Ultrasound/Biopsy show cirrhosis, but fibroscan score is 7.4

[Danteskid]

I’m somewhat perplexed… since my diagnosis I’ve been told I have cirrhosis, because of my biopsy and ultrasound results. A recent fibroscan score was 7.4, which is fibrosis. Although some parts of the fibroscan were as high as 8. Can someone explain this? My dr. was very vague in his explanation. Thank you❤️

[gwillistexas]

A stiffness result of 7-9 kPa is F2 score and that is moderate scarring, not cirrhosis. Are you seeing a hepatologist?

[Danteskid in reply to gwillistexas]

Thank you for your reply. Yes, I am seeing a hepatologist and I understand the scores, what I don’t understand is the ultrasounds saying “ liver is coarsened, consistent with cirrhosis”The disconnect between the two tests is what’s confusing to me. I am also AMA neg. and a partial responder to Urso.

[gwillistexas in reply to Danteskid]

I apologize. I overlooked the ultrasound result.

[Danteskid in reply to gwillistexas]

No worries! I figured you missed that.🙂

[DonnaBoll Administrator in reply to Danteskid]

I have a good friend who is also facing the same dilemma with good lab results but fibroscan showing some 'cirrhosis' evidence. I don't have an answer for this either. Maybe ask the experts on the Foundation's weekly chat on Thursdays. Are you familiar with that? I will see what I can find out in Dr. Jones' book as well regarding this. If anyone has the book, maybe they can look too - letting us know if they find anything.

[Gaspereaux in reply to DonnaBoll]

There is a part, Donna in the book where Dr. Jones talks about Fibroscan results. I don’t have it on me at the moment!

[DonnaBoll Administrator in reply to Gaspereaux]

I'll try to find it..

[gwillistexas]

I just saw Donna Boll posted scores a few days ago. This should make you feel better.

[sophiaS1980]

I would go by the biopsy, not fiboscan , why did you have this done in the first place (any symptoms?)

[DonnaBoll Administrator in reply to sophiaS1980]

When we rely on a biopsy for any type of result, we have to remember that a biopsy only takes 1/50,000 of your entire liver surface. Taking the smallest of specimens from exactly where the 'right' place might be isn't always done. Fibroscans do examine the entire surface of the liver for 'stiffness' or fibrosis.

[sophiaS1980 in reply to DonnaBoll]

I agree somewhat but fiboscan has many draw backs, weight/and the person doing it, Most docs treat according to a biopsy. MRE is the best tool but some countries do not have MRE, it measure stiffness of the whole liver.

[gwillistexas in reply to sophiaS1980]

I agree. My hepatologist says fibroscan is only a “guesstimate “ and he is who actually introduced the first fibroscan to Dallas. I’ve had poorly trained technicians and they had to get another technician to finish the scan. I’m thin and I think he isn’t ordering more fibroscans any longer for me. I’d rather have a biopsy. Fibroscan also pick up rib vibrations so that’s also a drawback.

[DonnaBoll Administrator in reply to sophiaS1980]

You are right about a MRE being more accurate - but many institutions don't have access to them. As far as relying on a biopsy, according to the Standard of Care, biopsies shouldn't be used for diagnosis unless there is a suspicion of another liver disease at play in the patient's medical conditions. If LFT's are elevated 1.5 times the 'normal' results and a + AMA blood test, that is considered sufficient for a diagnosis of PBC. Often lab work has to be repeated multiple times for it to be high enough to fulfill this part of the diagnosis. I know the Foundation is dedicated to educate health care professionals as well as patients in the Standard of Care. Available of equipment in smaller areas can greatly impact what the doctors have to use for sure.

[sophiaS1980 in reply to DonnaBoll]

I tell people thats really confused about their diagnoses to look at their Platelets, they are usually low or low normal, not over 200. Platelets are low to low normal in 85% of people with advanced liver disease.

[Danteskid in reply to DonnaBoll]

Thankyou all for your replies. I was diagnosed through biopsy because of being AMA neg. My confusion comes from ultrasound vs fibroscan. Ultrasound shows cirrhosis, fibroscan measures 7.4 which is fibrosis. I’ve heard conflicting things as to which is more accurate so I’m confused as what to believe.

[pizza07110711]

Did you have an actual biopsy or just the ultrasound and fibroscan? I would give more weight to a fibroscan vs an ultrasound.

[Danteskid in reply to pizza07110711]

Thank you for your response. I appreciate it.