Liver elastography for the diagnosis of portal hypertension in patients with liver cirrhosis

Progressive hepatic fibrosis is a feature of almost all chronic liver diseases. In their final stage, advanced cirrhosis, the clinical signs are diagnostic, but compensated liver cirrhosis is not always easy to diagnose. Apart from liver biopsy, serologic and elastographic non invasive methods for the evaluation of fibrosis severity were developed in the last few years. Studies have been made in order to assess their value for predicting the occurrence of cirrhosis complications, particularly portal hypertension. Both Transient Elastography and ARFI elastography are valuable methods for the early diagnosis of cirrhosis. While TE is a promising method for predicting the presence of portal hypertension in cirrhotic patients, the diagnostic accuracy of ARFI in the liver seems to be poor. Probably the accuracy of ARFI elastography can be significantly increased if spleen stiffness is assessed, alone or in combination with liver stiffness and other parameters.