Conflicting fibroscan and ultrasound results

[NorthLeedsJohnny]

Hello allA few months ago I had a fibroscan, following a series of raised blood test levels. It took over 2 months to get the result but when it came, it was 49.8 (with suboptimal parameters). My ribs are close together and my liver is placed higher in my abdomen than usual. I was advised that the result is indicative of cirrhosis.

I have had an endoscopy with no indication of varices. I've also had an ultrasound, which the sonographer said looked entirely normal. She said that, if I had cirrhosis, she would see that during the test.

After being given the fibroscan result, I saw a specialist gastro dietician. She put me on a high calorie, high fat diet, to compensate for some recent weight loss. However I do have cardiac issues, for which that diet is no good and really, should be avoided.

Other than being tired more than usual and some weight loss, I have no other symptoms.

As of now, I'm waiting for the liver consultant to get back to me.

Does anyone know what the next step might be? since one test tells me I have cirrhosis and the other says I don't. Presumably, repeating the fibroscan would give the same result as before, so wouldn't be helpful.

Could it be a biopsy?

Many thanks in advance.

[AyrshireK]

If your bloods were elevated at the time of your fibroscan that could also contribute to an inaccurate and potentially falsely inflated kPa score. It can not be relied upon for an accurate result where there is ongoing liver inflammation ..... the technology cannot differentiate between actual dense fibrotic tissue and inflamed liver tissue.

The contradictory results definitely need to be discussed with your liver doctor.

If you can identify and stop whatever is attacking your liver you should hopefully be able to slow or stop and inflammation, improve your liver numbers and possibly reverse any damage done.

It's highly unlikely that cirrhosis would be missed on an ultrasound, CT or MRI.

Katie

[NorthLeedsJohnny in reply to AyrshireK]

Thanks Katie. I managed to find and use the direct NHS email for the consultant, instead of going via the secretary. In the email, I gave her much the same as is on here. I wasn't sure how she would react. In fact she replied within about 15 mins. She said she'll look through all my results and get back to me shortly and hoped that was agreeable to me!!

Trevor

[AyrshireK in reply to NorthLeedsJohnny]

It's good that you have such a responsive and supportive consultant - we had the same at Edinburgh - she would phone back if I left a message. For some reason NHS Lothian told her off for emailing me back but I was 'allowed' to email her.

Hope you get answers soon and things get clarified for you.

Katie

[NorthLeedsJohnny]

Thanks for that. I'll mention it when she gets back to me.

Quite by chance, I got a replacement Samsung watch a few months ago. With it, free of charge, came a Withings smart sale (still on sale for £90). It provides readings for weight, BMI, overall fat, visceral fat, muscle mass, skeletal mass, water content etc. It's amazing!

It seems to suggest that fat is the level going down. Even though my overall weight has dropped, my muscle mass has actually gone up. I am trying to walk a lot though. I'm averaging around 12 to 13,000 steps every day.

Thanks again

[SymbolUK]

Hi Johnny,

Your story sounds just like mine expect my fibroscan was much higher than yours, read my post I posted recently.

Next step might be a biopsy if, like me, you have no other symptoms but the still say likely Cirrhosis….

All the best.

[NorthLeedsJohnny in reply to SymbolUK]

Thx for that. I did wonder if a biopsy might be next. Was your biopsy negative then?

[SymbolUK in reply to NorthLeedsJohnny]

Not exactly negative this is what the consulant said:

“The biopsy report is actually quite good news in a way. It doesn’t confirm the suspicion of significant damage or cirrhosis, advanced scarring or whatever you want to call it. It shows a little bit of fatty liver and very minor marginal fibrosis but really it doesn’t tally with what the fibro scan or the CT scan might allude to….”

I’m having a fibroscan done by a doctor rather than a visiting nurse who do the original one and see what that says too.

[NorthLeedsJohnny]

Thx again. I'm pleased you managed that. I weigh 74kg, so not as much room for weight loss!

[NorthLeedsJohnny]

I know. I want to avoid a fatty diet more than anything!

[NorthLeedsJohnny]

OK. I'll bear all that in mind! I certainly have lost muscle mass, especially over the last year. My GP originally put it down to sarcopenia due to my age. I'm 74. That may or may not have changed now because of all this! At the moment, my scale reckons my muscle mass is 54.8 kg.

[Evelyn22]

I keep getting conflicting results too. Ask for an ELF blood test (Enhanced Liver Fibrosis). It tests for markers in your blood that can indicate severity of fibrosis. It's not invasive and not really expensive. It's just 1 more tool to help figure it out.

[NorthLeedsJohnny in reply to Evelyn22]

Thanks for that. Following my initial bloods, I was given an ELF score of 9.8.

[NorthLeedsJohnny]

Thx. Hopefully things will be a bit clearer once the consultant has got back to me, which shesaud would be very soon.

[SymbolUK]

That’s great to hear, good job!

[AIHinSantaCruz]

In case helpful, prior to my definitive Autoimmune Hep diagnosis I had an ultrasound and they said my liver looked great. (Surprise and phew!). But then I had the liver biopsy and they said I was at F1-2, which is not terrible but not great. So it seems that the biopsy gave the more clear reading of liver damage than the ultrasound did.

[NorthLeedsJohnny in reply to AIHinSantaCruz]

Thanks for that. I've asked my GP if I've ever been tested for autoimmune Hep. I'm coeliac, which is autoimmune and I've also had another, lichen sclerosus, so it's possible I guess. I still don't know the answer.

[PeppyPo]

I'm wondering well praying that my fibroscan is wrong. Mine came back stage 4 fibrosis possibly cirrhosis. But my ultersound showed liveer was smooth with fatty liver and all my bloods came back great . I'm seeing liver specialist on Wednesday. I'm really hoping that fibroscan is wrong .

[NorthLeedsJohnny]

I'm actually at hospital now, with diverticulitis. I've had bloods again. The Surgical Assessment Unit consultant has just told me that I should still assume I have cirrhosis. He said that fibroscan is much more accurate than ultrasound. He also said that, if my liver is coping well, compensating for the problem, it would appear on the ultrasound quite normal, with no structural changes.

That has thrown me because I was assuming that, with few symptoms and conflicting scans, I would probably have a biopsy, which might prove the fibroscan wrong.

I've still not heard back from the liver consultant.