Serai Suraj D, Glenn Alexandra, Trout Andrew T, Lerebo Wondwossen T, Gee Michael S, Khanna Geetika, Anupindi Sudha A
Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Pediatr Radiol. 2025 Apr;55(4):846-856. doi: 10.1007/s00247-024-06107-z. Epub 2025 Jan 22.
Splenic stiffness is a potential imaging marker of portal hypertension. Normative spleen stiffness values are needed to define diagnostic thresholds.
To report stiffness measurements of the spleen in healthy children undergoing liver magnetic resonance (MR) elastography across MRI vendors and field strengths.
This was a post-hoc analysis of data collected under a prospective multicenter cross-sectional study. Volunteers aged 7-17.9 years without a known history of liver or spleen disease were recruited for a research MRI between February 2018 and October 2019. Gradient recalled echo (GRE) or spin-echo-echo-planar imaging (SE-EPI) MR elastography was performed on a total of three vendor platforms and at two field strengths (1.5 T (T) and 3 T) with standard right upper quadrant passive driver placement (frequency of 60 Hz). Two independent reviewers measured spleen stiffness, length, and volume. Descriptive statistics, independent sample t-tests or Mann-Whitney test, and Pearson's or Spearman's correlation were used.
From 101 study volunteers, 72 (34 female) had measurable splenic stiffness. Median age was 12 years (interquartile range [IQR], 9.9-14.9 years). Mean (± SD) spleen stiffness was 4.7 ± 0.9 kPa (IQR, 3.8-5.4 kPa) with 6.1 kPa reflecting the 95th percentile. Strong correlation was observed between reviewers (ICC = 0.89 [95%CI, 0.71-0.93; P < 0.001]). Male volunteers had slightly higher splenic stiffness compared to females: 4.9 ± 0.9 vs. 4.3 ± 0.8 kPa (P = 0.014). There was significant correlation between spleen stiffness and body mass index (r = 0.33 [95%CI, 0.06-0.56; P = 0.024]) but no other measure of patient size (r = 0.15-0.29). No significant difference in spleen stiffness was observed across vendors (P = 0.089) or field strengths (P = 0.236).
MR elastography-based spleen stiffness, measured as part of a liver MR elastography acquisition, is < 6.1 kPa in a healthy pediatric population and does not vary with MRI vendor or field strength.
脾脏硬度是门静脉高压的一种潜在影像学标志物。需要正常脾脏硬度值来确定诊断阈值。
报告在不同MRI设备供应商和场强下，接受肝脏磁共振（MR）弹性成像检查的健康儿童的脾脏硬度测量结果。
这是一项对前瞻性多中心横断面研究收集的数据进行的事后分析。招募了年龄在7至17.9岁、无已知肝脏或脾脏疾病史的志愿者，于2018年2月至2019年10月期间进行研究性MRI检查。在总共三个供应商平台上，以两种场强（1.5T和3T），采用标准的右上腹被动驱动放置（频率60Hz），进行梯度回波（GRE）或自旋回波 - 回波平面成像（SE - EPI）MR弹性成像。两名独立的评估者测量脾脏硬度、长度和体积。使用描述性统计、独立样本t检验或曼 - 惠特尼检验以及皮尔逊或斯皮尔曼相关性分析。
在101名研究志愿者中，72名（34名女性）有可测量的脾脏硬度。中位年龄为12岁（四分位间距[IQR]，9.9 - 14.9岁）。平均（±标准差）脾脏硬度为4.7±0.9kPa（IQR，3.8 - 5.4kPa），95%百分位数为6.1kPa。评估者之间观察到强相关性（组内相关系数ICC = 0.89 [95%CI，0.71 - 0.93；P < 0.001]）。男性志愿者的脾脏硬度略高于女性：4.9±0.9 vs. 4.3±0.8kPa（P = 0.014）。脾脏硬度与体重指数之间存在显著相关性（r = 0.33 [95%CI，0.06 - 0.56；P = 0.024]），但与其他患者体型测量指标无相关性（r = 0.15 - 0.29）。不同供应商（P = 0.089）或场强（P = 0.236）之间脾脏硬度无显著差异。
作为肝脏MR弹性成像检查一部分所测量的基于MR弹性成像的脾脏硬度，在健康儿童人群中<6.1kPa，且不随MRI设备供应商或场强而变化。
