Basis of using ultrasound elastography in diffuse and focal liver diseases

Морозова, Т. Г.; Борсуков, А. В.

doi:10.24835/1607-0763-2018-6-69-75

Cited by 4 publications

(1 citation statement)

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“…Как при очаговых, так и при всех формах диффузных изменений печени исследователями отмечена более высокая диагностическая информативность ЭСВ в сравнении с таковой при биопсии печени [22]. В работе П. И. Рыхтик и соавт.…”

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Ultrasound hepatic elastography with decaying signal technology allows assessing the degree of steatosis and dynamic monitoring of the effectiveness of NAFLD treatment

Николаевна

Тарасова

Цыганова

et al. 2020

jour

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The purpose of the research is to study the informativeness of the technology of Controlled Attenuation Parameter (CAP) in Shear Wave Elastography (SWE) in determining the degree of severity of liver steatosis depending on the elastometric quantitative values of liver fibrosis in a one-time study in a given volume of parenchima liver in patients with non-alcoholic fatty liver disease (NAFLD).Materials and methods of research. The study included 169 patients with NHTSA between the ages of 19 and 81, the average age was 41.7 ±11.3 years, examined in the “City Clinical Hospital No. 1” of the Ministry of Health, Chuvashia (Cheboksary, Russia). Patients with functional disorders of bile evacuation (n= 72) were the first group; the 2nd group were the patients with liver steatosis without manifestations of liver fibrosis (n = 28); the 3rd contained the patients with cirrhosis of the liver (n = 25); patients with chronic viral hepatitis B and C (n= 44) were in the 4th group. All patients were screened with ultrasonic shear wave elastography with elastometry in one-dimensional (TE) (FibroScan 502 TOUCH, France) and two dimensional (2DSWE) modes (Aixplorer, Supersonic Imagine, France). Elastometry (kPa) and steatometry (dB/m) were completed simultaneously within the same volume of the analyzed liver tissue with two sensing devices of “FibroScan 502 TOUCH”. The statistical processing was carried out with the help of IBM SPSS Statistics 10.0. The results are reflected in the form of median (Me), minimum (min), maximum (max) and medium (Emean) values, standard deviation (SD) of Jung’s elasticity module. Correlational analysis of the received values of parameters F and S was made with the descriptive method of Bland-Altman and the method of Spearman.Results and discussion. The average quantitative values of the severity of liver steatosis in patients with cirrhosis of liver had reliably lower values (234.5±62.1 dB/m) than in those suffering from steatosis of the liver without fibrosis (347.5±37.6 dB/m) and patients with chronic viral hepatitis (245.9±57.3dB/m, p lt; 0.001). The values of fibrosis in the same amount of the tested liver tissue with liver cirrhosis (45.5± 22.3 kP) were higher than similar rates in the other groups of patients with NAFLD (p lt; 0.001). Diagnostic informational content of the method of controlled ultrasound attenuation in establishing the degree of manifestation of liver steatosis had a higher specificity with II degree of liver steatosis (99.29% with a sensitivity of 84.92%).The results of the study allow us to recommend ultrasound elastography with the technology of controlled ultrasound attenuation to determine the severity of liver steatosis for both primary diagnosis and for dynamic monitoring of the liver condition of patients with NAFLD.

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Section: Introductionunclassified

Ultrasound hepatic elastography with decaying signal technology allows assessing the degree of steatosis and dynamic monitoring of the effectiveness of NAFLD treatment

Николаевна

Тарасова

Цыганова

et al. 2020

jour

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Acoustic radiation force impulse elastography in the evaluation of focal liver pathology: a prospective study

Kozubova,

Busko,

Bagnenko

et al. 2024

Lučevaâ diagn. ter.

