Published online Nov 7, 2015. doi: 10.3748/wjg.v21.i41.11542
Peer-review started: May 6, 2015
First decision: June 2, 2015
Revised: July 11, 2015
Accepted: August 31, 2015
Article in press: August 31, 2015
Published online: November 7, 2015
Core tip: Ultrasound-based elastographic methods are being used more and more for the non-invasive assessment of liver fibrosis, with very good accuracy in diagnosing cirrhosis. Transient elastography is a promising method for predicting portal hypertension in cirrhotics, but it cannot replace upper digestive endoscopy. The diagnostic accuracy of employing acoustic radiation force impulse elastography in the liver to predict portal hypertension is debatable. It may be significantly increased if spleen stiffness is assessed, whether alone or in combination with liver stiffness and other parameters. Two-dimensional shear-wave elastography, the ElastPQ technique and strain elastography all need to be evaluated as predictors of portal hypertension.