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Gerstenmaier JF, Gibson RN. Ultrasound in chronic liver disease. Insights Imaging. 2014;5(4):441-55doi: 10.1007/s13244-014-0336-2.
Gerstenmaier, J. F., & Gibson, R. N. (2014). Ultrasound in chronic liver disease. Insights into imaging, 5(4), 441-55. https://doi.org/10.1007/s13244-014-0336-2
Gerstenmaier, J F, and Gibson, R N. "Ultrasound in chronic liver disease." Insights into imaging vol. 5,4 (2014): 441-55. doi: https://doi.org/10.1007/s13244-014-0336-2
Gerstenmaier JF, Gibson RN. Ultrasound in chronic liver disease. Insights Imaging. 2014 Aug;5(4):441-55. doi: 10.1007/s13244-014-0336-2. Epub 2014 May 24. PMID: 24859758; PMCID: PMC4141343.
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Insights Imaging. 2014 Aug;5(4):441-55. doi: 10.1007/s13244-014-0336-2. Epub 2014 May 24.

Ultrasound in chronic liver disease.

Insights into imaging

J F Gerstenmaier, R N Gibson

Affiliations

  1. Department of Radiology, (RNG also University of Melbourne) The Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3050, Australia, [email protected].

PMID: 24859758 PMCID: PMC4141343 DOI: 10.1007/s13244-014-0336-2

Abstract

BACKGROUND: With the high prevalence of diffuse liver disease there is a strong clinical need for noninvasive detection and grading of fibrosis and steatosis as well as detection of complications.

METHODS: B-mode ultrasound supplemented by portal system Doppler and contrast-enhanced ultrasound are the principal techniques in the assessment of liver parenchyma and portal venous hypertension and in hepatocellular carcinoma surveillance.

RESULTS: Fibrosis can be detected and staged with reasonable accuracy using Transient Elastography and Acoustic Radiation Force Imaging. Newer elastography techniques are emerging that are undergoing validation and may further improve accuracy. Ultrasound grading of hepatic steatosis currently is predominantly qualitative.

CONCLUSION: A summary of methods including B-mode, Doppler, contrast-enhanced ultrasound and various elastography techniques, and their current performance in assessing the liver, is provided.

TEACHING POINTS: • Diffuse liver disease is becoming more prevalent and there is a strong clinical need for noninvasive detection. • Portal hypertension can be best diagnosed by demonstrating portosystemic collateral venous flow. • B-mode US is the principal US technique supplemented by portal system Doppler. • B-mode US is relied upon in HCC surveillance, and CEUS is useful in the evaluation of possible HCC. • Fibrosis can be detected and staged with reasonable accuracy using TE and ARFI. • US detection of steatosis is currently reasonably accurate but grading of severity is of limited accuracy.

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