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Review
. 2020 Nov;45(11):3463-3472.
doi: 10.1007/s00261-020-02717-x. Epub 2020 Sep 11.

Ultrasound-based liver elastography: current results and future perspectives

Cheng Fang  1 , Paul S Sidhu  2
Affiliations
Review

Ultrasound-based liver elastography: current results and future perspectives

Cheng Fang et al. Abdom Radiol (NY). 2020 Nov.

Abstract

Chronic liver disease affects 185 million population worldwide. It encompasses a heterogenous disease spectrum, but all can lead to the development of liver fibrosis. The degree of liver fibrosis is not only a prognosticator, but has also been used to guide the treatment strategy and to evaluate treatment response. Traditionally, staging of liver fibrosis is determined on histological analysis using samples obtained from an invasive liver biopsy. Ultrasound-based liver elastography is a non-invasive method of assessing diffuse liver disease in patients with known chronic liver disease. The use of liver elastography has led to a significant reduction in the number of liver biopsies performed to assess the severity of liver fibrosis and a liver biopsy is now reserved for only select sub-groups of patients. The aim of this review article is to discuss the key findings and current evidence for ultrasound-based elastography in diffuse liver disease as well as the technical challenges and to evaluate the potential research direction.

Keywords: Chronic liver disease; Cirrhosis; Fibrosis; Hepatitis; Liver elastography; Transient elastography.

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Conflict of interest statement

The authors declared that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Two strain elastography studies performed using Real-time Tissue Elastography (Hitachi Medical Corporation, Japan). a Liver elastogram from a 21-year-old male with chronic hepatitis B infection demonstrates “soft” liver texture indicated by relatively homogenous green colour. b Liver elastogram from a 59-year-old male with chronic hepatitis C infection demonstrates “hard” liver texture which corresponding to severe fibrosis on histological analysis. The parameters underneath the pictures can be used to compute semi-quantitative liver fibrosis index
Fig. 2
Fig. 2
Comparative pSWE and 2D-shear wave studies from the same patient. 44-years-old female with chronic hepatitis. a 2D-SWE performed on GE (LOGIQ E9) showed normal shear wave velocity indicated by homogenous blue colour. The dotted ROI circle was placed to calculate the velocity which is 0.8 m/s. b pSWE performed on Siemens (S3000 Acuson). A colour map was not produced using this technique instead the average shear wave velocity (0.77 m/s) within the rectangular ROI box was displayed in the left bottom corner on the screen. Patient had same day liver biopsy and showed to have Ishak fibrosis score of 0 from histological analysis
Fig. 3
Fig. 3
50-year-old male with alcohol-related liver disease. 2D-SWE (GE) showed heterogeneous mixed green, yellow and red colour elastogram box. The centre round dotted region of interest box was placed to calculate the shear wave velocity after the images were acquired
See this image and copyright information in PMC

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