Ultrasound-based Hepatic Elastography
- 1 October 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Clinical Gastroenterology
- Vol. 44 (9), 637-645
- https://doi.org/10.1097/mcg.0b013e3181e12c39
Abstract
A reliable, noninvasive marker to help clinicians evaluate hepatic fibrosis is urgently needed. The liver biopsy, an imperfect gold standard, has recognized limitations including sampling error and interobserver variability. Hepatic elastography (HE) is a novel sonographic method for assessing liver stiffness and has excellent accuracy in making the diagnosis of minimal fibrosis and cirrhosis. Several conditions intrinsic to the pathology of the liver compromise the positive predictive value of HE for fibrosis alone including acute hepatitis, obstructive cholestasis, and passive congestion. Technical considerations that hinder the performance of elastography include an advanced body mass index, the presence of ascites and narrow intercostal spaces. Despite these limitations, elastography has a role in staging fibrosis, prognosis of disease outcome, surveillance, and treatment decisions. HE is now being used in lieu of liver biopsy to investigate the natural history of chronic liver diseases. Additional studies are required to better define the appropriate role of HE in clinical practice.Keywords
This publication has 79 references indexed in Scilit:
- Assessment of Liver Fibrosis by Transient Elastography in Persons with Hepatitis C Virus Infection or HIV–Hepatitis C Virus CoinfectionClinical Infectious Diseases, 2009
- Assessment of fibrosis in chronic liver diseasesJournal of Digestive Diseases, 2009
- Liver biopsyHepatology, 2008
- Liver stiffness is an unreliable marker of liver fibrosis in patients with cardiac insufficiencyHepatology, 2008
- Exceeding the limits of liver histology markersJournal of Hepatology, 2008
- Extrahepatic cholestasis increases liver stiffness (FibroScan) irrespective of fibrosisHepatology, 2008
- New Diagnostic Method for Liver Fibrosis and CirrhosisIntervirology, 2008
- Mechanisms of Hepatic FibrogenesisGastroenterology, 2008
- Performance of Transient Elastography for the Staging of Liver Fibrosis: A Meta-AnalysisGastroenterology, 2008
- Reproducibility of transient elastography in the evaluation of liver fibrosis in patients with chronic liver diseaseGut, 2007