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. 2021 Sep;51(10):1873-1878.
doi: 10.1007/s00247-021-05079-8. Epub 2021 May 13.

Acoustic radiation force impulse imaging: normal values of spleen stiffness in healthy children

Sylviane Hanquinet  1 , Céline Habre  2 , Méryle Laurent  2 , Mehrak Anooshiravani  2 , Seema Toso  2
Affiliations

Acoustic radiation force impulse imaging: normal values of spleen stiffness in healthy children

Sylviane Hanquinet et al. Pediatr Radiol. 2021 Sep.

Abstract

Background: Acoustic radiation force impulse (ARFI) imaging is a noninvasive ultrasound elastography technique for evaluating tissue stiffness. The association of liver and spleen stiffness provides additional information in the assessment of portal hypertension. The technique and normal values of spleen stiffness by point shear wave elastography (p-SWE) in pediatrics have not been well documented.

Objective: Our aim is to describe the feasibility and normal ARFI elastography values in the spleen for healthy children and to compare measurements in two different probe positions (the axial and sagittal planes).

Materials and methods: Spleen p-SWE using ARFI values were measured with a 6C1 probe in 102 healthy children (age range: 8 weeks to 17 years) divided into four age groups. An average of nine (standard deviation: two) spleen stiffness measurements were taken during free breathing in each plane (axial and sagittal). The impact of age and measurement plane in the spleen was analyzed using multivariate models.

Results: There was no significant difference in spleen stiffness values taken at different ages, with an average of the medians of 2.43±0.31 m/s. There was no significant difference based on probe orientation: sagittal plane (median: 2.46±0.29 m/s) and axial plane (median: 2.43±0.32 m/s) with Student's t-test P=0.18. The mean depth of measurement varied between 2.3 cm and 3.7 cm, according to age.

Conclusion: Normal spleen stiffness values using ARFI imaging in children do not vary with age and correspond to a median of 2.43 m/s. No significant difference was found when using different probe positions.

Keywords: Acoustic radiation force impulse; Children; Normal values; Shear wave elastography; Spleen; Stiffness; Ultrasound.

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Conflict of interest statement

None

Figures

Fig. 1
Fig. 1
Acoustic radiation force impulse (ARFI) imaging measurements in a healthy 6-year-old boy using a 6C1 probe. a In the sagittal plane, shear wave velocity is 2.54 m/s at a depth of 3.3 cm. b In the axial plane, shear wave velocity is 2.30 m/s at a depth of 2.1 cm
Fig. 2
Fig. 2
A scatterplot with a regression line of the relationship between age (years) along the horizontal axis and median sagittal spleen shear wave velocities acoustic radiation force impulse (ARFI) (m/s) along the vertical axis (P-value=0.20, r=−0.131)
Fig. 3
Fig. 3
A scatterplot with a regression line of the relationship between age (years) along the horizontal axis and median of axial spleen shear wave velocities acoustic radiation force impulse (ARFI) (m/s) along the vertical axis (P-value=0.047, r=−0.198)
Fig. 4
Fig. 4
Box plots of median spleen elastography values between probe positions, axial and sagittal, in all populations. The line in the middle of the box is the median, the bottom and top of the box are the 25th and 75th percentiles. ARFI acoustic radiation force impulse
Fig. 5
Fig. 5
Box plots of interquartile range/median (IQR/M) of spleen elastography values between both probe positions, sagittal and axial. ARFI acoustic radiation force impulse
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