Various chronic liver diseases such as hepatitis B, C, and fatty liver disease can lead to tissue damage and subsequent scar tissue formation. As the scar tissue accumulates, the liver loses some of its elasticity and becomes stiffer.
Liver elastography involves the use of a surface ultrasound probe that delivers a low frequency pulse or shear wave to a small volume of liver tissue under the rib cage. The transmission of the sound wave is completely painless.
Doctors from the Hepatology Program at the University of Michigan use the FibroScan device, which was approved by the FDA for liver elastography measurements in patients with known chronic liver disease and particularly for patients with chronic hepatitis C and fatty liver disease.
Visit the Your Digestive System page to learn more about the digestive organs involved in this procedure.
How Is a Liver Elastography Performed?
The liver is located in the right upper abdomen under the rib cage. Patients are asked to lie flat on an examination table. A technician places the FibroScan probe between the ribs on the right side of the lower chest wall. A series of 10 painless pulses are then applied to the liver. The results are recorded on the equipment and an overall liver stiffness score is generated. This score is then interpreted by a qualified physician to predict the likelihood of advanced fibrosis or cirrhosis.
Patients are asked to wear loose clothing and should not consume any liquids or solids for a minimum of 3 hours before the test to increase the likelihood of obtaining reliable test results. The scan will take 10 to 15 minutes to complete, but patients should plan on being available for 30 minutes to allow time for preparation.
Why Do I Need a Liver Elastography?
Liver elastography procedures help your doctor determine the severity of hepatic fibrosis in patients with chronic liver disease. The FibroScan in particular can also help determine if a HCV patient does or does not have advanced fibrosis/cirrhosis, which can assist with treatment decisions regarding the need for oral antiviral therapy, liver cancer surveillance, etc. Some doctors also obtain serial liver elastography measurements once a year to see if the liver disease is improving or worsening over time.
FibroScan test results are always used in conjunction with other clinical data, laboratory test results, and liver imaging in managing individual patients.
What Are the Potential Complications from a Liver Elastography?
The FibroScan test is completely non-invasive, painless procedure that takes approximately 10 minutes to complete. Most patients with chronic liver disease can be assessed, but the test is not recommended or interpretable in patients with:
- Fluid in the abdomen (i.e. ascites, variceal bleeding or hepatic encephalopathy)
- Acute hepatitis
- Right heart failure
- Severe obesity
- Small rib spaces
- Inability to lie flat
It is not necessary to bring a driver for your liver elastography appointment. After the procedure, you will be immediately discharged from the procedure area and be able to leave without any restrictions. The doctor who completed and interpreted the procedure will send the test results to the doctor who ordered your procedure. FibroScan results will be available in about a week.
To make an appointment for a FibroScan test, please call the Hepatology office at 1-844-233-0433.