Nash Fibrosure and MRI one month later

[memlilt]

Hi, My GI suspected fatty liver after my primary noted a few years of elevated Alt & Ast. He did huge amt of bloodwork ending with an ultrasound and fibrosure test. Ultrasound showed enlarged liver and diffuse fatty infiltration. Fibrosure blood test showed F0; .64 steatosis; .5 Nash score. N1 Nash

Fibrosure test was NOT taken in a fasting state & I think it should have been. Would nonfasting impact the results of the fibrosure test materially?

I immediately went on a liver healthy diet- lost 20 pounds and one month later had an abdominals MRI for other reasons. The report stated for the liver: No enlargement or abnormal density.

Could this possibly be true in one month or is there a special MRI for NALFD?

I have repeat blood tests in June.

also- I am struggling now to lose more weight. have increased exercise but feel my weight loss has stalled and i feel hungry alot

[nash2 Partner]

Hi Memlilt

You pose interesting questions. First Fibrosure should be done with 8 hours of fasting since it is blood based. Ultrasound is not good at seeing fatty liver until the fat gets higher than about 30% of the liver and it can't see fibrosis directly. It is good that you changed your diet as that is valuable in any case. It is reasonable to wonder about the liver with extended periods of high liver enzymes but diagnosis is difficult. A standard MRI reveals structure but does poorly on fibrosis. There is a special version of MRI called elastography which is designed to measure liver stiffness and from that determine fibrosis. The cheapest and most convenient liver test is a Fibroscan which measure both liver stiffness and fat content. As to your question on timing. A liver that is not in trouble can resolve issues of fat fairly quickly with a diet change. Your liver was enlarged earlier, probably because of inflammation, which can go away quickly but that test should also have been done fasting as the liver gets bigger after eating. It is a reasonable guess that you had something going on with your liver which you have helped by changing your lifestyle but it is wise to stay on top of the question with your doctor.

Wayne