Ultrasound vs. fibroscan

Hi, I have a few posts on this board and I have a question regarding if I should go for Fibroscan or not. I live in the US and have had a blood test come back with mildly elevated bilirubin and mildly elevated direct bilirubin. All other blood measurements were within range. I also had an ultrasound done for "peace of mind" and the Dr. said that there is no abnormalities. However, I have seen that ultrasound is not particularly effective for determining liver disease and am sitting here wondering if I should still go in for a fibroscan just to make sure. I am still kind of 'on edge' about having liver issues and am wondering if there is any value beyond ultrasound results to having a fibroscan. Some comments would be appreciated, thank you!

6 Replies

  • The FIbroscan is one of the few methods of measuring Liver scarring, the bloods and ultrasound do not measure scarring. The bloods measure how much inflammation is present, usually when the Liver is starting to struggle there will be rises in the enzymes that take a while to resolve.

    So if you were drinking 10-15 years or whatever and you went right away and had bloods and an ultrasound that were normal, its a pretty safe bet that you don't have serious damage at that point. what it wont measure is how close you are to some problems. You could well have some fat building up that the tests wouldn't have seen.

    When enzymes are raised the question is "how long have they been raised?" if they have been raised for 10 years then is likely there is serious damage, if its for a few weeks and you stop it then the Liver can heal.

    Direct billirubin comes "directly out" of the Liver so it has been processed by the Liver, it shouldn't be in your blood. But this can be affected by anything slowing the Liver down like bile flow being hindered. Pancreas issues can also cause raises along with inflamed intestines and stomach, gall bladder etc.

  • If you have insurance and they pay for it all I'd get a liver biopsy. That will tell you your grade and stage (inflammation and damage)of damage better then the rest. It was totally pain free when I had it done and they use a camera to make sure everything is good. I agree with the other comments also.

  • Can't see this being a good idea at all - there are a lot of risks in getting a liver biopsy, it's not something that should be done casually.

    It's a good test when your doctors need confirmation of a diagnosis - it's terrible as a tool for speculative enquiry in a patient with otherwise normal liver results and a clear ultrasound (yes - including an instance of small rise in bilirubin).

    They usually use ultrasound to guide the needle and sampler to the right place. I'm not aware of any process where a camera looks at liver tissue or were you referring to the ultrasound?

    On the plus side though if the insurers and your doctor agreed to order a liver biopsy and something went wrong there would be a good case for clinical negligence on their part :)

  • RISK? Crossing the street is a RISK. What is it, like MAYBE 2% of the people will have some type of side effect from it. I gave THE BEST way to tell how much liver damage there is. I also agreed with the others about what they said. I had both the fibro and biopsy and they were actually both almost right on point in there results. Even after having the biopsy 5 or 6 years after the fibro.

    Just research everything you do. Of course coming to a forum is good to ask questions but you want to research to.

  • The biopsy is not totally pain free for some and it does have a risk of death, a small risk, but its there. I have read many stories of people having bad experiences and pain for years after.

    Doctors do not just do invasive procedures lightly, its a carefully considered process, it has to be of diagnostic benefit . It is a last resort to get cell information. The usual process is if someone has elevated LFTS and a reason cant be found, a biopsy is a good idea. Of course it can also be used to stage any scaring, but to be honest a Fibroscan would be the better option for this, although you don't get the cells to examine if you just want to know scarring then the Fibroscan covers 1/500th of the Liver where a biopsy is 1/50000th. A biopsy also has around 20-30% chance of showing less damage than there actually is if the needle is put into a part of the Liver that is healthier. Most Hep-c patients now would go for a Fibroscan over a biopsy, its accuracy is 95%, its non-invasive and its covers more of the Liver.

  • link below, (sorry last link didn't work...)

    Scroll down on this page for information about Fibroscans. I agree with the comments that Ralph has made. Your doctor should guide you on this matter. However, a Fibroscan is another window into the health of your liver. And if you have concerns, it is worth having a Fibroscan as the results might shift your lifestyle choices and/or require further investigation.... or show nothing significant at all. I hope this helps.


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