Coarsened Hepatic Echotexture

[Evelyn22]

This finding is from the newest elastography.

I thought I was doing everything right. KPA in 2022 was 10.5 F2-F.3, now it's 5.5 F0-F0-F1. I quit drinking alcohol in 2020, went on Mediterranean diet, and walk 1-3 miles per day.

The only vice I have is baked goods, cookies, cake, and candy.

2022 US Elastography normal echogenicity

2023 (2) 6-month abdominal US show liver echodense.

2024 US elastography "Elevated echogenicity diffusely in the hepatic parenchyma with coarsened hepatic echotexture suggesting chronic liver disease".

I was diagnosed with fibrosis but this ultra sound result looks like cirrhosis to me. Any feedback would be appreciated.

[Roy1955]

Did your recent scan give a KPa score?

[Evelyn22 in reply to Roy1955]

yes currently KPA. ranged from 4.1 to 5.5

2 years ago KPA ranged from 8.5 to 10.5 but no steatosis.

[Roy1955 in reply to Evelyn22]

Doubtful if you have cirrhosis if all hits were between 4.1 and 5.5 but US elastography does not measure for fatty liver. The abdominal US may have shown mild fatty liver but you need your Dr to clarify that.

I would be VERY happy to have scores like that!

[Spiff]

That's acreal concern for you and me . My last kpa 4 2 cat scan Normal .Us normal tiny tiny amount of fat wasn't on previous scan. No concern ..At one time I was diagnosed with cirrosis. Thank god it wasn't. I did have fibrosis. When it was checked it was f1 f2 though I suspect I was f2 f3 b4.

Unlike you I have started enjoying a wine sticking to the limits ..usually only 10 units a week ..now I'm concerned my next check up is in a year.

I hope you get a good conclusion..I am shocked as I'm sure that you are . Here's to a positive outcome ✨️ Yvonne

[Grassroots112 in reply to Spiff]

I don’t want to preach as a recovering alcoholic who is now just over a year sober who at one point had a fibro scan of 22.2kpa following jaundice and ascites (likely decompensated cirrhosis) and now thanks to a healthy diet, regular exercise and remaining sober, it’s now down to a 9kpa giving my liver’s status as moderate fibrosis, but I was told that although my liver appears to have remodelled itself, that’s no excuse to think I can have a drink or two again.

Because not even a scan or a biopsy would reveal what kind or level of scarring exists with my liver (fibrosis is scarring), only removing my liver and placing it under a microscope would do that my hep doctor told me.

In short he said I could drink again if I wanted, but it would eventually lead to cirrhosis if I didn’t already have it, again with the emphasis on they don’t even know because scans and biopsies can never fully 100% tell.

That’s why they go off a totality of everything which thankfully I’m told my current bloods, numerous scans and such suggest I don’t have cirrhosis and my liver is well compensating. Not that I needed told if I drink again what will happen, I know what will happen.

Again I’m not preaching and saying don’t drink, that’s your choice, but everything I’ve learned since is that fibrosis past the F0-F1 stage can’t be undone, and that the scarring can only get worse with a poor diet, drink, lack of exercise and medications and poor drugs, legal or otherwise.

I myself prefer not to risk anything after what I’ve went through or rather put my poor liver through even though at times I could kill for a drink. I hope your further drinking hasn’t damaged your liver any more and you get good results the next time you’re seen, you’re dancing with danger, however. The damage I did to mine I’ve undone a lot of that, but again my hep doctor said even moderate drinking would quickly send my liver back into a decompensated stage and that along with my family is what keeps me from hitting the bottle.

[Spiff in reply to Grassroots112]

Thank you for your comments duly noted. I never had jaundice or acetis thank god .and fortunately for me I'm not an alcoholic..i don't have fibrosis my kpa is 4.2 ..my scan says no cirrosis..but i am scared .i am going to reconsider my odd wine ..thank you .Well done on what you've achieved. I know its not easy....I don't think your preaching at all.

That's why this site is so helpful.

Thx

Yvonne

[Grassroots112 in reply to Spiff]

Thank you and I hope I didn’t come over as harsh or judgemental, I guess just from my own experiences and what I’ve learned about our livers, it’s clearly our diets that effect our health good and bad and it amazed me just how much a poor diet regardless of drinking was damaging to my liver. Even today if I have a cheat meal or two it can send my bloods off, so I know me drinking again will be really bad for my liver. Again hopefully any damage to yours has totally 100% resolved so if you are partial to a glass of wine which I’m sure won’t kill you, it will all be fine. I think the damage I did to my own was too much to ever fully come back from despite what my results and scans look like. Have a good day and take care

[Evelyn22]

sorry responded incorrectly

[Greengal314]

Hi Evelyn,

I wish there were more definitive interpretation techniques for ultrasounds, such as a measurement scale. Trying to decipher the word smithing is something that a lot of us have struggled with, including me.

