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liver elastography; hepatic transient elastography (FibroScan)

Indications: - evaluation of hepatic fibrosis & cirrhosis - vibration-controlled transient elastography used in combination with age, sex, diabetes status, serum AST, serum ALT & platelet count [3,4,5] - hepatic transient elastography is used to estimate risk of portal hypertension & need for non-selective beta-blocker prophylaxis for esophageal varices [2] Procedure: - ultrasound technique that uses mechanically induced shear wave Interpretation: - a threshold of >= 8.0 kPa considered elevated - a threshold of >= 25 kPa considered need for non-selective beta-blocker prophylaxis for esophageal varices [2] - a Fibrosis-4 score of 3.03 suggests high risk of advanced cirrhosis

General

elastography

References

  1. Harris R, Card T, Delahooke T, Aithal GP, Guha IN. Obesity is the most common risk factor for chronic liver disease: Results from a risk stratification pathway using transient elastography. Am J Gastroenterol 2019 Aug 27; PMID: 31453812 https://insights.ovid.com/crossref?an=00000434-900000000-99567
  2. NEJM Knowledge+ Gastroenterology
  3. Lin H et al. Vibration-controlled transient elastography scores to predict liver-related events in steatotic liver disease. JAMA 2024 Mar 21; PMID: 38512249 PMCID: PMC10958386 (available on 2024-09-21) https://jamanetwork.com/journals/jama/fullarticle/2816449
  4. Sanyal AJ et al Enhanced diagnosis of advanced fibrosis and cirrhosis in individuals with NAFLD using FibroScan-based Agile scores J Hepatol. 2023 Feb;78(2):247-259. PMID: 36375686 PMCID: PMC10170177 Free PMC article. https://www.journal-of-hepatology.eu/article/S0168-8278(22)03293-7/fulltext
  5. Pennisi G et al AGILE 3+ Score for the Diagnosis of Advanced Fibrosis and for Predicting Liver- related Events in NAFLD. Clin Gastroenterol Hepatol. 2023 May;21(5):1293-1302.e5. PMID: 35842119 https://www.cghjournal.org/article/S1542-3565(22)00646-2/abstract