Normal liver ultrasound and shear wave elastography
Hepatitis B diagnosed 2000. No previous liver imaging. Family history HCC ?cirrhosis ?portal hypertension ?hepatoma.
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No focal liver lesion. Liver echotexture is normal. Smooth liver surfaces. Main portal vein measures 9 mm and demonstrates antegrade flow. No flow within ligamentum teres. Spleen measures 5.5 centimetres.
- operator 1: median 1.13 m/s
- operator 2: median 1.11 m/s
No sonographic evidence of cirrhosis or portal hypertension. No focal liver lesion. The two ARFI measurement sets are concordant in the <F2 range.
ARFI reference values:
- 1.35 - absent or mild fibrosis (F0 or F1)
- 1.35-1.55 - significant fibrosis (F2)
- 1.55- 1.80 - severe fibrosis (F3)
- >1.80 - cirrhosis (F4)
Based on meta-analysis of pooled data which included a predominance of HCV patients - Friedrich-Rust et al J Viral hepatitis 2012, 19 e212-1219.
These threshold values are not absolute and results should be interpreted in clinical context. Such things as inflammatory activity and venous congestion can elevate the ARFI value.