30kPa - Am I fooling myself the fibro my be wrong (NAFLD)

[aranshaw]

Had a fibroscan done, it was 30kpa and 330 CAP, thats well into stage 4, on my ultrasound scan I had prior to it, it stated:

"The liver appeared normal size and shape. There is however diffuse increase in the parenchymal echogenicity in keeping with fatty liver.

No discrete focal lesions or fatty sparring evident. Normal antegrade flow was demonstrated within the portal vein. Impression: Fatty liver otherwise an unremarkable abdominal scan."

A CT scan I had prior to that said I had diffuse inflation of fat in the liver and "severe steatosis". I worry that the amount of fat in the liver has stopped the ultrasound from noticing the cirrhosis.

Im going to have a biopsy done.

Do I have any chance!?!? I have feelings of peripheral neuropathy I just feel I've no chance of the biopsy saying no cirrhosis.

My ALT before first scan was 166, now seems to be about 90ish 6 months on.

[Kristian]

Cirrhosis on an ultrasound would normally appear as a nobbily surface texture and is generally easy to pick up. Fibrosis is harder to spot visually on ultrasound, as its less likely to lead to significant changes that can be physically seen.

I think I've read with other posts that various things can affect fibroscan results, being over weight or lots of fatter deposits I think could be one of those.

Despite your fibroscan scores the other imaging tests you've had look quite reassuring. If there was any cirrhosis then these would have been able to pick it up.

So, yes, you have a chance, probably quite a good one. However, there is clearly an issue with the amount of fat in the liver so some treatment and lifestyle changes to reduce that are likely to be necessary. The biopsy should be able to help confirm the degree of fibrosis present, so that too should be reassuring. I've no doubt your doctor will be able to give you some good advice on what to do once he has been able to collate and review all the tests together.

[aranshaw in reply to Kristian]

Hello Kristian,

Thanks for your response, I have a BMI of 31, due to the amount on fat in the liver I have read that this can make it hard to see cirrhosis on an ultrasound sometimes, have you heard of this?

What concerns me the most is just how high the kpa score is, I can't see how it can be so high and I could come out of this without cirrhosis, a nurse told me it might just be because its so fatty but do you know if that alone could cause I high score? I thought the kpa was not the stiffness alone.

Thank you.

[Kristian in reply to aranshaw]

What the nurse said seems to ring true. Others have been told the same and this has been mentioned on various posts on this forum too. So, that does seem a likely explanation.

Just remember fibroscan is just one part of the bigger picture. Its unlikely the fat would have hidden any significant cirrhosis from the more visual scans you've had as there are noticeable surface changes that occur as a result that are relatively easily to see on imaging. So even if there was some cirrhosis, its unlikely to be widespread by the looks of it.

[redpoint72]

Hello there.I have liver cirrhosis.

All of my ultrasounds, show my liver as having a dense coarse echo texture. Also liver is stiff, hard, and shrunken is size.

Nothing like a healthy liver at all.

Obviously regular bloods are taken,in conjunction with ultrasounds,and ct scans, of which I've had them on a regular basis since diagnosis.

I was never offered a fibroscan,as I had very obvious symptoms from the start. So consultant deemed it not worthwhile to do.

I'm very sure that if your liver was in a bad way as mine is,an ultrasound wouldn't have missed it.

Take care...try not to worry to much,although I know easier said than done.

Utmost listen to your medical team.

My best. Chris

[aranshaw in reply to redpoint72]

Thank you for your reply Chris,

Very help & wish you the best.

Adam

[Fibro2021]

There is definitely a chance that your biopsy will show no cirrhosis. In one of the medical articles that I read, a clinical case was described when, in a patient with a preliminary diagnosis of cirrhosis, according to the results of a fibroscan, a subsequent biopsy showed only fatty degeneration of the liver without signs of cirrhosis. The authors of the article explained this phenomenon by fatty infiltration of hepatocytes, which led to an increase in liver stiffness on a fibroscan. Fibroscan is certainly a good but far from ideal tool.

[Roy1955]

With those score you probably are fooling yourself if your expecting anything but a diagnosis of cirrhosis!

[aranshaw in reply to Roy1955]

yeah, I think I was hoping the ultrasound report meant I had a chance, I get a biopsy at so,e point so I’ll find out for sure.

[Roy1955 in reply to aranshaw]

If you remove the cause of the damage you can stop it getting worse and causing you problems. I assume you know what's done the damage?

Cirrhosis is not a death sentence if you treat it with respect.