title: Real-time sono-elastography in the diagnosis of diffuse liver diseases.
abstract: OBJECTIVE
  To analyze whether computer-enhanced dynamic analysis of elastography movies is able to better characterize and differentiate between different degrees of liver fibrosis.
  
  
  METHODS
  The study design was prospective. A total of 132 consecutive patients with chronic liver diseases and healthy volunteers were examined by transabdominal ultrasound elastography. All examinations were done by two doctors.
  
  
  RESULTS
  Due to the limitations of the method, we obtained high-quality elastography information in only 73.48% of the patients. The kappa-means clustering method was applied to assess the inter-observer diagnosis variability, which showed good variability values in accordance with the experience of ultrasound examination of every observer. Cohen's kappa test indicated a moderate agreement between the study observers (kappa = 0.4728). Furthermore, we compared the way the two observers clustered the patients, using the test for comparing two proportions (t value, two-sided test). There was no statistically significant difference between the two physicians, regardless of the patients' real status.
  
  
  CONCLUSIONS
  Transabdominal real-time elastography is certainly a very useful method in depicting liver hardness, although it is incompletely tested in large multicenter studies.
authors.affiliation: Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, 1 Mai, 66, Craiova 200639, Romania. digheonea@gmail.com
authors.forename: Dan Ionuţ
authors.initials: DI
authors.lastname: Gheonea
authors.forename: Adrian
authors.initials: A
authors.lastname: Săftoiu
authors.forename: Tudorel
authors.initials: T
authors.lastname: Ciurea
authors.forename: Florin
authors.initials: F
authors.lastname: Gorunescu
authors.forename: Sevastiţa
authors.initials: S
authors.lastname: Iordache
authors.forename: Gabriel Lucian
authors.initials: GL
authors.lastname: Popescu
authors.forename: Smaranda
authors.initials: S
authors.lastname: Belciug
authors.forename: Marina
authors.initials: M
authors.lastname: Gorunescu
authors.forename: Larisa
authors.initials: L
authors.lastname: Săndulescu
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003199:Computer Systems; D003430:Cross-Sectional Studies; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008107:Liver Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014741:Video Recording