Liver Stiffness Measured by Shear-wave Elastography for Evaluating Intrahepatic Portal Hypertension in Children

J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):892-897. doi: 10.1097/MPG.0000000000001517.

Abstract

Objectives: 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.

Methods: 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).

Results: 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).

Conclusions: 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.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Elasticity Imaging Techniques / methods*
  • Female
  • Humans
  • Hypertension, Portal / diagnostic imaging*
  • Hypertension, Portal / physiopathology
  • Infant
  • Liver / diagnostic imaging*
  • Liver / physiopathology
  • Male
  • ROC Curve
  • Retrospective Studies
  • Sensitivity and Specificity