Delahaye J, et al. - Researchers evaluated if severe liver fibrosis detection can be improved with the use of elastography examination following the discovery of positive simple Doppler-US signs. The study sample consisted of 514 subjects with chronic liver disease who consecutively had a percutaneous liver biopsy. The association of three simple Doppler-US signs (liver surface irregularity, splenomegaly ≥110?mm, and demodulation of hepatic veins) with severe liver fibrosis was confirmed in multivariate analysis. In the detection of severe fibrosis, elastography improves Doppler-US accuracy. Results of this study suggested that this two-step procedure will aid radiologists to precisely identify subjects who need to be referred to specialist hepatologists during routine Doppler-US examinations.