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Diagnostic Performance of Ultrasound Elastography for Evaluating Portal Hypertension in Children: A Systematic Review and Meta‐analysis
Author(s) -
Kim Dong Wook,
Yoon Hee Mang,
Jung Ah Young,
Lee Jin Seong,
Oh Seak Hee,
Kim Kyung Mo,
Cho Young Ah
Publication year - 2019
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.1002/jum.14764
Subject(s) - medicine , portal hypertension , elastography , transient elastography , receiver operating characteristic , confidence interval , ultrasound , meta analysis , liver disease , chronic liver disease , subgroup analysis , radiology , cirrhosis , liver fibrosis
Objectives To assess the diagnostic performance of ultrasound (US) elastography in evaluating portal hypertension in children and compare the liver and spleen stiffness values between the portal hypertension and control groups. Methods Studies in the MEDLINE and Embase databases were selected that investigated the diagnostic performance of US elastography in children with portal hypertension up to December 21, 2017. Pooled sensitivity and specificity data were assessed by hierarchical logistic regression modeling. Results Eleven studies were included in the systematic review, and a meta‐analysis could be conducted in 7 of these publications to evaluate the diagnostic performance of US elastography. The summary sensitivity and specificity of this method for liver stiffness were 90% (95% confidence interval [CI], 83%–94%) and 79% (95% CI, 73%–84%), respectively, and the area under the hierarchical summary receiver operating characteristic curve was 0.92 (95% CI, 0.90–0.94). A subgroup analysis of 5 transient elastographic studies revealed similar diagnostic performance (sensitivity, 90%; specificity, 78%). In 10 of the 11 studies that investigated liver stiffness and 2 of the 3 studies that also measured spleen stiffness, patients in the portal hypertension group had a significantly higher stiffness value than the control group ( P < .05). Conclusions Ultrasound elastography shows good performance in diagnosing portal hypertension and can identify significant differences in liver and spleen stiffness in children with this condition. This method thus has considerable potential as a noninvasive tool for screening portal hypertension–related complications in children with chronic liver disease.