Ultrasound Elastography

TECHNIQUE:
Ultrasound of the right upper quadrant was performed. Ultrasound elastography of the liver was performed using a Phillips ultrasound machine with 10 separate measurements of the liver parenchyma with the patient in the supine position. Measurements were obtained approximately 2 cm beneath Glisson's capsule, perpendicular to the liver capsule. Images are of satisfactory quality.

FINDINGS:
ELASTOGRAPHY:

The median liver stiffness is: [#] m/sec.

The mean liver stiffness is: [#] m/sec.

The interquartile range is: [#].

IQR/median: [#]. (IQR/median value of greater than 0.15 indicates that a dataset is unreliable.)

RIGHT UPPER QUADRANT:

Liver: Normal parenchymal echotexture and echogenicity. No focal hepatic mass.

Gallbladder: No cholelithiasis, wall thickening, or pericholecystic fluid. Negative sonographic Murphy's sign.

Bile Ducts: No intrahepatic biliary ductal dilation. The common bile duct measures [#] cm.

Pancreas: Visualized portions of the head and body of the pancreas are unremarkable.

Right Kidney: Normal parenchymal echogenicity. No masses or calculi. No hydronephrosis.

Fluid: No evidence of ascites or pleural effusions.

IMPRESSION:

The median liver stiffness is [Field 3] m/sec, and the IQR/median value is [IQR/median]. This is [Pick list]:

• A normal elastography value with a low likelihood of severe fibrosis or cirrhosis.
• A low elastography value which rules out advanced chronic liver disease in asymptomatic patients.
• A high elastography value suggestive of advanced chronic liver disease.
• A high elastography value indicating advanced chronic liver disease.
• A high elastography value indicating advanced chronic liver disease and portal hypertension.