Liver ultrasound elastography: More than staging the disease

Gherlan, George Sebastian

doi:10.4254/wjh.v7.i12.1595

Cited by 24 publications

(18 citation statements)

References 41 publications

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“…Liver biopsy is not very well accepted by the parents of children with chronic hepatitis and it is difficult to use it during the follow-up in case of paediatric patients. There is a trend towards replacing liver biopsy by elastography for the evaluation of liver fibrosis among children with chronic diffuse liver diseases [7,8].…”

Section: Introductionmentioning

confidence: 99%

Comparison of three ultrasound based elastographic techniques in children and adolescents with chronic diffuse liver diseases.

et al. 2016

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Non-invasive techniques for liver fibrosis assessment were developed for adults and recent researches tested their accuracy in children. The only validated elastographic method for non-invasive liver fibrosis evaluation in children is Transient Elastography (TE). The aim of our study was to investigate the feasibility of liver stiffness (LS) measurement in paediatric patients with chronic liver diseases by means of Acoustic Radiation Force Impulse Elastography (ARFI) and 2D-Shear Wave Elastography (2D-SWE), compared to TE as reference method. Material and methods: We enrolled 54 consecutive children and adolescents with different chronic liver diseases. All patients were examined by means of TE, ARFI, and 2D-SWE. All measurements were performed in the right liver lobe, in the same session, in fasting condition. We considered reliable LS elastographic measurements as follows: for TE and ARFI -the median value of ten measurements with a success rate≥60% and an interquartile range<30%, for 2D-SWE -the median value of five measurements. Results: The successful measurement rate for TE was 94.4% (51/54). Taking TE as a reference method, sensitivity of ARFI for detecting fibrosis F1 was 71.42%, for F2-77.77%, for F3-62.5% and for F4-71.42%. Sensitivity of 2D-SWE for detecting F1 was 92.85%, for F2-83.33%, for F3-87.5% and for F4-85.71%. We found significant correlations between TE and 2D-SWE on the entire lot (Kappa correlation factor=0.843, p=0.001). Analyzing the subgroup with SR=60%-70%, we did not find significant correlation between TE and ARFI (Kappa correlation factor=0.172, p=0.452). Assessing the subgroup with SR>70%, we found a significant correlation between TE and ARFI (Kappa correlation factor=0.761, p=0.001). Conclusions: Overall, 2D-SWE correlate better with TE compared to ARFI in children. Excluding patients with less satisfactory technical parameters, we obtained significant correlations between all three methods. Both SWE and ARFI are non-invasive techniques feasible of performing on paediatric patients along with TE.

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Section: Introductionmentioning

confidence: 99%

Comparison of three ultrasound based elastographic techniques in children and adolescents with chronic diffuse liver diseases.

et al. 2016

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“…Recent technological advances have enabled liver-fibrosis staging using noninvasive ultrasound techniques, such as elastography, which provides an estimation of liver stiffness [1,2]. Conventional ultrasound-elastography techniques or strain imaging evaluate how tissues respond to a static compressive force and provide a qualitative map of elasticity [3].…”

Section: Introductionmentioning

confidence: 99%

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

Pellot‐Barakat

Chami

Corréas

et al. 2016

European Journal of Radiology

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International audienceThis study was undertaken to evaluate the impact of free-breathing (FB) vs. Apnea on Shear-wave elastography (SWE) measurements.Quantitative liver-stiffness measurements were obtained during FB and Apnea for 97 patients with various body-morphologies and liver textures. Quality indexes of FB and Apnea elasticity maps (percentage of non-filling (PNF), temporal (TV) and spatial (SV) variabilities) were computed. SWE measurements were also obtained from an homogeneous phantom at rest and during a mechanically-induced motion.Liver-stiffness values estimated from FB and Apnea acquisitions were correlated, particularly for homogeneous livers (r = 0.76, P < 0.001) and favorable body-morphologies (r = 0.68, P < 0.001). However FB values were consistently 20–25% lower than Apnea ones (P < 0.001). FB also systematically resulted in degradation of TV (P < 0.005) and PNF (P < 0.001) compared to Apnea but had no impact on SV. With the phantom, no differences between SWE measurements at rest and during motion were observed.Apnea and FB measurements are highly correlated, although FB data quality is degraded compared to Apnea and estimated stiffness in FB is systematically lower than in Apnea. These discrepancies between rest and motion states were observed for patients but not for phantom data, suggesting that patient breath-holding impacts liver stiffness

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“…It is an imaging method that allows measuring the hardness and rigidity of tissue according to the speed of propagation of sound waves [82]. Through this technique, it can estimate the degree of fibrosis in its different stages with a correlation of 83% with biopsy.…”

Section: Hepatic Elastographymentioning

confidence: 99%

An Updated Review on the Epidemiology, Pathophysiology, Etiology and Diagnosis of Liver Cirrhosis

Gy¹,

Sh²,

Cm³

2019

Preprint

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Liver cirrhosis is a chronic disease that is characterized by the presence of fibrosis and regeneration of nodules in the liver whose consequences are the development of portal hypertension and liver failure. Cirrhosis arises from a wide variety of chronic diseases, which progresses slowly after years or decades. Liver cirrhosis is a public health problem. It is usually associated with viral hepatitis, consumption of alcohol, metabolic syndrome, autoimmune processes, storage diseases, toxic substances, and medications. Cirrhosis is the fourteenth most common cause of death in adults throughout the world, the fourth in Europe and the ninth in the United States. The prevalence of this disease is underestimated because it is symptomatic it is not diagnosed in initial stages, and it usually goes to the decompensated stage at a rate of 5 to 7% per year. We review here the epidemiology, pathophysiology, etiology, and diagnosis of liver cirrhosis.

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Liver ultrasound elastography: More than staging the disease

Cited by 24 publications

References 41 publications

Comparison of three ultrasound based elastographic techniques in children and adolescents with chronic diffuse liver diseases.

Comparison of three ultrasound based elastographic techniques in children and adolescents with chronic diffuse liver diseases.

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

An Updated Review on the Epidemiology, Pathophysiology, Etiology and Diagnosis of Liver Cirrhosis

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