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CC BY-NC-ND 4.0 · Am J Perinatol 2025; 42(10): 1318-1324
DOI: 10.1055/a-2490-3259
Original Article

Changes in Liver Shear Wave Elastography of Preterm Infants during Hospitalization

Takahiro Kemmotsu 
1   Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
2   Department of Neonatology, Yokohama City University Medical Center, Yokohama, Japan
,
Tomoyuki Shimokaze 
1   Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
,
Yusuke Morita
1   Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
,
Tomoko Saito
1   Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
,
Katsuaki Toyoshima
1   Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
› Institutsangaben
Funding None.
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Abstract

Objective

Liver evaluation is essential in preterm infants because of exposure to hepatotoxic drugs, the effects of parenteral nutrition, and their organ immaturity. The clinical significance of shear wave elastography (SWE) which measures tissue elasticity, is unclear in preterm infants. For SWE application to liver evaluation in preterm infants, we examined the postnatal course and factors associated with changes.

Study Design

We prospectively measured liver SWE values every other week in 37 preterm infants born at 23 to 35 weeks gestation and 12 term infants born after 36 weeks gestation.

Results

The median early postnatal liver SWE value was 1.22 (interquartile range, 1.19–1.26) m/s. The correlations of liver SWE values with gestational age and birth weight were r = −0.18 (p = 0.23) and r = −0.21 (p = 0.157), respectively. The median liver SWE values from birth to 36 to 38 postmenopausal weeks were 1.22 (1.17–1.24) m/s at <28 weeks gestation (n = 9), 1.21 (1.18–1.25) m/s at 28 to 29 weeks gestation (n = 11), 1.24 (1.21–1.28) m/s at 30 to 31 weeks gestation (n = 8), and 1.21 (1.20–1.24) m/s at ≥32 weeks gestation (n = 9). There was no change over time in any gestational age group (p = 0.158). The median liver SWE values were 1.22 (1.17–1.25) m/s (n = 10) and 1.22 (1.19–1.25) m/s (n = 27) for small- and appropriate-for-gestational-age infants, respectively (p = 0.93). The correlations of abnormally high serum concentrations of direct bilirubin (>1.0 mg/dL) and alanine aminotransferase (>12 IU/L) with liver SWE values were r = 0.37 (p = 0.041) and r = 0.21 (p = 0.35), respectively.

Conclusion

Liver SWE values may be useful for the evaluation of liver damage with cholestasis in preterm infants because they remain constant regardless of gestational age and birth weight and do not change over time or with a deviation of body size.

Key Points

  • Liver SWE was prospectively performed in preterm infants.

  • Liver SWE was constant until term regardless of gestational age or birth weight.

  • Liver SWE values of preterm infants ranged from 1.2 to 1.3 m/s.

  • For preterm infants, elevation of liver SWE values reflected cholestasis.

  • Liver SWE may become the new standard for liver evaluation in preterm infants.

Keywords

acoustic radiation force impulse imaging - preterm infant - cholestasis - liver stiffness - small for gestational age

Ethical Approval

The study was conducted in accordance with the principles contained in the Declaration of Helsinki and was approved by the institutional review board of Kanagawa Children's Medical Center (No. 144-1). All parents or guardians of the participating infants were informed of the use of the test data and the study purpose using an opt-out approach. There were no inquiries regarding the non-use of data during the posting of the opt-out option because the liver SWE images were obtained simultaneously with comprehensive ultrasound examinations of the brain, heart, and abdominal organs for biweekly health monitoring purposes.




Publikationsverlauf

Eingereicht: 15. Oktober 2024

Angenommen: 25. November 2024

Accepted Manuscript online:
28. November 2024

Artikel online veröffentlicht:
28. Dezember 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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