Vergleich der Lebersteifigkeit im rechten und linken Leberlappen, gemessen mittels 2D-Scherwellen-Elastographie (Gerät: LOGIQ E9, GE), bei Leber-gesunden Probanden sowie Patienten mit chronischer Lebererkrankung

Comparison of liver stiffness in the right and left liver lobe, measured by 2D-shearwave elastography (sonography device: LOGIQ E9, GE) in healthy volunteers and in patients with chronic liver disease

by Bastian Grieme
Doctoral thesis
Date of Examination:2021-06-23
Date of issue:2021-06-23
Advisor:Prof. Dr. Dr. Albrecht Neeße
Referee:Prof. Dr. Margarete Schön
Referee:PD Dr. Thilo Sprenger
Persistent Address: http://dx.doi.org/10.53846/goediss-8634

 

 

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Abstract

English

The aim of this study was to compare liver stiffness measurement (LSM) values and the success rate of LSM in the right and left liver lobe, performed by 2D-shearwave elastography with the sonography device LOGIQ E9 (GE Healthcare). A total of 116 participants, 58 healthy volunteers (GP group) and 58 patients with chronic liver disease (CLD group), were prospectively included in the study. The LSM was performed in each group in the right liver lobe in neutral breathing position (standard technique), in the left liver lobe in neutral breathing position and in the left liver lobe in an inspirational position.  The additional use of the left liver lobe for LSM increased the success rate from 106/116 (91,4 %) to 112/116 (96,6 %; p = 0,098). High skin-liver capsule distance (SCD) and the presence of perihepatic ascites were independent risk factors for a non-successful LSM in both liver lobes independently from the breathing position. In addition, the ROI-Cor-distance (RCD) was an independent risk factor for a non-successful LSM in the left liver lobe in neutral breathing position in the GP group (p = 0,016). The chance for a successful LSM in the left liver lobe in neutral breathing position increased with higher RCD in the GP group.  LSM values in the left liver lobe (8,39 (± 4,83) kPa) were significantly higher compared to LSM values in the right liver lobe (6,27 (± 2,45) kPa; p < 0,001). LSM values in the left liver lobe in an inspirational breathing position were significantly higher compared to neutral breathing position in the right (p < 0,001) and left (p = 0,009) liver lobe. The LSM values in the right and left liver lobe showed a high correlation (r = 0,856). LSM in the left liver lobe overestimated the grade of fibrosis in 51,4 % of the patients with chronic liver disease and 31,5 % of the healthy volunteers.  Despite significantly higher LSM values, the study demonstrates that LSM in the left liver lobe may be an alternative if the LSM in the right liver lobe is not feasible. Advanced stages of liver fibrosis can be ruled out with high probability if LSM values in the left liver lobe are within normal range. When LSM in the left liver lobe show values > 9 kPa, further diagnostic investigations should be initiated because there is an increased probability of relevant liver fibrosis. 
Keywords: 2D-shearwave elastography; GE Logiq E9; liver stiffness; right liver lobe; left liver lobe; chronic liver disease
 
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