Noninvasive diagnostics of liver diseases - imaging methods

Introduction and spread of elastographical methods have changed clinical practice in hepatology substantially. Elastography is becoming more available and the field of non-invasive diagnostics of liver diseases keeps growing dynamically. New technologies and applications are being developed allowing non-invasive staging of liver diseases to much broader extent. Ultrasound based methods like transient elastography (TE) and shear wave elasto-graphy (SWE) are dominating the field of liver elastography. Both methods are able to distinguish advanced liver fibrosis/cirrhosis with high accuracy and in patients with all most common chronic liver diseases. A technically well performed examination and its interpretation in a clinical context are prerequisites for a valid diagnosis. TE also enables assessment of presence/severity of portal hypertension in patients with compensated chronic advanced liver disease. There are new methods under development and validation like an ultrasound-based liver fat content quantification, assessment of portal hypertension using elastography of the spleen or the use of elastography in the diagnostics of focal liver lesions.