Elastography in chronic liver disease: Modalities, techniques, limitations, and future directions

Aparna Srinivasa Babu, Michael L. Wells, Oleg M. Teytelboym, Justin E. Mackey, Frank H. Miller, Benjamin M. Yeh, Richard L. Ehman, Sudhakar K. Venkatesh*

*Corresponding author for this work

Research output: Contribution to journalArticle

71 Scopus citations


Chronic liver disease has multiple causes, many of which are increasing in prevalence. The final common pathway of chronic liver diseasis tissue destruction and attempted regeneration, a pathway that triggers fibrosis and eventual cirrhosis. Assessment of fibrosis is important not only for diagnosis but also for management, prognostic evauation, and follow-up of patients with chronic liver disease. Althougliver biopsy has traditionally been considered the reference standard for assessment of liver fibrosis, noninvasive techniques are the emerging focus in this field. Ultrasound-based elastography and magnetic resonance (MR) elastography are gaining popularity as the modalities of choice for quantifying hepatic fibrosis. These techniques have been proven superior to conventional cross-sectional imaging for evaluation of fibrosis, especially in the precirrhotic stages. Moreoverelastography has added utility in the follow-up of previously diagnosed fibrosis, the assessment of treatment response, evaluation for the presence of portal hypertension (spleen elastography), and evaluation of patients with unexplained portal hypertension. In this article, a brief overview is provided of chronic liver disease and the tools used for its diagnosis. Ultrasound-based elastography and MR elastography are explored in depth, including a brief glimpse into thevolution of elastography. Elastography is based on the principle of measuring tissue response to a known mechanical stimulus. Specific elastographic techniques used to exploit this principle include MR elastography and ultrasonography-based static or quasistatic strain imaging, one-dimensional transient elastography, point shear-wave elastography, and supersonic shear-wave elastography. The advantages, limitations, and pitfalls of each modality are emphasized.

Original languageEnglish (US)
Pages (from-to)1987-2006
Number of pages20
Issue number7
StatePublished - Nov 1 2016

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Babu, A. S., Wells, M. L., Teytelboym, O. M., Mackey, J. E., Miller, F. H., Yeh, B. M., Ehman, R. L., & Venkatesh, S. K. (2016). Elastography in chronic liver disease: Modalities, techniques, limitations, and future directions. Radiographics, 36(7), 1987-2006. https://doi.org/10.1148/rg.2016160042