Elastography in Hepatology
Elastography is based on liver ultrasound, but has a huge difference to the normal imaging technique of ultrasound of the liver. It uses mechanical waves that are sent through the liver. The speed of these waves through tissue provides data about the condition and stiffness of the liver and thus can indicate a liver fibrosis. Elastography might become a completely non-invasive substitute for Biopsy.
Important techniques in this field include:
Transient elastography makes it possible to measure the elasticity (stiffness) of tissue painlessly using ultrasound. This new method provides a particular benefit for populations at risk (haemophiliacs, transplant patients, etc.) and patients who refuse a biopsy.
Contrast Harmonic Imaging
Contrast harmonic imaging (CHI) is a new Doppler technology using the non-linear properties of ultrasound contrast agents. CHI is promising to further improve the differential diagnosis of liver lesions and the detection of metastases.
Magnetic Resonance Imaging (MRI)
A new technique uses a modified form of Magnetic Resonance Imaging (MRI) to accurately measure the elasticity of the liver. By applying vibrations to the liver, MRE obtains pictures of the mechanical waves passing through the organ. The wave pictures are then processed to generate a quantitative image of tissue stiffness.
Noninvasive Approaches Offer Substantial Market Potential in Liver Disease Diagnostics
Novel noninvasive liver diagnostics tests have a good potential to revolutionize the diagnosis in hepatology. Up to now liver biopsy is widely considered the diagnostic gold standard for the diagnosis of liver fibrosis and liver cirrhosis. However, biopsy as an invasive procedure is not appropriate for all patients with liver disease. Therfore noninvasive liver diagnostics tests might play a significant role in the management of patients with liver disease.
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Studies and publications
- Noninvasive diagnosis of liver fibrosis by ultrasonic transient elastography (Fibroscan).
European Journal of Gastroenterology & Hepatology. 18(12):1321-1325,
Nguyen-Khac, Eric; Capron, Dominique