Ultrasonography.
2023 Apr;42(2):286-296. 10.14366/usg.22107.
Usefulness of two-dimensional shear wave elastography in diagnosing hepatic veno-occlusive disease in pediatric patients undergoing hematopoietic stem cell transplantation
- Affiliations
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- 1Department of Radiology, Seoul National University Hospital, Seoul, Korea
- 2Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- 3Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
- 4Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
- 5Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- 6Seoul National University Cancer Research Institute, Seoul National University Children's Hospital, Seoul, Korea
- 7Wide River Institute of Immunology, Seoul National University, Hongcheon, Korea
- KMID: 2540931
- DOI: http://doi.org/10.14366/usg.22107
Abstract
- Purpose
This study aimed to evaluate the usefulness of two-dimensional shear wave elastography (2D-SWE) in diagnosing hepatic veno-occlusive disease (VOD) in pediatric patients.
Methods
This study retrospectively included pediatric patients who underwent hematopoietic stem cell transplantation (HSCT) between November 2019 and January 2021. All 34 patients (8.7±5.0 years) were examined using 2D-SWE for an initial diagnosis. A subgroup analysis was performed using the data from follow-up examinations of patients diagnosed with VOD. The characteristics of the initial VOD diagnosis were compared with the longitudinal changes observed in VOD patients who underwent multiple ultrasound examinations.
Results
In total, 19 patients were diagnosed with VOD at 17.6±9.4 days after HSCT. All VOD patients showed hepatomegaly, ascites, and gallbladder wall thickening. Liver stiffness was higher in VOD patients than in non-VOD patients (12.4±1.1 vs. 6.3±0.8 kPa, P<0.001). Liver stiffness values above 7.2 kPa showed 84.2% sensitivity and 93.3% specificity in distinguishing VOD from non-VOD (area under the curve, 0.925; 95% confidence interval, 0.780 to 0.987; P<0.001). A subgroup analysis of 11 patients showed a linear decrease in liver stiffness values after VOD diagnosis with treatment (first, second, and third follow-ups; 13.5±1.7, 11.3±1.4, and 9.5±0.8 kPa, respectively), but without statistical significance in the pairwise analysis.
Conclusion
Liver stiffness measured using 2D-SWE increased in pediatric patients who develop VOD after HSCT. Therefore, liver stiffness can be a predictive and quantitative parameter for diagnosing VOD.
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