Feasibility study and control values of transient elastography in healthy children.
Transient elastography (TE) is a new technique for the non-invasive assessment of liver fibrosis. The degree of fibrosis is equivalent to the liver stiffness measured in kilopascal (kPa). It is frequently used in adult patients with a mean normal stiffness of 4.4-5.5 kPa. Since 2008, liver stiffness...
| Publicado en: | European Journal of Pediatrics Vol. 171; no. 2; pp. 353 - 361 |
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| Autores principales: | , , , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Feb2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104399189&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104399189 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03406199 CR1 jtl: European Journal of Pediatrics issn: 03406199 maglogo: N pubinfo: dt: Feb2012 vid: 171 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104399189 NLM21861093 2011769381 10.1007/s00431-011-1558-7 NLM21861093 104399189 ppf: 353 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Feasibility study and control values of transient elastography in healthy children. aug: au: Engelmann G Gebhardt C Wenning D Wühl E Hoffmann GF Selmi B Grulich-Henn J Schenk JP Teufel U Engelmann, Guido Gebhardt, Caroline Wenning, Daniel Wühl, Elke Hoffmann, Georg F Selmi, Buket Grulich-Henn, Juergen Schenk, Jens Peter Teufel, Ulrike affil: Department of General Pediatrics, University Hospital, Heidelberg, INF 430, 69120 Heidelberg, Germany sug: subj: Ultrasonography Equipment and Supplies Ultrasonography Methods Liver Ultrasonography Adolescence Child Child, Preschool Pilot Studies Female Human Infant Infant, Newborn Liver Anatomy and Histology Male Prospective Studies Reference Values Adolescent: 13-18 years Child: 6-12 years Child, Preschool: 2-5 years Infant: 1-23 months Infant, Newborn: birth-1 month Female Male ab: Transient elastography (TE) is a new technique for the non-invasive assessment of liver fibrosis. The degree of fibrosis is equivalent to the liver stiffness measured in kilopascal (kPa). It is frequently used in adult patients with a mean normal stiffness of 4.4-5.5 kPa. Since 2008, liver stiffness can be measured even in small children and infants following the availability of a new probe with a smaller diameter (S-probe 5 mm) than the regular probe (M-probe 7 mm). We report control values for healthy children between 0 and 18 years and investigated the feasibility of this technique in a pediatric population. For control values, TE was performed in infants and children after exclusion of liver disease by medical history, clinical examination, blood investigation, and abdominal ultrasound. For feasibility analyses the results of all TE performed in our clinic were analyzed irrespective of the underlying disease. Liver stiffness was measured with the S-probe (thorax diameter <45 cm (S1) or 45-75 cm (S2)) and the M-probe (thorax diameter >75 cm) according to the manufacturer's recommendations. A total of 240 healthy children were analyzed to establish control values. The median liver stiffness was 4.7 kPa resulting in an upper limit of normal of 6.47 kPa. Median values of stiffness were significantly age dependent with 4.40, 4.73, and 5.1 kPa in children 0-5, 6-11, and 12-18 years (p = 0.001) while the interquartile range decreased with age (0.8, 0.7, and 0.6 kPa). The resulting upper limit of normal (median plus 1.64 times standard deviation) was 5.96, 6.65, and 6.82 kPa. Girls between 11 and 18 years showed a significantly lower median stiffness than boys of the same age (4.7 vs. 5.6 kPa; p < 0.005). Feasibility was tested in 975 consecutive liver stiffness measurements (LSM) in children 0-18 years of age. Patients with invalid LSM were significantly younger than those with valid LSM (5.8 vs. 9.7 years, p < 0.0001), showed a significantly higher stiffness (10.2 vs. 6.17, p < 0.0001), and examinations took significantly longer (202 vs. 160 s, p < 0.0001). TE is technically possible in children of all age groups. The upper limit of normal increases significantly with age. Due to movement artifacts the measurement is reliable from the age of 6 without sedation. In younger children the number of invalid measurements increases significantly. Further studies are needed to asses the value of TE in the diagnosis and follow-up of liver disease in pediatric hepatology. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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