ultrasound : wouldn’t fibrosis be seen... - Living with Fatty...

Living with Fatty Liver and NASH

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ultrasound

Realy profile image
14 Replies

wouldn’t fibrosis be seen on a ultrasound as architecture changes or abnormalities in the echotechture.I’ve read that this may be seen if fibrosis is advanced. I’ve seen so many people post that fibroscan says one thing and further testing shows that fibroscan wa not accurate.

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Realy profile image
Realy
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14 Replies
ThyroidDeb profile image
ThyroidDeb

My understanding is an ultrasound does not show fibrosis or cirrhosis. It's a tool best used to show ascites or tumors and liver size. I have it yearly for cancer detection. The reason I am on this journey was an ultrasound for another reason showed the enlarged liver. My blood levels weren't off by much, my primary debated on referring me and was going to pass everything off to the Fatty Liver and keep an eye on that but decided not to. Glad she didn't.

Realy profile image
Realy in reply to ThyroidDeb

I was told it can pick up cirrhosis. But like every test there is variables. I’m seeing more and more posts about fibroscan dicrepencies. Overestimation.

ThyroidDeb profile image
ThyroidDeb in reply to Realy

My understanding is an ultrasound can show irregularities suggesting cirrhosis/fibrosis, such as in the shape of the liver and blood flow but further testing needs to be done, such as:Elastography is a type of imaging test that checks your organs to see if they are stiffer than normal. Stiff areas in your organs may be a sign of disease. Elastography is mainly used to check the liver for stiffness. Stiff areas in the liver are a sign of scar tissue (fibrosis) caused by liver disease.

Realy profile image
Realy in reply to ThyroidDeb

MRI elastography?

ThyroidDeb profile image
ThyroidDeb in reply to Realy

Never had because I went the biopsy route.

Realy profile image
Realy in reply to ThyroidDeb

Your Dr doesn’t use fibroscan correct?

ThyroidDeb profile image
ThyroidDeb in reply to Realy

Correct

Realy profile image
Realy in reply to ThyroidDeb

I may want the MRI one next I have had fibroscan and fibrosis blood test diffrent results but 6 months in between tests lost slot of weight

Dasil7 profile image
Dasil7 in reply to Realy

Fibroscan is notoriously inaccurate if your bmi is over 30.

lusitania84 profile image
lusitania84

The best thing you can do is listen to your doctors. No offense to anyone on here(myself included) but we aren't doctors. I would say that ultrasound can see cirrhosis but it can't see the specific stages like an MRE or fibroscan. That's my understanding based on what my doctors have told me. That's why they suggest follow up ultrasounds. So just listen to your doctors but make sure you get second opinions, etc.

Str8jacket profile image
Str8jacket

Ultrasound can sometimes confirm cirrhosis, and sometimes miss it. No one test is perfect--ultrasound is decent but is one of the less specific imaging tests. It relies on quality of images, which can vary, and subjective interpretation by a radiologist, which can vary too. You can search how good various tests are at confirming cirrhosis (positive predictive value) and at ruling it out (negative predictive value). Including a link below which has a discussion of the accuracy of some diagnostic tools--it's not the last word but should give you an idea of the issues. To understand the analysis you'll have to get an understanding of some statistical concepts like sensitivity, specificity, positive and negative predictive values, uncertainty, etc etc.

If you don't want to go that far, you could probably order the various imaging tests something like CT/Ultrasound<Fibroscan<MRE<biopsy, but it's not truly certain precisely how good each test is at ruling in and ruling out cirrhosis. Even biopsy, the gold standard, is imperfect. Diagnoses are usually made based on many factors- patient history (like alcohol, NASH, HCV, etc), symptoms, blood work, and multiple imaging tests.

ncbi.nlm.nih.gov/pmc/articl...

Realy profile image
Realy in reply to Str8jacket

I have done ultrasound, fibroscan. And the Fibrosis blood test for fibrosis,steatosis,activity. Also had Fib4,Apri,and other blood calculations.

mtk0925 profile image
mtk0925

ultrasound is usually the first test to see how the liver looks

Realy profile image
Realy in reply to mtk0925

yes I guess it’s the first tool to see if any early changes can be seen.

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