Pediatric Radiology

, Volume 49, Issue 1, pp 91–98 | Cite as

Performance of two--dimensional ultrasound shear wave elastography: reference values of normal liver stiffness in children

  • Paraskevi GalinaEmail author
  • Efthymia Alexopoulou
  • Aglaia Zellos
  • Virginia Grigoraki
  • Tania Siahanidou
  • Nikolaos L. Kelekis
  • Maria Zarifi
Original Article



Two-dimensional (2-D) shear wave elastography is a new sonographic elastography method for noninvasive measurement of liver stiffness.


The aim of this study was to establish reference values of normal liver stiffness on 2-D shear wave elastography in children.

Materials and methods

Two-dimensional shear wave elastography values were measured in 202 children with no liver disease from the neonatal period to puberty, who were divided into 4 age groups: newborns and infants, preschoolers, elementary school children and adolescents. We investigated the effects of age, depth of elastography measurement, transducer, number of measurements per child, liver size and Doppler parameters of hepatic blood flow on liver elasticity values.


The mean normal liver elasticity value in the study population was: 4.29±0.59  kilopascals (kPa). In neonates and infants, mean liver elasticity value was 4.63 (± 0.6) kPa, in preschoolers and elementary school children, 4.05 (± 0.57) kPa and 4.15 (± 0.52) kPa, respectively, and in adolescents, 4.39 (± 0.55) kPa. Values in neonates and infants as well as adolescents were significantly higher than in preschoolers and elementary school children (Kruskal-Wallis, P<0.001; Mann-Whitney U tests, P<0.05). There was no significant association between liver elasticity values and size of the right lobe or Doppler parameters of hepatic blood flow. Different depths and the number of elastography measurements had no effect on liver elasticity values.


Two-dimensional shear wave elastography is achievable in a wide range of age in children. We established the reference values of normal liver stiffness on 2-D shear wave elastography in children.


Adolescents Children Elastography Liver stiffness Two-dimensional shear wave imaging Ultrasound 


Compliance with ethical standards

Conflicts of interest


Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of RadiologyChildren’s Hospital “Agia Sofia”AthensGreece
  2. 2.Department of RadiologyGeneral University Hospital “ATTIKON”, Medical School, National and Kapodistrian University of AthensAthensGreece
  3. 3.1st Department of PediatricsChildren’s Hospital “Agia Sofia”AthensGreece
  4. 4.1st Department of Pediatrics, National and Kapodistrian University of AthensChildren’s Hospital “Agia Sofia”AthensGreece

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