建石 良介

Ryosuke TATEISHI

東京大学医学部附属病院消化器内科

Department of Gastroenterology, The University of Tokyo Hospital, Japan

キーワード :

Transient elastography （TE） using Fibroscan is a totally non-invasive method to measure liver stiffness that correlates with the degree of liver fibrosis. Fibroscan can evaluate liver stiffness from the velocity of a low-frequency elastic wave produced by a vibrator with a 5-MHz transducer. The usefulness of TE in the evaluation of liver fibrosis has been widely validated with liver biopsy in various chronic liver diseases including chronic viral hepatitis, alcoholic liver disease and non-alcoholic fatty liver disease. It is also utilized in the evaluation of liver fibrosis in liver-transplanted patients. Several cohort studies reported that TE could stratify the risk of hepatocellular carcinoma （HCC） in patients with chronic hepatitis B and C. TE would be superior to liver biopsy in this field because it can further stratify the grade of fibrosis in the range of liver cirrhosis. Another advantage of TE over liver biopsy is that it can easily evaluate the chronological change of liver fibrosis owing to its non-invasiveness. Several limitations were reported. Liver stiffness cannot be measured in patients with atrophic liver, ascites, or excess obesity. It also should be noted that liver stiffness increases in several conditions other than liver fibrosis including acute hepatitis, congested liver and obstructive jaundice. Fibroscan is now the most prevalent among various elastographic methods due to its applicability and reliability and has become an essential tool in our daily practice.