Liver stiffness changes in patients with established liver cirrhosis

Abstract

Even though cut-offs for liver stiffness (LS) values for the diagnosis of liver cirrhosis may vary according to the underlying disease etiology, transient elastography (TE) with its upper detection limit of 75 kPa allows for a further stratification of patients within the cirrhotic range. Additionally, due to its non-invasive nature, LS can be measured repeatedly. LS changes in patients with liver cirrhosis are commonly observed and can either be attributed to therapeutic interventions or changes in hepatic hemodynamics. Therapeutic interventions like alcohol detoxification or viral eradication are usually associated with an LS decrease, paralleled by an improvement of transaminase levels and hepatic function scores. On the other hand, changes in the behavioral pattern of patients like weight gain may result in increasing LS values. Therapeutic interventions targeting hepatic hemodynamics and therefore a decrease in portal hypertension also lead to decreasing LS values in most patients, and a decrease of LS is generally associated with an improved prognosis. Therefore, serial LS measurements are a valuable follow-up tool for patients with liver cirrhosis and may help in the decision-making of patient monitoring. However, LS changes need to be interpreted in the context of further clinical and laboratory findings.