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INTRODUCTION: Determining the nature of focal liver pathology is an important issue, especially in oncological practice. Imaging methods with contrast enhancement are the main methods for diagnosing pathology of the hepatobiliary tract, however, there are limitations in the use of computed tomography, magnetic resonance imaging, and contrast-enhanced ultrasound. In recent years, acoustic radiation force impulse elastography has become a widely used method in assessing changes in the liver. This technique has been successfully used to quantify diffuse disease in the liver, and scientific research is currently being actively conducted to determine the threshold values of the stiffness of various liver lesions.OBJECTIVE: To determine the possibility of an alternative method for differential diagnosis of solid liver lesions from pseudofocal lesions using the acoustic radiation force impulse elastography technique in the context of multiparametric ultrasound examination. MATERIALS AND METHODS: The study included 64 patients with a history of cancer. In all cases, contrast-enhanced computed tomography and multiparametric ultrasound using acoustic radiation force impulse elastography technology were performed to assess quantitative indicators of lesion stiffness in the non-cirrhotic liver. The minimum, average and maximum stiffness of the lesion was assessed, expressed in m/s based on the results of 10 measurements. The results obtained were compared with accepted standards for the stiffness of the liver parenchyma for assessing diffuse changes, recommended by EFSUMB. RESULTS: In accordance with the final clinical diagnosis, the studies included focal liver lesions: hemangioma (n=16; 25.0%), focal steatosis (n=19; 29.7%), metastases (n=29; 45.3%). We assessed three subgroups of values: the minimum value, the maximum and the average. The most important parameter used for further interpretation of the data is the average stiffness value based on the results of all measurements. When assessing this indicator for hemangioma, the median was 1.63 m/s, the standard deviation was 0.36, and the range was 1.02 m/s. For these focal lesions the 25th percentile is 1.47 m/s, the 75th percentile is 2.01 m/s. For metastatic lesions, the median was 1.83 m/s. When determining the standard deviation, this indicator was 0.34 m/s, and the range was 1.58 m/s. Also, the values of the 25th percentile were 1.68 m/s, and the 75th were 2.08 m/s. When analyzing these indicators of stiffness in focal steatosis, the following values were obtained: median — 1.09 m/s; range — 0.21 m/s and standard deviation — 0.06 m/s. The 25th percentile values were 1.025 m/s, the 75th percentile — 1.105 m/s. DISCUSSION: Based on the presented data, solid lesions, such as hemangioma and metastasis, had significantly high stiffness values in comparison with unchanged liver parenchyma. Our results are close to the values described in a number of large studies, but at the moment there is no consensus regarding the threshold values, as well as the methodology for performing the study and determining the zone for assessing stiffness in the lesion, which makes this technique promising for further study. CONCLUSION: Performing a multiparametric ultrasound examination using the technique of acoustic radiation force impulse elastography to assess quantitative indicators of stiffness in the lesion makes it possible to identify changes in the liver at the screening stage, conduct constant non-invasive monitoring of cancer patients, and determine further tactics for patient management. This technique is a promising, easily accessible, economical and, most importantly, dose-free diagnostic tool for detecting and characterizing liver lesion, allowing to reduce the time of differential diagnosis at the initial stage and reduce the costs of further research.

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Elastography and Steatometry of the Liver from the Position of World Experts 2018–2022

Borsukov,

Venidiktova,

Skutar

et al. 2023

jour

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Purpose: To evaluate the dynamics of the opinions of world experts on the materials of world recommendations on ultrasound elastography and liver steatometry from the standpoint of the domestic level of development of ultrasound diagnostics and on the basis of our own data.Material and methods: 16 main provisions of the World Guidelines for Liver Elastography in 2018 were reviewed and comments were made, differences from the European Guidelines of 2017 and the first World Guidelines of 2015 were noted. We reviewed and commented on the 2020 SRU comments. The final scientific publication of a large group of world experts in 2022 is analyzed in detail, where for the first time the norms and threshold values between benign and malignant neoplasms of a large number of human organs and tissues are given.Results: From 2006 to the present, more than 45,000 ultrasound studies have been carried out on our own material (n=15627), some differences in approaches to liver elastometry are given, and approaches to the use of ultrasound steatometry are considered.Conclusion: Threshold development vectors are shown, techniques to avoid artifacts and reduce the risk of obtaining false negative and false positive elastometry results are proposed. There is caution of the expert community in the review of the method of quantitative steatometry based on the measurement of the attenuation coefficient of the ultrasound wave.

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Basis of using ultrasound elastography in diffuse and focal liver diseases

Cited by 4 publications

References 4 publications

Ultrasound hepatic elastography with decaying signal technology allows assessing the degree of steatosis and dynamic monitoring of the effectiveness of NAFLD treatment

Ultrasound hepatic elastography with decaying signal technology allows assessing the degree of steatosis and dynamic monitoring of the effectiveness of NAFLD treatment

Acoustic radiation force impulse elastography in the evaluation of focal liver pathology: a prospective study

Elastography and Steatometry of the Liver from the Position of World Experts 2018–2022

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