Elastography in chronic liver disease: modalities, techniques, limitations, and future directions
A Srinivasa Babu, ML Wells, OM Teytelboym… - Radiographics, 2016 - pubs.rsna.org
Radiographics, 2016•pubs.rsna.org
Chronic liver disease has multiple causes, many of which are increasing in prevalence. The
final common pathway of chronic liver disease is tissue destruction and attempted
regeneration, a pathway that triggers fibrosis and eventual cirrhosis. Assessment of fibrosis
is important not only for diagnosis but also for management, prognostic evaluation, and
follow-up of patients with chronic liver disease. Although liver biopsy has traditionally been
considered the reference standard for assessment of liver fibrosis, noninvasive techniques …
final common pathway of chronic liver disease is tissue destruction and attempted
regeneration, a pathway that triggers fibrosis and eventual cirrhosis. Assessment of fibrosis
is important not only for diagnosis but also for management, prognostic evaluation, and
follow-up of patients with chronic liver disease. Although liver biopsy has traditionally been
considered the reference standard for assessment of liver fibrosis, noninvasive techniques …
Chronic liver disease has multiple causes, many of which are increasing in prevalence. The final common pathway of chronic liver disease is tissue destruction and attempted regeneration, a pathway that triggers fibrosis and eventual cirrhosis. Assessment of fibrosis is important not only for diagnosis but also for management, prognostic evaluation, and follow-up of patients with chronic liver disease. Although liver biopsy has traditionally been considered the reference standard for assessment of liver fibrosis, noninvasive techniques are the emerging focus in this field. Ultrasound-based elastography and magnetic resonance (MR) elastography are gaining popularity as the modalities of choice for quantifying hepatic fibrosis. These techniques have been proven superior to conventional cross-sectional imaging for evaluation of fibrosis, especially in the precirrhotic stages. Moreover, elastography has added utility in the follow-up of previously diagnosed fibrosis, the assessment of treatment response, evaluation for the presence of portal hypertension (spleen elastography), and evaluation of patients with unexplained portal hypertension. In this article, a brief overview is provided of chronic liver disease and the tools used for its diagnosis. Ultrasound-based elastography and MR elastography are explored in depth, including a brief glimpse into the evolution of elastography. Elastography is based on the principle of measuring tissue response to a known mechanical stimulus. Specific elastographic techniques used to exploit this principle include MR elastography and ultrasonography-based static or quasistatic strain imaging, one-dimensional transient elastography, point shear-wave elastography, and supersonic shear-wave elastography. The advantages, limitations, and pitfalls of each modality are emphasized.
©RSNA, 2016
Radiological Society of North America
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