title: Strain elastography for assessment of liver fibrosis and prognosis in patients with chronic liver diseases.
abstract: BACKGROUND
  Estimation of liver stiffness is essential in the treatment of liver diseases. Various procedures alternative to liver biopsy have been developed, and transient elastography using shear wave is an established method for evaluating liver stiffness and has been shown to be a prognostic indicator. In contrast, strain elastography (SE) has been applied to evaluate liver stiffness, however the significance remains uncertain.
  
  
  METHODS
  We retrospectively analyzed 598 patients who underwent SE to evaluate the ability of estimating liver stiffness and the prognosis. Elasticity index (EI) was evaluated as an indicator of liver stiffness in this study.
  
  
  RESULTS
  EI was increased as histological fibrosis advanced. EI was significantly different between mild fibrosis (F0-2) and advanced fibrosis (F3, 4). In contrast, EI was similar among those with different activity scores. EI showed better diagnostic performance in estimating advanced fibrosis than other serological markers and good reproducibility. Furthermore, EI was shown to be an independent prognostic factor in patients with chronic liver diseases and also with hepatocellular carcinoma (HCC) with advanced stage.
  
  
  CONCLUSIONS
  SE could estimate advanced liver fibrosis without influence of liver inflammation unlike other serological liver fibrosis markers. SE might be a prognostic factor in chronic liver diseases and HCC.
authors: The Third Department of Internal Medicine, Toyama University Hospital, 2630 Sugitani, Toyama, 930-0194, Japan. tajikazu@med.u-toyama.ac.jp.
authors: Kazuto
authors: K
authors: Tajiri
authors: The Third Department of Internal Medicine, Toyama University Hospital, 2630 Sugitani, Toyama, 930-0194, Japan.
authors: Kengo
authors: K
authors: Kawai
authors: The Third Department of Internal Medicine, Toyama University Hospital, 2630 Sugitani, Toyama, 930-0194, Japan.
authors: Toshiro
authors: T
authors: Sugiyama
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology; D002908:Chronic Disease; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers
keywords: Hepatocellular carcinoma; Liver biopsy; Liver stiffness; Prognosis; Strain elastography