Engelmann G, Quader J, Teufel U, Schenk JP. Limitations and opportunities of non-invasive liver stiffness measurement in children. World J Hepatol 2017; 9(8): 409-417 [PMID: 28357028 DOI: 10.4254/wjh.v9.i8.409]
Corresponding Author of This Article
Guido Engelmann, MD, Department of Paediatrics, Lukas Hospital, Preussenstraße 84, D-41464 Neuss, Germany. engelmann@lukasneuss.de
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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
Abstract
Changes in liver structure are an important issue in chronic hepatopathies. Until the end of the 20th 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.
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.
