Liver fibrosis staging with a new 2D-shear wave elastography using comb-push technique: Applicability, reproducibility, and diagnostic performance
(A) Applicable SWE examination with technical success and reliable measurement in a 43-year-old male liver donor with a body mass index (BMI) of 25.73 kg/m2. The region of interest (ROI) was placed in the right upper lobe, avoiding large vessels and areas with artifacts, and 17.7mm away from the Glisson capsule. Sufficient color maps covering more than 50% of the sampling area for all acquisitions were obtained, which was regarded as a technical success. The interquartile range/median ratio was 6.51%, which was lower than 30% and was considered as a reliable measurement. The median liver stiffness (LS) value was 4.15kPa, and the histologic fibrosis was proven to be stage F0. Note that the distance between the transducer and Glisson capsule was 17.5mm. (B) Non-applicable SWE examination with technical failure in a 68-year-old female patient with a BMI of 21.26kg/m2,who was awaiting liver transplantation. The ROI was placed in the right upper lobe, devoid of large vessels and areas of artifacts, and 15.4mm away from the Glisson capsule. Despite 12 trials, color filling of the elastography map was insufficient, which was regarded as a technical failure. Note that this was the only case of technical failure in our study, and the distance between the transducer and Glisson capsule was 34.0mm.