Limitations and opportunities of non-invasive liver stiffness measurement in children

doi:10.4254/wjh.v9.i8.409

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World Journal of Hepatology

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World J Hepatol. Mar 18, 2017; 9(8): 409-417
Published online Mar 18, 2017. doi: 10.4254/wjh.v9.i8.409

Limitations and opportunities of non-invasive liver stiffness measurement in children

Guido Engelmann, Jasmin Quader, Ulrike Teufel, Jens Peter Schenk

Guido Engelmann, Jasmin Quader, Department of Paediatrics, Lukas Hospital, D-41464 Neuss, Germany

Ulrike Teufel, Department of General Paediatrics, Centre for Paediatric and Adolescent Medicine, University of Heidelberg, D-69120 Heidelberg, Germany

Jens Peter Schenk, Department of Diagnostic and Interventional Radiology, Division of Paediatric Radiology, University Hospital of Heidelberg, 69120 Heidelberg, Germany

Author contributions: Engelmann G performed most of the writing of the manuscript; Quader J created the figures and tables and performed the statistical analyses; Teufel U coordinated the writing and performed data analyses; Schenk JP wrote the sections on real-time tissue elastography and magnetic resonance elastography.

Conflict-of-interest statement: There is no conflict of interest associated with any of the authors who contributed their efforts in this manuscript.

Correspondence to: Guido Engelmann, MD, Department of Paediatrics, Lukas Hospital, Preussenstraße 84, D-41464 Neuss, Germany. engelmann@lukasneuss.de

Telephone: +49-2131-8883501 Fax: +49-2131-8883599

Received: October 7, 2016
Peer-review started: October 10, 2016
First decision: November 11, 2016
Revised: December 27, 2016
Accepted: January 11, 2017
Article in press: January 14, 2017
Published online: March 18, 2017
Processing time: 156 Days and 21.3 Hours

Abstract

Changes in liver structure are an important issue in chronic hepatopathies. Until the end of the 20^th century, these changes could only be determined by histological analyses of a liver specimen obtained via biopsy. The well-known limitations of this technique (i.e., pain, bleeding and the need for sedation) have precluded its routine use in follow-up of patients with liver diseases. However, the introduction of non-invasive technologies, such as ultrasound and magnetic resonance imaging, for measurement of liver stiffness as an indirect marker of fibroses has changed this situation. Today, several non-invasive tools are available to physicians to estimate the degree of liver fibrosis by analysing liver stiffness. This review describes the currently available tools for liver stiffness determination that are applicable to follow-up of liver fibrosis/cirrhosis with established clinical use in children, and discusses their features in comparison to the “historical” tools.

Keywords: Children; Transient elastography; Liver fibrosis; Liver biopsy

Core tip: Non-invasive liver stiffness measurement is a new and helpful tool for assessing liver fibroses in children, but it cannot yet replace liver biopsy.