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Background <p>Biliary atresia casuses progressive liver fibrosis in infants. After Kasai portoenterostomy (KPE), non-invasive liver monitoring is essential. Shear wave elastography (SWE) offers a promising alternative to biopsy.</p> Objectives <p>To evaluate the diagnostic performance, reproducibility, and inter-technique consistency of three shear wave elastography (SWE) modalities—point-SWE (p-SWE), two-dimensional SWE (2D-SWE), and supersonic shear imaging (supersonic-SWE)—in children with biliary atresia post-KPE.</p> Materials and methods <p>This prospective study (March 2024–November 2024) recruited 76 children: 47 biliary atresia patients (mean age, 5.7 ± 3.3&#xa0;years; 24 girls) post-KPE and 29 healthy controls (mean age, 6.9 ± 3.2&#xa0;years; 12 girls). Liver stiffness values were obtained using three SWE techniques. Statistical methods included the Mann–Whitney U test, Friedman test, intraclass correlation coefficients (ICCs), Spearman correlation, and generalized liner model analysis.</p> Results <p>Biliary atresia group showed significantly higher liver stiffness values than controls across all techniques (supersonic-SWE: 8.20 vs. 5.20&#xa0;kPa, p-SWE: 6.60 vs. 3.50&#xa0;kPa, 2D-SWE: 4.90 vs. 2.90&#xa0;kPa; all <i>P</i>&lt; 0.001). Supersonic-SWE yielded higher liver stiffness values than p-SWE and 2D-SWE (<i>P</i>&lt; 0.05). Strong correlations were observed. Reproducibility was good to excellent (ICCs: 0.74 to 0.90), with supersonic-SWE demonstrating the highest ICC. Anteroposterior diameter of the left lobe was an independent predictor significantly associated with liver stiffness values (<i>P</i>&lt; 0.001). Supersonic-SWE required longer measurement time than other techniques (<i>P</i>&lt; 0.001).</p> Conclusion <p>SWE is a reliable tool for liver stiffness assessment in biliary atresia patients, however, inter-technique and inter-vendor discrepancies highlight the need for standardized protocol and techniques should not be used interchangeably.</p> Graphical Abstract <p></p>

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Diagnostic performance and reproducibility of shear wave elastography techniques for liver stiffness assessment in children with biliary atresia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月16日

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  • Manli Fu,
  • Chao Geng,
  • Liqiong Shi,
  • Jiaoyan Tan,
  • Han Jing,
  • Xueqiang Yan,
  • Li Yuan

摘要

Background

Biliary atresia casuses progressive liver fibrosis in infants. After Kasai portoenterostomy (KPE), non-invasive liver monitoring is essential. Shear wave elastography (SWE) offers a promising alternative to biopsy.

Objectives

To evaluate the diagnostic performance, reproducibility, and inter-technique consistency of three shear wave elastography (SWE) modalities—point-SWE (p-SWE), two-dimensional SWE (2D-SWE), and supersonic shear imaging (supersonic-SWE)—in children with biliary atresia post-KPE.

Materials and methods

This prospective study (March 2024–November 2024) recruited 76 children: 47 biliary atresia patients (mean age, 5.7 ± 3.3 years; 24 girls) post-KPE and 29 healthy controls (mean age, 6.9 ± 3.2 years; 12 girls). Liver stiffness values were obtained using three SWE techniques. Statistical methods included the Mann–Whitney U test, Friedman test, intraclass correlation coefficients (ICCs), Spearman correlation, and generalized liner model analysis.

Results

Biliary atresia group showed significantly higher liver stiffness values than controls across all techniques (supersonic-SWE: 8.20 vs. 5.20 kPa, p-SWE: 6.60 vs. 3.50 kPa, 2D-SWE: 4.90 vs. 2.90 kPa; all P< 0.001). Supersonic-SWE yielded higher liver stiffness values than p-SWE and 2D-SWE (P< 0.05). Strong correlations were observed. Reproducibility was good to excellent (ICCs: 0.74 to 0.90), with supersonic-SWE demonstrating the highest ICC. Anteroposterior diameter of the left lobe was an independent predictor significantly associated with liver stiffness values (P< 0.001). Supersonic-SWE required longer measurement time than other techniques (P< 0.001).

Conclusion

SWE is a reliable tool for liver stiffness assessment in biliary atresia patients, however, inter-technique and inter-vendor discrepancies highlight the need for standardized protocol and techniques should not be used interchangeably.

Graphical Abstract