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Updated: Sep 17, 2025
Application of Ultrasound and Shear Wave Elastography Imaging in a Rat Model of NAFLD/NASH
Published on: April 20, 2021
Impact of Contrast-Enhanced Ultrasound on Hepatic Two-Dimensional Shear Wave Elastography: Does Elastography Need to
Jiayao Huang1, Qingyu Wu1, Bowen Zhuang1
1Sun Yat-sen University First Affiliated Hospital, Department of Medical Ultrasonics, Guangzhou, Guangdong, China.
Objective:
The present study aims to explore the dynamic impact of contrast-enhanced ultrasound (CEUS) on hepatic two-dimensional shear wave elastography (2D-SWE), especially in its assessment of liver fibrosis, and to analyze the pathological and biological basis of this impact.
Methods:
From August 2023 to August 2024, 220 participants were prospectively enrolled, among which 111 underwent liver histopathological examination. The 2D-SWE examinations were conducted at the pre-CEUS phase, CEUS phase (5-6 min after the injection of SonoVue), early post-CEUS phase (8-10 min after the injection), and late post-CEUS phase (25-30 min after the injection), respectively. Analysis of variance compared the indexes across different phases. Multivariate linear regression analyses identified the factors influencing the difference in 2D-SWE measurement values (Emean) between pre-CEUS and CEUS phases.
Results:
Emean at the CEUS phase and early post-CEUS phase was significantly lower than the pre-CEUS levels [the mean difference was 1.70 kPa and 0.90 kPa, respectively, both p < 0.001]. At the late post-CEUS phase, the Emean returned to the pre-CEUS levels (p = 0.078). Compared to the pre-CEUS phase, the percentage of the downgrade of significant fibrosis at the CEUS, early post-CEUS, and late post-CEUS phase was 55.3%, 35.3%, and 6.0%, respectively; while the downgrade of cirrhosis was 37.8%, 18.3%, and 2.4%, respectively. Liver inflammatory activity (p = 0.008, β = 0.88, 95% CI = 0.24-1.52) independently influenced the differences between the pre-CEUS and CEUS phase Emean. The higher the inflammatory activity grade, the greater the differences in Emean.
Conclusion:
Following CEUS, 2D-SWE measurement values initially decrease and subsequently return to baseline levels. This transient decrease can lead to a downgraded assessment of liver fibrosis. Furthermore, the liver inflammatory activity is an independent factor influencing the magnitude of the reduction in 2D-SWE measurement values after CEUS.
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