Liver Diagnostics via Ultrasound Elastography
Fatty liver causes no pain — so it is often discovered only when it has already progressed. With modern ultrasound elastography we can detect it early, and in early stages it is fully reversible.
The liver is silent: it doesn't signal through pain when it becomes fatty. Only after years — sometimes decades — does scarring (fibrosis) or cirrhosis develop, and at that point damage can no longer be reversed. Ultrasound elastography is a kind of "palpation by ultrasound": it measures how soft or firm the liver tissue is, and how much fat is deposited. The examination takes a few minutes, is painless, and uses no radiation.
Chronic liver diseases (MASLD — Metabolic Associated Fatty Liver Disease) often progress silently and unnoticed[1]. The typical progression is: fatty liver → fibrosis → liver cirrhosis. The earlier the diagnosis, the better we can intervene — because fatty liver is fully reversible in early stages. Ultrasound elastography is a non-invasive, safe method for assessing liver quality.
What Elastography Measures
- Liver Stiffness: Quantification of fibrosis stage (transformation of healthy liver tissue into scar tissue), a sign of beginning liver cirrhosis.
- Steatosis Grade: Assessment of the extent of fat deposition in liver tissue using quantitative ultrasound measurements (QUS).
Samsung V5 — Quantitative Liver Diagnostics
At our practice, we work with the Samsung V5 ultrasound system. Beyond conventional B-mode sonography, the device offers specialized tools for quantitative assessment of liver tissue — non-invasive, reproducible, and without radiation exposure.
Overview: Staged diagnostics in liver disease[3]
Fatty Liver Diagnostics (Steatosis)
TAI™ — Tissue Attenuation Imaging
Quantitative measurement of ultrasound attenuation in liver tissue. TAI™ captures the change in center frequency under optimal transmission and reception conditions. The greater the attenuation, the more pronounced the steatosis — an objective numerical value rather than subjective assessment.
Normal Liver
Fatty Liver (increased attenuation)
TSI™ — Tissue Scatter Distribution Imaging
Quantification of backscatter in liver tissue. The distribution of scattered ultrasound signals changes depending on the fat content of the tissue and allows differentiated assessment of the steatosis grade.
Normal Liver
Fatty Liver (altered scatter distribution)
Fibrosis Diagnostics (Liver Stiffness)
S-Shearwave Imaging™ — Shear Wave Elastography
Non-invasive assessment of tissue stiffness. Highly focused ultrasound pulses generate shear waves, and their propagation speed is measured. The result is expressed in kPa or m/s — the stiffer the tissue, the higher the value. Color-coded elastograms and quantitative measurements enable reliable fibrosis staging without liver biopsy.[4]
S-Shearwave Elastography
Color-coded Elastogram
Images: © Samsung Healthcare. Source: Samsung Liver Analysis Solution. Functionality depends on device and configuration.[3]
For Whom is This Diagnostics Relevant?
- Obesity + Metabolic Syndrome: Increased risk for fatty liver and progressive MASLD.
- Type 2 Diabetes with Elevated Liver Values: For differential diagnosis and fibrosis risk assessment.
- Known Fatty Liver (Follow-up): Regular monitoring for early detection of fibrosis.
- Elevated Liver Values of Unknown Cause: To characterize liver disease and plan therapeutic interventions.
Advanced ultrasound elastography (TAI™, TSI™, S-Shearwave™) for quantitative assessment of steatosis and fibrosis is an individual health service and is not covered by statutory health insurance. We perform it within the extended internal medicine consultation (Thursdays).
Billing follows the GOÄ. Scope and costs are discussed transparently in advance; before the service is provided, we conclude a written agreement in accordance with § 18 (8) BMV-Ä.
References
- European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol. 2024;81(3):492–542.
- S3 Guidelines on Obesity — Prevention and Treatment. AWMF Registry No. 050-001, German Obesity Society (DAG), updated 2024.
- Samsung Healthcare. Liver Analysis Solution — EzHRI™, TAI™, TSI™, S-Shearwave Imaging™. resources.samsunghealthcare.com/en/LiverAnalysisSolution.
- Samsung Healthcare. White Paper: S-Shearwave™ Elastography Liver Evaluation — Recommended Values. Article # WP201704-Shear Wave, RS80A, 2017.
- Jeon SK, Lee JM, Joo I et al. Quantitative Ultrasound Radiofrequency Data Analysis for the Assessment of Hepatic Steatosis. Korean J Radiol. 2021;22(7):1077–1086.
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Contact Information
04159 Leipzig
Office Hours
| Monday | 07:00 – 12:00 12:30 – 15:00 |
|---|---|
| Tuesday | 07:00 – 12:00 13:00 – 18:00 |
| Wednesday | 07:00 – 12:00 12:30 – 15:00 |
| Thursday | 08:00 – 12:00 13:00 – 16:00 (private, by appt.) |
| Friday | 08:00 – 12:00 |
Note: Reachable by phone during office hours at 0341 5210871