While the spectrum of liver diseases has changed in last few years and nonalcoholic fatty liver disease (NAFLD) becoming the main field of activity in
hepatology, the evaluation of patients with chronic liver disease has shifted mainly
from invasive methods (liver biopsy) to non-invasive methods. Liver ultrasound-based
elastography, as a non-invasive method for predicting liver fibrosis, has been
extensively studied and developed in the last fifteen years, demonstrating its good
value for the evaluation of chronic liver diseases of different etiologies. Current
elastography guidelines advise on how and when to use these elastographic methods in
clinical practice and highlight their advantages and also their limitations too. Moreover,
the rapid innovation of ultrasound systems has allowed the development of new
software tools that allow, in addition to quantifying fibrosis, the quantification of
steatosis and the viscoelastic properties of tissues, such as inflammation, thus turning
the ultrasound systems into multiparametric methods (multiparametric ultrasoundMPUS). Also, besides liver stiffness, spleen stiffness is a good predictor for liver
cirrhosis complications, such as portal hypertension and there are current
recommendations and clear criteria for when to use elastography for evaluating portal
hypertension.
Keywords: 2D-SWE, Liver elastography, Liver steatosis, pSWE, Shear-wave elastography, Spleen stiffness, Steatosis quantification, Transient elastography.
