Assessment of Liver and Splenic Stiffness Using Shear Wave Elastography in Pediatric Patients with Hepatic Fibrosis

Elzayat, Wessam Abdelrahman; Elkalioubie, Mona; Barel, Subash; Adel, Noha; Onsy, Marwa

doi:10.21608/svuijm.2025.395012.2201

Assessment of Liver and Splenic Stiffness Using Shear Wave Elastography in Pediatric Patients with Hepatic Fibrosis

Document Type : Original research articles

Authors

¹ Department of Diagnostic and Intervention Radiology, Faculty of Medicine, Cairo University Hospitals, Kasr Al-Ainy, Cairo, Egypt

² Department of Pediatrics, Gasteroenterology Unit, Faculty of Medicine, Cairo University Hospitals, Kasr Al-Ainy, Cairo, Egypt

10.21608/svuijm.2025.395012.2201

Abstract

Background: Chronic liver diseases in children, often progress to cirrhosis and fibrosis. Accurate staging of liver fibrosis is crucial for treatment and prognosis. Noninvasive methods like shear wave elastography (SWE) have emerged as alternatives to liver biopsy. Both liver and spleen SWE show diagnostic potential in pediatric chronic liver disease.
Objectives: This study evaluated SWE’s accuracy versus liver biopsy in staging hepatic fibrosis and assessed the reliability of spleen SWE in pediatric patients.
Patients and methods: A cross-sectional analysis of 115 children (70 with liver disease, 45 healthy controls) was conducted at Abu El Reesh Pediatric Hospital. Liver and spleen stiffness were measured via SWE and compared with biopsy findings.
Results: There was no age or gender differences between patients and controls (p>0.05). Patients with chronic liver disease had significantly higher liver SWE (6.9±3.68kpa vs. 4.23±1.22kpa, p <0.001) and (3.19±1.77 m/s vs. 1.86±0.5 m/s, p<0.001). In particular, patients with biliary atresia exhibited the highest stiffness values (19.7±15.2 kPa). Patients had higher spleen SWE (5.16±3.2kpa vs. 3.5±1.25kpa, p=0.003) and (2.78±0.7 m/s vs. 2.49±1.18, p=0.081) than the control group, yet it was statistically insignificant. ROC analysis demonstrated liver elastography (AUC=0.744) as a robust predictor of liver disease, while spleen elastography was a moderate predictor (AUC=0.666). Liver SWE (Kpa) showed strong correlation with METAVIR stages (r=0.699, *p*<0.001) while Spleen SWE (Kpa) showed moderate correlation (r=0.565, *p*<0.001).
Conclusion: Liver and spleen SWE reliably detect hepatic fibrosis stages in children, offering a noninvasive alternative to biopsy. These findings underscore SWE’s clinical utility in pediatric liver disease management.

Keywords