Point Shear Wave Elastography
Pp. 44-87 (44)
Simona Bota, Ruxandra Mare and Ioan Sporea
VTQ (ARFI) elastography is a new method developed in the last 5-6 years
for the non-invasive evaluation of liver fibrosis, integrated into a Siemens Acuson
ultrasound system. Ten valid measurements are performed in the right liver lobe, a
median value is calculated and the result is expressed in meters/second. The AUROC’s
range between 0.75-0.85 for predicting significant fibrosis and for predicting cirrhosis
between 0.85-0.95. To increase the accuracy of liver cirrhosis diagnosis, the spleen
stiffness (SS) assessed by VTQ (ARFI) can be used. VTQ (ARFI) it is a reproducible
method (intraclass correlation coefficient ranging from 0.81-0.87), especially in
patients with severe fibrosis and cirrhosis. Similar with Transient Elastography (TE),
elevated levels of aminotransferases are associated with the increase of liver stiffness
(LS) values assessed by VTQ (ARFI). Even if the manufacturer did not recommend the
use of technical parameters IQR (interquartile range interval) and SR (success rate)
well-known from TE, published data proved that the accuracy of the method
significantly increased with the use of these quality parameters. Regarding the
prediction of liver cirrhosis complications, especially portal-hypertension, data
regarding the usefulness of LS and/or SS are not so solid, but VTQ (ARFI) accuracy
can be increased by combining different parameters.
ElastPQ is a newly developed point Shear Waves elastographic method. Only few data,
but with promising results, were published until now regarding this technique.
ARFI elastography, Chronic hepatitis, ElastPQ, Liver cirrhosis, Liver
stiffness, Portal hypertension, VTQ.
Department of Gastroenterology, Hepatology, Nephrology and Endocrinology, Klinikum Klagenfurt, Austria, 11, Feschnigstrasse, 9020 Klagenfurt am Wörthersee, Austria.