Pediatric Radiology

, Volume 43, Issue 5, pp 552–557 | Cite as

A pilot study of the characterization of hepatic tissue strain in children with cystic-fibrosis-associated liver disease (CFLD) by acoustic radiation force impulse imaging

  • Christopher B. Behrens
  • Juliane H. Langholz
  • Jessika  Eiler
  • Raphael  Jenewein
  • Lutz Naehrlich
  • Konstantin  Fuchs
  • Sebastian  Harth
  • Gabriele  A. Krombach
  • Gerhard  F. P. Alzen
Original Article



Progressive fibrotic alterations of liver tissue represent a major complication in children with cystic fibrosis. Correct assessment of cystic-fibrosis-associated liver disease (CFLD) in clinical routine is a challenging issue. Sonographic elastography based on acoustic radiation force impulse imaging (ARFI) is a new noninvasive approach for quantitatively assessing in vivo elasticity of biological tissues in many organs.


To characterize ARFI elastography as a diagnostic tool to assess alteration of liver tissue elasticity related to cystic fibrosis in children.

Materials and methods

ARFI elastography and B-mode US imaging were performed in 36 children with cystic fibrosis. The children’s clinical history and laboratory parameters were documented. According to the findings on conventional US, children were assigned to distinct groups indicating severity of hepatic tissue alterations. The relationship between US findings and respective elastography values was assessed. Additionally, differences between ARFI elastography values of each US group were statistically tested.


Children with sonomorphologic characteristics of fibrotic tissue remodeling presented significantly increased values for tissue elasticity. Children with normal B-mode US or discrete signs of hepatic tissue alterations showed a tendency toward increased tissue stiffness indicating early tissue remodeling.


Assessment of children with CFLD by means of ARFI elastography yields adequate results when compared to conventional US. For detection of early stages of liver disease with mild fibrotic reactions of hepatic tissue, ARFI elastography might offer diagnostic advantages over conventional US. Thus, liver stiffness measured by means of elastography might represent a valuable biological parameter for evaluation and follow-up of CFLD.


Acoustic radiation force impulse imaging Cystic fibrosis Liver fibrosis Elastography 


Conflict of interest

None declared.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Christopher B. Behrens
    • 1
  • Juliane H. Langholz
    • 1
  • Jessika  Eiler
    • 1
  • Raphael  Jenewein
    • 1
  • Lutz Naehrlich
    • 3
  • Konstantin  Fuchs
    • 1
  • Sebastian  Harth
    • 2
  • Gabriele  A. Krombach
    • 2
  • Gerhard  F. P. Alzen
    • 1
  1. 1.Department of Pediatric RadiologyUniversity Hospital GiessenGiessenGermany
  2. 2.Department of RadiologyUniversity Hospital GiessenGiessenGermany
  3. 3.Department of PediatricsUniversity Hospital GiessenGiessenGermany

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