Lancharro Zapata Ángel, Aguado Del Hoyo Alejandra, Sánchez Gómez de Orgaz María Del Carmen, Del Pilar Pintado Recarte Maria, Navarro Pablo González, Velosillo González Perceval, Marín Rodríguez Carlos, Ruíz Martín Yolanda, Sanchez-Luna Manuel, Ortega Miguel A, Bravo Arribas Coral, León Luís Juan Antonio
Diagnostic Imaging Department, Paediatric Radiology Section, Gregorio Marañón General University Hospital, 28009 Madrid, Spain.
Maternal and Infant Research Unit Alonso Family Foundation (UDIMIFFA), Gregorio Marañón Health Research Institute (IiSGM), 28009 Madrid, Spain.
J Clin Med. 2025 Aug 1;14(15):5418. doi: 10.3390/jcm14155418.
To determine reference values of liver stiffness during the first week of extrauterine life in healthy newborns, according to gestational age, sex, and birth weight, using three elastography techniques: point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE) with convex and linear probes. This was a cross-sectional observational study conducted at a single center on a hospital-based cohort of 287 newborns between 24 and 42 weeks of gestation, admitted between January 2023 and May 2024. Cases with liver disease, significant neonatal morbidity, or technically invalid studies were excluded. Hepatic elastography was performed during the first week of life using pSWE and 2D-SWE with both convex and linear probes. Clinical and technical neonatal variables were recorded. Liver stiffness values were analyzed in relation to gestational age, birth weight, and sex. Linear regression models were applied to assess associations, considering -values < 0.05 as statistically significant. After applying exclusion criteria, valid liver stiffness measurements were obtained in 208 cases with pSWE, 224 with 2D-SWE (convex probe), and 222 with 2D-SWE (linear probe). A statistically significant inverse association between liver stiffness and gestational age ( < 0.03) was observed across all techniques except for 2D-SWE with the linear probe. Only 2D-SWE with the convex probe showed a significant association with birth weight. No significant differences were observed based on neonatal sex. The 2D-SWE technique with the convex probe demonstrated significantly shorter examination times compared to pSWE ( < 0.001). Neonatal liver stiffness measured by pSWE and 2D-SWE with a convex probe shows an inverse correlation with gestational age, potentially reflecting the structural and functional maturation of the liver. These techniques are safe, reliable, and provide useful information for distinguishing normal findings in preterm neonates from early hepatic pathology. The values obtained represent a valuable reference for clinical hepatic assessment in the neonatal period.
为了根据胎龄、性别和出生体重，使用三种弹性成像技术（点剪切波弹性成像（pSWE）以及使用凸阵探头和线阵探头的二维剪切波弹性成像（2D-SWE））确定健康新生儿宫外生活第一周肝脏硬度的参考值。这是一项在单一中心进行的横断面观察性研究，研究对象为2023年1月至2024年5月间收治的287例孕24至42周的住院新生儿队列。排除患有肝脏疾病、严重新生儿疾病或技术上无效研究的病例。在出生后第一周使用pSWE以及使用凸阵探头和线阵探头的2D-SWE进行肝脏弹性成像检查。记录临床和技术方面的新生儿变量。分析肝脏硬度值与胎龄、出生体重和性别的关系。应用线性回归模型评估相关性，将P值<0.05视为具有统计学意义。应用排除标准后，208例使用pSWE、224例使用2D-SWE（凸阵探头）和222例使用2D-SWE（线阵探头）获得了有效的肝脏硬度测量值。除使用线阵探头的2D-SWE外，所有技术均观察到肝脏硬度与胎龄之间存在统计学显著的负相关（P<0.03）。仅使用凸阵探头的2D-SWE显示与出生体重存在显著相关性。基于新生儿性别未观察到显著差异。与pSWE相比，使用凸阵探头的2D-SWE技术显示检查时间显著更短（P<0.001）。通过pSWE和使用凸阵探头的2D-SWE测量的新生儿肝脏硬度与胎龄呈负相关，这可能反映了肝脏的结构和功能成熟度。这些技术安全、可靠，为区分早产儿的正常表现与早期肝脏病变提供了有用信息。所获得的值为新生儿期临床肝脏评估提供了有价值的参考。
