Liver elastography — when reliable?

Reliable when median of ≥ 10 valid measurements, IQR ≤ 30% of median and ALT < 5× ULN. Values are falsely elevated in acute hepatitis, hepatic congestion and cholestasis.

Cutoff for significant fibrosis (F ≥ 2)?

Depends on technique and equipment. In SWE, F2 ≥ 7.1 kPa and F4 (cirrhosis) ≥ 12.5 kPa are reference points in hepatitis C. Consult equipment- and etiology-specific values.

Report template — Ultrasound of elastography

When to use

Ultrasound elastography quantifies tissue stiffness — used for non-invasive staging of liver fibrosis, characterization of thyroid, breast, prostate and renal nodules. Most common techniques are shear-wave (SWE), strain elastography (compression) and transient elastography (FibroScan).

What to evaluate

Shear wave speed (Vs in m/s) or Young's modulus (kPa).
Median of valid measurements (≥ 5–10), IQR ≤ 30% of median.
Conversion to liver Metavir stages (local reference): F0–F4.
Caveats: fasting ≥ 3 h, supine position, avoid deep inspiration, avoid venous congestion.

Interactive template

Fill the blanks0/5

COM ELASTOGRAFIA HEPÁTICA - Fígado: com dimensões normais, contornos regulares e bordas finas. Ecotextura parenquimatosa hepática homogênea. Não foram detectadas lesões focais ao método. Realizada elastografia com a técnica “ shear wave ” (2D-SWE, GE Healthcare – Aparelho: Vivid T8 LOGIQ P7 Series), com medidas múltiplas. Mediana das Elasticidades ( liver stifness ) no lobo direito calculada em kPa . - Veias porta e hepáticas: pérvias ao estudo Doppler colorido, com calibres preservados. - Vesícula biliar: tópica, normodistendida, com paredes finas e regulares e conteúdo anecogênico, sem cálculos. - Vias biliares intra e extra-hepáticas: sem dilatações - Pâncreas: com dimensões, contornos e ecogenicidade normais. - Baço: com dimensões normais, homogêneo. Conclusão: - Elastografia hepática por 2D-SWE com índice de Elasticidade calculado em kPa, inferindo ausência presença de fibrose clinicamente significativa. Valores de referência*: • < 5 kPa: Normal; • 5-9 kPa: Provavelmente sem fibrose clinicamente significativa (≤ F2); • 9-13 kPa: Provavelmente com fibrose clinicamente significativa (≥ F3); • 13-17 kPa: Cirrose; • > 17 kPa: Cirrose descompensada (hipertensão portal). * Barr, Richard G., et al. "Update to the society of radiologists in ultrasound liver elastography consensus statement." Radiology 296.2 (2020): 263-274. Referências Bibliográficas: Barr RG et Al – Elastography Assessment of Liver Fibrosis: Society of Radiologists in Ultrasound Consensus Conference Statement – Radiology 2015; 276 (3): 845-861 G. Ferraioli et al - WFUMB Guidelines for Ultrasound Elastography - Liver - Ultrasound in Med. & Biol., Vol. 41, No. 5, pp. 1161–1179, 2015 DOI: https://doi.org/10.1016/j.ultrasmedbio.2015.03.007

Template in Brazilian Portuguese (clinical reporting language). Adapt to your service protocol. Not medical advice — the physician reviews, edits and signs.

How to use

Replace each [...] with the exam's measurement or descriptor.
Adapt the conclusion to your service protocol before signing.
Use the template as a starting point — not a replacement for physician review.
In Laudos.AI, dictate findings in natural speech and the AI structures text in this format for review.

Frequently asked

Liver elastography — when reliable?: Reliable when median of ≥ 10 valid measurements, IQR ≤ 30% of median and ALT < 5× ULN. Values are falsely elevated in acute hepatitis, hepatic congestion and cholestasis.
Cutoff for significant fibrosis (F ≥ 2)?: Depends on technique and equipment. In SWE, F2 ≥ 7.1 kPa and F4 (cirrhosis) ≥ 12.5 kPa are reference points in hepatitis C. Consult equipment- and etiology-specific values.

References

EFSUMB Guidelines on Ultrasound Elastography, 2017.
Friedrich-Rust M et al., Gastroenterology 2008.