Ultrasound elastography

Ultrasound elastography is avoided in people with the following conditions:

• Narrow rib space
• Fluid in the abdomen (ascites)
• Heart failure 
• Very obese 
• Inability to lie flat on their back 
• Acute inflammation in the liver (hepatitis)
• Excess of iron deposition in the liver

Your healthcare practitioner may order this test in the following conditions:

• To detect liver diseases, if you show the following symptoms:
  • Jaundice (yellowing of the skin and eyes)
  • Weight loss 
  • Heavy nosebleed 
  • Bruising easily
  • Confusion
  • Swelling in the legs and abdomen 
  • Itching 
  • Fatigue 
  • Loss of appetite
• To monitor the treatment response 
• To guide a liver biopsy 
• To detect the risk of complications related to liver disease such as ascites

Following are a few ways you may be asked to prepare for ultrasound elastography:

• You will be asked to wear loose and comfortable clothes or a hospital gown for the test.
• The doctor may ask you not to have sugary beverages before the test.
• Fasting may be needed for six to eight hours before the test.
• You may be asked to eat fat-free food before the test.
• Women should inform their doctor if they are pregnant.

The following procedure is performed for the ultrasound elastography:

• The healthcare practitioner will ask you to lie on the exam table with the area of the right stomach being exposed.
• A clear water-based gel is spread on the surface of the area to be examined. 
• A transducer probe is placed on the right side, between the ribs of the lower chest wall.
• This probe will send the sound waves, which reach the liver and are bounced back. 
• A computer will then measure the waves that are bounced and convert them into pictures.

Ultrasound elastography takes approximately 30 minutes.

You may not feel any pain during the ultrasound scan. However, you may be able to feel the vibrations that are passed inside the liver.

The results of elastography are measured in kiloPascal (kPa). A normal range is between 2 to 7 kPa, which indicates no scarring. A range of greater than 7 kPa would indicate the presence of fibrosis. 

Depending on the range, the fibrosis can be divided into various stages as follows:

• F0: No scarring 
• F1: Mild fibrosis
• F2: Moderate fibrosis
• F3: Severe fibrosis
• F4: Advanced fibrosis or cirrhosis

Some of the conditions that may show fibrosis are as follows:

• Non-alcoholic fatty liver disease (a condition caused by abnormal metabolism)
• Hepatitis B and Hepatitis C (diseases caused by hepatitis viruses)
• Alcohol hepatitis (a liver disease that is caused due to excess of alcohol consumption)
• Cholestatic liver (a condition in which the flow of fluids like bile is blocked in the liver)

The benefits of doing ultrasound elastography are as follows:

• It is a non-invasive imaging procedure.
• There is no radiation exposure in this test.
• It shows a larger portion of the liver as compared to biopsy.

There is no known risk of undergoing ultrasound elastography.

You can restart your daily activities again after the test and no special precautions are needed.

The doctor may perform a liver function blood test or a liver biopsy along with ultrasound elastography to confirm a particular condition.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.