Kim, Dong Wook; Yoon, Hee Mang; Jung, Ah Young; Lee, Jin Seong; Oh, Seak Hee; Kim, Kyung Mo; Cho, Young Ah
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
2018Aug ; 9 ( 16 ) :.
PMID : 30117178
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Kim, Dong Wook - Department of Radiology, Taean-gun Health Center and County Hospital, Pyeongcheon-ri, Korea.
Yoon, Hee Mang - Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Korea.
Jung, Ah Young - Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Korea.
Lee, Jin Seong - Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Korea.
Oh, Seak Hee - Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kim, Kyung Mo - Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Cho, Young Ah - Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Korea.
ABSTRACT
OBJECTIVES: To assess the diagnostic performance of ultrasound (US) elastography in evaluating portal hypertension in children and compare the liver and spleen stiffness values between the portal hypertension and control groups.
METHODS: Studies in the MEDLINE and Embase databases were selected that investigated the diagnostic performance of US elastography in children with portal hypertension up to December 21, 2017. Pooled sensitivity and specificity data were assessed by hierarchical logistic regression modeling.
RESULTS: Eleven studies were included in the systematic review, and a meta-analysis could be conducted in 7 of these publications to evaluate the diagnostic performance of US elastography. The summary sensitivity and specificity of this method for liver stiffness were 90% (95% confidence interval [CI], 83%-94%) and 79% (95% CI, 73%-84%), respectively, and the area under the hierarchical summary receiver operating characteristic curve was 0.92 (95% CI, 0.90-0.94). A subgroup analysis of 5 transient elastographic studies revealed similar diagnostic performance (sensitivity, 90%; specificity, 78%). In 10 of the 11 studies that investigated liver stiffness and 2 of the 3 studies that also measured spleen stiffness, patients in the portal hypertension group had a significantly higher stiffness value than the control group (P?
CONCLUSIONS: Ultrasound elastography shows good performance in diagnosing portal hypertension and can identify significant differences in liver and spleen stiffness in children with this condition. This method thus has considerable potential as a noninvasive tool for screening portal hypertension-related complications in children with chronic liver disease. CI - ??2018 by the American Institute of Ultrasound in Medicine.
keyword
children; chronic liver disease; portal hypertension; stiffness measurement; ultrasound elastography
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