I'm getting a fibroscan done on Tuesday, my first time. My doctor and specialist said they don't think I have anything as serious as cirrhosis, given that my last three ultrasounds done jn 2021, 2023 and August 13, 2024 all showed the same thing: grade 1 steatosis (mild fatty liver) with no other abnormalities. All liver enzyme and liver function tests have been well within normal for a long time. The reason for the fibroscan, according to my internist, is because in an endoscopy done by a gastroenterologist in July, he ghpught he saw portal gastropathy, which is often, although not always caused bybportal hypertension and cirrhosis.
Regardless, can anyone with experience with fibroscans tell me what the numbers are that I should look for, and their significance, once the scan is done?
Thanks very much in advance,
Terry
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ToughToes
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Type 'Understanding your fibroscan' into your search engine and you should bring up a page from Memorial Sloan Kettering Cancer Centre which thoroughly but simply explains the procedure and what results it reveals - the main scores you'll want to know are the kPa (tissue density) and CAP (fat content score).
No they are independent of each other - the tissue density (kPa score) will correlate to whatever degree of fibrosity may be present from F0 (normal healthy liver) to F4 (Cirrhosis)
CAP score reflects the degree of fatty change in the liver - a score up to 400.
You can have a high CAP score (high amount of fat in the liver) without fibrosity and you can have fibrosity/cirrhosis without fatty change.
About Your CAP score
Your healthcare provider will use your CAP score to find out your steatosis grade. Your CAP score is measured in decibels per meter (dB/m). This score will range from 100 dB/m to 400 dB/m. Your CAP score and steatosis grade can go up or down over time.
The following table shows ranges of CAP scores, and the matching steatosis grades. It shows how much of your liver is affected by fat buildup. Normal livers can have up to 5% of fatty changes in them. A score below 238 dB/m means the amount of fatty change in your liver is not higher than normal.
CAP Score Steatosis grade Portion of your liver affected by fatty change
Thanks again. Good to know. In other words then, itpossible for someone to have more than a normal amount of fat in their liver, but have little to no fibrosis and, therefore, no cirrhosis?
Yes, there are stages to fatty liver disease :- The main stages of NAFLD are:
1) simple fatty liver (steatosis) – a largely harmless build-up of fat in the liver cells that may only be diagnosed during tests carried out for another reason
2) non-alcoholic steatohepatitis (NASH) – a more serious form of NAFLD, where the liver has become inflamed. [Picked up in blood tests where elevated liver inflammation markers will identify whether the liver is inflamed]
3) fibrosis – where persistent inflammation causes scar tissue around the liver and nearby blood vessels, but the liver is still able to function normally
4) cirrhosis – the most severe stage, occurring after years of inflammation, where the liver shrinks and becomes scarred and lumpy; this damage is permanent and can lead to liver failure (where your liver stops working properly)
Not every liver disease goes through a fatty liver stage, inflammation (from whatever reason) can go on to lead to fibrosis and scarring.
And you don't have any liver issues at all? But, you seem very informed about the topic. In your opinion, do you think it would be unusual that someone with garde 1 mild fatty liver (minimal stage) on consecutive ultrasounds and normal liver enzymes and luver function blood tests might have enough fibrosis seen in a fibroscan to be considered cirrhosis? Or is this a real longshot?
We've corresponded before when 4 years ago you were experiencing weird things in your stools. It seems like you've not yet had a definite diagnosis.
I've been supporting hubby for 12+ years and spent lots of time here on the forum plus researching and learning along the way.
As regards your stage of liver disease I think you just need to wait and see what your fibroscan says - in light of good bloods your result should prove fairly accurate.
Because when there is any inflammation present in bloods it can falsely inflate the fibroscan score - fibroscan notoriously can not tell the difference between inflamed liver tissue and that which is genuinely fibrotic SO with no inflammation showing in your bloods your fibroscan result should be more accurate.
Conditions That Can Affect Your Fibrosis Results
Certain conditions can cause a liver stiffness result that’s too high, which makes it incorrect. You may have less scarring than your results suggest. This can happen if you have:
Liver inflammation (swelling): This can be caused by a recent liver illness. It can also be caused by long-term, heavy alcohol use.
Benign (not cancer) or cancerous (cancer) tumors in your liver.
Liver congestion: This means that your liver is too full of blood or other fluids. This is usually caused by heart failure.
FibroScan may give less accurate results, or no results at all if you have:
Obesity: This means your body mass index (BMI) is higher than 30 (a high, unhealthy amount of body fat).
Ascites: Fluid building up in your belly.
Biliary obstruction: A blockage that does not let enough bile flow out of your liver.
Scar tissue: Tissue from surgery or radiation built up near your liver.
Your healthcare provider may use imaging tests, such as ultrasound, CT, or MRI, to see your liver. They may use blood tests or a certain type of MRI to measure scarring and fatty changes in your liver.
Very interesting! I don't have any of those things, although I am about 25 pounds overweight. As far as I know, I haven't been tested for heart failure, but I don't think I have it. Do you know what the symptoms would be for that? Would heart failure be pretty obvious? Any idea what kind of testing they would do to check if your liver was congested with blood, or some other fluid?
I'm sorry for being such a pain, but you have so much good information.
My liver issues were only found by accident during an endoscopy for something unrelated. They saw portal gastropathy from that - my bloods are fine (although were slightly high at one point), my scan showed just a fatty liver but my fibroscan showed moderate fibrosis.
Hope you get on ok! Be interested to see what they say to you about the gastropathy as they aren’t concerned but I’m worried about it all!
Thanks. Yours sounds similar to mine, although I hope my fibroscan results are mild, if any, fibrosis. What did your Dr have ro say about the portal gsstropathy?
He has been quite dismissive of it. I’ve asked him outright - can I have portal gastropathy if my liver is not that bad? He just says let’s focus on the fact that my liver is functioning well and keep an eye on me.
So I think I have F2/F3 - my KPA was 10 - I have no symptoms, my bloods were normal last time and my ultrasounds are just showing fatty! But I do have a slightly enlarged spleen which can also be caused by portal hypertension.
I just keep focused on the fact that I’m not showing any symptoms and to just keep going with eating well and keeping healthy.
Thanks. I hear you. The gastroenterologist who first mentioned PH to me, also seen during an endoscopy dine for unrelated reasons didn't seem all that concerned either. In fact, as I was being wheeled out of the Or, He said to me that, "It all looked food, top and bottom", as I had a colonoscopy done at the same time.
My response to him was the same as yours, how can I have portal gastropathy, which is usually caused by cirrhosis, when I only have mild fatty liver, as reported by ultrasounds on December 2023 and August 2024?
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