Assessment of chronic liver disease by multiparametric ultrasound: results from a private practice outpatient facility

• Published in: Abdominal radiology (New York) Vol. 46; no. 11; pp. 5152 - 5161
• Main Authors: Aitharaju, Varun, De Silvestri, Annalisa, Barr, Richard G.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-11-2021
• Subjects: Elasticity Imaging Techniques; Gastroenterology; Hepatobiliary; Hepatology; Humans; Imaging; Liver - diagnostic imaging; Liver Cirrhosis - pathology; Medicine; Medicine & Public Health; Non-alcoholic Fatty Liver Disease - diagnostic imaging; Non-alcoholic Fatty Liver Disease - pathology; Outpatients; Private Practice; Radiology; Ultrasonography; Shear wave elastography; NAFLD; Liver stiffness; Shear wave dispersion; NASH; Attenuation coefficient
• ISSN: 2366-004X; 2366-0058
• DOI: 10.1007/s00261-021-03225-2

Purpose
To assess chronic liver disease (CLD) using multiparametric US in a private practice setting in a cohort of patients with increased skin-to-liver distance.
Methods
110 consecutive patients with increased skin-to-liver distance scheduled for US assessment of CLD were reviewed for study completion time, liver stiffness values (LS), attenuation imaging, and shear wave dispersion slope. The ROI was placed 2 cm below the liver capsule. The study included patients with NAFLD/NASH (68), hepatitis C (30), prior Fontan surgery (1), elevated liver function tests (5), alcohol abuse (3), hepatitis B (2), and primary biliary cirrhosis (1). IQR/M values were obtained. Comparison of less experienced sonographers (LES) and more experienced sonographers (MES) were evaluated through Student’s t test for independent data. Pearson coefficient r of correlation among quantitative variables was calculated.
Results
The mean time to perform the exam was 129.7 ± 62.1 s. There was a statistically significant difference between LES and MES. The mean IQR/M for LS was 12.3 ± 5.5% m/s. Overall, in a cohort of difficult patients, 4.5% of LS values were not reliable. Fat quantification using attenuation imaging had a mean value of 0.60 ± 0.15 dB/cm/MHz (range 0.35–0.98 cm/dB/MHz) with an IQR/M of 14.7 ± 9.2%. Less reliable measurements of steatosis were obtained in 4.5% of patients. The mean shear wave dispersion slope was 12.74 ± 4.05 (m/s)/kHz (range 7.7–27.5 (m/s)/kHz) with an IQR/M of 38.7 ± 20.2% (range 3–131%). 20.9% of patients had values suggestive of compensated advanced chronic liver disease (cACLD).
Conclusion
Multiparametric US can provide assessment of CLD in less than 3 min in most patients and identify patients at risk for cACLD.