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Liver stiffness measurements with supersonic shear wave elastography in the diagnosis of biliary atresia: a comparative study with grey-scale US

  • Ultrasound
  • Published:
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Abstract

Objectives

To prospectively assess the diagnostic performance of supersonic shear wave elastography (SSWE) in identifying biliary atresia (BA) among infants with conjugated hyperbilirubinaemia by comparing this approach with grey-scale ultrasonography (US).

Methods

Forty infants were analysed as the control group to determine normal liver stiffness values. The use of SSWE values for identifying BA was investigated in 172 infants suspected of having BA, and results were compared with the results obtained by grey-scale US. The Mann-Whitney U test, unpaired t-test, Spearman correlation and linear regression were also performed.

Results

The success rates of SSWE measurements in the control and study group were 100% (40/40) and 96.4% (244/253), respectively. Age, direct bilirubin, and indirect bilirubin all significantly correlated with SSWE in the liver (all P < 0.001). Linear regression showed that age had a greater effect on SSWE values than direct or indirect bilirubin. The diagnostic performance of liver stiffness values in identifying BA was lower than that of grey-scale US (area under the receiver operating characteristic curve [AUC], 0.790 vs 0.893, P < 0.001).

Conclusions

SSWE is feasible and valuable in differentiating BA from non-BA. However, its diagnostic performance does not exceed that of grey-scale US.

Key points

• SSWE could be successfully performed in an infant population.

• For infants, the liver stiffness will increase as age increases.

• SSWE is potentially useful in assessing infants suspected of biliary atresia.

• SSWE is inferior to grey-scale US in identifying biliary atresia.

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Abbreviations

BA:

biliary atresia

TE:

transient elastography

SSWE:

supersonic shear wave elastography

ARFI:

acoustic radiation force impulse

ICC:

intraclass correlation coefficient

ALT:

alanine aminotransferase

AST:

aspartate aminotransferase

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Acknowledgements

The scientific guarantor of this publication is Xiao-yan Xie.

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

This study has received funding by National Natural Science Foundations of China (nos. 81501480 and 81371555) and Natural Science Foundation of Guangdong province (no. 2015A030313060).

No complex statistical methods were necessary for this paper.

Institutional Review Board approval was obtained.

Written informed consent was obtained from all subjects (patients) in this study.

Some study subjects or cohorts have been previously reported by Zhou et al. [3].

Methodology: a prospective diagnostic study performed at one institution.

Author information

Authors and Affiliations

  1. Department of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, People’s Republic of China

    Lu-yao Zhou, Quan-yuan Shan, Xiao-na Lin, Bao-xian Liu & Xiao-yan Xie

  2. Department of Paediatric surgery, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, People’s Republic of China

    Hong Jiang

  3. Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, People’s Republic of China

    Dong Chen

Authors
  1. Lu-yao Zhou
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  2. Hong Jiang
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  3. Quan-yuan Shan
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  4. Dong Chen
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  6. Bao-xian Liu
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Correspondence to Xiao-yan Xie.

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ESM Fig. 1

Bland-Altman analysis of inter-observer agreements between each of two operators. a Agreement between operator 1 and operator 2. b Agreement between operator 1 and operator 3. c Agreement between operator 2 and operator 3 (DOCX 6004 kb)

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Zhou, Ly., Jiang, H., Shan, Qy. et al. Liver stiffness measurements with supersonic shear wave elastography in the diagnosis of biliary atresia: a comparative study with grey-scale US. Eur Radiol 27, 3474–3484 (2017). https://doi.org/10.1007/s00330-016-4710-y

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  • DOI: https://doi.org/10.1007/s00330-016-4710-y

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