title: Ultrasound-based elastography for the diagnosis of portal hypertension in cirrhotics.
abstract: Progressive fibrosis is encountered in almost all chronic liver diseases. Its clinical signs are diagnostic in advanced cirrhosis, but compensated liver cirrhosis is harder to diagnose. Liver biopsy is still considered the reference method for staging the severity of fibrosis, but due to its drawbacks (inter and intra-observer variability, sampling errors, unequal distribution of fibrosis in the liver, and risk of complications and even death), non-invasive methods were developed to assess fibrosis (serologic and elastographic). Elastographic methods can be ultrasound-based or magnetic resonance imaging-based. All ultrasound-based elastographic methods are valuable for the early diagnosis of cirrhosis, especially transient elastography (TE) and acoustic radiation force impulse (ARFI) elastography, which have similar sensitivities and specificities, although ARFI has better feasibility. TE is a promising method for predicting portal hypertension in cirrhotic patients, but it cannot replace upper digestive endoscopy. The diagnostic accuracy of using ARFI in the liver to predict portal hypertension in cirrhotic patients is debatable, with controversial results in published studies. The accuracy of ARFI elastography may be significantly increased if spleen stiffness is assessed, either alone or in combination with liver stiffness and other parameters. Two-dimensional shear-wave elastography, the ElastPQ technique and strain elastography all need to be evaluated as predictors of portal hypertension.
authors.affiliation: Roxana Şirli, Ioan Sporea, Alina Popescu, Mirela Dănilă, Department of Gastroenterology and Hepatology, "Victor Babeş" University of Medicine and Pharmacy, 300736 Timişoara, Romania.
authors.forename: Roxana
authors.initials: R
authors.lastname: Şirli
authors.affiliation: Roxana Şirli, Ioan Sporea, Alina Popescu, Mirela Dănilă, Department of Gastroenterology and Hepatology, "Victor Babeş" University of Medicine and Pharmacy, 300736 Timişoara, Romania.
authors.forename: Ioan
authors.initials: I
authors.lastname: Sporea
authors.affiliation: Roxana Şirli, Ioan Sporea, Alina Popescu, Mirela Dănilă, Department of Gastroenterology and Hepatology, "Victor Babeş" University of Medicine and Pharmacy, 300736 Timişoara, Romania.
authors.forename: Alina
authors.initials: A
authors.lastname: Popescu
authors.affiliation: Roxana Şirli, Ioan Sporea, Alina Popescu, Mirela Dănilă, Department of Gastroenterology and Hepatology, "Victor Babeş" University of Medicine and Pharmacy, 300736 Timişoara, Romania.
authors.forename: Mirela
authors.initials: M
authors.lastname: Dănilă
mesh_terms: D042241:Early Diagnosis; D054459:Elasticity Imaging Techniques / Q000379:methods*; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology* / Q000503:physiopathology; D008099:Liver / Q000000981:diagnostic imaging*; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors
keywords: Acoustic radiation force impulse elastography; Portal hypertension; Transient elastography; Two-dimensional shear-wave elastography