Elastography—A Bona Fide Non-Invasive Method for Assessing Non-Alcoholic Fatty Liver Disease in Children

Pediatric obesity has become a major public health problem worldwide, resulting in a wide spectrum of systemic complications. Liver disease associated with obesity, also known as nonalcoholic fatty liver disease (NAFLD), is currently the most common chronic liver condition in children. Therefore, it...

Full description

Bibliographic Details
Main Authors: Cristina Oana Mărginean, Lorena Elena Meliț, Maria Oana Săsăran
Format: Article
Language:English
Published: MDPI AG 2021-04-01
Series:Applied Sciences
Subjects:
Online Access:https://www.mdpi.com/2076-3417/11/7/3240
_version_ 1797538801924440064
author Cristina Oana Mărginean
Lorena Elena Meliț
Maria Oana Săsăran
author_facet Cristina Oana Mărginean
Lorena Elena Meliț
Maria Oana Săsăran
author_sort Cristina Oana Mărginean
collection DOAJ
description Pediatric obesity has become a major public health problem worldwide, resulting in a wide spectrum of systemic complications. Liver disease associated with obesity, also known as nonalcoholic fatty liver disease (NAFLD), is currently the most common chronic liver condition in children. Therefore, its timely and proper diagnosis is essential for preventing further development of cirrhosis. Multiple studies focused on identifying the most accurate non-invasive diagnostic method for liver fibrosis or cirrhosis. Although liver biopsy remains the gold-standard in terms of this hepatopathy, elastography methods emerged as a relatively reliable alternative to liver biopsy. Thus, recent studies revealed the great importance of these non-invasive methods not only in diagnosing pediatric NAFLD, but also in its staging. MRE is commonly considered to have a greater accuracy than ultrasound-based elastography methods, but with lower availability and higher costs. Ultrasound-based elastography methods (transient elastography (TE), p-SWE, and 2-dimensional shear wave elastography (2D-SWE)) were proved to have similar accuracy in NAFLD staging. Nevertheless, multiple confounding factors account for potential challenges when using elastography for liver stiffness measurement, such as age, obesity itself (i.e., BMI), transaminase levels, or portal flow. A potential solution for facing these challenges might be represented by a complex approach based on the combination between elastography, clinical and laboratory findings. Although the studies that assessed the role of elastography in pediatric NAFLD staging are scarce, the current knowledge underlines a crucial role of these techniques taking into account their ability to distinguish between fibrosis degrees, their non-invasive patterns, lower costs and side effects when compared to liver biopsy. Therefore, elastography might become a cornerstone in staging pediatric NAFLD.
first_indexed 2024-03-10T12:36:34Z
format Article
id doaj.art-435e1d456cfb4d65ad6f2ebef9b611e8
institution Directory Open Access Journal
issn 2076-3417
language English
last_indexed 2024-03-10T12:36:34Z
publishDate 2021-04-01
publisher MDPI AG
record_format Article
series Applied Sciences
spelling doaj.art-435e1d456cfb4d65ad6f2ebef9b611e82023-11-21T14:13:19ZengMDPI AGApplied Sciences2076-34172021-04-01117324010.3390/app11073240Elastography—A Bona Fide Non-Invasive Method for Assessing Non-Alcoholic Fatty Liver Disease in ChildrenCristina Oana Mărginean0Lorena Elena Meliț1Maria Oana Săsăran2Department of Pediatrics I, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street no 38, 540136 Transylvania, RomaniaDepartment of Pediatrics I, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street no 38, 540136 Transylvania, RomaniaDepartment of Pediatrics III, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street no 38, 540136 Transylvania, RomaniaPediatric obesity has become a major public health problem worldwide, resulting in a wide spectrum of systemic complications. Liver disease associated with obesity, also known as nonalcoholic fatty liver disease (NAFLD), is currently the most common chronic liver condition in children. Therefore, its timely and proper diagnosis is essential for preventing further development of cirrhosis. Multiple studies focused on identifying the most accurate non-invasive diagnostic method for liver fibrosis or cirrhosis. Although liver biopsy remains the gold-standard in terms of this hepatopathy, elastography methods emerged as a relatively reliable alternative to liver biopsy. Thus, recent studies revealed the great importance of these non-invasive methods not only in diagnosing pediatric NAFLD, but also in its staging. MRE is commonly considered to have a greater accuracy than ultrasound-based elastography methods, but with lower availability and higher costs. Ultrasound-based elastography methods (transient elastography (TE), p-SWE, and 2-dimensional shear wave elastography (2D-SWE)) were proved to have similar accuracy in NAFLD staging. Nevertheless, multiple confounding factors account for potential challenges when using elastography for liver stiffness measurement, such as age, obesity itself (i.e., BMI), transaminase levels, or portal flow. A potential solution for facing these challenges might be represented by a complex approach based on the combination between elastography, clinical and laboratory findings. Although the studies that assessed the role of elastography in pediatric NAFLD staging are scarce, the current knowledge underlines a crucial role of these techniques taking into account their ability to distinguish between fibrosis degrees, their non-invasive patterns, lower costs and side effects when compared to liver biopsy. Therefore, elastography might become a cornerstone in staging pediatric NAFLD.https://www.mdpi.com/2076-3417/11/7/3240elastographychildrennonalcoholic fatty liver disease
spellingShingle Cristina Oana Mărginean
Lorena Elena Meliț
Maria Oana Săsăran
Elastography—A Bona Fide Non-Invasive Method for Assessing Non-Alcoholic Fatty Liver Disease in Children
Applied Sciences
elastography
children
nonalcoholic fatty liver disease
title Elastography—A Bona Fide Non-Invasive Method for Assessing Non-Alcoholic Fatty Liver Disease in Children
title_full Elastography—A Bona Fide Non-Invasive Method for Assessing Non-Alcoholic Fatty Liver Disease in Children
title_fullStr Elastography—A Bona Fide Non-Invasive Method for Assessing Non-Alcoholic Fatty Liver Disease in Children
title_full_unstemmed Elastography—A Bona Fide Non-Invasive Method for Assessing Non-Alcoholic Fatty Liver Disease in Children
title_short Elastography—A Bona Fide Non-Invasive Method for Assessing Non-Alcoholic Fatty Liver Disease in Children
title_sort elastography a bona fide non invasive method for assessing non alcoholic fatty liver disease in children
topic elastography
children
nonalcoholic fatty liver disease
url https://www.mdpi.com/2076-3417/11/7/3240
work_keys_str_mv AT cristinaoanamarginean elastographyabonafidenoninvasivemethodforassessingnonalcoholicfattyliverdiseaseinchildren
AT lorenaelenamelit elastographyabonafidenoninvasivemethodforassessingnonalcoholicfattyliverdiseaseinchildren
AT mariaoanasasaran elastographyabonafidenoninvasivemethodforassessingnonalcoholicfattyliverdiseaseinchildren