Ultrasound Elastography of the Liver: What the Clinician Needs to Know

Cirrhosis can be divided into two groups: compensated and decompensated, which have substantially different prognoses. Although more difficult to detect clinically, compensated cirrhosis has a better prognosis, and early treatment may prevent progression. Although invasive tests such as liver biopsy and the HVPG are effective for evaluating fibrosis and the risk of varices, their invasive nature limits their utility. The literature has shown that elastography is an effective and noninvasive tool for staging fibrosis, predicting clinically significant portal hypertension and varices, and monitoring the response to treatment. Of the different elastographic methods available to monitor liver stiffness, those that include B-mode sonograms show a greater benefit because of their ability to ensure an appropriate region of interest for liver stiffness measurements, subjectively assess for signs of advanced fibrosis, and screen for hepatocellular carcinoma in an at-risk population. As new and effective therapies for the etiologies of cirrhosis become more commonplace, the use of ultrasound elastography figures to increase as well. © 2017 by the American Institute of Ultrasound in Medicine.