Elastography in chronic liver disease: Modalities, techniques, limitations, and future directions

Aparna Srinivasa Babu, Michael L. Wells, Oleg M. Teytelboym, Justin E. Mackey, Frank H. Miller, Benjamin M. Yeh, Richard L. Ehman, Sudhakar K. Venkatesh

Research output: Contribution to journalArticlepeer-review

94 Scopus citations


Chronic liver disease has multiple causes, many of which are increasing in prevalence. The final common pathway of chronic liver diseasis tissue destruction and attempted regeneration, a pathway that triggers fibrosis and eventual cirrhosis. Assessment of fibrosis is important not only for diagnosis but also for management, prognostic evauation, and follow-up of patients with chronic liver disease. Althougliver biopsy has traditionally been considered the reference standard for assessment of liver fibrosis, noninvasive techniques are the emerging focus in this field. Ultrasound-based elastography and magnetic resonance (MR) elastography are gaining popularity as the modalities of choice for quantifying hepatic fibrosis. These techniques have been proven superior to conventional cross-sectional imaging for evaluation of fibrosis, especially in the precirrhotic stages. Moreoverelastography has added utility in the follow-up of previously diagnosed fibrosis, the assessment of treatment response, evaluation for the presence of portal hypertension (spleen elastography), and evaluation of patients with unexplained portal hypertension. In this article, a brief overview is provided of chronic liver disease and the tools used for its diagnosis. Ultrasound-based elastography and MR elastography are explored in depth, including a brief glimpse into thevolution of elastography. Elastography is based on the principle of measuring tissue response to a known mechanical stimulus. Specific elastographic techniques used to exploit this principle include MR elastography and ultrasonography-based static or quasistatic strain imaging, one-dimensional transient elastography, point shear-wave elastography, and supersonic shear-wave elastography. The advantages, limitations, and pitfalls of each modality are emphasized.

Original languageEnglish (US)
Pages (from-to)1987-2006
Number of pages20
Issue number7
StatePublished - Nov 1 2016

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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