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Review
. 2018 Jul-Aug;7(4):252-256.
doi: 10.4103/eus.eus_29_18.

EUS liver assessment using contrast agents and elastography

Andrea Lisotti  1 , Marta Serrani  1 , Giancarlo Caletti  1 , Pietro Fusaroli  1
Affiliations
Review

EUS liver assessment using contrast agents and elastography

Andrea Lisotti et al. Endosc Ultrasound. 2018 Jul-Aug.

Abstract

Transabdominal-US is the first-line imaging modality used to assess the whole liver parenchyma and vascularization; EUS assessment of the liver is incomplete and is not sufficient to rule out the presence of focal liver lesions. On the other hand, due the high diagnostic yield in detecting very small (< 1 cm) lesions, EUS is considered complementary to radiological imaging techniques for the investigation of liver parenchyma. Scarce data are available regarding the investigation of liver parenchyma using both EUS-elastography (EUS-E) and CH-EUS. The aim of this review is to evaluate the clinical role of image enhancement techniques, namely EUS-E and contrast harmonic-EUS (CH-EUS), for the evaluation liver diseases. Despite a potential interest for the application of EUS-E in the assessment of liver diseases, available evidence relegates this technique only to research areas, such as the differential diagnosis between benign and malignant focal liver lesions and the quantification of liver fibrosis in diffuse parenchymal diseases. With the future introduction of EUS shear-wave elastography, interesting data can be obtained for the assessment of liver fibrosis during real-time EUS evaluation. The usefulness of CH-EUS for the evaluation of liver disease is limited by the intrinsic EUS ability to explore only the left lobe and a small part of the right lobe. CH-EUS could be used to increase the diagnostic ability of EUS for the detection and characterization of small lesions and for guiding tissue sampling. Targeting EUS-guided treatments with either EUS-E or CH-EUS might represent potential future applications.

Keywords: Contrast agent; EUS; elastography; liver.

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Conflict of interest statement

There are no conflicts of interest

Figures

Figure 1
Figure 1
EUS elastography in a patient with pancreatic adenocarcinoma and multiple hypoechoic liver lesions
Figure 2
Figure 2
Contrast harmonic-EUS in a patient with pancreatic adenocarcinoma; (a) arterial phase (0–30 s), (b) portal phase (30–120 s), (c) late venous phase (>120 s)
Figure 3
Figure 3
Contrast harmonic-EUS arterial phase of hepatocellular carcinoma in a patient with hepatitis C virus-related cirrhosis
See this image and copyright information in PMC

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