Ultrasound liver elastography beyond liver fibrosis assessment

Ultrasound liver elastography beyond liver fibrosis assessment

Ferraioli G; Barr RG

World Journal of Gastroenterology

2020

2020-06-28

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.

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

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journalArticle

3413-3420

24

26

1007-9327

NEOMED College of Medicine

Department of Radiology

August 2020 List

Mercy Health St Elizabeth Boardman Hospital