Non-invasive liver fibrosis assessment in children: Two Dimensional Shear Wave Elastography and point Shear Wave Elastography

Author(s):  
C Pienar ◽  
PI Velea ◽  
I Ciuca ◽  
TV Moga ◽  
A Popescu ◽  
...  
2020 ◽  
Vol 22 (4) ◽  
pp. 192-195
Author(s):  
I. I. Zhirkov ◽  
A. V. Gordienko ◽  
I. M. Pavlovich ◽  
V. V. Yakovlev ◽  
D. Yu. Serdyukov

The presents modern information about a non-invasive instrumental technique for assessing fibrotic changes in the liver elastography. The data on the history of the origin of the term elastography are presented, several of its definitions are given, and attention is also paid to the main principle of the technique percussion, which is traditionally used in an objective study of a patient. The facts about the dual terminology of the technique in the literature are presented, in which some authors use the term elastography, and the other part elastometry. When analyzing the literature, it turned out that in foreign sources the term elastography is much more often used, and both names of the method are used in Russian. Given the greater prevalence of the elastography option, it is more logical to use it, but each of these names has its own right to exist. Definitions are given for the basic physical concepts associated with the elastography method elasticity, rigidity and Youngs modulus of elasticity. From the point of view of application in clinical practice, elastography techniques can be divided into four groups: compression elastography, which is more often used in oncodiagnostics, transient, point and two-dimensional shear wave elastography, used in the diagnosis of liver fibrosis. Physical classification involves dividing elastography into two types: static, which includes compression elastography, and dynamic, which includes transient, point and two-dimensional shear wave elastography. Transient elastography is implemented in devices of the FibroScan family, point elastography in ultrasound scanners from Hitachi Aloka, Siemens and Philips, two-dimensional shear wave elastography in devices from Supersonic Imagine, Toshiba, Siemens, Mindray, General Electric. The widest range of possibilities for assessing liver fibrosis is provided by two-dimensional shear wave elastography. The combined use of several techniques is expected to increase the diagnostic accuracy in determining fibrosis. Magnetic resonance elastography has the greatest accuracy among elastographic techniques, but its application is limited due to the complexity and high cost of equipment, therefore, this technique has not yet found wide application in clinical practice.


2016 ◽  
Vol 25 (4) ◽  
pp. 525-532 ◽  
Author(s):  
Monica Lupșor-Platon ◽  
Radu Badea ◽  
Mirela Gersak ◽  
Anca Maniu ◽  
Ioana Rusu ◽  
...  

There has been great interest in the development of non-invasive techniques for the diagnosis of liver fibrosis in chronic liver diseases, including ultrasound elastographic methods. Some of these methods have already been adequately studied for the non-invasive assessment of diffuse liver diseases. Others, however, such as two-dimensional Shear Wave Elastography (SWE), of more recent appearance, have yet to be validated and some aspects are for the moment incompletely elucidated. This review discusses some of the aspects related to two-dimensional SWE: the examination technique, the examination performance indicators, intra and interobserver agreement and clinical applications. Recommendations for a high-quality examination technique are formulated. Key words:  –  –  – Two-dimensional Shear Wave Elastography. Abbreviations: 2D- SWE: Two-dimensional Shear Wave Elastography; 3D- SWE: Three-dimensional Shear Wave Elastography; AUROC: area under the receiver operating characteristic curves; ARFI Acoustic Radiation Force Impulse Elastography; EFSUMB: European Federation of Societies for Ultrasound in Medicine and Biology; HVPG: hepatic venous pressure gradient; LS: liver stiffness; LR: likelihood ratio; NPV: negative predictive value; PPV: positive predictive value; ROI: region of interest; RT-E: Real Time-Elastography; Se: sensitivity; Sp: specificity; TE: Transient Elastography; US: ultrasound; VM: valid measurement; E: Young’s modulus


Radiology ◽  
2015 ◽  
Vol 275 (1) ◽  
pp. 290-300 ◽  
Author(s):  
Jian Zheng ◽  
Huanyi Guo ◽  
Jie Zeng ◽  
Zeping Huang ◽  
Bowen Zheng ◽  
...  

2020 ◽  
Author(s):  
Yao-Kuang Huang ◽  
Ren-Ching Wang ◽  
Sheng-Shun Yang ◽  
Shou-Wu Lee ◽  
Hsin-Ju Tsai ◽  
...  

Abstract Studies for evaluating the diagnostic performance of two-dimensional Shear-wave Elastography (2D-SWE) in a patient cohort including various liver disorders, remain limited. We aimed to evaluate the validity of 2D-SWE in the diagnosis of advanced liver fibrosis amongst patients with various liver disorders. In this pathology-based study, patients who underwent a liver biopsy for various benign liver diseases were prospectively recruited during the period between February, 2017 and September, 2020. Data of 2D-SWE, Fibrosis-4 Index (FIB-4), and Aspartate Aminotransferase to Platelet Ratio Index (APRI) were simultaneously collected. The cut-off values for predicting advanced fibrosis, i.e. Metavir fibrosis stage ≥ F3, were determined using Receiver Operating Characteristic (ROC) analysis. The diagnostic performance was evaluated and then compared by Area Under the ROC (AUROC). In total, 95 patients were recruited for study analysis. The diagnostic performance of 2D-SWE was significantly superior to that of both FIB-4 (AUROC: 0.88, 95% confidence interval [CI]: 0.80-0.94; vs 0.72, 95%CI: 0.62-0.81; p=0.001) and APRI (AUROC: 0.88, 95%CI: 80-0.94; vs 0.76, 95%CI: 0.66-0.84; p=0.007). With an optimal cutoff value of 9.3 kPa, the sensitivity and specificity were 90.91% and 76.47%, respectively. In subgroup analysis, the AUROC of 2D-SWE was the highest when compared to that of FIB-4 and APRI in patients with chronic hepatitis B, chronic hepatitis C, fatty liver, and concurrent hepatitis. 2D-SWE can therefore be a valid non-invasive method in the detection of advanced liver fibrosis in various liver diseases.


Sign in / Sign up

Export Citation Format

Share Document