Elastography - New Imagistic Method for Assessment of Liver Structure in Children

Abstract

Elastography is a new method based on ultrasound imaging, which allows assessment of tissue structure in terms of their stiffness, useful in exploring various organs and systems. Objectives and aim Study of liver tissue elasticity in children by real-time elastography in normal (healthy children) and in the context of certain disease. Material and method Our study (prospective type) was carried out at the Ist Pediatric Clinic Tg.-Mures, Romania in the period 2010, September - 2011, April. An ultrasound machine Siemens S 2000 with an up-to-date soft was used for the elastographic assessment of liver by ARFI (Acustic Radiation Force Impulse Imaging) tehnique, using “Virtual Touch (VT) Tissue Quantification” technology (for quantification of fibrosis) in children: a lot of different conditions (various liver injuries) and a control group (healthy). The degree of tissue stiffness was expressed as a numerical value called SWV (shear wave velocity), measuring at the level of 8 and 1 liver segments, to highlight differences depending on anatomical structure, but also differentiated on pathology (ie healthy versus those with particular injuries). Measurement data were correlated with biochemical parameters. Results. Higher SWV-values were found in group with liver-damage (p=0,04). Aspartate transaminase and alanine transaminase were statistically significant different between the groups; transaminases increased parallel with SWV (fibrosis degree) in children with liver damage. Conclusion: Elastography completes diagnostic possibilities, providing information on the degree of hepatic elasticity (even degree of fibrosis), with special importance in liver imaging in adults, but also in pediatric practice.