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Determination of normal hepatic elasticity by using real-time shear-wave elastography
Chong Hyun Suh1, So Yeon Kim, Kyoung Won Kim
1From the Department of Radiology and Research Institute of Radiology (C.H.S., S.Y.K., K.W.K., S.J.L., M.G.L.), Department of Gastroenterology (Y.S.L.), Department of Clinical Epidemiology & Biostatistics (J.B.L.), Department of Liver Transplantation Surgery (S.G.L.), and Department of Pathology (E.Y.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, South Korea.
Real-time shear-wave elastography (SWE) establishes normal liver elasticity reference values between 2.6-6.2 kPa. This reliable method accurately diagnoses hepatic fibrosis, unaffected by age, BMI, or steatosis.
Area of Science:
- Hepatology
- Medical Imaging
- Diagnostic Ultrasound
Background:
- Liver elasticity measurement is crucial for diagnosing liver disease.
- Real-time shear-wave elastography (SWE) offers a non-invasive method for assessing liver stiffness.
- Establishing normal reference values is essential for accurate interpretation of SWE results.
Purpose of the Study:
- To determine normal reference values for liver elasticity using real-time shear-wave elastography (SWE).
- To assess the measurement reliability of SWE in a diverse patient population.
- To investigate the influence of age, BMI, and hepatic steatosis on liver elasticity measurements.
Main Methods:
- Retrospective analysis of 196 patients with biopsy-proven normal livers undergoing SWE and liver biopsy.
- Calculation of reference ranges for liver elasticity (2.5th and 97.5th percentiles).
- Evaluation of measurement reliability using intraclass correlation coefficient (ICC) and assessment of confounding factors (age, BMI, steatosis).
Main Results:
- The reference range for normal hepatic elasticity was determined to be 2.6-6.2 kPa.
- A cutoff value of 6.2 kPa demonstrated high sensitivity (91%) and specificity (95.9%) for diagnosing hepatic fibrosis.
- The intraclass correlation coefficient (ICC) for elasticity measurements was 0.924, indicating high reliability. Potential confounding factors had negligible effects.
Conclusions:
- Normal hepatic elasticity values measured by SWE in histologically normal livers range from 2.6 to 6.2 kPa.
- SWE provides highly reliable measurements for assessing liver elasticity.
- Age, BMI, and hepatic steatosis do not significantly affect liver elasticity measurements in normal livers.
