Chinese Hepatolgy ›› 2025, Vol. 30 ›› Issue (10): 1384-1388.

• Metabolic Associated Fatty Liver Disease • Previous Articles     Next Articles

Application of ultrasound TE, SWE, and RTE technologies in evaluating liver stiffness in metabolic associated fatty liver disease

QU Zhen1, ZHOU Ya-ning2, XIAO Sa1   

  1. 1. Department of the Second Imaging Medicine, Xi′an Mental Health Center/Xi′an Institute of Mental Health, Xi′an 710100,China;
    2. Ultrasound Diagnosis Center, Shaanxi Provincial People's Hospital,Xi′an 710068,China
  • Received:2024-11-20 Online:2025-10-31 Published:2025-12-16

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Abstract: Objective This study explores the effectiveness of Transient Elastography (TE), Shear Wave Elastography (SWE), and Real-Time Elastography (RTE) in assessing liver stiffness values in patients with metabolic associated fatty liver disease(MAFLD). Methods A retrospective analysis was conducted on the clinical data of 104 MAFLD patients who visited our hospital from February 2021 to February 2024. According to the Metavir scoring system, patients were divided into three groups: 41 in the F0~1 steatosis group, 35 in the F2~3 fibrosis group, and 28 in the F4 cirrhosis group. All patients underwent RTE, TE, and SWE ultrasound elastography examinations to measure liver stiffness, with the diagnostic value for MAFLD fibrosis assessed using receiver operating characteristic (ROC) curves. Results Significant differences were observed in liver stiffness measurements between the groups for all three techniques (P<0.05). As the degree of fibrosis increased, the liver stiffness values measured by RTE, TE, and SWE also increased, correlating positively with the degree of fibrosis (TE: r=0.706, SWE: r=0.742, RTE: r=0.739, all P<0.05). The area under the curve (AUC) for RTE, TE, and SWE in diagnosing significant fibrosis (F≥2) and cirrhosis (F4) were 0.912/0.824, 0.924/0.853, and 0.955/0.804, respectively, with sensitivities of 88.9%/96.4%, 81.0%/78.6%, and 88.9%/96.4%, and specificities of 95.1%/61.8%, 97.6%/81.6%, and 90.2%/53.9%, respectively. Among these, TE and SWE showed superior diagnostic values over RTE. Conclusion In the diagnosis of MAFLD, ultrasound elastography techniques (TE, SWE, and RTE) effectively assess liver stiffness. All three techniques accurately reflect the extent of liver fibrosis, with TE and SWE performing better in diagnosing fibrosis and cirrhosis. Clinically, the appropriate technology can be selected based on specific circumstances to improve diagnostic accuracy.

Key words: Transient elastography, Shear wave elastography, Real-time elastography, Metabolic associated fatty liver disease, Liver stiffness