Editors: Ioan Sporea, Roxana Șirli

Hepatic Elastography Using Ultrasound Waves Revised Edition of Volume 1

Special Offer (PDF + Printed Copy): US $84
Printed Copy: US $84
ISBN: 978-1-68108-402-2 (Print)
ISBN: 978-1-68108-401-5 (Online)
Year of Publication: 2016
DOI: 10.2174/97816810840151160101


Liver biopsy (LB) is sometimes considered to be the "gold standard" for the evaluation of liver morphology in the diagnosis of chronic hepatopathies. A major disadvantage of LB is its invasiveness: the risk of post-biopsy discomfort for patients and sometimes, of serious complications; the lack of sensitivity to detect fibrosis, due to its heterogeneity and the difficulty to obtain adequate physical samples for pathological examination is also problematic. In these circumstances, the idea of LB as the "gold standard" for staging and grading chronic hepatitis in routine medical diagnoses is questionable.

Non-invasive methods such as ultrasound elastography provide an effective alternative for liver evaluation without the risk of complications that arise from liver biopsies. There are a number of variants of elastographic techniques which include transient elastography (FibroScan, Echosens), Acoustic Radiation Force Impulse (ARFI) elastography (Siemens S2000) and other methods of shear wave elastography.

This revised edition of Hepatic Elastography Using Ultrasound Waves presents an updated set of chapters on the related topic. Chapters cover several methods of hepatic elastography (transient, shear wave, real time strain, elastPQ etc.). This edition consolidates all methods of point shear wave elastography (including ARFI and ElastPQ methods) into a single chapter and presents information on 2D shear wave elastography in a separate chapter. In addition, this revised edition offers readers new information on the comparison of each elastographic technique and supplements readers with a set of general guidelines on liver elastography. This revised edition is an essential reference for hepatologists interested in non invasive diagnostic methods for liver diseases.


Chronic liver diseases are common worldwide, including chronic viral hepatitis B and C, alcohol related and non-alcoholic fatty liver disease (NAFLD) and many others. The use of ultrasound has significantly contributed to the evolution of hepatology.

B mode ultrasound is the most frequently used initial imaging modality to examine patients with acute and chronic liver diseases. Doppler ultrasound techniques provide morphological and functional information of the liver vascularity which is most important for the evaluation of portal hypertension and its complications. Contrast enhanced ultrasound has revolutionized liver imaging. More recently the ultrasound based elastography technology has introduced a new dimension of imaging. The introduction and widespread use of non-invasive elastography techniques have reduced the need for invasive liver biopsies (LB) in patients with chronic liver disease.

The revised edition of the eBook edited by Prof. Dr. Ioan Sporea and Dr. Roxana Şirli on liver elastography summarizes the current and up to date knowledge on the use of elastography in the evaluation of liver diseases. The ebook introduces an understanding of this novel technique through the lens of important clinical background information which is also discussed. The well-known Roumanian authors around Prof. Ioan Sporea have published not only this book but also evidence based National Guidelines and Practical Recommendations on liver elastography. This book and the “practical recommendations” are helpful for all doctors starting to use these methods.

The book describes the physical principles of elastography, referring to the elastography guidelines of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) and World Federation on Ultrasound in Medicine and Biology (WFUMB).

Various elastography modalities are available, requiring different examination techniques and providing slightly different clinical information. The techniques described include transient elastography and acoustic radiation force impulse (ARFI) elastography, 2D shear Waves elastography and strain elastography amongst others. Importantly, examination technique, reproducibility and confounding factors are explained in detail.

A link to this book is available on the EFSUMB website (www.efsumb.org).

Congratulations to the authors who write with the benefit of their long standing clinical and research expertise in this field. I commend their valuable contributions to elastography.

Christoph F. Dietrich
Caritas Krankenhaus Bad Mergentheim
Chefarzt der Med. Klinik 2
Past EFSUMB President
Past DGE-BV President
Uhlandstr. 7
97980 Bad Mergentheim
E-mail: Christoph.dietrich@ckbm.de