Real-time sono-elastography in the diagnosis of diffuse liver diseases

To analyze whether computer-enhanced dynamic analysis of elastography movies is able to better characterize and differentiate between different degrees of liver fibrosis.

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.

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.

Transabdominal real-time elastography is certainly a very useful method in depicting liver hardness, although it is incompletely tested in large multicenter studies.