Ultrasound-based assessment of liver stiffness: Essential insights and anticipated outcomes
Liver elastography is a vital, non-invasive diagnostic tool used to determine the health of an individual's liver. This procedure, which assesses the thickness and elasticity of liver tissue, plays a crucial role in diagnosing liver fibrosis or estimating its severity.
Preparing for the Procedure
Most people undergoing liver elastography need to fast for 6-8 hours before the procedure. Certain foods and sugary drinks can affect liver stiffness, so doctors may advise eating a light, fat-free meal the evening before the procedure and avoiding sweet beverages.
Types of Liver Elastography
There are two main types of liver elastography: ultrasound elastography and magnetic resonance elastography (MRE).
Ultrasound Elastography (UE)
During an ultrasound elastography, a person lies on their back with their abdomen exposed, and a gel is applied to the right abdominal area. A specialized ultrasound probe is then placed on the skin over the liver area, emitting a low-frequency vibration to generate shear waves through the liver. The velocity of these waves correlates with liver stiffness and is measured to assess fibrosis.
Magnetic Resonance Elastography (MRE)
In an MRE, a person must remove any metal items and inform the radiographer of any internal metal or electronic devices. They then lie on a narrow table that moves into a large, tunnel-shaped MRI machine. A small pad on the abdomen sends vibrations into the liver, and an external mechanical driver generates vibrations sent into the liver while MRI sequences capture wave propagation. Data processing generates quantitative stiffness maps of liver tissue.
Methods of Liver Elastography
Transient Elastography (TE)
Transient Elastography, also known as FibroScan®, is a widely used, non-invasive ultrasound-based technique. It measures liver stiffness by assessing shear wave velocity. Although it has limited accuracy in obese patients, it is easy to use and quick.
Point Shear Wave Elastography (pSWE) and Two-Dimensional Shear Wave Elastography (2D-SWE)
Both pSWE and 2D-SWE are ultrasound-based methods that measure the speed of shear waves in the liver. pSWE provides quantitative stiffness values at a specific point, while 2D-SWE measures shear wave speed across a plane of liver tissue, producing a real-time elastogram that maps liver stiffness over a region.
Endoscopic Ultrasound-guided Liver Elastography (EUS-LE)
EUS-LE is a newer approach performed during endoscopic ultrasound where shear wave velocity measurement is combined with liver biopsy and portal pressure gradient assessment in a single session. This method provides a direct, safe measurement of liver stiffness and tissue sampling, with potential advantages in personalized patient care.
Each method balances trade-offs between cost, ease of use, accuracy, and patient characteristics, with ultrasound-based TE (including pSWE and 2D-SWE) being most commonly used clinically, while MRE and EUS-LE provide advanced options in specific settings.
Interpreting the Results
Doctors grade liver stiffness according to one of four grades: no scarring, mild scarring, moderate scarring, and advanced scarring. Moderate scarring indicates the presence of fibrosis, while advanced scarring indicates cirrhosis.
Early detection and treatment of fibrosis can potentially reverse fibrosis and prevent it from developing into cirrhosis or liver cancer. Some people with early-stage liver disease do not experience symptoms, but if symptoms occur, they may include swelling, bruising easily, jaundice, confusion, changes in stool and urine color, nausea and vomiting, unexplained fever, loss of appetite, fatigue, and easy bruising.
In conclusion, liver elastography is an essential tool in assessing liver health, providing non-invasive, quantitative data on liver stiffness and fibrosis. By understanding the different methods and their applications, healthcare professionals can make informed decisions about the most appropriate approach for each individual case.
- The contextual importance of abstaining from alcohol use during liver elastography procedures becomes evident when considering its potential effect on liver stiffness, influencing the accuracy of the diagnostic process.
- Given the role of science and medical-conditions in the development of therapies and treatments, the advancements in techniques like Transient Elastography (TE) and Endoscopic Ultrasound-guided Liver Elastography (EUS-LE) have significantly improved health-and-wellness outcomes for individuals diagnosed with chronic diseases like cirrhosis.
- In light of the increasing prevalence of chronic diseases, the proactive approach to early detection and treatment of fibrosis, as facilitated by diagnostic tools like liver elastography, is paramount in mitigating the progression of liver-related health issues.
- As part of the broader health-and-wellness landscape, liver elastography not only serves as a crucial diagnostic tool but also contributes to the improved understanding of various medical-conditions and chronic diseases, furthering the realm of science and therapies-and-treatments.
