Liver shear wave elastography: the problem of accuracy and reproducibility
The article reviews the influence of various factors on the accuracy and reproducibility of liver stiffness measurements using shear wave elastography (SWE), as well as on the reliability of judgments about the norm and pathology. The tasks included analyzing the factors affecting the accuracy of measurements of liver stiffness depending on the equipment; testing various SWE techniques for their advantages and disadvantages; identifying the factors depending on the patient (body mass index, gender, respiration, etc.); finding out the reproducibility of liver stiffness measurements in SWE, depending on the skills of the operator, the minimal measurements, the use of contrast-enhanced ultrasound. The most important factors affecting the results of liver stiffness measurements include using SWE method, the diagnostic equipment and the sensors, the measurement depth and acoustic access; the reliability of various SWE methods is approximately equivalent. Among modern ultrasonic SWE technologies, the most efficient to visualize the measurement area are ARFI technologies — point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE). Two-dimensional SWE (2D-SWE) provides maximum color visual information about the state of liver tissue elasticity.