Assessment of liver involvement in Wilson’s disease with different liver echo patterns based on liver stiffness evaluated on Transient elastography and Sound Touch Viscoelastography

Wilson's disease (WD) liver damage is caused by abnormal copper deposition in the liver. Whether the degree of hepatic impairment correlates with the severity of liver involvement on ultrasound imaging remains unclear. This study aimed to categorize the liver echo patterns of WD according to the B-ultrasound and correlated the degree of hepatic injury with different liver echo patterns based on Transient elastography (TE) and Sound Touch Viscoelastography (STVi). A retrospective study was conducted on 106 WD patients. A consistency analysis was performed on liver stiffness measurement (LSM) through TE and STVi. The liver echo characteristics of all patients were categorized through B-ultrasound, and the differences in LSM_TE, LSM_STVi, demographic and anthropometric data, and serological indicators among different patterns were compared. Both TE and STVi measurements exhibited high consistency in intra-observer and inter-observer differences. There were 6 echo patterns in the liver parenchyma of WD, among which "block-like" fatty liver and nodule patterns were more characteristic. The 6 types of liver echo patterns were classified into three groups: fatty liver pattern, coarse pattern, and nodule pattern. There was no significant difference in age, gender, and body mass index among the three groups. The comparison results of LSM_TE and LSM_STVi among the three groups showed that the coarse pattern was higher than the fatty liver pattern, and there was no significant difference between the nodule pattern and the coarse pattern or the fatty liver pattern. The P III N-P of fatty liver and coarse patterns was higher than that of the nodule pattern. Characteristic ultrasound features of liver parenchyma help us diagnose WD. The degree of liver involvement on imaging may not correspond consistently with the actual level of liver damage. STVi can be used as a reliability method to evaluate the degree of WD liver damage quantitatively, and its other application values in WD are worth further exploration.