Noninvasive diagnosis of cirrhosis: A review of different imaging modalities

Abstract

Progressive hepatic fibrosis can lead to cirrhosis, so its early detection is fundamental. Staging fibrosis is also critical for prognosis and management. The gold standard for these aims is liver biopsy, but it has several drawbacks, as it is invasive, expensive, has poor acceptance, is prone to inter observer variability and sampling errors, has poor repeatability, and has a risk of complications and mortality. Therefore, non-invasive imaging tests have been developed. This review mainly focuses on the role of transient elastography, acoustic radiation force impulse imaging, and magnetic resonance-based methods for the noninvasive diagnosis of cirrhosis.

Keywords: Liver; Cirrhosis; Elastography; Acoustic radiation force impulse imaging; Magnetic resonance elastography

Core tip: In order to overcome the well-known drawbacks of liver biopsy, different non-invasive imaging tests have been developed for diagnosing and staging liver fibrosis. At present, transient elastography and acoustic radiation force impulse imaging are the most widely used. Reviewing literature, it seems that acoustic radiation force impulse imaging, having the advantage of being included in ultrasound equipments, could provide higher reproducibility and successful measurements rate, with a more precise examination than transient elastography. Magnetic resonance-based methods, especially hepatospecific contrast medium uptake/excretion measurements and elastography, are promising but still not universally available tools.