Ultraschall Med 2013; 34 - WS_SL24_09
DOI: 10.1055/s-0033-1354961

Liver stiffness by shear wave elastography is influenced by meal and meal-related haemodynamic modifications

L Vonghia 1, 2, W Werlinden 1, P Pelckmans 1, P Michielsen 1, S Francque 1
  • 1Department of Gastroenterology and Hepatology, Universitary Hospital Antwerp, Antwerp, Belgium
  • 2Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, Bari, Italy

Purpose: To evaluate the effect of meal and meal-related haemodynamic variations on LS measurement by Shear Wave Elastography, given the emerging role of this technique in the non-invasive evaluation of liver fibrosis.

Material and methods: 10 healthy volunteers were enrolled in the study. LS, echo color Doppler analysis of portal vein and hepatic artery, as well as liver and spleen dimensions were evaluated before a meal (T0) and 30' (T30), 60'(T60) and 120' (T120) postprandially.

Results: LS values increased 30' postprandially and decareased from 60' postprandially, returning to baseline values after 2 hours (LS T0: 5.2 ± 1.06kPa, LS T30': 6.3 ± 0.8kPa, LS T60': 6 ± 1.3kPa, LS T120' 5 ± 1kPa; p:0.02). Portal flow showed comparable kinetics (T0 0.52 ± 0.22L/min, T30 1.08 ± 0.32L/min, T60 0.77 ± 0.52L/min, T120 0.48 ± 0.21L/min; p: 0.02). Portal mean velocity was significantly increased at T30 (T0 11.3 ± 2.5 cm/s, T30 16.1 ± 4.7 cm/s; p. 0.02), and returned to values comparable to baseline from T60 on (T60' 14.2 ± 3.6 cm/s, T120' 13.5 ± 3.4 cm/s; p.> 0.05). Hepatic artery maximal (Vmax) and mean (Vmean) velocity, after a decrease at T30, progressively increased up to T120, where they reached values higher than baseline (Vmax: T0 52.8 ± 36.8 cm/s, 30' 45.4 ± 17.4 cm/s, T60 55.6 ± 23.5 cm/s, T120 73.7 ± 44.2 cm/s; p: 0.04; Vmean: T0 36.4 ± 27 cm/s, T30 28.3 ± 11.7 cm/s, T60 35.6 ± 16 cm/s, T120 48.1 ± 29 cm/s; p: 0.04). The Resistivity Index (RI) of the hepatic artery increased from T30 after meal (T0 0.62 ± 0.07 cm/s, T30 0.74 ± 0.08 cm/s; p:0.02, T60 0.73 ± 0.05 cm/s; p:0.02) and decreased at T120 (T120 0.69 ± 0.08 cm/s p > 0.05). Liver and spleen diameters did not show variations.

Conclusion: LS transiently increases postprandially in relation to the meal-induced haemodynamic variations in portal and hepatic arterial flow, and returns to baseline 120' after the meal. LS evaluation should hence be performed fasting or at least 120′ after a meal.