Abstract: Objective To assess liver elasticity in children with Kawasaki disease during the acute phase using shear wave elastography (SWE).Methods A total of 104 children with acute Kawasaki disease were enrolled in the Kawasaki disease group, which was further divided into two subgroup: coronary artery dilation(CAD) with 49 cases and non-coronary artery dilation (NCAD) with 55 cases. A control group of 50 healthy children, mached for age and sex, was also included. General and laboratory data were collected for all three groups. Liver elasticity was assessed using SWE to measure the maximum elastic value (Emax) and the average elastic value (Emean), with comparions made between the groups. The correlation between liver function indices and Emean was also analyzed. Additionally, laboratory markers such as white blood cell count (WBC), C-reactive protein (CRP), platelet count (PLT), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were collected from the pediatric patients.Results Serum levels of WBC (17.62±3.48×10⁹/L), CRP (15.3±1.13 mg/L), PLT (478.67±93.45×10⁹/L), ESR (0.56±0.04 mm/h), IL-6 (82.21±6.87 pg/mL), AST (26.12±2.68 U/L), and ALT (28.91±1.87 U/L) in the CAD group were significantly higher than those in the NCAD and control group (P<0.05). Additionally, liver Emax (8.22±1.25 kPa) and Emean (6.67±1.57 kPa) values in the CAD group were higher than those in the NCAD group and control group. Correlation analysis showed that AST and ALT were positively correlated with Emean in the Kawasaki disease group (r=0.539, 0.638, both P<0.05).Conclusion SWE is a feasible method for evaluating liver damage in the acute phase of Kawasaki disease in children.

Key words: Shear wave elastography, Kawasaki disease (KD), Coronary artery dilatation, Elasticity of the liver