Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2018; 24(9): 957-970
Published online Mar 7, 2018. doi: 10.3748/wjg.v24.i9.957
Quantitative and noninvasive assessment of chronic liver diseases using two-dimensional shear wave elastography
Li-Ting Xie, Chun-Hong Yan, Qi-Yu Zhao, Meng-Na He, Tian-An Jiang
Li-Ting Xie, Chun-Hong Yan, Qi-Yu Zhao, Meng-Na He, Tian-An Jiang, Department of Ultrasound, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Xie LT, Yan CH, Zhao QY, He MN and Jiang TA contributed to the research, and to drafting and editing of the manuscript; all authors approved the final draft submitted.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Tian-An Jiang, MD, PhD, Professor, Surgeon, Department of Ultrasound, The First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road, No.79, Hangzhou 310003, Zhejiang Province, China.
Telephone: +86-18857127666
Received: December 28, 2017
Peer-review started: December 29, 2017
First decision: January 17, 2018
Revised: February 1, 2018
Accepted: February 9, 2018
Article in press: February 9, 2018
Published online: March 7, 2018

Two-dimensional shear wave elastography (2D-SWE) is a rapid, simple and novel noninvasive method that has been proposed for assessing hepatic fibrosis in patients with chronic liver diseases (CLDs) based on measurements of liver stiffness. 2D-SWE can be performed easily at the bedside or in an outpatient clinic and yields immediate results with good reproducibility. Furthermore, 2D-SWE was an efficient method for evaluating liver fibrosis in small to moderately sized clinical trials. However, the quality criteria for the staging of liver fibrosis are not yet well defined. Liver fibrosis is the main pathological basis of liver stiffness and a key step in the progression from CLD to cirrhosis; thus, the management of CLD largely depends on the extent and progression of liver fibrosis. 2D-SWE appears to be an excellent tool for the early detection of cirrhosis and may have prognostic value in this context. Because 2D-SWE has high patient acceptance, it could be useful for monitoring fibrosis progression and regression in individual cases. However, multicenter data are needed to support its use. This study reviews the current status and future perspectives of 2D-SWE for assessments of liver fibrosis and discusses the technical advantages and limitations that impact its effective and rational clinical use.

Keywords: Elastography, Shear wave, Chronic liver disease, Liver fibrosis

Core tip: There has been considerable research in recent years dedicated to the development of noninvasive methods of chronic liver diseases (CLDs). These include novel elastography methods. In this review, we outline the current state and future perspectives of the commonly used two-dimensional shear wave elastography (2D-SWE) in CLDs. In particular, we discuss the applications and problems in chronic viral hepatitis, nonalcoholic fatty liver disease, alcoholic liver disease, liver transplantation, focal liver lesions, and autoimmune liver disease to synthesize existing evidence for the reader. This is the first full and complete review to assess various CLDs using 2D-SWE.