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Updated: Jul 3, 2025

Application of Ultrasound and Shear Wave Elastography Imaging in a Rat Model of NAFLD/NASH

Application of Ultrasound and Shear Wave Elastography Imaging in a Rat Model of NAFLD/NASH

Published on: April 20, 2021

Liver Elastography in Acute Liver Failure: A Pilot Study.

Francesca M Trovato^1,2, Florent Artru^1,2, Rosa Miquel²

¹School of Immunology and Microbial Sciences, Department of Inflammation Biology, Kings College London, London, United Kingdom.

Critical Care Explorations

|February 12, 2024

Summary

Sequential liver elastography monitoring in acute liver failure (ALF) shows stiffness peaks at day 5 in survivors, aiding prognosis. This noninvasive method may help differentiate ALF from acute-on-chronic liver failure (ACLF).

Keywords:

acute liver failure acute-on-chronic liver failure diagnostic ultrasound elastography tissue elasticity imaging

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Last Updated: Jul 3, 2025

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Published on: July 20, 2022

Area of Science:

Hepatology
Medical Imaging
Critical Care Medicine

Background:

Acute liver failure (ALF) is a critical condition requiring precise patient selection for intensive care and potential liver transplantation.
Liver elastography, a noninvasive technique for measuring hepatic stiffness, has yielded inconclusive results in ALF patients previously.
Accurate assessment of ALF severity and prognosis is crucial for timely intervention and management.

Purpose of the Study:

To evaluate the feasibility and reliability of serial ultrasonographic and elastographic monitoring in patients with acute liver failure.
To assess the potential of liver stiffness measurement (LSM) and spleen characteristics in predicting ALF outcomes.
To differentiate ALF from acute-on-chronic liver failure (ACLF) using noninvasive imaging techniques.

Main Methods:

An observational study involving patients with ALF, ACLF, and healthy controls (HC) admitted to a Liver Intensive Therapy Unit.
Sequential measurements of liver stiffness (using ElastPQ), spleen size, spleen stiffness, and portal vein flow were recorded.
Physiologic and histologic data were collected for comparative analysis.

Main Results:

Liver stiffness was significantly different between HC, ALF, and ACLF patients at admission (p=0.0301).
Spleen size and stiffness effectively discriminated between ALF and ACLF.
While initial LSM did not predict survival, the trend over 10 days showed a peak at day 5 in survivors, with persistently high stiffness in non-survivors.

Conclusions:

Liver stiffness in ALF peaks around day 5, decreasing in survivors and indicating prognosis by day 7.
Liver stiffness measurement, combined with spleen assessment, may help distinguish ALF from ACLF.
Sequential elastography offers a feasible and potentially reliable method for monitoring ALF patients.