Quantitative Shear-Wave Elastography of the Liver in Preterm Neonates with Intra-Uterine Growth Restriction

PLoS One. 2015 Nov 18;10(11):e0143220. doi: 10.1371/journal.pone.0143220. eCollection 2015.

Abstract

The feasibility and reproducibility of liver stiffness measurements using Supersonic Shear-wave Imaging (SSI) in preterm neonate have not been reported. Our aim was to determine if liver stiffness differs between intra-uterine growth restriction (IUGR) and appropriate for gestational age (AGA) preterm infants with/without cholestasis. We measured liver stiffness (in kPa) in 45 AGA and 18 IUGR preterm infants, and assessed reproducibility in 26 preterms using Intraclass Correlation Coefficients (ICC) and Bland-Altman tests. Liver stiffness values were compared between AGA and IUGR with and without cholestasis and correlated with birth weight. Measurements showed high reproducibility (ICC = 0.94-0.98 for intra-operator, 0.86 for inter-operator) with good agreement (95% limits: -1.24 to 1.24 kPa). During the first postnatal week, liver stiffness was higher in IUGR (7.50 ±1.53 kPa) than in AGA infants (5.11 ±0.80 kPa, p<0.001). After day 8, liver stiffness remained unchanged in AGA but increased progressively in IUGR infants (15.57 ±6.49 kPa after day 21). Liver stiffness was higher in IUGR neonates with cholestasis (19.35 ± 9.80 kPa) than without cholestasis (7.72 ± 1.27 kPa, p<0.001). In conclusion, quantitative liver SSI in preterms is feasible and reproducible. IUGR preterms who will develop cholestasis present high liver stiffness even at birth, before biological cholestasis occurs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Birth Weight
  • Cholestasis / diagnosis*
  • Cholestasis / diagnostic imaging
  • Cholestasis / mortality
  • Cholestasis / physiopathology
  • Elasticity Imaging Techniques / instrumentation
  • Elasticity Imaging Techniques / methods*
  • Female
  • Fetal Growth Retardation / diagnosis*
  • Fetal Growth Retardation / diagnostic imaging
  • Fetal Growth Retardation / mortality
  • Fetal Growth Retardation / physiopathology
  • Gestational Age
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Liver / diagnostic imaging
  • Liver / physiopathology*
  • Male
  • Reproducibility of Results
  • Survival Analysis

Grants and funding

The research leading to these results has received funding from the European Research Council (ERC) under the European Union's Seventh Framework Programme (FP7/2007-2013)/ERC grant agreement no. 339244-FUSIMAGINE.