Acoustic radiation force impulse-imaging in the assessment of liver fibrosis in children

Background Acoustic radiation force impulse-imaging (ARFI) uses sound waves to interrogate the mechanical stiffness of a tissue. Objective To determine the usefulness of ARFI for estimating liver fibrosis in children. Materials and methods A prospective masked study of children with chronic liver disease (CLD) and/or before liver transplant (LT) comparing ARFI with histopathological analysis. Children with no history of liver disease served as a control group. ARFI was performed with Virtual Touch software using ACUSON S2000. Share wave velocities (SWV) of several regions within the liver were measured. Results Fifty-two children were studied (mean age 8 years; range 1-16 years). The abnormal group included 10 children (31%) with CLD and 22 (69%) planned for LT. There were 20 normal controls. Mean SWV was 1.70 m/s in the abnormal group and 1.19 m/s in the controls. For diagnosis of fibrosis stage >= F1, >= F2 and F4, the areas under the receiver-operator characteristics curves were 0.834, 0.818 and 0.983, respectively. Conclusion SWV is related to the degree of liver fibrosis in children, and may be a non-invasive alternative to biopsy.