Assessment of chronic liver disease by multiparametric ultrasound: results from a private practice outpatient facility

Varun Aitharaju, Annalisa De Silvestri, Richard G. Barr

Research output: Contribution to journalArticlepeer-review


Purpose: To assess chronic liver disease (CLD) using multiparametric US in a private practice setting in a cohort of patients with increased skin-to-liver distance. Methods: 110 consecutive patients with increased skin-to-liver distance scheduled for US assessment of CLD were reviewed for study completion time, liver stiffness values (LS), attenuation imaging, and shear wave dispersion slope. The ROI was placed 2 cm below the liver capsule. The study included patients with NAFLD/NASH (68), hepatitis C (30), prior Fontan surgery (1), elevated liver function tests (5), alcohol abuse (3), hepatitis B (2), and primary biliary cirrhosis (1). IQR/M values were obtained. Comparison of less experienced sonographers (LES) and more experienced sonographers (MES) were evaluated through Student’s t test for independent data. Pearson coefficient r of correlation among quantitative variables was calculated. Results: The mean time to perform the exam was 129.7 ± 62.1 s. There was a statistically significant difference between LES and MES. The mean IQR/M for LS was 12.3 ± 5.5% m/s. Overall, in a cohort of difficult patients, 4.5% of LS values were not reliable. Fat quantification using attenuation imaging had a mean value of 0.60 ± 0.15 dB/cm/MHz (range 0.35–0.98 cm/dB/MHz) with an IQR/M of 14.7 ± 9.2%. Less reliable measurements of steatosis were obtained in 4.5% of patients. The mean shear wave dispersion slope was 12.74 ± 4.05 (m/s)/kHz (range 7.7–27.5 (m/s)/kHz) with an IQR/M of 38.7 ± 20.2% (range 3–131%). 20.9% of patients had values suggestive of compensated advanced chronic liver disease (cACLD). Conclusion: Multiparametric US can provide assessment of CLD in less than 3 min in most patients and identify patients at risk for cACLD.

Original languageEnglish
JournalAbdominal Radiology
Publication statusAccepted/In press - 2021


  • Attenuation coefficient
  • Liver stiffness
  • NASH
  • Shear wave dispersion
  • Shear wave elastography

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology


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