Q: Ultrasound-based elastography can be used to evaluate

A) liver fibrosis
B) Acute Kidney Injury
C) Non-Ischemic Cardiomyopathy
D) Splenic infarction
E) Response to thrombolytic therapy


Answer: A

 Principle behind ultrasound-based elastography is simple. As expected, fibrotic tissue differs from normal healthy tissue in a way that they respond to excitation. Ultrasound-based elastography can be used as an alternative to liver biopsy for the assessment of hepatic fibrosis. Not only liver biopsy carries bleeding risk due to its invasive nature but also provides only a small portion of the liver parenchyma.

In experienced hands, ultrasound-based elastography can also be used to predict complications of cirrhosis such as development of varices and hepatocellular carcinoma. Also, it can differentiate between benign and malignant lesions and can diagnose focal nodular hyperplasia.

To further refine, this technique is divided accordingly into transient elastography, point-shear wave elastography (SWE), two-dimensional (2D)-SWE, and strain elastography. 


 References: 

1.  Parkes J, Guha IN, Roderick P, et al. Enhanced Liver Fibrosis (ELF) test accurately identifies liver fibrosis in patients with chronic hepatitis C. J Viral Hepat 2011; 18:23.

2. Guibal A, Boularan C, Bruce M, et al. Evaluation of shearwave elastography for the characterisation of focal liver lesions on ultrasound. Eur Radiol 2013; 23:1138.

3. Brunel T, Guibal A, Boularan C, et al. Focal nodular hyperplasia and hepatocellular adenoma: The value of shear wave elastography for differential diagnosis. Eur J Radiol 2015; 84:2059.

4. Lu Q, Ling W, Lu C, et al. Hepatocellular carcinoma: stiffness value and ratio to discriminate malignant from benign focal liver lesions. Radiology 2015; 275:880.

5. Nahon P, Kettaneh A, Tengher-Barna I, et al. Assessment of liver fibrosis using transient elastography in patients with alcoholic liver disease. J Hepatol 2008; 49:1062.