Abstract
Background and AimsPediatric use of liver transient elastography (TE) is attractive for its non-invasiveness, but reference values have not been established. We aimed to determine reference values for TE in children.MethodsIn pediatric patients (1 to 18 years), TE (FibroScan®) with an M probe was used for both liver stiffness measurement (LSM) and measurement of hepatic fat deposition by using a controlled attenuation parameter (CAP). The patients were divided into three relevant age groups: preschoolers (1 to 5 years), elementary school children (6 to 11 years), and adolescents (12 to 18 years). Overweight or obese patients or those with known liver disease, elevated serum liver enzymes, or hepatic echogenic abnormality were excluded from the study.ResultsAmong 139 children, 123 (88.5%; 62 male; median age, 11.7 years; age range, 1.3 to 17.2 years) were successfully subjected to M-probe TE without anesthesia. Median LSM increased with age: it was 3.4 kPa (2.3 to 4.6 kPa, 5th to 95th percentiles) at ages 1 to 5 years; 3.8 (2.5 to 6.1) kPa at ages 6 to 11; and 4.1 (3.3 to 7.9) kPa at ages 12 to 18 (P = 0.001). Median CAP was not age dependent: it was 183 (112 to 242) for ages 1 to 18 years.ConclusionsM-probe TE is suitable in a wide age range of children from age 1 year up. In children without evidence of liver disease, LSM has an age-dependent increase, whereas CAP does not differ between ages 1 and 18.
Highlights
Liver transient elastography (TE) using FibroScan1 (Echosens, Paris, France) is a non-invasive method of assessing liver fibrosis without liver biopsy in both adults and children [1,2,3,4,5,6,7,8]
In children without evidence of liver disease, liver stiffness measurement (LSM) has an age-dependent increase, whereas controlled attenuation parameter (CAP) does not differ between ages 1 and 18
Previous studies have demonstrated LSM to be reliable for assessing the severity of various fibrotic liver diseases [1,2,3,4,5,6,7,8,9] and CAP to be an effective parameter for diagnosing steatosis [9,10,11]; the combination of LSM and CAP assessment is appropriate for discriminating non-alcoholic steatohepatitis from non-alcoholic fatty liver disease [9,12]
Summary
Liver transient elastography (TE) using FibroScan (Echosens, Paris, France) is a non-invasive method of assessing liver fibrosis without liver biopsy in both adults and children [1,2,3,4,5,6,7,8]. To assess the diagnostic accuracy, it was important to determine cut-off LSM and CAP values for predicting liver fibrosis and steatosis stages and to determine reference values for screening healthy individuals [2,3,4,5,6, 10, 11]. We aimed to determine age-dependent reference values for both LSM and CAP in children by using FibroScan with a 3.5-MHz standard M probe (diameter, 7 mm) designed for simultaneous measurement of LSM and CAP. To ensure the same measurement conditions for assessing the age dependency of both LSM and CAP, we used an M probe on all of the pediatric patients in our study. Because general anesthesia has been found to increase LSM values in children [13], we evaluated both LSM and CAP values in children without using general anesthesia
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
