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Conclusions (multiparametric ultrasound for the work-up of chronic liver disease)
Overview Chronic liver disease (CLD) is a significant cause of morbidity and mortality worldwide, and in Chapter 1 the extent of the problem is fully discussed. There are now effective treatments for liver disease caused by hepatitis B or hepatitis…
Focal liver lesions in the setting of chronic liver disease
Introduction Any discussion of chronic liver disease (CLD) would be remiss if a detailed description of hepatocellular carcinoma (HCC) were not included. In 2018 primary liver cancer was projected to be the sixth most diagnosed and fourth most common cause…
Shear wave dispersion
Introduction Acoustic radiation force impulse (ARFI) is a continually developing technology that provides biomechanical information concerning tissue elasticity (stiffness) by emitting a push pulse, which generates laterally propagating shear waves (SWs). In addition to elasticity, viscosity provides biomechanical information concerning…
Noninvasive assessment of liver steatosis with ultrasound techniques
Introduction Worldwide, obesity has nearly tripled since 1975. The World Health Organization (WHO) reports that, as of 2016, more than 1.9 billion adults 18 years or older were overweight, and, of these, over 650 million were obese. The WHO report…
Liver shear wave elastography: Guidelines
Introduction Guidelines for the use of elastography in diffuse liver disease have been released by societies or federations of societies. The first set of guidelines was released by European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) in…
Liver stiffness beyond the staging of liver fibrosis
Introduction Shear wave elastography (SWE) assesses stiffness, not fibrosis. In addition to fibrosis, there are some factors or clinical conditions that may lead to an increase of liver stiffness (LS). They are known as confounding factors for fibrosis staging: liver…
The role of ultrasound in portal hypertension
Introduction Portal hypertension (PH) is a clinical syndrome characterized by an increase of the pressure gradient between the portal vein (PV) and the inferior vena cava (IVC) above 5 mmHg and develops when there is a resistance in the portal–venous…
Staging liver fibrosis with shear wave elastography
Introduction Chronic liver disease is a major worldwide health problem. It may be due to several etiological factors that lead to necroinflammation with subsequent fibrosis (i.e., formation of scar tissue). Fibrosis, which is the consequence and not the cause of…
Artifacts in liver stiffness evaluation
Overview of artifacts in liver shear wave elastography The use of shear wave elastography techniques proves valuable in providing qualitative and quantitative elasticity maps of the liver. There are, however, common disturbances that can affect the tissue measurements of stiffness.…