Comparison of 2-D Shear Wave Elastography and Transient Elastography for Assessing Liver Fibrosis in Chronic Hepatitis B

Zeng, Jie; Zheng, Jian; Huang, Zeping; Chen, Shigao; Liu, Jing; Wu, Tao; Zheng, Rongqin; Lü, Ming-De

doi:10.1016/j.ultrasmedbio.2017.03.014

Cited by 59 publications

(72 citation statements)

References 30 publications

(32 reference statements)

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“…A routine two‐dimensional US examination was performed before SWE examination to exclude morphologic abnormalities of the liver, spleen, gallbladder, and biliary system. The probe was then placed along an intercostal space and perpendicular to the liver capsule . After the patient briefly suspended respiration, the SWE box was placed on the liver parenchyma of segment V and VI under the visual control of two‐dimensional US, avoiding large vascular and biliary structures.…”

Section: Methodsmentioning

confidence: 99%

“…The velocity can be converted into a stiffness measurement (in kPa) using two constants, namely, Young's modulus and tissue density. A faster sound wave indicates a greater degree of tissue stiffness . In recent years, rapid development of US elastography has occurred, including transient elastography (TE), acoustic radiation force impulse (ARFI), real‐time tissue elastography (RTE), and real‐time shear wave maps (SWE) .…”

Section: Introductionmentioning

confidence: 99%

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Shear‐wave elastography of the liver in a healthy pediatric population

Yang

Sun

Tang

et al. 2019

J of Clinical Ultrasound

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Purpose The aim of this study was to determine the elastic modulus values of normal liver tissue in school‐age children by shear wave elastography (SWE) and to study the factors that influence these stiffness measurements. Methods Six hundred and four school‐age children (295 girls and 309 boys) who were recruited at a hospital and had normal results of specific laboratory tests and imaging studies underwent SWE examinations. The elastic modulus values were obtained in segment V and VI for each subject and comparisons were made between age groups. Results The mean elastic modulus values for school‐age children were 6.3 ± 1.1 kPa for segment V and 6.2 ± 1.1 kPa for segment VI. A positive linear trend in liver stiffness was found for the 6 to 9‐year‐old age group in segments V and VI (R2 = 0.076 vs R2 = 0.085, respectively, P < .05). No statistically significant difference in liver stiffness was found between genders and between segment groups (P > .05). Conclusion SWE is a feasible method to measure liver stiffness in the school‐age population. We established a normal range of liver elastic modulus values in school‐age children, which will provide a basis for evaluating the changes in liver stiffness caused by various diseases.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Shear‐wave elastography of the liver in a healthy pediatric population

Yang

Sun

Tang

et al. 2019

J of Clinical Ultrasound

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“…In patients with infectious hepatitis, nonalcoholic fatty liver disease, and alcoholic liver disease, composite models comprised of laboratory values, patient characteristics, and hepatic elastography either by magnetic resonance or ultrasound, have been developed primarily to predict the presence of cirrhosis . However, to the best of our knowledge, there are only two post‐Fontan reports, with 10 patients each, that have compared liver biopsy findings with either magnetic resonance or ultrasound hepatic elastography .…”

Section: Discussionmentioning

confidence: 99%

“…Notwithstanding its limitations, secondary to sampling and intraobserver and interobserver variations, liver biopsy is the accepted gold standard for determining the degree of hepatic fibrosis, regardless the etiology; nevertheless, a noninvasive method that correlates with the degree of liver fibrosis would be a more practical clinical approach. Previous, large patient cohort studies report correlations between liver pathology and noninvasive methods, including composite models comprised of multiple patient variables, in those with infectious hepatitis, nonalcoholic fatty liver disease, and alcoholic liver disease . However, there are few reports comparing liver biopsy findings with noninvasive approaches in patients with Fontan associated liver disease (FALD); thus, there are no current, useful, clinic‐based, noninvasive methods that strongly correlate one with the other .…”

