Impact of probe-induced abdominal compression on two-dimensional shear wave elastography measurement of split liver transplants in children

Michael Groth; Lutz Fischer; Uta Herden; Florian Brinkert; Jan Beime; Philipp Deindl; Gerhard Adam; Jochen Herrmann

doi:10.1055/a-2049-9369

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Table of Contents

Rofo 2023; 195(10): 905-912
DOI: 10.1055/a-2049-9369

Pediatric Radiology

Impact of probe-induced abdominal compression on two-dimensional shear wave elastography measurement of split liver transplants in children

Der Einfluss der schallkopfinduzierten abdominellen Kompression auf die 2-dimensionale Scherwellen-Elastografie in Kindern mit Split-Leber-Transplantaten

Michael Groth

¹Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Section of Pediatric Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

,

Lutz Fischer

²Hepatobiliary Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

,

Uta Herden

²Hepatobiliary Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

,

Florian Brinkert

³Pediatric Gastroenterology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

,

Jan Beime

³Pediatric Gastroenterology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

,

Philipp Deindl

⁴Department of Neonatology and Pediatric Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

,

Gerhard Adam

⁵Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

,

Jochen Herrmann

¹Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Section of Pediatric Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

› Author Affiliations

Abstract

Purpose To evaluate the effect of probe-induced abdominal compression of split liver transplants (SLT) in children on 2D-shear wave elastography (SWE) values.

Materials and Methods Data from 11 children (4.7 ± 4.8 years) who had undergone SLT and SWE were evaluated retrospectively. Elastograms were obtained with probes placed in an epigastric, midline position on the abdominal wall, with no and slight compression, using convex and linear transducers. For each identically positioned probe and condition, 12 serial elastograms were obtained and the SLT diameter was measured. Liver stiffness and degree of SLT compression were compared.

Results Slight probe pressure resulted in SLT compression, with a shorter distance between the cutis and the posterior margin of the liver transplant than in the measurement with no pressure (curved array, 5.0 ± 1.1 vs. 5.9 ± 1.3 cm, mean compression 15 %± 8 %; linear array, 4.7 ± 0.9 vs. 5.3 ± 1.0 cm, mean compression 12 %± 8 %; both p < 0.0001). The median liver stiffness was significantly greater with slight pressure than with no pressure (curved transducer, 13.38 ± 3.0 vs. 7.02 ± 1.7 kPa, p < 0.0001; linear transducer, 18.53 ± 7.1 vs. 9.03 ± 1.5 kPa, p = 0.0003).

Conclusion Slight abdominal compression can significantly increase SWE values in children with left-lateral SLT. To obtain meaningful results and reduce operator dependency in free-hand examinations, probe pressure must be controlled carefully.

Key points:

Probe-induced compression can increase elastography values in split liver transplants in children
In free-hand examination, probe pressure must be controlled carefully
Pressure loading can be determined indirectly by the anteroposterior transplant diameter

Citation Format

Groth M, Fischer L, Herden U et al. Impact of probe-induced abdominal compression on two-dimensional shear wave elastography measurement of split liver transplants in children. Fortschr Röntgenstr 2023; 195: 905 – 912

Zusammenfassung

Ziel Evaluation des Effektes der Kompression durch die Ultraschallsonde bei der 2D-Scherwellen-Elastografie (SWE) auf die Elastografiewerte bei Split-Leber-Transplantaten (SLT) in Kindern.

Material und Methoden 11 SWE-Untersuchungen von Kindern (4.7 ± 4.8 Jahre) nach SLT wurden retrospektiv ausgewertet. Elastogramme wurden mit der Konvex- und Linearsonde in einer mittig epigastrischen Position mit nahezu keiner und wenig Kompression angefertigt. Es wurden jeweils 12 Elastogramme erfasst. SLT-Diameter wurden bestimmt. Leber-Steifigkeit und SLT-Kompression wurden verglichen.

Ergebnisse Wenig Sondendruck resultierte, verglichen mit nahezu keinem Druck, in einer SLT-Kompression mit kürzerer Entfernung zwischen Kutis und SLT-Hinterrand (Konvex: 5.0 ± 1.1 vs. 5.9 ± 1.3 cm, mittlere Kompression 15 % ± 8 %; Linear: 4.7 ± 0.9 vs. 5.3 ± 1.0 cm, mittlere Kompression: 12 % ± 8 %; beide p < 0.0001). Die mediane Leber-Steifigkeit war mit leichter Kompression signifikant höher als nahezu ohne (Konvex: 13.38 ± 3.0 vs. 7.02 ± 1.7 kPa, p < 0.0001; Linear: 18.53 ± 7.1 vs. 9.03 ± 1.5 kPa, p = 0.0003).

Schlussfolgerung In Kindern nach SLT kann leichte Kompression SWE-Werte signifikant erhöhen. Um aussagekräftige Ergebnisse zu erhalten und zur Reduzierung der Auswerterabhängigkeit sollte der Sondendruck kontrolliert werden.

Kernaussagen:

Ultraschallsondendruck kann Elastografiewerte bei Kindern mit Split-Leber-Transplantaten erhöhen
Der ausgeübte Sondendruck muss beim Untersuchen aufmerksam kontrolliert werden
Ultraschallsondendruck kann indirekt über den anteroposterioren Transplantatdiameter bestimmt werden

Key words

elasticity imaging techniques - ultrasonography - liver transplantation - child - pressure

Full Text

References

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