From the Guidelines
Acute increases in elastography values are primarily caused by inflammation, congestion, and fibrosis in tissues, as well as other factors such as recent food intake, physical factors, and certain medications. When tissues become inflamed due to conditions like acute hepatitis, they swell and become stiffer, leading to higher elastography readings 1. Vascular congestion, such as in heart failure or Budd-Chiari syndrome, causes blood pooling that increases tissue stiffness. Acute cholestasis with bile duct obstruction can rapidly increase liver stiffness. Recent food intake, especially high-fat meals, can temporarily elevate liver elastography values by increasing portal blood flow 1. Physical factors like breath-holding during deep inspiration or performing the Valsalva maneuver during measurement artificially increase readings by compressing tissues. Certain medications with hepatotoxic effects may cause acute inflammation leading to elevated values. Understanding these factors is crucial for accurate interpretation of elastography results, as they may lead to overestimation of fibrosis or disease severity if not properly accounted for during assessment. Some of the key factors that can influence liver stiffness measurements on elastography include edema, inflammation, extrahepatic cholestasis, and passive congestion 1. It is essential to consider these factors when interpreting elastography results to ensure accurate diagnosis and treatment of liver disease. Patients undergoing US elastography should be fasting to minimize the impact of recent food intake on liver stiffness measurements 1. By taking these factors into account, clinicians can use elastography to accurately assess liver disease and make informed treatment decisions. The most recent and highest quality study on this topic, published in 2025, highlights the importance of considering these factors when interpreting elastography results 1.
From the Research
Causes of Acute Increase in Elastography Values
- Acute liver damage can cause an acute increase in elastography values, as seen in a study published in 2008 2, which found that transient elastography frequently yields pathologically high values in patients with acute liver damage.
- Inflammation is another factor that can lead to an acute increase in elastography values, as mentioned in a study published in 2017 3, which listed inflammation as one of the key factors that limit the applicability of liver stiffness measurements.
- Liver vein congestion and cholestasis can also cause an acute increase in elastography values, as noted in the same study 3.
- A recent meal can affect elastography values, as stated in the 2017 study 3, which highlighted the importance of considering various factors that can influence liver stiffness measurements.
- Other factors such as obesity, observer experience, and ascites can also impact elastography values, as discussed in the 2017 study 3.
Elastography in Liver Disease
- Elastography can be used to diagnose liver fibrosis and cirrhosis, as well as to monitor treatment response and disease progression, as discussed in a study published in 2020 4.
- Transient elastography has been used to assess hepatic fibrosis regression in patients with chronic hepatitis B treated with oral antiviral agents, as seen in a study published in 2014 5.
- Elastography has been shown to be a useful tool in the management of chronic liver disease, including the assessment of fibrosis, treatment response, and portal hypertension, as discussed in a study published in 2016 6.