Journal of pediatric gastroenterology and nutrition · 2026
Diagnostic utility of shear wave elastography in pediatric celiac disease: Assessment of mesenteric and ileal stiffness.
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Ergen Yasin Maruf, Çaviş Tuğba, Teke Selçuk, Başaran Edibe Gözde, Akçay Birce İzgi, Balamtekin Necati
Аннотация
OBJECTIVE: To investigate the diagnostic utility of abdominal shear wave elastography (SWE) in pediatric celiac disease (CD) by assessing mesenteric and terminal ileal stiffness and its association with serologic activity, histologic severity, and gluten-free diet (GFD) duration.
METHODS: In this prospective study, 84 children with CD and 80 matched healthy controls were evaluated. Mesenteric and terminal ileal stiffness values were measured using SWE. CD patients were stratified by GFD duration (short-term: ≤6 months vs. long-term: >6 months) and tissue transglutaminase immunoglobulin A (tTG-IgA) levels. Diagnostic performance was determined using receiver operating characteristic (ROC) curves.
RESULTS: Mesenteric and ileal SWE values were significantly higher in CD patients than controls (p < 0.001 for both). Mesenteric stiffness demonstrated an area under the ROC curve (AUC) of 0.81 with an optimal cut-off of 9.03 kPa, while ileal stiffness showed an AUC of 0.83 with a cut-off of 9.71 kPa. Subgroup analysis revealed no significant difference in baseline Marsh scores between the short-term and long-term GFD groups (p = 0.305), despite a dramatic decline in tTG-IgA levels in the long-term group (p < 0.001). Elevated stiffness persisted in both newly diagnosed and GFD-treated patients compared with controls (all p < 0.001). No significant correlations were observed between SWE values and concurrent tTG-IgA levels or Marsh subtypes (all p > 0.05).
CONCLUSION: Increased mesenteric and ileal stiffness in children with CD likely reflect transmural involvement and structural remodeling beyond the mucosal injury. These findings demonstrate that SWE has good diagnostic utility and may serve as a valuable complementary noninvasive tool in the evaluation and clinical monitoring of pediatric CD.
METHODS: In this prospective study, 84 children with CD and 80 matched healthy controls were evaluated. Mesenteric and terminal ileal stiffness values were measured using SWE. CD patients were stratified by GFD duration (short-term: ≤6 months vs. long-term: >6 months) and tissue transglutaminase immunoglobulin A (tTG-IgA) levels. Diagnostic performance was determined using receiver operating characteristic (ROC) curves.
RESULTS: Mesenteric and ileal SWE values were significantly higher in CD patients than controls (p < 0.001 for both). Mesenteric stiffness demonstrated an area under the ROC curve (AUC) of 0.81 with an optimal cut-off of 9.03 kPa, while ileal stiffness showed an AUC of 0.83 with a cut-off of 9.71 kPa. Subgroup analysis revealed no significant difference in baseline Marsh scores between the short-term and long-term GFD groups (p = 0.305), despite a dramatic decline in tTG-IgA levels in the long-term group (p < 0.001). Elevated stiffness persisted in both newly diagnosed and GFD-treated patients compared with controls (all p < 0.001). No significant correlations were observed between SWE values and concurrent tTG-IgA levels or Marsh subtypes (all p > 0.05).
CONCLUSION: Increased mesenteric and ileal stiffness in children with CD likely reflect transmural involvement and structural remodeling beyond the mucosal injury. These findings demonstrate that SWE has good diagnostic utility and may serve as a valuable complementary noninvasive tool in the evaluation and clinical monitoring of pediatric CD.