Program Information
Shear Wave Elastography Ultrasound in a Pediatric Population with Hepatic Veno-Occlusive Disease
M Goette*, N Dodd , R Krance , P Masand , Texas Children's Hospital, Houston, TX
Presentations
WE-DE-708-5 (Wednesday, August 2, 2017) 10:15 AM - 12:15 PM Room: 708
Purpose: To evaluate the feasibility of shear wave elastography ultrasound as a potential non-invasive tool to facilitate early diagnosis of hepatic veno-occlusive disease (HVOD) in a pediatric population who undergo hematopoietic stem cell transplantation (HSCT).
Methods: Under IRB approval, HSCT patients (N=10, age: 10.0 ± 6.38 y) suspected of developing HVOD per the revised Seattle criteria were considered for inclusion. Patients underwent ultrasound imaging during the onset of HVOD symptoms and after symptom resolution, as determined by a physician according to the following clinical criteria: total bilirubin, AST, ALT, alkaline phosphatase, GGT, Albumin, percent weight gain. All ultrasound exams were performed using a GE Logic-E9 unit with a curvilinear 9 MHz transducer. Four measurements were made in Couinaud’s liver segments numbers 5 through 8 (16 total). For each US SWE exam, mean and standard deviation were derived for each liver segment and for the liver as a whole.
Results: Of the ten patients who consented for the study, three were removed due to discharge or withdrawal of consent. Figure 1 displays two exams for a patient, one during moderate HVOD with elevated SWE measurements and one after treatment with resolution of symptoms and lower SWE measurements. Figure 2 shows the results for the seven patients with imaging during and after HVOD symptoms, in which the mean SWE values during HVOD were significantly higher than after HVOD resolution (2.08 ± 0.61 m/s, and 1.43 ± 0.12 m/s, respectively; p=0.03) for the whole liver.
Conclusion: This study demonstrated the ability of shear wave elastography to measure significantly higher liver stiffness in pediatric patients during HVOD symptom onset and after HVOD resolution.
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