There appears to be such a widespread of variance - both between or within a category (such as f1-3, cirrhosis). based on interpretation.

Maybe instead, just look at your specific parameters - clinically (bloodwork, fibroscan, physical symptoms), knowing that one person’s F2 could be another’s cirrhosis, fatty liver, etc… I’ve read people who state they just have “fatty liver,” who have much more skewed bloodwork, physical symptoms than others who have been diagnosed “cirrhosis.”

In the end, the most important factors are those specific to you, regardless of how anyone wants to categorize it.

I hope this helps. 😊

[Evelyn22 in reply to Greengal314]

Thanks Greengal,

That's exactly the conclusion I've come to. Even the technician was impressed that my KPA dropped from 10.5 to 5.5. I was so happy about that and then so discouraged and confused about the radiologist impressions.

The more I read about the radiology terminology the more I learn that it's all subjective. He/she read the Images and came to conclusions without any other info. Like you said, they don't know my exercise routine, bloodwork, or symptoms.

I do believe I have fatty liver, cheating on my diet I gained 10 Pounds. I'm reading that fibrosis and fat resemble each other by causing coarsening of the echotexture and fat causes more brightness and wall blurring.

When I read such harsh terminology I was deflated. But the scientific results (KPA) were unexpectedly good. So I'm going with what I know to be true and work on losing that 10 Pounds and eat more healthy.

Thanks for your reply, you reaffirmed what I was thinking.

[Greengal314]

Great job Evelyn!

Some radiologists are more critical than others -likely to make sure they don’t miss anything at all… and protecting their patients and own professional integrity.

Don’t let that take away from your improvement !

Have a fantastic week!

[Grassroots112]

The whole grading or scaling of liver disease confuses me full stop. For example a fibro scan reading of 19kpa could be cirrhosis, but might not be if the damage is down to alcohol, where as a reading of say 15kpa would mean cirrhosis for someone with an auto immune disease for example.

It’s bonkers and I guess why my own doctor keeps telling me unless they removed my liver and placed it under a microscope they would never know exactly how badly damaged my liver is and to what extent in terms of any fibrosis and scarring.

I know they go off a totality of results based on a myriad of stuff like scans, tests, bloods etc. but I do wish the liver experts in the medical world could maybe get together and develop a system that we can all at least follow.

That’s why places like this and the good people on here are amazing as people are speaking from real life experiences and providing great insight, knowledge, advice and all kinds. I just got a don’t ever drink again, watch your salt and fatty foods and here’s 28 days worth of diuretics and a see you in a few months, bye after an almost 2 week stay in hospital last March.

No nutritional advice, no what this or that means, all of which I had to learn from places like here otherwise I think I’d still weight the ten stones I did when I left hospital not knowing how important protein is and grazing etc.

[Evelyn22 in reply to Grassroots112]

I know what you mean Grassroots, they don't make any of it easy to understand and without explanations panic can set in. This site is great because you can chat with people who understand what you're going through.

Nutrition is tough for me too. I try to go by a Mediterranean diet more or less. Like you said grazing is best but it's so easy to slip. My weakness is sweets and pastries, it was easier to give up wine and smoking. 😆

Keep living your best life, our best is all we can do!

[Grassroots112 in reply to Evelyn22]

Yep and I really believe if things were better explained and we were more up to date with things we could do more ourselves to make positive and better health decisions or choices. I had to learn all about high protein and liver disease for example and how important it was, for the first 2 months after leaving hospital I had hardly gained any real weight even though I was eating 3 meals a day. I learned I needed lots of meals a day but in smaller portions and a high protein diet, I was actually told by a nurse to try and stick to a lower protein diet which I now know is in relation to those suffering HE, but which had no bearing on me and don’t get me started on Google and what that can turn up when searching. I’ve been dead 10 times by now already due to so-called life expectancy, have had a liver transplant. or rather needed one by now, can reverse cirrhosis, cirrhosis is all down to Bill Gates and Covid, that I just need to eat salad every day and… anyway, well it did lead me to here so that’s a huge plus, have a good evening and take care.