What do V median (Velocity median) 1.5 m/sec, E median (Elasticity median) 6.8 kPa, and EIQR (Interquartile Range)/median 7% indicate in elastography?

Elastography Results Interpretation

These elastography values indicate normal liver stiffness with no evidence of significant fibrosis, and the measurements meet quality criteria for reliable interpretation.

Understanding the Measurements

V median (Velocity median) 1.5 m/sec

• This represents the shear wave velocity through liver tissue, which is within the normal range 1
• Shear wave velocity correlates directly with tissue stiffness—the faster the wave travels, the stiffer the tissue 1
• A velocity of 1.5 m/sec corresponds to the E median value through the mathematical relationship between velocity and elasticity 1

E median (Elasticity median) 6.8 kPa

• This liver stiffness value is below all established thresholds for significant fibrosis across all chronic liver disease etiologies 1
• For context, this value is:
  • Well below the 11.0 kPa cutoff for cirrhosis in chronic hepatitis B 1
  • Significantly below the 12.5 kPa threshold for cirrhosis in hepatitis C, NAFLD, and alcoholic liver disease 1
  • Below the 9.5 kPa cutoff used to rule out advanced fibrosis in post-treatment hepatitis C patients 2
• In healthy populations, normal liver stiffness does not exceed 2.7 kPa by MRE, though transient elastography typically shows slightly higher baseline values 3
• This measurement suggests minimal to no fibrosis (F0-F1 on METAVIR scale) 4

EIQR/median 7%

• This quality metric indicates excellent measurement reliability 1
• The interquartile range (IQR) divided by the median value assesses measurement variability 1
• For valid transient elastography results, the IQR/median should be ≤30% 1
• At 7%, this measurement far exceeds quality standards, indicating highly reproducible and reliable results 1
• When reported in kPa (as in this case), IQR/median <30% is required; when reported in m/s, <15% is required 1

Clinical Implications

Risk Stratification

• These values indicate very low risk for liver-related complications 5, 6
• The patient is well below thresholds associated with:
  • Portal hypertension (17.0 kPa) 1
  • High-risk esophageal varices (19.5 kPa) 1
  • Clinically significant portal hypertension 1

Management Recommendations

• No liver biopsy is indicated at this stage, as noninvasive testing is sufficient 5
• If underlying liver disease is present (such as viral hepatitis or NAFLD), disease-specific treatment should be initiated based on etiology 2
• Regular monitoring with repeat elastography in 12 months is appropriate if risk factors for liver disease are present 2
• Monitor liver biochemistry (ALT, AST, bilirubin, albumin) every 6 months if chronic liver disease is suspected 2

Important Caveats

Factors That Can Falsely Elevate Measurements

• Recent food intake within 2-3 hours can artificially increase liver stiffness 1
• Acute hepatitis or active inflammation 1
• Alcohol consumption 1
• Extrahepatic cholestasis 1
• Congestive heart failure causing liver congestion 1
• Amyloidosis 1

Technical Considerations

• The excellent IQR/median ratio (7%) confirms these measurements are not affected by technical limitations 1
• At least 10 valid measurements should have been obtained to calculate this median 1
• The measurement quality far exceeds the minimum acceptable threshold of 30% 1