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Hepatic Fibrosis/Elastography
Amir M. Pirmoazen, MD; Aya Kamaya, MD, FSRU, FSAR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        TERMINOLOGY

        • Definitions

          • Regenerative response to chronic inflammation and hepatocyte injury → excessive accumulation of extracellular matrix proteins, such as collagen → hepatic fibrosis
          • Most common etiologies
            • Nonalcoholic fatty liver disease (NAFLD)
            • Chronic hepatitis C virus (HCV) infection
            • Alcoholic liver disease
          • Quantifying liver fibrosis can predict outcome and guide treatment
            • Early diagnosis is crucial to halt progression to cirrhosis and its potential complications including hepatocellular carcinoma (HCC) and portal hypertension

        IMAGING

        • General Features

          • CT Findings

            • MR Findings

              • Ultrasonographic Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Staging, Grading, & Classification

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Natural History & Prognosis

                                • Treatment

                                  Selected References

                                  1. Barr RG et al: Update to the Society of Radiologists in Ultrasound liver elastography consensus statement. Radiology. 296(2):263-74, 2020
                                  2. Furlan A et al: Comparison of 2D shear wave elastography, transient elastography, and MR elastography for the diagnosis of fibrosis in patients with nonalcoholic fatty liver disease. AJR Am J Roentgenol. 214(1):W20-6, 2020
                                  3. Pirmoazen AM et al: Quantitative ultrasound approaches for diagnosis and monitoring hepatic steatosis in nonalcoholic fatty liver disease. Theranostics. 10(9):4277-89, 2020
                                  4. Horowitz JM et al: Evaluation of hepatic fibrosis: a review from the society of abdominal radiology disease focus panel. Abdom Radiol (NY). 42(8):2037-53, 2017
                                  5. Lin YS: Ultrasound evaluation of liver fibrosis. J Med Ultrasound. 25(3):127-9, 2017
                                  6. Beland MD et al: A pilot study estimating liver fibrosis with ultrasound shear-wave elastography: does the cause of liver disease or location of measurement affect performance? AJR Am J Roentgenol. 203(3):W267-73, 2014
                                  7. D'Onofrio M et al: Acoustic radiation force impulse of the liver. World J Gastroenterol. 19(30):4841-9, 2013
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        TERMINOLOGY

                                        • Definitions

                                          • Regenerative response to chronic inflammation and hepatocyte injury → excessive accumulation of extracellular matrix proteins, such as collagen → hepatic fibrosis
                                          • Most common etiologies
                                            • Nonalcoholic fatty liver disease (NAFLD)
                                            • Chronic hepatitis C virus (HCV) infection
                                            • Alcoholic liver disease
                                          • Quantifying liver fibrosis can predict outcome and guide treatment
                                            • Early diagnosis is crucial to halt progression to cirrhosis and its potential complications including hepatocellular carcinoma (HCC) and portal hypertension

                                        IMAGING

                                        • General Features

                                          • CT Findings

                                            • MR Findings

                                              • Ultrasonographic Findings

                                                • Imaging Recommendations

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      • Staging, Grading, & Classification

                                                        • Gross Pathologic & Surgical Features

                                                          • Microscopic Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  Selected References

                                                                  1. Barr RG et al: Update to the Society of Radiologists in Ultrasound liver elastography consensus statement. Radiology. 296(2):263-74, 2020
                                                                  2. Furlan A et al: Comparison of 2D shear wave elastography, transient elastography, and MR elastography for the diagnosis of fibrosis in patients with nonalcoholic fatty liver disease. AJR Am J Roentgenol. 214(1):W20-6, 2020
                                                                  3. Pirmoazen AM et al: Quantitative ultrasound approaches for diagnosis and monitoring hepatic steatosis in nonalcoholic fatty liver disease. Theranostics. 10(9):4277-89, 2020
                                                                  4. Horowitz JM et al: Evaluation of hepatic fibrosis: a review from the society of abdominal radiology disease focus panel. Abdom Radiol (NY). 42(8):2037-53, 2017
                                                                  5. Lin YS: Ultrasound evaluation of liver fibrosis. J Med Ultrasound. 25(3):127-9, 2017
                                                                  6. Beland MD et al: A pilot study estimating liver fibrosis with ultrasound shear-wave elastography: does the cause of liver disease or location of measurement affect performance? AJR Am J Roentgenol. 203(3):W267-73, 2014
                                                                  7. D'Onofrio M et al: Acoustic radiation force impulse of the liver. World J Gastroenterol. 19(30):4841-9, 2013