Non-Invasive Investigation of Liver Cirrhosis

SUMMARY: The investigation of cirrhosis of the liver requires regular screening aimed at the detection or prevention of complications. This article reviews the usefulness of transient elastography in making a diagnosis of liver cirrhosis, against a background of other methods. Transient elastography is a novel, easily applicable and painless method to assess cirrhosis by measuring liver stiffness. Methods: All publications found in a PubMed search using the key words „elastography and liver“ up to December 2006 were considered. Results: Depending on the chosen cut-off and the etiology of liver disease, sensitivities of 77 to 100 % and specificities of 82 to 97 % were reported for the diagnosis of liver cirrhosis by transient elastography. Thus higher sensitivities were found for transient elastography compared to other non-invasive fibrosis detection methods despite similar specificities. Discussion: In the context with clinical signs, ultrasound and laboratory parameters, transient elastography might be particularly helpful for the non-invasive diagnosis of liver cirrhosis making histology dispensable in many cases. For differentiation of earlier stages of liver fibrosis, liver biopsy still remains superior to transient elastography.