Evaluation of portal hypertension by real‐time shear wave elastography in cirrhotic patients

Abstract

In cirrhotic patients, LSM by SWE is highly correlated with HVPG value regardless of ascites. SWE is a new reliable non-invasive diagnostic tool to predict CSPH and SPH, even in cirrhotic patients with ascites.

Shear‐wave elastography of the liver and spleen identifies clinically significant portal hypertension: A prospective multicentre study

“…Recent studies introduced Shear-wave elastography of the liver (L-SWE) as a promising tool to diagnose portal hypertension. [10][11][12] These studies find good diagnostic accuracy of L-SWE with specificity and sensitivity ranging between 80% and 90%, which was partly better compared head-to-head with TE. Using two different cut-offs to rule-in and rule-out CSPH, sensitivity and specificity could be increased up to more than 90%.…”

“…Firstly, TE is useless in patients with ascites; secondly, TE shows high failure rates in obese patients especially in patients with a BMI >30 kg/m 2 ; thirdly, TE offers only a regional elasticity measurement, but no anatomical image; and fourthly, the small sample size is by definition not representative for the whole liver . Therefore, SWE has already been introduced as a promising and equally accurate tool to diagnose portal hypertension and the stage of liver fibrosis and cirrhosis in chronic liver disease …”

“…Recent studies introduced Shear‐wave elastography of the liver (L‐SWE) as a promising tool to diagnose portal hypertension . These studies find good diagnostic accuracy of L‐SWE with specificity and sensitivity ranging between 80% and 90%, which was partly better compared head‐to‐head with TE.…”

Does motion affect liver stiffness estimates in shear wave elastography? Phantom and clinical study

“…Liver-stiffness measurements obtained during different breathing phases were described in previous papers where patients were asked to hold their breath [15][16][17]. The authors of those studies considered the same two breathing phases and found that liver stiffness at end-expiration was significantly higher than that at end-inspiration.…”

“…An experimental study on pigs [14] demonstrated that liver stiffness measures with transient elastography (Fibroscan, Echosens) was directly affected by central venous pressure, which is increased during a Valsalva maneuver. In addition, a recent study using SWE technology on 115 cirrhotic patients showed that liver-stiffness measurements were strongly correlated with the hepatic venous pressure gradient [15]. Hence, asking patients to hold their breath could lead to overestimation of liver stiffness.…”