The Elastographic Aspect of Liver in Pediatric Patients with Hepatopathies and Malignities Versus Healthy Children

Background: Liver injury in context of chronical diseases, including malignacies, obesity, viral hepatitis, drug-related hepatotoxicity is an important concern for practicing pediatricians. The usual (biochemical) parameters for liver assessment prove to be now insufficient. Nowadays there is a high interest for finding non-invasive methods of hepatic evaluation, as an alternative to liver biopsy. Elastography fills a gap, provi-ding information on the degree of hepatic fibrosis.
Objective: Real-time elastographic assessment of liver tissue in correlation with biochemical parameters in children with hepatopathies and malignancies versus healthy children.
Material and method: Between September 15, 2010 and March 15, 2011 we conducted a prospective study in the Ist Pediatric Clinic Tîrgu Mureș, Romania, including a group of children with various malignancies under/after chemotherapy, a group of children with liver diseases (drug-related hepatotoxicity, obesity, hepatitis) and a control group composed of children with normal biochemical parameters. We assessed the liver tissue elasticity, expressed as SWV (shear wave velocity) on elastography, biochemical parameters, then statistical correlations were performed.
Results: Comparing SWV-values between the three groups, higher speeds were found in groups with liver damage after chemotherapy and those with hepatopathies (p=0.04). Aspartate transaminase (AST, IU) and alanine transaminase (ALT, IU) levels were different in a statistically significant manner between the three groups (p=0.0006 and 0.0002 respectively). In the after-chemiotherapy group significant correlations were obtained between elasticity and AST (p=0.0001).
Conclusions: In children with liver damage, SWV (which is correlated with the degree of liver fibrosis) increase in parallel with transaminases.