Liver elastography is a modern, non-invasive, and painless imaging test used to assess the stiffness (fibrosis) of the liver tissue (parenchyma). It is essentially a “stiffness ultrasound” that helps evaluate liver fibrosis or cirrhosis without the need for a liver biopsy.
The technique is based on the emission of sound waves (typically shear waves) into the liver and the measurement of the speed at which these waves travel through the tissue. The stiffer the liver tissue (e.g., due to fibrosis), the faster the waves travel.
When Liver Elastography Is Useful:
- Detection and staging of liver fibrosis (e.g., in chronic hepatitis B or C, fatty liver disease, or NASH)
- Monitoring the progression of liver disease without the need for repeated biopsies
- Assessing the risk of developing cirrhosis
- Evaluating patients before or after liver transplantation
- Identifying patients who require more intensive treatment or follow-up
Procedure
The procedure is similar to a regular abdominal ultrasound. The patient lies on their back while the doctor places the ultrasound probe over the liver area (upper right abdomen). Special software records the speed of wave propagation and calculates the tissue stiffness, usually expressed in kilopascals (kPa). The examination is quick, painless, and radiation-free. In some cases, fasting for 2–3 hours before the examination is recommended.