BACKGROUND While liver biopsy remains the gold standard, given the procedure risks and sampling errors, there is a need for reliable noninvasive biomarkers of hepatic fibrosis. OBJECTIVE Determine the accuracy of two-dimensional shear wave elastography (2-D SWE) in predicting the histological severity of liver fibrosis in pediatric patients with known or suspected liver disease. MATERIALS AND METHODS Subjects 0-18 years old with known or suspected liver disease and liver biopsy within 30 days (n=70) were included. Comparisons by 2-D SWE were made to a control group (n=79). Two-dimensional SWE was performed using the GE LOGIQ E9 system. Liver biopsy specimens were scored according to METAVIR and Ishak scoring systems using Spearman's Rho correlation. Receiver operator characteristic (ROC) analysis, Kruskal-Wallis and Mann-Whitney U tests were conducted. RESULTS Control group median 2-D SWE measurements were lower than in subjects with any degree of liver fibrosis (P<0.001). Those with METAVIR F0 and Ishak 0 scores had significantly lower median 2-D SWE measurements (1.35 m/s; 1.36 m/s) than those with more advanced liver disease (F1-F3: 1.49-1.62 m/s; 1-4: 1.45-1.63 m/s) (P<0.05 for all), whereas the 2-D SWE in the higher scores were similar. Results did not differ between METAVIR and Ishak scores for any degree of fibrosis. Fibrosis scores moderately correlated with median 2-D SWE measurements (rs=0.43). The area under the curve for F1 compared to combined control/F0 was 0.89 (95% confidence interval [CI] 0.83-0.95; P<0.001) with sensitivity of 94.6% and specificity of 78.6%. Results for Ishak score 1 were similar. The ideal cutoff value for identifying fibrosis was determined to be 1.29 m/s. CONCLUSION The liver 2-D SWE measurements correlated with the histological liver fibrosis scores, regardless of the histopathological scoring system, although 2-D SWE was better at identifying patients with early fibrosis, not at distinguishing among the individual fibrosis levels. Two-dimensional SWE using the GE LOGIQ US system is useful for identifying pediatric patients at risk for liver fibrosis.

中文翻译：

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剪切波弹性成像与儿科肝病患者的肝纤维化评分相关。

背景虽然肝活检仍然是金标准，但考虑到手术风险和采样误差，仍然需要可靠的肝纤维化非侵入性生物标志物。目的 确定二维剪切波弹性成像 (2-D SWE) 在预测已知或疑似肝病儿科患者肝纤维化组织学严重程度方面的准确性。材料和方法 0-18 岁患有已知或疑似肝病并在 30 天内进行肝活检的受试者 (n=70) 被纳入。通过 2-D SWE 与对照组 (n=79) 进行比较。使用 GE LOGIQ E9 系统进行二维 SWE。肝活检标本根据 METAVIR 和 Ishak 评分系统使用 Spearman's Rho 相关性进行评分。进行了接受者操作特征 (ROC) 分析、Kruskal-Wallis 和 Mann-Whitney U 检验。结果对照组中位二维 SWE 测量值低于任何程度肝纤维化受试者（P<0.001）。METAVIR F0 和 Ishak 0 评分患者的 2-D SWE 测量中位数 (1.35 m/s; 1.36 m/s) 显着低于患有更严重肝病的患者 (F1-F3: 1.49-1.62 m/s; 1-4 ：1.45-1.63 m/s）（均 P<0.05），而较高分数中的 2-D SWE 相似。对于任何程度的纤维化，METAVIR 和 Ishak 评分的结果没有差异。纤维化评分与二维 SWE 测量中位数中度相关（rs=0.43）。与组合对照/F0 相比，F1 的曲线下面积为 0.89（95% 置信区间 [CI] 0.83-0.95；P<0.001），敏感性为 94.6%，特异性为 78.6%。Ishak 1 分的结果相似。确定纤维化的理想截止值为 1.29 m/s。结论 无论组织病理学评分系统如何，肝脏 2-D SWE 测量结果与组织学肝纤维化评分相关，尽管 2-D SWE 能够更好地识别早期纤维化患者，而不是区分个体纤维化水平。使用 GE LOGIQ US 系统的二维 SWE 对于识别有肝纤维化风险的儿科患者非常有用。