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…
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…
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…
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.…
Before scanning the patient It is important to remember that liver stiffness is measured, not liver fibrosis. Liver stiffness is influenced by fibrosis, inflammation, and congestion. Therefore obtaining clinical information before starting the examination is helpful. Important patient factors that…
General protocol For all of the ultrasound (US) shear wave elastography (SWE) techniques (vibration controlled transient elastography [VCTE], point shear wave elastography [pSWE] and two-dimensional shear wave elastography [2D-SWE]), adherence to a strict protocol when assessing liver stiffness is required.…
Introduction to stiffness Liver diseases, such as nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH), alcoholic liver disease, viral hepatitis as well others, may be characterized by the accumulation of extracellular matrix material (collagen, fibronectin, proteoglycans, and glycosaminoglycans), fats and triglycerides,…
Introduction Chronic liver disease (CLD) is a substantial worldwide problem. Any disease that incites liver inflammation can lead to liver fibrosis, which can then progress to cirrhosis. The stage of liver fibrosis is important to determine prognosis, surveillance, progression, or…
The burden of chronic liver disease Chronic liver disease (CLD) is a significant cause of morbidity and mortality and an important contributor to the burden of disease and health care utilization worldwide. It is estimated that CLD accounts for approximately…
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