Diagnostic problems in two-dimensional shear wave elastography of the liver

Naganuma, Hiroko; Ishida, Hideaki; Uno, Atsushi; Nagai, Hiroshi; Kuroda, Hidekatsu; Ogawa, Masahiro

doi:10.4329/wjr.v12.i5.76

Cited by 22 publications

(16 citation statements)

References 54 publications

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“…This is contrary to the results of a previous study on Beagle dogs, which reported no significant difference in liver stiffness between intercostal and subcostal approaches (10). In humans, the subcostal approach is known to demonstrate a false elevation in liver stiffness due to probe compression artifacts (39). Thus, the intercostal approach is recommended because it can be performed with less compression (40).…”

Section: Discussionmentioning

confidence: 61%

Effects of Confounding Factors on Liver Stiffness in Two-Dimensional Shear Wave Elastography in Beagle Dogs

Cha

Kim

et al. 2022

Front. Vet. Sci.

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BackgroundTwo-dimensional shear wave elastography (2D-SWE) is a powerful technique that can non-invasively measure liver stiffness to assess hepatic fibrosis.PurposeThis study aimed to identify the effects of confounding factors, including anesthesia, breathing, and scanning approach, on liver stiffness when performing 2D-SWE in dogs.Materials and MethodsNine healthy Beagle dogs were included in this study. Hepatic 2D-SWE was performed, and liver stiffness was compared between conscious and anesthetized states, free-breathing and breath-holding conditions, and intercostal and subcostal approaches. For the anesthetized state, the breath-holding condition was subdivided into seven phases, which included forced-expiration (5 and 10 mL/kg), end-expiration (0 cm H2O), and forced-inspiration (5, 10, 15, and 20 cm H2O), and liver stiffness was compared among these phases. Changes in liver stiffness were compared between intercostal and subcostal approaches according to breathing phases.ResultsNo significant difference was observed in liver stiffness between the conscious and anesthetized states or between the free-breathing and breath-holding conditions. No significant difference was noted in liver stiffness among the breathing phases, except for forced-inspiration with high airway pressure (15 and 20 cm H2O in the intercostal approach and 10, 15, and 20 cm H2O in the subcostal approach), which was associated with significantly higher liver stiffness (p < 0.05). Liver stiffness was significantly higher in the subcostal approach than in the intercostal approach (p < 0.05). Changes in liver stiffness were significantly higher in the subcostal approach than in the intercostal approach in all forced-inspiratory phases (p < 0.05).ConclusionIn conclusion, when performing 2D-SWE in dogs, liver stiffness is unaffected by anesthesia and free-breathing. To avoid inadvertent increases in liver stiffness, the deep inspiratory phase and subcostal approach are not recommended. Thus, liver stiffness should be interpreted considering these confounding factors.

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Section: Discussionmentioning

confidence: 61%

Effects of Confounding Factors on Liver Stiffness in Two-Dimensional Shear Wave Elastography in Beagle Dogs

Cha

Kim

et al. 2022

Front. Vet. Sci.

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“…We think that physical compression of the liver by visceral fat can increase liver stiffness in the absence of liver fibrosis in abdominally obese individuals. Since excessive external compression of the liver by an ultrasound probe has been reported to increase liver stiffness by 2D-SWE [ 18 ], it is reasonable to think that excessive internal compression of the liver also increases liver stiffness. It is well known that waist circumference is correlated with the visceral fat area [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Correlation between Liver Stiffness by Two-Dimensional Shear Wave Elastography and Waist Circumference in Japanese Local Citizens with Abdominal Obesity

Miyoshi

Hamaguchi

Kitagawa³

et al. 2021

JCM

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Background: Various factors other than fibrosis could affect liver stiffness (LS), measured by two-dimensional shear wave elastography (2D-SWE). We aimed to clarify the factors affecting LS in local citizens. Methods: We performed a cross-sectional study among local citizens of a health checkup program. Abdominal obesity was defined as waist circumference ≥85 cm for men and ≥90 cm for women. We evaluated the correlation between LS by 2D-SWE (Aplio 500) and waist circumference with linear regression analyses. We selected the following items as variables in the multivariate analysis: waist circumference, sex, hypertension, diabetes, diagnostic components of metabolic syndrome, γ−glutamyl transpeptidase, total bilirubin, NAFLD fibrosis score, and an indicator of a fatty liver, evaluated ultrasonographically. Results: Overall, 345 individuals were included; 318 (181 men and 137 women; age, 63.4 years; waist circumference, 84.0 cm; LS, 5.79 kPa) were analyzed, 128 of whom had abdominal obesity and significantly higher LS than non-abdominally obese individuals. In the multivariate analysis, waist circumference was positively, independently, and significantly correlated with LS only in abdominally obese individuals. Conclusions: Liver stiffness by 2D-SWE could increase with increases in waist circumference in local citizens with abdominal obesity. Physicians should pay attention when assessing the LS of abdominally obese individuals.

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“…Das Prinzip beruht darauf, die Ankunftszeit der Scherwellen/Distanz vom Stoßimpuls zur Bestimmung der Geschwindigkeit der Scherwellen zu verwenden. Die Messung ist möglich, weil die Geschwindigkeit der Scherwellen im Vergleich zur Geschwindigkeit der Ultraschall-impulse (etwa 1540 m/s) sehr langsam ist (< 1-10 m/s) [10].…”

Section: Physikalische Prinzipien Von Pswe Und 2-d-sweunclassified

SOP Scherwellenelastografie (Acoustic Radiation Force Impulse, ARFI)

Nowotny¹,

Kratzer²

2021

Gastroenterologie up2date

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Die sonoelastografischen (ARFI-)Verfahren bieten die Möglichkeit, eine relevante Fibrose der Leber nichtinvasiv zu diagnostizieren, und können ggf. helfen, eine Leberbiopsie zu vermeiden. Des Weiteren kann die Messung der Lebersteifigkeit mittels ARFI im Therapie-Monitoring diffuser Lebererkrankungen eingesetzt werden. Die nachfolgende SOP beschreibt die Einflussfaktoren und Prozeduren zur Gewinnung optimaler 2-D-Elastografie-Messwerte der Leber. Einleitung Chronische Lebererkrankungen können zu einem narbigen Umbau des Lebergewebes führen. Symptome des fibrotischen Umbaus der Leber treten meist erst sehr spät auf. Daher bleibt eine Erkrankung häufig lange unbemerkt oder wird zufällig im Rahmen der Abklärung anderer Beschwerden entdeckt. Des Weiteren ist eine Leberfibrose bzw. -zirrhose eine der häufigsten Ursachen für die Entwicklung einer portalen Hypertonie sowie von Komplikationen wie Ösophagusvarizen, Aszites oder Leberversagen [1]. Die B-Bild-Sonografie ist für eine frühe sichere Diagnostik nicht sensitiv genug und zeigt erst in fortgeschrittenen Stadien typische Veränderungen in der Leber.

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Diagnostic problems in two-dimensional shear wave elastography of the liver

Cited by 22 publications

References 54 publications

Effects of Confounding Factors on Liver Stiffness in Two-Dimensional Shear Wave Elastography in Beagle Dogs

Effects of Confounding Factors on Liver Stiffness in Two-Dimensional Shear Wave Elastography in Beagle Dogs

Correlation between Liver Stiffness by Two-Dimensional Shear Wave Elastography and Waist Circumference in Japanese Local Citizens with Abdominal Obesity

SOP Scherwellenelastografie (Acoustic Radiation Force Impulse, ARFI)

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