Assessment of chronic liver disease by multiparametric ultrasound: results from a private practice outpatient facility.
ELASTOGRAPHY; NAFLD; Shear wave elastography; Liver stiffness; NASH; MANAGEMENT; Attenuation coefficient; Shear wave dispersion; FIBROSIS; GUIDELINES; HEPATIC STEATOSIS; RADIATION FORCE IMPULSE; RADIOLOGISTS; SOCIETY; STIFFNESS
PURPOSE: To assess chronic liver disease (CLD) using multiparametric US in a private practice setting in a cohort of patients with increased skin-to-liver distance. METHODS: 110 consecutive patients with increased skin-to-liver distance scheduled for US assessment of CLD were reviewed for study completion time, liver stiffness values (LS), attenuation imaging, and shear wave dispersion slope. The ROI was placed 2 cm below the liver capsule. The study included patients with NAFLD/NASH (68), hepatitis C (30), prior Fontan surgery (1), elevated liver function tests (5), alcohol abuse (3), hepatitis B (2), and primary biliary cirrhosis (1). IQR/M values were obtained. Comparison of less experienced sonographers (LES) and more experienced sonographers (MES) were evaluated through Student's t test for independent data. Pearson coefficient r of correlation among quantitative variables was calculated. RESULTS: The mean time to perform the exam was 129.7 ± 62.1 s. There was a statistically significant difference between LES and MES. The mean IQR/M for LS was 12.3 ± 5.5% m/s. Overall, in a cohort of difficult patients, 4.5% of LS values were not reliable. Fat quantification using attenuation imaging had a mean value of 0.60 ± 0.15 dB/cm/MHz (range 0.35-0.98 cm/dB/MHz) with an IQR/M of 14.7 ± 9.2%. Less reliable measurements of steatosis were obtained in 4.5% of patients. The mean shear wave dispersion slope was 12.74 ± 4.05 (m/s)/kHz (range 7.7-27.5 (m/s)/kHz) with an IQR/M of 38.7 ± 20.2% (range 3-131%). 20.9% of patients had values suggestive of compensated advanced chronic liver disease (cACLD). CONCLUSION: Multiparametric US can provide assessment of CLD in less than 3 min in most patients and identify patients at risk for cACLD.
Aitharaju V; De Silvestri A; Barr RG
Abdominal Radiology
2021
2021-07-25
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1007/s00261-021-03225-2" target="_blank" rel="noreferrer noopener">10.1007/s00261-021-03225-2</a>
Assessment of chronic liver disease by multiparametric ultrasound: results from a private practice outpatient facility.
To assess chronic liver disease (CLD) using multiparametric US in a private practice setting in a cohort of patients with increased skin-to-liver distance.
110 consecutive patients with increased skin-to-liver distance scheduled for US assessment of CLD were reviewed for study completion time, liver stiffness values (LS), attenuation imaging, and shear wave dispersion slope. The ROI was placed 2 cm below the liver capsule. The study included patients with NAFLD/NASH (68), hepatitis C (30), prior Fontan surgery (1), elevated liver function tests (5), alcohol abuse (3), hepatitis B (2), and primary biliary cirrhosis (1). IQR/M values were obtained. Comparison of less experienced sonographers (LES) and more experienced sonographers (MES) were evaluated through Student’s t test for independent data. Pearson coefficient r of correlation among quantitative variables was calculated.
Aitharaju V; De Silvestri A; Barr RG
Abdominal Radiology
2021
2021-07-25
Journal Article
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Shear wave liver elastography.
Cirrhosis; Liver stiffness; Point shear wave elastography; Real-time shear wave elastography; Shear wave elastography
Chronic liver disease is a substantial world-wide problem. Its major consequence is increasing deposition of fibrous tissue within the liver leading to the development of cirrhosis with its consequences of portal hypertension, hepatic insufficiency, and hepatocellular carcinoma. The stage of liver fibrosis is important to determine prognosis, surveillance, prioritize for treatment, and potential for reversibility. The process of fibrosis is dynamic and regression of fibrosis is possible with treatment of the underlying conditions. Previously, the only method of staging the degree of fibrosis was liver biopsy. The recent development of ultrasound elastography techniques allows a non-invasive method of estimating the degree of liver fibrosis. Transient elastography (TE) is a non-imaging elastographic technique, while point shear wave (p-SWE) and 2D-SWE combine imaging with elastography. The evidence at this time suggests that p-SWE is as accurate as but more reliable than TE, while 2D-SWE is more accurate than TE. This review discusses the background of chronic liver disease, the types of ultrasound elastography, how to perform an examination, and how to interpret the results.