Section: Introductionmentioning

confidence: 99%

“…Previous, large patient cohort studies report correlations between liver pathology and noninvasive methods, including composite models comprised of multiple patient variables, in those with infectious hepatitis, nonalcoholic fatty liver disease, and alcoholic liver disease. [7][8][9][10][11][12][13][14][15] However, there are few reports comparing liver biopsy findings with noninvasive approaches in patients with Fontan associated liver disease (FALD); thus, there are no current, useful, clinic-based, noninvasive methods that strongly correlate one with the other. 4,5,[16][17][18][19][20][21] This study reports our experience comparing post-Fontan hepatic biopsy findings with a composite, noninvasive index derived from liver-ultrasound, shearwave elastography (SWE) measurements, model for end-stage liver disease excluding INR (MELD-XI) scores, and time post-Fontan.…”

Section: Introductionmentioning

confidence: 99%

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A composite noninvasive index correlates with liver fibrosis scores in post-Fontan patients: Preliminary findings

Evans

Acherman

Ciccolo

et al. 2017

Congenital Heart Disease

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Objective: We hypothesized that clinic-based, hepatic-ultrasound, elastography measurements, either alone or in combination with other noninvasive variables, might correlate with liver-biopsy fibrosis scores in patients post-Fontan. Results: We identified a total of 79 post-Fontan patients that underwent cardiac catheterization and liver biopsy. Of the 79 patients, 53 met inclusion criteria, and 32 consented to undergo hepatic-ultrasound elastography. Of the 32 that underwent elastography, data from 30 patients was used for analysis. We found no statistically significant differences in demographics, laboratory values, or cardiac catheterization data between the 30 included patients and the 21 that did not participate. Utilizing data from the 30 included patients, we found a strong, highly statistically significant correlation between the Fontan hepatic index values and total fibrosis scores (R 5 0.8, P < .00001). However, the cohort size prevented reliable discriminating cut-off values for the range of total fibrosis scores.Conclusions: In a small cohort of patients post-Fontan, preliminary findings suggest that the composite Fontan hepatic index might be a clinically useful, noninvasive method of serially monitoring for hepatic fibrosis. Further studies, with large patient cohorts, are necessary to validate our findings and develop clinically useful discriminatory cutoff values. K E Y W O R D SFontan, hepatic fibrosis, shear-wave elastography

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Performance of shear wave elastography: A single centre pilot study of mixed etiology liver disease patients with normal BMI

Laroia

Srinivasan

Yadav

et al. 2021

Australas J Ultrason Med

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Purpose: To assess the performance of shear wave ultrasound elastography (SWE) for non-invasive grading of fibrosis in normal BMI patients with varied aetiology chronic liver disease. Method: Prospective SWE liver and spleen stiffness (LS, SS respectively) of 124 patients (94 men, mean age 45.4 AE 12.4 years, mean BMI 19.66 AE 1.49) with CLD of mixed aetiology, who underwent liver biopsy, between January 2019-20 was analysed using receiver operating curve (ROC) and classification analysis regression tree (CART) to determine fibrosis cut-off values and nominal logistical regression to quantify fibrosis. Results: Of 124 patients, 50 (40%) had non-alcoholic steatohepatitis (NASH), 31 (25%) chronic hepatitis B (CHB) and 43 (35%) alcoholic liver disease (ALD) on biopsy. Overall mean LS and SS of the study population was 11.81 AE 5.9 and 16.88 AE 10.8 kPa, respectively. LS cut-off value <8 kPa was consistent with F0, 9-14 kPa for F1-F2 and >14.9 kPa for F3-F4 fibrosis on biopsy. On application of CART, LS value < 5.3 kPa was discriminative for NASH, 5.32 to <12.64 kPa for CHB, >12.64 kPa for ALD, SS <15.3 kPa was discriminative for NASH, 15.3-30 kPa for CHB and >30 kPa for ALD in our study population. Conclusion: SWE is a viable non-invasive tool for assessment of liver fibrosis grading in a population of mixed aetiology CLD. LS values in conjunction with SS are promising predictors of F2-F3 fibrosis with potential to discriminate select categories like CHB and NASH in such a population.

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Comparison of 2-D Shear Wave Elastography and Transient Elastography for Assessing Liver Fibrosis in Chronic Hepatitis B

Cited by 59 publications

References 30 publications

Shear‐wave elastography of the liver in a healthy pediatric population

Shear‐wave elastography of the liver in a healthy pediatric population

A composite noninvasive index correlates with liver fibrosis scores in post-Fontan patients: Preliminary findings

Performance of shear wave elastography: A single centre pilot study of mixed etiology liver disease patients with normal BMI

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