Shear Wave Elastography of Liver: Measurement of normal liver stiffness in healthy population and factors affecting it

  • Namrita Dhar Junior Resident, Department of Radiodiagnosis and Imaging, Government Medical College, Jammu, Jammu and Kashmir,India
  • Dr. Ishan Gupta Lecturer, Department of Radiodiagnosis and Imaging, Government Medical College, Jammu, Jammu and Kashmir, India
  • Kulbhushan Gupta Professor, Department of Radiodiagnosis and Imaging, Government Medical College, Jammu, Jammu and Kashmir,India.
Keywords: Shear wave elastography, Liver stiffness measurement, Healthy subjects, Non-invasive diagnosis, Normal

Abstract

Background: Shear Wave Elastography (SWE) is a recent non-invasive method for determining liverstiffness. SWE is a two-dimensional elastography technique in which an amplitude-modulated beamof focused ultrasound is used to generate shear waves which are then transmitted by the transducerto the region of interest (ROI), where the propagation speed of shear waves is measured. Thepresent study is the first attempt to measure the normal range of liver stiffness using SWE in ahealthy population from North India and to study the effect of age, gender, and BMI on the liverstiffness values in the healthy population.

Methods: This cross-sectional observational study wasconducted in the Department of Radiodiagnosis and Imaging, Government Medical College, Jammuon 117 healthy subjects without any known liver pathology or history of any liver disease. B-ModeUltrasound scan, followed by SWE Examination was performed on all subjects using SAMSUNGRS80EVO using CA1-7A convex array probe with a frequency of 1 to 7 MHz.

Results: Successfulresults were obtained in 98.2%. The mean value of liver stiffness in 115 healthy subjects was 4.74± 0.91 kPa, and the 95% confidence interval was 4.58-4.91 kPa. (Range: 2.7-7.8 kPa). There wereno statistically significant differences in liver stiffness values regarding age, gender and BMI in thehealthy population (all p> 0.05).

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References

References:
1. Belongia EA, Costa J, Gareen IF, Grem JL, Inadomi JM, Kern ER, McHugh JA, Petersen GM, Rein MF, Sorrell MF, Strader DB, Trotter HT. NIH consensus development statement on management of hepatitis B. NIH Consens State Sci Statements 2008; 25: 1–29.
2. Froehlich F, Lamy O, Fried M, Gonvers JJ. Practice and complications of liver biopsy. Results of a nationwide survey in Switzerland. Digestive Diseases and Sciences 1993; 38: 1480-1484.
3. Persico M, Palmentieri B, Vecchione R, Torella R, de SI. Diagnosis of chronic liver disease: Reproducibility and validation of liver biopsy. Am J Gastroenterol 2002; 97: 491– 492.
4. Barr RG, Ferraioli G, Palmeri ML, Goodman ZD, Garcia-Tsao G, Rubin J, Garra B, Myers RP, Wilson SR, Rubens D, Levine D. Elastography Assessment of Liver Fibrosis: Society of Radiologists in Ultrasound Consensus Conference Statement. Ultrasound Q. 2016; 32(2): 94-107.
5. Sporea I, Lie I. Shear wave elastography. Ultraschall Med 2012; 33(4): 393-4.
6. Cosgrove D, Piscaglia F, Bamber J, Bojunga J, Correas JM, Gilja OH, Klauser AS, Sporea I, Calliada F, Cantisani V, D'Onofrio M, Drakonaki EE, Fink M, Friedrich-Rust M,
Fromageau J, Havre RF, Jenssen C, Ohlinger R, Săftoiu A, Schaefer F, Dietrich CF; EFSUMB. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 2: Clinical applications. Ultraschall Med 2013; 34(3): 238-53.
7. Bavu E, Gennisson JL, Couade M, Bercoff J, Mallet V, Fink M, Badel A, Vallet-Pichard A, Nalpas B, Tanter M, Pol S. Noninvasive in vivo liver fibrosis evaluation using supersonic shear imaging: A clinical study on 113 hepatitis C virus patients. Ultrasound Med Biol 2011; 37: 1361–1373.
8. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004; 363: 157–163.
9. Huang Z, Zheng J, Zeng J, Wang X, Wu T, Zheng R. Normal liver stiffness in healthy adults assessed by real-time shear wave elastography and factors that influence this method. Ultrasound Med Biol 2014; 40(11):2549-55.
10. Castera L, Foucher J, Bernard PH, Carvalho F, Allaix D, Merrouche W, Couzigou P, de Ledinghen V. Pitfalls of liver stiffness measurement: A 5-year prospective study of 13,369 examinations. Hepatology 2010; 51: 828–835.
11. Madhok R, Tapasvi C, Prasad U, Gupta AK, Aggarwal A. Acoustic radiation force impulse imaging of the liver: Measurement of the normal mean values of the shearing wave velocity in a healthy liver. J Clin Diagn Res 2013; 7: 39–42.
12. Mulabecirovic A, Mjelle AB, Gilja, OH, Vesterhus, M, Havre RF. Liver elasticity in healthy individuals by two novel shear-wave elastography systems—Comparison by age, gender, BMI and number of measurements. PLoS One 2018; 13(9): e0203486.
13. Popescu A, Sporea I, Sirli R, Bota S, Focsa M, Danila M, Nicolita D, Martie A, Sendroiu M, Juchis A. The mean values of liver stiffness assessed by Acoustic Radiation Force Impulse elastography in normal subjects. Med Ultrason 2011; 13: 33–37.
14. Colombo S, Belloli L, Zaccanelli M, Badia E, Jamoletti C, Buonocore M, Del PP. Normal liver stiffness and its determinants in healthy blood donors. Dig Liver Dis 2011; 43: 231– 236.
15. Das K, Sarkar R, Ahmed SM, Mridha AR, Mukherjee PS, Das K, Dhali GK, Santra A, Chowdhury A. Normal liver stiffness measure (LSM) values are higher in both lean and obese individuals: A population-based study from a developing country. Hepatology 2012; 55: 584–593.
16. Kim SU, Choi GH, Han WK, Kim BK, Park JY, Kim DY, Choi JS, Yang SC, Choi EH,
Ahn SH, Han KH, Chon CY. What are ‘‘true normal’’ liver stiffness values using FibroScan? A prospective study in healthy living liver and kidney donors in South Korea. Liver Int 2010; 30: 268–274.
17. Sirli R, Bota S, Sporea I, Jurchis A, Popescu A, Gradinaru-Tascau O, Szilaski M. Liver stiffness measurements by means of supersonic shear imaging in patients without known liver pathology. Ultrasound Med Biol 2013; 39: 1362–1367.
18. Fung J, Lee CK, Chan M, Seto WK, Wong DK, Lai CL, Yuen MF. Defining normal liver stiffness range in a normal healthy Chinese population without liver disease. PLoS One 2013; 8(12): e85067.
How to Cite
1.
Namrita Dhar, Dr. Ishan Gupta, Kulbhushan Gupta. Shear Wave Elastography of Liver: Measurement of normal liver stiffness in healthy population and factors affecting it. Int J Med Res Rev [Internet]. 2022Oct.29 [cited 2024Dec.23];10(5):141-6. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/1395
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Original Article