 years (range 0.1−17.9), and that of the 15 controls was 11.8 years (range: 2.6−16.6). Results: There was a significant difference in SWE values between histologic grades of fibrosis (p = 0.003), with a positive correlation according to the grade (r = 0.7; p < 0.0001). Overall, a difference in SWD values between grades of inflammation was found (p = 0.009) but with a lack of correlation (r = 0.1; p = 0.67). Comparing inflammation grades 0−1 (median:13.6 m/s kHz [min; max; 8.4; 17.5]) versus grades 2−3 (16.3 m/s kHz [14.6; 24.2]) showed significant differences between the groups (p = 0.003). In the 30 individuals with a steatosis score of 0, ATI was measured in 23 cases with a median value of 0.56 dB/cm/MHz. Conclusion: Comprehensive ultrasound analysis was feasible to apply in children and has the potential to reflect the various components of liver affection non-invasively. Larger studies are necessary to conclude to what extent these image-based markers can classify the grade of fibrosis, inflammation and steatosis.
评估多种超声标志物对儿科患者肝脏纤维化、炎症和脂肪变性进行无创特征分析的可行性。材料与方法：将定量超声测量剪切波弹性成像（SWE）、剪切波频散（SWD）和衰减成像（ATI）与经皮肝活检及对照组的相应测量值进行比较并关联。结果：32例患者的中位年龄为12.1岁（范围0.1 - 17.9岁），15例对照组患者的中位年龄为11.8岁（范围：2.6 - 16.6岁）。结果：纤维化组织学分级之间的SWE值存在显著差异（p = 0.003），且根据分级呈正相关（r = 0.7；p < 0.0001）。总体而言，炎症分级之间的SWD值存在差异（p = 0.009），但缺乏相关性（r = 0.1；p = 0.67）。比较炎症0 - 1级（中位值：13.6 m/s kHz [最小值；最大值；8.4；17.5]）与2 - 3级（16.3 m/s kHz [14.6；24.2]）显示两组之间存在显著差异（p = 0.003）。在30例脂肪变性评分为0的个体中，23例测量了ATI，中位值为0.56 dB/cm/MHz。结论：综合超声分析在儿童中应用是可行的，并且有潜力无创地反映肝脏病变的各种成分。需要更大规模的研究来确定这些基于图像的标志物在多大程度上能够对纤维化、炎症和脂肪变性的分级进行分类。
