Real-time sono-elastography in the diagnosis of diffuse liver diseases

AIM: To analyze whether computer-enhanced dynamic analysis of elastography movies is able to better characterize and differentiate between different degrees of liver fibrosis. METHODS: The study design was prospective. A total of 132 consecutive patients with chronic liver diseases and healthy volunteers were examined by transabdominal ultrasound elastography. All examinations were done by two doctors. RESULTS: Due to the limitations of the method, we obtained high-quality elastography information in only 73.48% of the patients. The kappa-means clustering method was applied to assess the inter-observer diagnosis variability, which showed good variability values in accordance with the experience of ultrasound examination of every observer. Cohen's kappa test indicated a moderate agreement between the study observers (kappa = 0.4728). Furthermore, we compared the way the two observers clustered the patients, using the test for comparing two proportions (t value, two-sided test). There was no statistically significant difference between the two physicians, regardless of the patients' real status. CONCLUSION: Transabdominal real-time elastography is certainly a very useful method in depicting liver hardness, although it is incompletely tested in large multicenter studies.