Transient liver elastography in unsedated control children: Impact of age and intercurrent illness

Lewindon, Peter J., Balouch, Fariha, Pereira, Tamara N., Puertolas-Lopez, Mora V., Noble, Charlton, Wixey, Julie A. and Ramm, Grant A. (2016) Transient liver elastography in unsedated control children: Impact of age and intercurrent illness. Journal of Paediatrics and Child Health, 52 6: 637-642. doi:10.1111/jpc.13151

Author Lewindon, Peter J.
Balouch, Fariha
Pereira, Tamara N.
Puertolas-Lopez, Mora V.
Noble, Charlton
Wixey, Julie A.
Ramm, Grant A.
Title Transient liver elastography in unsedated control children: Impact of age and intercurrent illness
Journal name Journal of Paediatrics and Child Health   Check publisher's open access policy
ISSN 1440-1754
Publication date 2016-06-01
Sub-type Article (original research)
DOI 10.1111/jpc.13151
Volume 52
Issue 6
Start page 637
End page 642
Total pages 6
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell
Collection year 2017
Language eng
Formatted abstract
Aim: Transient elastography (TE) is a rapid, non-invasive, reproducible assessment of liver fibrosis by liver stiffness measurement (LSM). Uncertainty remains regarding utility in children, unsedated and <6 years of age. The importance of general health at the time of study has not been addressed. We report our experience of TE in unsedated control children, impact of intercurrent illness and using new published reliability criteria.

Methods: From April 2011 to March 2013, 173 studies were performed in unsedated, healthy control children and children with intercurrent illness without detectable liver disease presenting to the Royal Children's Hospital, Brisbane, Australia. LSM reliability was assessed using interquartile range/median (IQR/M ≤ 30%) of 10 valid measurements.

Results: A total of 123 (F:M, 52:71) of 173 studies (71.1%) gave reliable results. In children 0–2 years reliability was 36%, and >2 years reliable results were obtained in ~80%. LSM increased with age; 0–2 years (3.5 ± 0.5 kPa), 3–5 years (3.8 ± 0.3 kPa) and 6–11 years (4.1 ± 0.2 kPa) with healthy older children 12–18 years similar to adults (4.5 ± 0.2 kPa). LSM did not vary with gender (female, 4.5 ± 0.2 vs. male, 4.8 ± 0.2 kPa). Children with intercurrent, non-hepatological illnesses had higher LSM (5.2 ± 0.2 kPa (range, 2.8–11.1 kPa)) compared to healthy children ((4.1 ± 0.1 kPa, range, 2.1–6.3 kPa); P = 0.0001).

Conclusions: TE in unsedated children is feasible from infancy but most reliable after 2 years. Intercurrent illness increases LSM; hence, study context is important when interpreting results.
Keyword Elastography
Healthy children
Hepatic fibrosis
Liver stiffness measurement
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
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Faculty of Medicine
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Created: Fri, 22 Jul 2016, 16:02:07 EST by Julie Wixey on behalf of UQ Centre for Clinical Research