Liver stiffness measurements with supersonic shear wave elastography in the diagnosis of biliary atresia: a comparative study with grey-scale US.
OBJECTIVES
To prospectively assess the diagnostic performance of supersonic shear wave elastography (SSWE) in identifying biliary atresia (BA) among infants with conjugated hyperbilirubinaemia by comparing this approach with grey-scale ultrasonography (US).


METHODS
Forty infants were analysed as the control group to determine normal liver stiffness values. The use of SSWE values for identifying BA was investigated in 172 infants suspected of having BA, and results were compared with the results obtained by grey-scale US. The Mann-Whitney U test, unpaired t-test, Spearman correlation and linear regression were also performed.


RESULTS
The success rates of SSWE measurements in the control and study group were 100% (40/40) and 96.4% (244/253), respectively. Age, direct bilirubin, and indirect bilirubin all significantly correlated with SSWE in the liver (all P < 0.001). Linear regression showed that age had a greater effect on SSWE values than direct or indirect bilirubin. The diagnostic performance of liver stiffness values in identifying BA was lower than that of grey-scale US (area under the receiver operating characteristic curve [AUC], 0.790 vs 0.893, P < 0.001).


CONCLUSIONS
SSWE is feasible and valuable in differentiating BA from non-BA. However, its diagnostic performance does not exceed that of grey-scale US.


KEY POINTS
• SSWE could be successfully performed in an infant population. • For infants, the liver stiffness will increase as age increases. • SSWE is potentially useful in assessing infants suspected of biliary atresia. • SSWE is inferior to grey-scale US in identifying biliary atresia.
['Zhou|Lu-Yao|LY|', 'Jiang|Hong|H|', 'Shan|Quan-Yuan|QY|', 'Chen|Dong|D|', 'Lin|Xiao-Na|XN|', 'Liu|Bao-Xian|BX|', 'Xie|Xiao-Yan|XY|']
D001656:Biliary Atresia D001663:Bilirubin D016022:Case-Control Studies D003937:Diagnosis, Differential D054459:Elasticity Imaging Techniques D005240:Feasibility Studies D005260:Female D006801:Humans D006932:Hyperbilirubinemia D007223:Infant D007231:Infant, Newborn D008099:Liver D008103:Liver Cirrhosis D008297:Male D012372:ROC Curve D015203:Reproducibility of Results D014463:Ultrasonography
Biliary atresia Infant Hyperbilirubinaemia Ultrasonography Elasticity imaging techniques