Barr Richard G
Abdominal radiology (New York)
2018
2018-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s00261-017-1375-1" target="_blank" rel="noreferrer noopener">10.1007/s00261-017-1375-1</a>
Ultrasound liver elastography beyond liver fibrosis assessment
Heart failure; children; guidelines; Liver stiffness; Shear wave elastography; transient elastography; consensus; portal-hypertension; heart; Budd Chiari syndrome; central venous-pressure; congestion; fontan circulation; Fontan circulation; Hepatic sinusoidal obstruction syndrome; Liver congestion; stiffness measurements; Valvular diseases; Liver congestion
Several guidelines have indicated that liver stiffness (LS) assessed by means of shear wave elastography (SWE) can safely replace liver biopsy in several clinical scenarios, particularly in patients with chronic viral hepatitis. However, an increase of LS may be due to some other clinical conditions not related to fibrosis, such as liver inflammation, acute hepatitis, obstructive cholestasis, liver congestion, infiltrative liver diseases. This review analyzes the role that SWE can play in cases of liver congestion due to right-sided heart failure, congenital heart diseases or valvular diseases. In patients with heart failure LS seems directly influenced by central venous pressure and can be used as a prognostic marker to predict cardiac events. The potential role of LS in evaluating liver disease beyond the stage of liver fibrosis has been investigated also in the hepatic sinusoidal obstruction syndrome (SOS) and in the Budd-Chiari syndrome. In the hepatic SOS, an increase of LS is observed some days before the clinical manifestations; therefore, it could allow an early diagnosis to timely start an effective treatment. Moreover, it has been reported that patients that were successfully treated showed a LS decrease, that reached pre-transplantation value within two to four weeks. It has been reported that, in patients with Budd-Chiari syndrome, LS values can be used to monitor short and long-term outcome after angioplasty.
Ferraioli G; Barr RG
World Journal of Gastroenterology
2020
2020-06-28
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.3748/wjg.v26.i24.3413" target="_blank" rel="noreferrer noopener">10.3748/wjg.v26.i24.3413</a>
Liver Ultrasound Elastography: An Update To The World Federation For Ultrasound In Medicine And Biology Guidelines And Recommendations
Acoustic radiation; Acoustics; acting antiviral therapy; controlled attenuation parameter; Elastography; Elastography; Focal liver lesions; force impulse; hepatitis-c virus; hypertension; liver; Liver diseases; Liver fibrosis; Liver stiffness; noninvasive assessment; Nuclear Medicine & Medical Imaging; Portal; portal-hypertension; radiation force impulse; Radiology; Shear wave elastography; shear-wave; significant; stiffness measurement; Strain elastography; time tissue elastography; Transient elastography; Transient elastography; ultrasound; World Federation for Ultrasound in Medicine and Biology guidelines
Ferraioli G; Wong V W S; Castera L; Berzigotti A; Sporea L; Dietrich C F; Choi B I; Wilson S R; Kudo M; Barr R G
Ultrasound in Medicine and Biology
2018
2018-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/j.ultrasmedbio.2018.07.008" target="_blank" rel="noreferrer noopener">10.1016/j.ultrasmedbio.2018.07.008</a>
Elastography for pediatric chronic liver disease: A review and expert opinion.
shear wave elastography; children; transient elastography; liver stiffness; diffuse liver disease; magnetic resonance elastography
In adults with chronic liver diseases, ultrasound and magnetic resonance shear wave elastography (SWE) can replace liver biopsy in several clinical scenarios. Several guidelines on the use of ultrasound SWE for the adult population have been published. However, the number of publications in the pediatric population is limited, and available guidelines on SWE do not specifically address pediatric chronic liver diseases. In this article, we review the literature on the use of SWE for pediatric chronic liver diseases and provide expert opinion on how to use SWE, both ultrasound and magnetic resonance techniques, in the pediatric population. (© 2020 American Institute of Ultrasound in Medicine.)
Ferraioli G;Barr RG;Dillman JR
Journal Of Ultrasound In Medicine
2020
2020-09-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1002/jum.15482" target="_blank" rel="noreferrer noopener">10.1002/jum.15482</a>
WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 3: liver.
*Practice Guidelines as Topic; Elastic Modulus; Elasticity Imaging Techniques/*standards; elastography; focal liver lesions; guidelines; Internationality; liver; Liver Cirrhosis/*diagnostic imaging/*physiopathology; liver diseases; liver fibrosis; liver stiffness; Liver/*diagnostic imaging/*physiopathology; Mechanical; Shear Strength; shear wave elastography; strain elastography; Stress; transient elastography; ultrasound; WFUMB
The World Federation for Ultrasound in Medicine and Biology (WFUMB) has produced these guidelines for the use of elastography techniques in liver disease. For each available technique, the reproducibility, results, and limitations are analyzed, and recommendations are given. Finally, recommendations based on the international literature and the findings of the WFUMB expert group are established as answers to common questions. The document has a clinical perspective and is aimed at assessing the usefulness of elastography in the management of liver diseases.
Ferraioli Giovanna; Filice Carlo; Castera Laurent; Choi Byung Ihn; Sporea Ioan; Wilson Stephanie R; Cosgrove David; Dietrich Christoph F; Amy Dominique; Bamber Jeffrey C; Barr Richard; Chou Yi-Hong; Ding Hong; Farrokh Andre; Friedrich-Rust Mireen; Hall Timothy J; Nakashima Kazutaka; Nightingale Kathryn R; Palmeri Mark L; Schafer Fritz; Shiina Tsuyoshi; Suzuki Shinichi; Kudo Masatoshi
Ultrasound in medicine & biology
2015
2015-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ultrasmedbio.2015.03.007" target="_blank" rel="noreferrer noopener">10.1016/j.ultrasmedbio.2015.03.007</a>